Cancer research in the media: say it clearly and sensitively


Recently, mainstream media portrayal of cancer research has been thrust into the spotlight, with the driving force being the release of Cristian Tomasetti and Bert Vogelstein’s paper ‘Variation in cancer risk among tissues can be explained by the number of stem cell divisions’ [1]. Despite looking to identify the reasons behind variation in cancer risk between tissue types, a choice of two words within the abstract inflated the findings to media headlines stating that ‘most cancers are due to bad luck’.

As a result of this series of events, we have been preoccupied with the interaction between the media and cancer researchers, and how situations like this could be avoided in the future. We spoke to Henry Scowcroft, Cancer Research UK’s News and Multimedia Editor, to discuss his thoughts on the media coverage of Tomasetti and Vogelstein’s paper, and what researchers can do to ensure that their message is correctly represented.

Recent coverage of the paper from Johns Hopkins University (MD, USA) has been somewhat controversial. Can you put this into perspective for us? What were your initial reactions to the paper?

The scientists who authored the research paper were some fairly eminent research scientists; Vogelstein, for example, has done some incredible work over his career. They were doing what science does – taking an idea and investigating. It was published in a prominent journal, as happens when you’re a senior research scientist who’s done something really intriguing, and the research got out there.

The press release pulled out the emotive language used in the paper discussing ‘bad luck’. They could have said ‘chance’, they could have said ‘random effect’ – the choice of words was not helpful. There are some things that you know the media is going to go for, and the media quite understandably went for that.

You sometimes get a certain degree of Chinese whispers with a research paper presented as a press release and distributed to the wider media. Somehow, in this case, the explanation of two-thirds of variance among different tissue types was presented to the public as ’two-thirds of people who get cancer is just bad luck’. That is not what the research found and it was really unfortunate that that got out there, because for people that don’t want to make lifestyle changes it could theoretically give them an excuse for not doing so.

Increasingly – as well as funding lifesaving cancer research and providing information to people affected by the disease – our role as a charity has come to encompass being the place people look to when these things hit the media, which is a great place to be. So we felt we had to respond to the way this story was reported, and did so on our blog. It wasn’t easy – the story had all the hallmarks of being questionable but then you realize that it was carried out by some well-respected scientists. You then go and find out that actually what they did, and what was reported they did, were not entirely the same thing.

What do you think are the possible dangers of such a message being interpreted as it was in the media?

It’s an interesting one and it’s something that’s not very well studied, although there are groups that investigate the effects of such situations. There’s a research paper I really love that was published by our researchers at University College London (UK). They looked at bowel cancer screening uptake around the time there was a big story in the media about a new potential bowel screening test: rates of screening for the existing test went up [2]. So we know that stories in the media affect people’s behavior, and that suggests that the impact of these things can be important.

The other good example is when celebrities go public with diagnoses of cancer; Angelina Jolie being a good example. You see changes in people’s behavior, sometimes for the better, sometimes for the worse. These situations matter a lot, but it’s difficult to measure and it’s difficult to say how important it is. The sort of things you’d love to know are ‘to what degree does a recommendation from a friend versus seeing the front page of a newspaper over someone’s shoulder on the computer affect some people’s decision-making processes?’ Obviously the answer is going to be ‘it depends on the individual’, but how much and to what degree, it’s very difficult to know.

It was interesting to see that our research showing how lifestyle is linked to more than half a million cancers over 5 years upset a few of the people that read it [3]. They knew someone, or they themselves lead a very healthy lifestyle and got cancer. It just goes to show that this whole issue of communicating things like risk, chance and statistics in the public sphere – particularly with something as emotive as cancer – is a minefield. What we take from that is the care you need to take with these sorts of things.

Is there anything scientists can do to make sure that their research is portrayed correctly by the media?

There was a really interesting piece of research in the British Medical Journal late last year looking at how the source of ‘hype’ is often the researcher themselves or the press release, rather than the journalist [4]. You can argue that journalists have a duty to scrutinize, but the reality of the modern media is that people don’t have time.

So the message to scientists on this is to be really careful with your language. Do engage with the media, just get some help from your press office. If your press office is pushing you to say something you don’t really want to say, question it, but make sure you engage with it. Don’t run away and hide because if you don’t say it someone else will.  If you put something inflammatory in the abstract of your paper and then don’t talk to journalists, someone else will end up talking about your research on your behalf.

One encouraging trend emerging is with altmetrics and open-access publication, and being able to see what discussion your research is generating. We have some researchers at CRUK where their press release didn’t get much coverage, but a blog post about their work got out far and wide. Their altmetric score is really healthy because they’ve engaged and they’re communicating more widely. I think that message of engaging is important, but it’s also incumbent on press offices to make sure they do a good job too. Think through what you’re going to say and say it clearly and sensitively.

Recently, however, the media environment has changed for the good. It used to be that a story gets out there, everyone looks at it and that’s the end of it. Now you have social media, blogs and the possibility to react. One of the things we see when we do these kind of reaction pieces is that you get your initial interest in it, but over the next 6 months the blog post gets used in discussion forums and on Facebook by people saying to their friends ’actually that’s not quite right’.

Around the time that this story broke, CRUK released new data about cancer and lifestyle. What are CRUK’s main focusses currently in terms of cancer prevention and what are your key aims for the future?

There are two levels on which this works. There’s the individual level, which is in terms of the lifestyle advice, but then there’s the policy level with regard to what government should be doing. The key thing for us in the immediate future is standardized packaging for cigarettes. That’s a really important policy intervention that we’re really pushing for and we’re hoping will be implemented.

More widely, lifestyle plays a role. There are things like aspirin, which, while its role still has a few question marks over it, will play some role undoubtedly in the future – what and for whom we don’t quite know yet. There are particular things like tamoxifen for women at high risk of breast cancer, but in terms of the big picture of the UK population that’s relatively small. The other thing to mention is being able to offer more targeted screening as we increase understanding of predisposition and risk genes.

That sort of segues into early diagnosis and that, I would say, is just as much a huge priority for us as prevention. Finding markers in the blood such as circulating tumor cells is one of the hottest topics in the field at the moment, particularly it’s looking tantalizingly like you might be able to look at the circulating DNA and work out if an individual has cancer, what type of cancer it is and potentially how genetically advanced it is in terms of its potential to spread.

Forty years ago less than one-quarter of patients survived for 10 years or more, now it’s half of patients and – as we said in our research strategy – we want to make that three-quarters within the next 20 years [5]. We’re pushed a lot to say ‘we’re going to cure it’, but that’s not a realistic statement. However, saying we’ll increase 10-year survival to 75% in the next two decades is more reasonable.

What more do you think could be done by clinicians to increase awareness around the importance of lifestyle choices?

Clinicians being able to have a full and informed conversation with their patients, particularly in the primary care setting; but also having time to talk with patients to be able to understand their lifestyle to help them make positive changes.

Changing these things can be really difficult and we acknowledge that. We know that with the environment out there, with advertising and marketing etc., it can be very difficult to change your lifestyle. We hope that putting messages about lifestyle out there, and allowing people to understand what the impact could be, could help.

References:

  1. Tomasetti C, Vogelstein B. Cancer etiology. Variation in cancer risk among tissues can be explained by the number of stem cell divisions. Science. 347(6217), 78–81 (2015).
  2. Lo SH, Vart G, Snowball J, Halloran SP, Wardle J, von Wagner C. The impact of media coverage of the Flexible Sigmoidoscopy Trial on English colorectal screening uptake. J Med Screen. 19(2), 83–88 (2012).
  3. Cancer Research UK press release
  4. Sumner P, Vivian-Griffiths S, Boivin J et al. The association between exaggeration in health related science news and academic press releases: retrospective observational study. BMJ. 349, g7015 (2014).
  5. Cancer Research UK strategy

Disclaimer

The opinions expressed in this interview are those of the interviewee and do not necessarily reflect the views of Future Medicine Ltd.