Less thorough than a competing Associated Press (AP) story on the same study, this online CBS story emphasizes the “dramatic” and “enormous” benefits that a cheap over-the-counter vitamin pill could have for the prevention of nonmelanoma skin cancer. But it never quantifies that benefit in a way that would provide a meaningful measure of impact. It also never mentions tried-and-true skin cancer prevention methods — e.g. limiting exposure, using shade, and applying sunscreen — that were front and center in AP’s coverage. And CBS doesn’t explicitly point out that the cancers prevented in this study were of the nonlethal variety — readers will need to make that leap for themselves based on the story’s somewhat disjointed description.
Both stories could have done more to alert readers to the preliminary nature of these findings, which come from an abstract to be presented at a conference that’s still several weeks away. It’s almost impossible adequately to evaluate the quality of research that’s announced on a conference call before it’s even been presented to other scientists.
Skin cancer affects about 5 million people in the U.S. each year, making it one of the most common forms of cancer, and rates have been on the rise for the past three decades (probably because people are living longer, getting more sun exposure, and enjoying better detection methods). Most of these cancers are basal and squamous cell cancers, which typically aren’t lethal and affect about 2.2 million Americans every year. But those with either form of cancer have increased risk of being diagnosed with melanoma — a more deadly skin cancer that affects 74,000 and kills about 10,000 Americans annually. Overall, the lifetime risk of getting any skin cancer is 20 percent, and the risk of dying from melanoma is about 2.4 percent — so any potential prevention method, especially a simple one, is bound to receive widespread attention.
We’re told right off the bat that twice-daily nicotinamide supplements cost about $10 a month.
The story cites a 23 percent reduction in skin cancers and quotes a researcher who calls it “a dramatic number” that “could make a major impact.”
But unlike the competing AP story, CBS never provides the absolute numbers that would help readers assess the true size of the benefit for themselves. As AP points out, the vitamin takers developed fewer than two nonmelanoma skin cancers on average versus roughly 2.5 cancers for the others.
We’re told via the study’s author that twice-daily nicotinamide is “safe,” but that it’s “not something we’d recommend at this stage for the general population.” The author’s claims to safety can’t be verified without a look at the actual study data (which haven’t been published yet), but since the references we’ve consulted generally support the idea that adverse effects are minimal, we’ll give the benefit of the doubt.
The tone of the story overall is enthusiastic. Instead of offering any critical analysis of the study methods or results, the two quoted outside experts pump up expectations by calling the benefits “dramatic” and “enormous.” Only in the second-to-last paragraph are there any restraining comments offered by one of the study authors, who notes that “It’s not something we’d recommend at this stage for the general population,” and that the benefits appear to wear off when patients stop taking the supplements.
Contrast this with AP’s acknowledgment, high up in the story, that “Australia has higher rates of skin cancer than the U.S. and other parts of the world, and some doctors may want more evidence beyond this single study before recommending the pills.”
There’s also never any explicit acknowledgment, as the AP story provides, that the skin cancers we’re talking about here are of the less serious variety. The story notes initially that these patients had nonmelanoma skin cancers, and then it later states that basal and squamous cell skin cancers “can usually be treated successfully” and that melanomas are the “most dangerous type.” But this disconnected discussion will probably leave many readers confused and uncertain as to how dangerous the cancers looked at in this study are and therefore how much benefit the treatment provides.
And as with AP’s coverage, another concern is that this story gives no sense of the preliminary nature of these findings, which come from an abstract for a meeting of cancer specialists occurring a few weeks from now. The story notes that the findings “are being presented at the annual meeting of the American Society of Clinical Oncology later this month,” but it doesn’t explain why that’s a reason to view them cautiously. These results haven’t been published in a journal, which means they haven’t undergone full peer review and nobody has had a chance to scrutinize the complete study data.
This article hashes out key statistics with skin cancer in general, basal and squamous cell skin cancers (which are described as readily treatable), and melanomas (which are more deadly). As noted above, we think the discussion will leave readers confused as to what kind of cancers were prevented in this study. But since we’ve already docked points elsewhere, we’ll rule the story Satisfactory here.
Two independent sources are quoted in this story about the study. But as with AP’s coverage, the quotes offered here provide little in the way of substantive analysis.
But that’s one of the pitfalls of reporting on abstracts that haven’t even been presented to a scientific conference yet, much less published. It’s almost impossible to get truly substantive analysis because the data haven’t been adequately scrutinized.
We’ll award a borderline Satisfactory, however, since their comments do relate specifically to the expected impact of the benefit reported in the study.
Tried-and-true skin cancer prevention methods — e.g. limiting exposure, using shade, and applying sunscreen — aren’t mentioned. We’re also told that basal and squamous skin cancers are typically treatable, but not how. It would have helped this article to mention cryogenic freezing, radiation, and surgical removal as ways to treat those cancers.
The article’s first paragraph establishes that nictotinamide is an “over-the-counter vitamin supplement” and thus readily available — at least in theory. The study’s lead author also adds: “It’s safe, it’s almost obscenely inexpensive, and it’s already widely commercially available.”
We’ll award a Satisfactory, but we’d note that the competing AP story dug deeper, cautioning that “A check of one major drugstore chain found only other forms of B3, such as niacin, or combination B vitamins.”
There’s no explicit acknowledgment of the novelty of the research or where the research fits within the large body of studies that have looked at vitamins for cancer prevention.
Since two outside experts are quoted, we can be sure the story didn’t rely excessively on a news release.
Systematic, Criteria-Driven
Even when stories get the facts right, they often fail to provide crucial context and caveats that would help audiences make sense of the news — or lack thereof, says @garyschwitzer of @HealthNewsRevu https://t.co/b7YO2fYt0a
Why fact-checking is not enough to prevent the spread of misleading health care news...@HealthNewsRevu https://t.co/fzC2JbDYGV
Simply fact-checking an article "fails to capture questions of nuance and context that arise – or should arise – whenever evaluating medical evidence." https://t.co/HrYkGj12q1
Comments (1)
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darwinslapdog
May 18, 2015 at 9:15 pmI hear a lot about “prevention” which people equate to things like weed killer or skillet coating, but the same people sit out in the sun all day with no hat, no sunscreen and drink way more than the daily limit of one drink for women. When you mention the sun, they wave you off and say they’re Italian or something, but if you say you fetilized the lawn they go nuts and say we’re all going to die of cancer.
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