A vaccine against the virus that causes most cervical cancers is an important new preventive tool, and the implications are far-reaching for future generations of women who will be spared much of the anxiety and invasive monitoring that is part of cervical cancer screening today.
However, two issues make this story unbalanced and possibly misleading.
First, by focusing on the number of women worldwide who are diagnosed with and die from cervical cancer, it overstates the impact of the disease in the United States–where the vaccine is to be licensed and used. Less than 10,000 women are expected to be diagnosed with the condition this year in the United States, and about 3,700 will die from it. The “huge excitement” about the vaccine’s approval is not balanced by any mention of the costs and challenges of delivering 3 doses of it to young women in the developing world. It would also have been helpful to estimate how many women would need to get the vaccine in order to prevent one cervical cancer death and the other problems that can be associated with HPV.
Second, by stating that cervical cancer is ‘one of the most deadly’ cancers, and by including the story of a young white woman who died from advanced cervical cancer, the story paints an inaccurate picture of the actual experience of the disease in this country. Several other cancers are both more common and more deadly in the U.S., including lung, colon, and ovarian cancers. The young woman’s story is compelling, and younger women will benefit most from a vaccine that prevents cancer and other HPV-related problems. However, providing some additional information on cervical cancer would have helped viewers to put her story in perspective. For example, in 2002-03, just 5.6% of cervical cancer deaths were in women aged 34 and younger. More than half were in women aged 57 and older. And black women die of cervical cancer at twice the rate of white women.
More than 5 minutes was devoted to the story – a long time for TV news – so there certainly was time available to explore these important issues.
Given that the story cites worldwide cervical cancer statistics to explain the importance of this vaccine, it would have been helpful to note how much the vaccine will cost.
The story states that the vaccine will “greatly reduce” the risk for problems related to HPV infection. It would have been helpful to include estimates of the actual number of infections and cancers prevented, and how many women will need to receive the vaccine to prevent one case of cancer or the other problems that can be related to HPV infection.
The story notes that 0.2% of women dropped out of trials because of side effects, but it does not specify what those side effects were. Nonetheless, we’ll give the story the benefit of the doubt and rate it satisfactory here.
The evidence provided in the story is accurate, but somewhat limited: that 70% of cervical cancers are caused by HPV, that the vaccine prevents nearly 100% of these types of HPV, and that the risk for other HPV-related problems (abnormal pap tests, genital warts, etc.) will be greatly reduced. The source of the evidence (trials involving 21,000 women) is not described, however. The notion seems to be that FDA approval implies there is good scientific evidence.
The vaccine is being considered for use in the United States, and so it would have been more appropriate to note how many women in this country are expected to be diagnosed with (about 9,700) or die from (about 3,700) cervical cancer this year. Citing the worldwide numbers overstates the impact of the disease here, as does stating that cervical cancer is “one of the most deadly forms.”
It is true that problems related to HPV — not cancer deaths, but cancer treatments (including surgery that can cause infertility), as well as abnormal pap smears, diagnostic procedures, and the associated anxiety — do tend to affect young women more. However, highlighting a story of a 28-year-old white woman who was diagnosed with advanced cervical cancer misrepresents the typical situation in the United States for cervical cancer patients. This woman’s experience, while certainly devastating to her family and friends, is not typical. In 2002-03, just 5.6% of cervical cancer deaths were in women aged 34 and younger, while more than 50% were in women aged 57 and older. Death rates are twice as high in black women compared with white women.
The story told by Sara Lyle about her friend’s death from cervical cancer could have been balanced by an expert who commented on how typical or unusual her case was. There is no mention of sources of information or corroboration from any other expert.
The story does not mention how the new vaccine fits into the context of other available options for reducing the risk for HPV infection, other than a brief mention of abstinence.
The story states that the FDA is expected to approve the vaccine, and that it will probably be available later this summer.
There is no evidence that the story relied solely or largely on a news release.
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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