One day after New York Times reporter Gina Kolata created a “firestorm” of controversy with a front-page story saying the benefits of cancer screening “have been overstated,” the Times is back with another story–by another reporter–trying to clarify the issue.

The second story has a decidely different tone. “Most people believe that finding cancer early is a certain way to save lives,” writes Tara Parker-Pope. “But the reality of cancer screening is far more complicated.”

Ah–complicated. It’s those complications that so often trip us up.

The two stories cover the same ground, and say roughly the same things. But note the difference in approach. The first story prompted a headline writer to write, “Cancer Society, in Shift, Has Concerns on Screenings.” (This and other quotes are from the online versions of these stories.)

Concern. A “shift.” Something’s up, and it sounds slightly conspiratorial. Especially when Kolata writes in the second graf, (as I noted here earlier) that the American Cancer Society “is quietly working” on a message saying that screening for breast and prostate cancer  “can come with a real risk…”

Parker-Pope describes the cancer society’s action in much more benign terms that suggest vigilance and responsibility, not conspiracy: “The cancer society says it will continue to revise its public messages about cancer screening as new information becomes available,” she writes.

The headline on her story was, “Benefits and Risks of Cancer Screening Are Not Always Clear, Experts Say.” It doesn’t have the spine of the hed on Kolata’s story, but it’s not as frightening, either.

The cancer society itself was even clearer in a statement it released in response to Kolata’s story: “American Cancer Society Stands by Its Screening Guidelines; Women Encouraged to Continue Getting Mammograms,” the headline read.

So did Kolata have a scoop? Or did she hype it?

Her story hangs chiefly on one particularly inflammatory quote by Dr. Otis Brawley, the cancer society’s chief medical officer, in the third paragraph:

“But I’m admitting that American medicine has overpromised when it comes to screening.”

Did Kolata’s aggressive reporting force Brawley to “admit” that American medicine had exaggerated its claims for screening? We can imagine how Kolata might have pursued it. “Yes, Dr. Brawley, I know that’s what you said before, but you have to admit that you’ve overpromised. You have to admit it! Don’t you? DON’T YOU?” And an aggravated Brawley finally spits out, “But I’m admitting it!”

Maybe this is what he really thinks, and Kolata nailed him. Maybe the reaction to her story forced him to back down, concealing his real feelings behind more considered opinions.

That’s a possibility; often what sources say in frustration or in the face of determined questioning is closer to what they believe than what they say when they are asked to politely give a statement.

On the other hand, this is not an admission akin to, say, a ball player admitting he’s used steroids.

Screening has generated controversy for years, and scores of researchers have “admitted” that its claims have been exaggerated.

Both Kolata’s and Parker-Pope’s stories mention the report that triggered these stories, an analysis of breast and prostate cancer screening published this week in the Journal of the American Medical Association. That paper, too, is far more temperate. It’s entitled “Rethinking Screening for Breast Cancer and Prostate Cancer.” And after a detailed analysis of the risks and benefits, it concludes that what’s needed is not less screening, but better screening.

A view from afar: Way over on the other coast, meanwhile, Karen Kaplan of the Los Angeles Times does a nice dissection of Kolata’s story on the Times’s Booster Shots blog. She notes that Brawley has said the same thing before, including in a 2008 published report. And she notes other instances in which published reports or researchers have taken similar positions.

Enough said; it’s time to cast your vote: Kolata, or Parker-Pope?

I cast my lot with Parker-Pope. (And Kaplan.)

- Paul Raeburn

This entry was posted on Friday, October 23rd, 2009 at 1:27 pm and is filed under Health & Medicine Stories, Science Stories. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.