But a semblance of balance was recovered in the body of the story, which pointed out some important caveats about the research. Why wait until the last sentence, though, to report on the bottom line impact of the study (which is that it will have no impact at all on medical practice)? Wouldn’t readers be better served seeing that info higher up? There is already evidence that circumcision reduces the risk for infections; the current report adds nothing to the decision-making process.
Parents have a lot to consider when choosing whether to circumcise a newborn son. At this point in time, the risk of prostate cancer isn’t something that should factor into this decision.
Readers may also be interested in this assessment of the study by the surgeon-blogger known as The Skeptical Scalpel.
Although the story didn’t discuss costs, we don’t think the cost of circumcisions is really in question.
The headline for this article — “‘Cutting’ your risk of prostate cancer” — fails on two levels. Not only is the pun quite bad, but the use of the active verb suggests that there is a causal relationship between circumcision and prostate cancer, which is something this observational study can’t prove. Although the text of the story communicated this fact appropriately, it should be reflected in the headline as well.
While absolute risks generally cannot be estimated from case-control studies, extrapolating the 15% relative risk reduction to the 16% lifetime risk for being diagnosed with prostate cancer would suggest that circumcision would be associated with at most a 1% or 2% absolute risk reduction–likely less for clinically important cancers. Of course, the study provides no information on whether circumcision is related to prostate cancer mortality–an important issue given that most prostate cancers are indolent.
Possible harms of circumcision, such as pain, are not discussed.
The story notes some caveats such as possible underreporting of sexually transmitted infections. And it says that the study is “not likely to spur any change in recommendations or medical practice.”
But the argument that “infections” are known to cause cancer is somewhat misleading. The vast majority of this association arise from HPV (cervical, anal, oropharyngeal), HCV (hepatoma), and HIV (lymphoma). However, the Cancer article cites only indirect evidence supporting a link between circumcision, sexually-transmitted infection, and prostate cancer.
Case control studies are notoriously susceptible to bias. At best, findings are hypothesis generating. However, given the biases (arising from poorly or unmeasured confounders, problems measuring and exposures, selecting appropriate control groups), only a dramatically increased or decreased risk is notable. A 15% relative risk reduction is within the range of statistical noise.
We’ll flag this story for an overly bombastic and totally unnecessary lead sentence. Cancer is not the medical equivalent of Lord Voldemort from the Harry Potter books.
The story concludes with a statement attributed to the American Cancer Society suggesting that the findings won’t change medical practice. While this statement is certainly no substitute for an actual conversation with an expert, it’s more context than we see from many similar blog posts about medical studies. We’ll give it a passing grade, though barely.
We’ll rule this one Not Applicable. It didn’t discuss alternative ways to reduce the risk of prostate cancer and that is understandable.
The story didn’t discuss any alternative ways to reduce the risk of prostate cancer. Studies have suggested that chemoprevention with drugs such as finasteride or dutasteride can reduce the risk of prostate cancer by about 25%. Though the benefits of this are controversial, it would provide a ballpark comparison.
The availability of circumcisions is not in question.
The story notes that previous studies have shown a link between circumcision and reduced risk of sexually transmitted infections — the same mechanism that is proposed to explain the association with reduced prostate cancer incidence.
The story is not based on a press release as far as we can tell.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
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