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HPV test beats Pap for cervical cancer screening


5 Star

HPV test beats Pap for cervical cancer screening

Our Review Summary

 By using clear language, the story tells readers exactly what they need to know saying, for example, “Screening women with no symptoms for ovarian cancer with a blood test and an ultrasound exam is harmful” and “Cervical cancer is easy to prevent.”

This is a solid example of how to report on multiple studies from a conference, on deadline, and to do so with clarity and context.


Why This Matters

Screening for diseases seems like a win-win, and advocates for early screening often present it as an inviolable law that screenings save lives. As this story shows, evidence is mounting that not all screenings do save lives and that some, in fact, can do actual harm. We wish more stories spoke as plainly about the benefits and risks of screening as this one does.


Does the story adequately discuss the costs of the intervention?


The story does not list the costs of all the screenings mentioned, but we give it a passing grade for at least addressing the issue of costs-versus-benefits. The story says, “HPV tests cost $80 to $100 compared to $20 to $40 for Paps.”

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


The story quantifies the benefits, or lack of benefits, in terms that everyone can understand. For example, it says, “Only about three out of 100,000 women each year developed cervical cancer after negative HPV and Pap tests. HPV tests were twice as good as Paps for predicting risk. Adding a Pap after a negative HPV test did little to improve risk prediction.”

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


This is one of the strengths of the piece, that it takes harms head-on in a screening story, instead of assuming that early screening could do nothing but prevent disease and death. The story does a good job quantifying the harms for some of the screenings mentioned and, for others, explains that the studies did not address harms. It says in its third bullet point, “Screening women with no symptoms for ovarian cancer with a blood test and an ultrasound exam is harmful. It didn’t prevent deaths and led to thousands of false alarms, unneeded surgeries and serious complications.” Later, the story becomes more specific, saying, “After 13 years, there were no major differences in ovarian cancers found or deaths from the disease. Screening found only 212 cancers while giving 3,285 false alarms that led to 1,080 unneeded biopsy surgeries and 163 serious complications.”

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

The story does a decent job evaluating the quality of the evidence and, surprisingly for a story this concise, manages to sketch the outlines of the study design for all three of the studies mentioned, providing the number of people studied, the ages, the time frame and other details. For example, it says, “Researchers at Memorial Sloan-Kettering Cancer Center in New York used stored blood samples that 12,000 Swedish men gave for a heart study decades ago, when most were 44 to 50 years old. They also had second samples from some of them six years later, and samples from other 60-year-old men.”

Does the story commit disease-mongering?

The story does not engage in disease-mongering and makes an effort to actually narrow the scope of people who would benefit or not benefit from the various screenings mentioned. For example, it says, “A single PSA blood test at ages 44 to 50 might help predict a man’s risk of developing advanced prostate cancer or dying of it up to 30 years later. The PSA test is notoriously unreliable, but using it this way separates men who need a close watch from those who are so low-risk that they can skip testing for five years or more.”

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


The story made good use of experts who put the studies’ findings into context. The story also noted the funding behind the studies and one potential conflict of interest, saying, “The National Cancer Institute, the Swedish Cancer Society and several foundations paid for the work, and one researcher holds patents for two PSA-related tests.”

Does the story compare the new approach with existing alternatives?


Alternative screening strategies for cervical cancer were discussed.

The option of not being screened for prostate cancer came through in this quote:”They’re identifying a group of guys who don’t need to be screened, or need to be screened less often,” said Dr. Otis Brawley, the cancer society’s chief medical officer.

For ovarian cancer the story emphasized that the study in question was “a warning to people who get screening tests that aren’t recommended, or who question whether screening can ever hurt.”

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

The story makes repeated reference to the widespread use of early screening for cancer. For example, it says, “Most groups don’t recommend PSA tests, but most men over 50 get them anyway.” Another great feature of the story is the explicit mention that the testing strategy for PSA is not yet “available”, i.e. that it needs to be validated before being adopted for clinical use.

Does the story establish the true novelty of the approach?


Where novelty was at issue, the story establishes novelty, saying, for example, “The new study was the first big one to examine a newer screening tool, HPV tests, with or without Pap smears in routine practice.”

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


The story goes far beyond any news release.

Total Score: 10 of 10 Satisfactory


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