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Sorting Out Pills to Reduce Breast Cancer Risk

Rating

5 Star

Sorting Out Pills to Reduce Breast Cancer Risk

Our Review Summary

The results of the latest breast cancer prevention trial, the STAR trial, received wide press coverage across a variety of media. The coverage varied tremendously in its quality. This New York Times piece, with the benefit of a few weeks to prepare, does an excellent job of explaining the controversy surrounding this trial and why many groups, including the American Cancer Society, are skeptical about the findings.

This story does a great job of quantifying the benefits of raloxifene compared to tamoxifen. Not only did the story provide absolute numbers in quantifying the benefit, but it also explained why presenting only relative risk reductions can be deceiving. The story also provides sufficient information on the harms of raloxifene compared to tamoxifen (including highlighting the fact that the differences between the two were not statistically significant) and adequately describes the design of the study. The story does explain that one downside of raloxifene is that it does not appear to reduce the risk of ductal carcinoma in situ (DCIS), which tamoxifen does. There is one error in the story – about 50% of DCIS will progress to invasive cancer, not 10% as stated in the story.

The story mentions that raloxifene is already marketed as Evista, a drug used to prevent osteoporosis after menopause, but that Eli Lilly has petitioned the FDA to approve it to prevent breast cancer.

The story does not engage in disease mongering; it accurately describes the 5-yr. risk of developing breast cancer for an average 60-64 year old woman. The story even provides a link where the reader can calculate their own predicted risk.

Because the story quotes multiple sources from different backgrounds, the reader can be reassured that the story does not rely solely on a press release as a source of information.

The story does not discuss costs of treatment.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

No costs were mentioned.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story does a very good job of quantifying the benefits of raloxifene compared to tamoxifen. Not only did the story provide absolute numbers in quantifying the benefit, but it also explained why presenting only relative risk reductions can be deceiving.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story provides sufficient information on the harms of raloxifene compared to tamoxifen. The story does explain that one downside of raloxifene is that it does not appear to reduce the risk of ductal carcinoma in situ (DCIS), which tamoxifen does. There is one error in the story – about 50% of DCIS will progress to invasive cancer, not 10% as stated in the story.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story adequately describes the design of the study.

Does the story commit disease-mongering?

Satisfactory

The story accurately describes the 5-yr. risk of developing breast cancer for an average 60-64 year old woman. The story provides a link where the reader can calculate their own predicted risk.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story quotes multiple sources who have differing opinions of the significance of these findings.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions tamoxifen as the alternative to raloxifene.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story mentions that Raloxifene is already marketed as Evista, a drug used to prevent osteoporosis after menopause, but that Eli Lilly has petitioned the FDA to approve it to prevent breast cancer.

Does the story establish the true novelty of the approach?

Satisfactory

The story is clear that raloxifene is an existing drug but that Eli Lilly is asking the FDA to approve it for another purpose.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Because the story quotes multiple sources from different backgrounds, the reader can be reassured that the story does not rely solely on a press release as a source of information.

Total Score: 9 of 10 Satisfactory

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