An Opportunity for Balance Lost

Yesterday was an important day in cancer medicine, with the release of a major study with promising findings on using low dose CT scans for the early detection of lung cancer in heavy smokers. We worked to help reporters and the public understand that the data, while promising, must be interpreted with caution. As Otis W. Brawley, M.D., our chief medical officer said in a prepared statement:

“As with any study of screening, there are also potential harms to be considered, such as potential overdiagnosis and needless surgeries. We have learned from the long-term analysis of other screening tests, such as mammography, that it is important to consider both benefit and harms associated with the test.”

Even the researchers who did the study voiced caution, noting that the study was not enough to start recommending widespread screening, and being careful to point out the critical issue of harms caused by false positives.

Unfortunately, not everyone was as careful. One advocacy group used the study to reiterate their call to Demand A Scan. Another said “CT screening for lung cancer should be incorporated into evidence-based practice and reimbursed in the same manner as mammography screening.

So when we had the opportunity to help bring understanding to the viewers of ABC’s World News Tonight, we jumped at the chance. Dr. Len Lichtenfeld reiterated in a recorded interview many of the points he had made in his blog entry, the title of which says it all “CT Scans Decrease Lung Cancer Death Rates, But Look Before You Leap.”

So how did ABC News do? Not well. While it’s true the test holds “new hope” for a “Holy Grail” in cancer medicine, there was barely a mention of potential harms, or that the data has not been published or critically reviewed by independent experts, and that some experts say these findings may prove difficult to reproduce under less controlled conditions.

Dr. Lichtenfeld made several of those points in the interview, but this was the sound bite that got used:

“There is a possibility that the American Cancer Society will recommend this as a screening test in the near future.”

That was it. Left off was any caveat, many of which Len provided during the interview. On a more positive note, ABC’s online version of the story more accurately reflected Dr. Lichtenfeld’s overall analysis:

“What was not said today is that we have enough to make a blanket recommendation that everyone get screened [by CT scans],” said Lichtenfeld. “It’s going to take time for experts to give it some thought.”

To their credit, ABC News noted the possibility that smokers would use the availability of a screening test to justify continuing smoking. That’s a real risk, but certainly not the only one. But leaving viewers with the impression that the American Cancer Society’s view was that this was a test we would soon be recommending fell short of the mark, and failed to reflect the balance in our position.

About David Sampson

I am the director of medical and scientific communications for the American Cancer Society national home office.
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