Last year one of our CIPR Diploma public relations students looked at the media’s reporting of science stories for his dissertation. Reports today about a study into the risks of HRT are fascinating as a case study of this.
Take the “report” in the Guardian – HRT linked to 1,000 deaths from cancer – which is totally missing any critical analysis. Written by Sarah Boseley, health editor, it is worth deconstructing for the use of language alone. How dismissive to state:
HRT has been used by millions of women to alleviate the symptoms of menopause or – in some cases – because they hope it will help them remain youthful and active for longer.
The report by Professor Valerie Beral is said to be “authoritative” and “the first firm calculation of deaths related to HRT” – which is entirely different from the opening paragraph’s claim:
Hormone replacement therapy may have caused the deaths of more than 1,000 women in the UK from ovarian cancer since 1991, scientists reveal today.
Boseley states those taking it are “risking death from a particularly lethal form of cancer” and directs a conclusion that the research “will not be the last straw for HRT, but it may well reduce the numbers willing to take the risk of hormone treatment.”
She also states that “Prof Beral and her colleagues have already shown that women who take the therapy are at increased risk of breast cancer and womb cancer. The risks of breast cancer are the highest, accounting for a probable 20,000 cases over a decade.” No mention of the fact that these results have been shown to be an over-estimate (see below).
Although acknowledging “Early findings about health risks attached to HRT were hugely controversial” – Boseley makes no effort to explore these, stating “but Prof Beral thinks the problems have now been generally accepted.”
“People like to say there is a debate about HRT. I think that’s not true,” she said. “Some people like to make out that it is uncertain what is going on, but I don’t think there has been a debate for a long time. GPs are increasingly aware and so are women. The important thing is that women know these figures are right and not exaggerated.”
The results of the study are not put into any context and the figures that “one woman in 2,500 will get ovarian cancer while a long-term user of HRT and one in every 3,300 will die from it” are not related to non-users, which is relevant to make sense of the data.
There is a bizarre conclusion in relation to HRT’s value for osteoporosis:
“My personal view is that the sensible thing is to take HRT when you are 80,” said Prof Beral. “My mother is 90 and has had a lot of fractures. I was very happy to say to my mother take HRT at 90.” What mattered at that point was her quality of life. “If she has breast cancer when she is 95 – so what?”
How many 80-year old women suffer from the menopause?
The Times has an equally one-sided headline: “HRT alert after more than 1,000 women die.” Nigel Hawkes, Health Editor states:
HRT increases the risk of the disease by 20 per cent, the biggest investigation of links between HRT and cancer has found. Although the absolute risk is low, millions of women took HRT in the 1990s and so the total impact is large: an extra 1,300 cases of the disease and 1,000 deaths between 1991 and 2005, according to the Million Women Study.
However here we see a balance with “The findings were challenged by John Stevenson, of the Royal Brompton Hospital in London and the chairman of the charity Women’s Health Concern.”
“The study grossly overestimates the breast cancer risk, and now we have findings from a five-year study that have to be extended to a 14-year time frame to make them more sensational,” he said. “This is not science, and the findings themselves fly in the face of cancer biology.”
The BBC and GMTV breakfast television reports also sought to put the study into context and give practical advice to those who may be concerned.
I have no interest in the issue of HRT itself, my question is over the impact of simplistic reporting. Blind acceptance of a study, reproducing a press release (as can be seen from the common language used), lack of alternative perspectives or context, sensationalised headlines, pejorative language – all contribute to a sense of panic and fear. They may also affect public understanding of medical and scientific research.
Last week it was reducing obesity issues to a “fat gene” – and I’ve already heard people cite this as a reason for being overweight. It serves no purpose at all for those involved in public relations or the media to generate this simplistic reporting of science.