This is a story reporting results of a systematic review of studies about the relationship of IUDs to cervical cancer. After combing through multiple studies, the researchers identified 16 high-quality studies. Evidence in those studies indicated women with IUDs are 30% less likely to get cervical cancer, the story said.
But we wanted to know: 30% less than what? What is the incident rate in women with IUDs — and women without them? To its credit, the story points out that these were observational studies, meaning they weren’t actual clinical trials, and more evidence is needed before women should make the decision to get an IUD just as a way of preventing cervical cancer.
The results of this research reaffirm earlier studies suggesting that there is a reduced risk of cervical cancer associated with the use of IUD’s. However, until an experimental trial is conducted, readers should take the findings with a grain of salt.
The exact cost of an IUD wasn’t mentioned in the story, but it did allude to the low cost of the product. The story also missed an opportunity to articulate the economic issues associated with HPV vaccine availability, namely the manufacturing cost of the vaccines and the profitability focus of the pharmaceutical industry.
The story explained that women who used an IUD were 30% less likely to develop cervical cancer but did not provide any quantification of that number. Readers need to know: 30% less than what? The incidence of the disease would have improved the story and placed the 30% reduction into perspective. There are approximately 400-500,000 case of cervical cancer diagnosed annually with a 50% death rate overall worldwide. The incidence of the disease varies widely with an incidence of approximately 16/100,000 in developing countries compared to approximately 10/100,000 in the developed world.
Although this story did a great job on most counts, it didn’t mention potential harms of IUDs. Cramping, spotting between periods, and heavier periods are all possible side effects. The bigger issue that the story could have mentioned, though, is that IUDs don’t protect against other STIs.
The writer was careful to quote the authors of the study about the limitations of the quality of evidence. This was a synthesis of previously existing evidence, all of which were observational studies. Observational studies can demonstrate that two things are associated, but they don’t prove that one causes another. That is, they can suggest correlation, but not causality. That came across clearly.
No disease mongering here. Cervical cancer kills hundreds of thousands of women across the world every year.
Unfortunately, the story depended on quotes only from the lead author of the study. Verification of the significance of study findings by an independent expert would have strengthened credibility of the story.
The story did a good job of comparing IUDs to vaccines and regular screening, even going into the details of when and how often each of those should occur, and making it clear that IUDs are not yet a proven option for cervical cancer prevention.
IUDs have been available to women for decades. The only issue the story might have considered further is how available they are in low-income nations where vaccines and regular screening are not accessible to many women.
This story reported the findings of a systematic review. That means it’s not going to be breaking news. What it does, though, is to synthesize existing research and make clear exactly what the state of current knowledge about the topic is.
The author appears to have interviewed the lead author of the study in addition to reading the news release. The story also quotes statistics from the World Health Organization.
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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