Readers react to NYT front page on marathoners & colon cancer
Unpublished, observational, no control group - but on the front page?
The first reaction I saw came from Dr. Eric Topol, a cardiologist who is founder and director of the Scripps Research Translational Institute - who posted on the Bluesky social media platform:
The New York Times story was about research that was presented at a conference of the American Society of Clinical Oncology. It has not been published in a medical journal.
It began with three patients who were marathoners. They each came to one oncologist and were found to have advanced colon cancer. The Times wrote that the doctor then “launched a study, recruiting 100 marathon and ultramarathon runners aged 35 to 50 to undergo a colonoscopy. The results were staggering. Almost half the participants had polyps, and 15 percent had advanced adenomas likely to become cancerous.”
What readers thought
Dr. Topol’s questioning of the story’s placement on the Times’ front page was followed by about a dozen critical comments following his Bluesky post. Examples:
This headline is clearly click-bait.
The real danger is media over-interpretation.
Quality of science and identification of weak or flawed studies is why I am on Bluesky now. Thank you for posting.
“Staggering”? Sounds like fear mongering.
On the X social media platform, where Dr. Topol published the same post, there were more critical comments:
Research studies have become the Wild West. I can pretty much find a study to back up any point of view I want.
I am interested to see what gets published under peer review.
I’d question if the media focus skews perception. A small, uncontrolled study can highlight trends, but it doesn’t confirm causation or justify alarm without broader evidence.
a single headline can shape the narrative before we have the full data.
The longer I do this work - and I’ve been doing this for more than 50 years - the more I learn the value of listening to - and responding to reader comments. The New York Times did not offer readers a chance to comment online about the story. That is unfortunate. Times readers often leave some of the most intelligent and insightful comments on biomedical research stories.
Lessons for readers
Healthy skepticism is good. Cynicism and loss of trust in science and in journalism - seen in some of the comments - is not healthy. Be critical of the evidence - and be specific - if you believe that’s justified, but don’t use the comment section to make broad, sweeping blasts at entire professions of journalism and science..
Learn what the limitations of an observational study are. Learn why it’s important to know if there was a control group or not. Learn why you should be wary of claims made about unpublished research studies. Those are evidence issues you should sink your teeth into.
Dr. Topol’s question - why is an uncontrolled, unpublished study that has not been peer-reviewed on the front page of The New York Times? - seems appropriate. You can learn by observing how other biomedical researchers react to news - and news placement - like this.
Lessons for journalists
Even though some of the comments I didn’t republish were snarky, it helps to make every effort to meet readers where they are. Many readers are weary and wary of stories about such early findings, especially the ones that are never replicated, are hammered in peer review, or that are later proven wrong.
There were important caveats in the story. That was a plus - something biomedical research stories should always include. One independent expert was quoted saying:
…the study was important but limited.
It lacked a control arm consisting of similar young adults who were not long-distance runners, he noted, and the family histories of colon cancer among the marathoners were not entirely known.
“It’s possible exercising didn’t cause the problem but was in fact the reason they became long-distance runners; because someone dear to them had cancer.”
Summary
I agree with the reader who left the comment that it will be interesting to see what gets published after peer review. I agree that this study at least raises important questions that can be the target of future research.
But I also think there’s no harm in waiting to write a news story about a study like this until it’s been published and other researchers have had a chance to see all the evidence in writing. News consumers are being flooded with a firehose of health news information every hour of every day. News organizations need to be more judicious about the stories to which they draw attention..If journalists don’t wait for scientific publication, as this case suggests, there may be harm in publishing a front-page story now and losing readers as a result. Let’s not forget the famed front-page Gina Kolata kerfuffle in the New York Times in 1998. That drew voluminous criticism from the science writing community. We’ve been down that road before with the Times and don’t need to travel it again. If you’ve never read anything about that mess, I urge you to click the link. I realize that, as someone who’s done this for 50+ years, something from 1998 feels like yesterday to me but perhaps not to you.
My career does not extend to half a century, but does span several decades. I have been a medical skeptic since internship in 1985. I also lament medical articles that can be misleading, particularly when studies are observational, uncontrolled, contain design flaws or rely upon surrogate markers which may be far removed from the targeted objective. Despite all of those caveats, I do feel that this article is newsworthy and contained sufficient qualifiers to protect readers from overzealous interpretation. A context is that we are observing more colon cancer in younger individual for unknown reasons which explains why the age for screening has been lowered to age 45. I agree that the piece appeared on prime NYT real estate, but I quite often I wonder wh an article on Page 1 merited this placement. Similarly, why was a headline worded with seemingly tendentious phrasing…. This is a very deep rabbit hole to burrow into.
An important lesson and reminder, especially these days when social media has captured the health media stream with unproven thoughts and recommendations. Thank you!