This story carefully reports on these results, with appropriate caveats that emphasize the small size of the study, the preliminary nature of the results and narrow patient population (those with pre-cancerous lesions or early-stage cancer). It quotes several independent experts and discloses potential conflict of interest. The story could have been improved by mentioning the cost of the IUD and insurance coverage.
The progestin-containing IUD (brand name Mirena) is a highly effective, well-tolerated form of birth control. Pathology studies have also shown that the IUD can cause reversal of cellular changes, known as hyperplasia, in the lining of the uterus (enodmetrium) that could later lead to certain kinds of endometrial cancer.Oral progestins are an established treatment for endometrial hyperplasia and have also been used in some cases of endometrial cancer in younger women. Targeting progesterone release directly to the uterine lining through the IUD presents a potential advance in effectiveness and tolerability of treatment, while preserving fertility.
The primary treatment for endometrial cancer is hysterectomy, or surgical removal of the uterus. However, for some women, particularly younger women who wish to preserve their fertility, the idea of a non-surgical alternative, is welcome news. A small study was published in this week’s Annals of Oncology followed 20 women with hyperplasia and 14 women with early-stage endometrial cancer who had a progestin-IUD implanted. Almost all (95%) of those with hyperplasia experienced reversal, while about half (57%) of those with early-stage endometrial cancer did.
The story does not mention any costs of the IUD or other treatments.
The story quantifies the benefits of the progestin IUD in several ways.
The story accurately notes that the study reported no adverse effects. The study’s authors reported only on adverse effects that were sufficient to require suspension of treatment.
The story provides important details about the current study that help the reader evaluate the strength of the evidence. It even emphasizes that the new treatment approach is "still uNPRoven".
The story does not exaggerate the seriousness or prevalence of uterine cancer and is clear to point out that this treatment is only appropriate for a small subset of cases.
The story quotes several independent experts and notes that none had a conflict of interest.
The story compares the progestin IUD with systemic hormones and hysterectomy
The progestin IUD is clearly available.
The story clearly states that the Mirena IUD is not a new idea, but using it to treat early-stage endometrial cancer is relatively novel.
Because the story quotes several independent experts, the reader can assume that the story did not rely on a press release as the sole source of information.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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