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Common Painkillers May Help Prevent Skin Cancer: Study

Rating

4 Star

Tags

Common Painkillers May Help Prevent Skin Cancer: Study

Our Review Summary

This is another one of those stories that will leave readers’ heads spinning. In the opening sentence, we learn that takings NSAIDs “appears to significantly lower the risk for developing several major forms of skin cancer.” And throughout the story, there is reinforcement of the message that higher-dose users “appeared to benefit from the strongest protective effect.” But then in the last sentence, the story seems to take it all back by claiming that the study “did not prove a cause-and-effect relationship” between NSAIDs and cancer.

So which part of the story should we believe — the part that consistently uses cause-and-effect language to describe the relationship between NSAIDs and skin cancer, or the out-of-context line at the end that tells us there was no such relationship? The message would have been a lot clearer if the story had avoided using cause-and-effect language– “may help prevent”…”lowers risk”…”appeared to benefit” — throughout.

The absence of discussion of harm is a second major drawback.

 

Why This Matters

It would be great if we could add skin cancer prevention to the list of benefits associated with regular use of anti-inflammatory pain drugs. These drugs are cheap, widely available, and many people are already taking them for prevention of cardiovascular disease. The evidence presented here, however, is far from the final word on the matter.

NSAIDs also have potential for serious harm in the form of bleeding risk.  All meds should be taken with caution, and there are other very effective ways of reducing skin cancer risk.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

The cost of NSAIDs is not in question.

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

Not Satisfactory

The story cites statistics appropriately, but mischaracterizes what the data mean. The story tells us that skin cancer risk “fell” or “dropped” in those taking NSAIDs, suggesting that that we know that the lower risk came after the subjects took NSAIDs. With this type of study design, however, we can’t be sure of the timeline. All we know is that the researchers tracked NSAID prescriptions and cancer diagnoses — we don’t know if the cancer developed before or after the subjects took the pills. Which is why it’s inappropriate to suggest that cancer risk “fell” in the subjects who used NSAIDs, because we don’t know for sure if the NSAIDs had anything to do with it.

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

Not Satisfactory

There was no discussion of the harms associated with long-term use of aspirin, including bleeding in the gastrointestinal tract and brain. The suggestion that “most” people are already taking aspirin for cardiovascular disease prevention is also potentially misleading, since regular aspirin use is recommended primarily for those at higher risk of heart disease.

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

Not Satisfactory

There were some efforts to inject caution into the reporting, but not enough to overcome the passages that oversold the findings and drew conclusions that this study can’t support. The story provides no sense of where this study, which features a fairly weak case-control design, sits in the hierarchy of medical evidence.

By the time the appropriate final line rolls around – “While the study found an association between skin cancer risk and NSAIDs, it did not prove a cause-and-effect relationship” – the story had already used causal langauge throughout, such as:

  • “appeared to lower risk”
  • “appears to significantly lower the risk”
  • “apparent protective effect”
  • “the greatest effect…”
  • “risk…dropped”
  • “risk…fell”
  • “appeared to benefit”
  • “this exciting article gives physicians and consumers a relatively simple way of diminishing one’s risk”

Each of these statements required editing or quotes required counter-explanation about the limitations of observational data.

Does the story commit disease-mongering?

Satisfactory

No disease-mongering.

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

Satisfactory

An independent expert was quoted, although unfortunately his comments tend to reinforce the story’s exuberance rather than restrain it. Why this private practice dermatologist was chosen as the one independent expert is unknown.  Does he have a research background?  The quote doesn’t offer any evaluation of the evidence.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions sun protection as a key method of preventing skin cancer.

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

Not Applicable

The availability of NSAIDs isn’t in question.

Does the story establish the true novelty of the approach?

Satisfactory

The story mentions previous research suggesting that these drugs may have anti-cancer effects.

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

Satisfactory

The story includes interviews with one of the study authors and an independent expert. It was not based on a press release.

Total Score: 5 of 8 Satisfactory

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