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Red wine prevents breast cancer? I’ll drink to that!

Rating

3 Star

Red wine prevents breast cancer? I’ll drink to that!

Our Review Summary

It’s ironic that we just published two blog pieces last week that mentioned surrogate markers (both links appear in our comments below), and along comes this story trumpeting a finding that involved only surrogate markers – without any of the expected caveats.

The LA Times publishes an excellent Healthy Skeptic column.  The principles of that column needed to be employed in this story.

 

Why This Matters

How would you expect women who want to prevent breast cancer to react when they see a headline and a first sentence like the one this story had?

But the story did not include the wisdom that appeared in the news release promoting the study:

“Until larger studies are done, (one of the study co-authors) would not recommend that a non-drinker begin to drink red wine.”

 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

Not applicable.  The cost of red wine is not in question.

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

Not Satisfactory

The story suggests benefits throughout:

  • “prevents breast cancer?” in the headline
  • “might be the next big thing in breast cancer prevention” in the opening sentence

But the study it reported only pointed to surrogate markers – hormone levels – not to any outcomes that are immediately meaningful in women’s lives.  The limitations of this finding simply weren’t discussed.

Readers would be well advised to read last Friday’s blog post about The Ten Commandments of the New Therapeutics.  Two of them came into play in this story:

  • Thou shalt consider benefits of drugs (or red wine, in this case) as proven only by hard endpoint studies.
  • Thou shalt not bow down to surrogate endpoints, for these are but graven images.

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

Satisfactory

The story included past warnings about alcohol consumption for “women intent on warding off breast cancer.”

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

Not Satisfactory

As already noted, the story didn’t discuss the limitations of surrogate markers.  Readers would also be well advised to see our blog post about a recent BMJ editorial, “The idolatry of the surrogate.” 

And, while it mentioned that this was a small study, it didn’t offer any comment about the limitations in trying to draw conclusions from such a tiny sample.  Instead, it emphasized the researcher’s self-description of this as a “rigorous study.”

Finally, the story does not mention that the findings are at odds with a systematic review of available evidence, which concluded, based on dozens of studies, that “alcoholic drinks are or may be a cause of various cancers, irrespective of the type of alcoholic drink. The causal factor is evidently alcohol (ethanol) itself. There is no significant evidence that alcohol protects against any cancer. The extent to which alcoholic drinks are a cause of various cancers depends on the amount of alcohol drunk.”

Does the story commit disease-mongering?

Satisfactory

There was no disease mongering of breast cancer.

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

Not Satisfactory

There was no second source, no independent source.  That would have helped.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story compares red wine with the class of drugs called aromatase inhibitors.

But that class of drugs has a long track record.

This was a tiny, very short-term study of red wine.

Yet the story allowed the researchers to assert that “this this was the first rigorous study to find that red wine is a ‘nutritional aromatase inhibitor in healthy premenopausal women.’  ”

That’s a pretty bold comparison after such a preliminary finding.  An independent expert probably would have challenged that, but the story didn’t provide any such challenge.

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

Not Applicable

Not applicable.  The availability of red wine is not in question.

Does the story establish the true novelty of the approach?

Satisfactory

The story offered some context about other wine-breast cancer research and pointed out how and why this result was different.

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

Satisfactory

The story didn’t rely solely or largely on a news release.

Even the Cedars-Sinai news release, though, included more caveats than the story did.  The news release stated:

“that large-scale studies still are needed to evaluate the safety and effectiveness of red wine to see if it specifically alters breast cancer risk.  He cautioned that recent epidemiological data indicated that even moderate amounts of alcohol intake may generally increase the risk of breast cancer in women. Until larger studies are done, he said, he would not recommend that a non-drinker begin to drink red wine.”

A bit different than the story putting “I’ll drink to that” in the headline, “might be the next big thing in breast cancer prevention” in the first sentence, and signing off with with “L’chaim!”

Total Score: 4 of 8 Satisfactory

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