The story pushes the narrative that anti-inflammatory painkillers, like aspirin and NSAIDs, have an “anticancer benefit.” Here’s what we would have liked to have seen more emphasis on:
Many people are at risk of skin cancer due to genetic factors and a history of unprotected sun exposure. This story might lead some of those people to conclude that a daily aspirin or ibuprofen can help them reduce that risk. In light of the limitations discussed above, however, that would be an unsupported and potentially dangerous conclusion to draw.
Sun exposure is a known modifiable risk factor for skin cancer. This study was unable to account for UV exposure history as it was based on registry data. People who take more NSAIDS may stay out of the sun less, or wear more sunscreen for various reasons. It is impossible to talk about causation from observational data, and this particular study lacks detail on other key risks for skin cancer.
The cost of aspirin and other NSAIDs is not in question.
Although absolute risks generally cannot be estimated from case-control studies such as this one, we think the story could have done a better job putting these statistics into context. For example, the story notes that researchers found a 17% lower risk of basal cell carcinomas (“the most common form of skin cancer in the U.S..”) in those taking long-term, high dose NSAIDs, but doesn’t mention that this cancer almost never spreads beyond the skin. Squamous cell carcinoma is also a slow-growing type of cancer that is usually treated before it can cause complications. Meanwhile, melanoma — a very dangerous type of cancer — is thankfully quite rare, and so the modest 13% relative reduction reported in this study is likely to represent a very small number of cancer cases when put in absolute terms. In the grand scheme of things, the reductions seen were small and many of the cancers possibly prevented would not be clinically important.
The story mentions that aspirin and NSAIDs can cause bleeding and are associated with adverse cardiovascular effects. However, maybe these important caveats should have come sooner than paragraph eight of a nine-paragraph story. Moreover, the story could have provided some sense as to how frequently these adverse events occur and if they are common enough to counterbalance the apparent decrease in cancer associated with these drugs.
The story calls the study “a trial” and suggests that there is a cause-and-effect relationship between NSAIDs and skin cancer reduction — e.g. ” An aspirin a day could keep skin cancer away,” and aspirin use “led to a 46% lower risk of melanoma,..” In fact, this was a case-control study (a type of observational study), a design that is quite susceptible to bias and that can’t support the conclusions that this story draws about NSAIDs preventing cancer. The most we can say is that this research shows an association that needs to be tested in more rigorous studies.
To its credit, the story does note that there were gaps in the information available to the researchers, which may have skewed the comparisons. But this nod to limitations is too little to counteract the story’s overall tilt in favor of benefits.
The story states that basal cell carcinoma (BCC) is “the most common form of skin cancer in the U.S.” While the statement is true, BCC is also the slowest-growing and least dangerous form of skin cancer. Nonetheless, we’ll give the story the benefit of the doubt on this criterion.
No independent sources were quoted. An independent voice could have helped address some of the unanswered questions.
There were no direct references to alternative methods for preventing skin cancer — like using sunscreen, avoiding midday sun, etc. Even an additional line could have satisfied this criterion.
The availability of NSAIDs is not in question.
The story nods to previous research suggesting cancer prevention benefits from NSAIDs.
The story acknowledges lifting a quote from this press release, but there’s no evidence that the story used any other content from the release. We can’t be sure about this one, so we’ll rate it not applicable.
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
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like