The media and the two major prostate cancer screening trials

An unexpected publication in the urology literature is an article analyzing the ways in which selected major media reported on the results of the Prostate Lung Colorectal Ovarian Cancer (PLCO) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) trials after their publication in the New England Journal of Medicine in early 2009.

Obviously (at least to regular readers of these columns), the results of these two major trials, presented together in the same issue of the New England Journal, were a big deal “media-wise.” And interpretation of the results of the trials by the media depended on the point of view of the “interpreter” and the sophistication of all concerned in assessing the trials’ structures, methodologies, data quality, etc.

Lawrentschuk et al. have tracked the ways that the Internet sites of major newspapers in the UK, Australia, and North America, and of other Internet-only news organizations, reported on the data from the two trials. They carefully monitored selected media with regard to content, positive or negative presentation of the trial data, and the use of expert commentary in interpretation of the data.

Based on the data they collected, the authors report the following:

  • 48 major newspapers reported on the two studies on-line within an average (median) of 1.5 days after publication in the New England Journal (range, 0-175 days)
  • Major on-line news sources largely reported  on the day of publication (range, 0-110 days).
  • For the newspaper-based Internet articles
    • 23 percent indicated that screening was a positive endeavor.
    • 31 percent indicated that screening was a negative endeavor. 
    • 46 percent were neutral.
  • In terms of geographic viewpoint
    • 78 percent of newspaper-based articles originating in the UK indicated insufficient screening.
    • 57 percent of  newspaper-based articles originating in the USA reported screening as being excessive.
    • 80 percent of  newspaper-based articles originating in Canada reported screening as being excessive.
    • On-line only media reflected US-based news reporting.

The authors conclude that (rightly or wrongly) world newsprint media in general portrayed screening in a negative light after publication of the results of the ERSPC and PLCO studies.

So far we have seen only the abstract of this article, which was recently published on-line in BJU International. We have requested a copy of the complete article and will comment further on this if we feel it is worth doing so.

2 Responses

  1. In my opinion, those of us who have “been there, done that” and found we had prostate cancer are glad that we found out early enough to at least begin some form of treatment option and extended our lives for more years than if we had neglected testing.

  2. Thanks so much, Sitemaster, for reporting this interesting study. It will be interesting if the full study recognizes the critical flaws in both trials and reports how many articles in the media recognized those flaws.

    After being heavily involved in survivor issues for more than 11 years now since my diagnosis for a challenging case of prostate cancer, I’ve concluded that some in the media are interested in ratings — pushing emotional buttons — far more than truth or the welfare of their audiences, but that other reporters do their best. Unfortunately, that “best” effort is so often hampered by inadequate knowledge and not knowing how to select the true experts to comment insightfully on specific issues.

    It was immediately clear to some of us that the reports of the two screening trials — PLCO and ERSPC –were severely flawed, so much so that their conclusions were completely undermined on the side unfavorable toward the value of screening. To me, those trials, as reported at the time, were only valid as indicating lower bounds for the value of screening. As years have gone by, the European results, with additional and more detailed follow-up, have been increasingly favorable toward screening, a trend which seems highly likely to me to continue.

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