Friday, 20 April 2007

Well I never!

The media have been buzzing this week with news of a study published in the Lancet looking at HRT and cancer. The Scotsman read the article. It was, they said, a “shocking” report showing women on HRT were at “substantially increased risk” of cancer. The figure they quote is a 20% risk increase. Shocking indeed.

A doctor writing in the Telegraph was so shocked that she believes HRT should be banned. It’s a lifestyle drug, she says used by “feisty modern women” hoping to hang on to their sex lives and she wouldn’t recommended it at all, so dangerous is it.

The BBC also read about a 20% increase. They kindly explained that “This translates to one extra case of ovarian cancer for every 2,500 women taking HRT and one extra death from ovarian cancer in every 3,300 users.”

Reuters, it seemed, had read a different report. The study they read was one “suggesting – but not yet proving – that HRT causes breast and ovarian cancer”.

A professor writing in the Telegraph, alongside the sceptical doctor, says risks and benefits should be balanced. The risk is small and some women are “severely disabled” by menopause symptoms.

The headline in the Lancet itself says that 1000 deaths amongst the study cohort since 1991 can be put down to HRT. Just to put that into perspective that works out as one extra death a week over the 16 years of the study.

Is it worth the risk? The BBC tells us that the symptoms of menopause may include aches and pains, insomnia, hot flushes, dry skin, tiredness, bladder problems, depression, panic attacks, poor memory. Oh and there’s osteoporosis too.

So – what’s the moral of the story? Always read with an open mind and never be dazzled by statistics. Look at resources such as CASP to help you read papers critically, and read books like “How to Read Paper” or the recent Guardian Bad Science article on manipulation of statistics.

You can also look at the Hitting the Headlines facility on the National Library for Health. This regular looks at the stories in the headlines and looks at the facts behind them.

Read with your brain fully engaged, and never believe everything you read in the papers!

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