This article briefly (353 words) examines a retrospective analysis of 6,655 Swiss breast cancer patients followed between 1980 and 2003 . The study looks at the hypothesis that there might be a link between estrogen and lung cancer. Patients taking tamoxifen had a lower rate of lung cancer deaths, but statistically insignificant reduction in the development of lung cancer. The actual number of study patients with both breast and lung cancer was small, and the article contained little or no discussion of possible confounding factors, side effects, or costs. There were no independent sources quoted.
This article offers more promise than evidence or context . Both small-cell lung cancer and breast cancer are devastating diseases. The article would be improved with more well-presented, high quality evidence and the framework to make sense of it.
Although generic tamoxifen is a relatively inexpensive medication, there was neither discussion of the medication cost in the article nor discussion of the cost of tests involved in evaluating such a treatment.
As this is an observational study, much of the problem with understanding benefits/harms of tamoxifen in this article involves an incomplete description of what is known and not known. In particular, there was not discussion of the significance of the small number of women who developed lung cancer, the statistical comparison used was based on general assumptions and not further addressed in the story, and possible confounding factors were not addressed either.
There is a brief reference to side effects from tamoxifen As some effects are dangerous, clearer information on the potential harms would be critical in the decision-making process between patient and physician.
On the one hand, the writer carefully differentiated between those who develop lung cancer and those who die from lung cancer. On the other hand, there was no caution in the article regarding the preliminary, limited nature of this evidence for breast and lung cancer patients, and the need for a fully developed trial rather than relying on retrospective data alone.
Although the original journal was mentioned, there was no independent expert source quoted. The likelihood of conflict of interest is not addressed.
Current treatment of non-small cell lung cancer was not discussed.
The article adequately establishes that although Tamoxifen is available by prescription, largely for treatment of breast cancer, it is not currently prescribed for lung cancer.
The article makes clear the fact that tamoxifen is not a new medication, but rather, that the association with lung cancer survival is relatively new. .References to newer estrogen blockers were vague.
Not applicable because we’re can’t be sure whether the story relied on a news release. No one was quoted.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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