Connecting the Dots
Harry Truman famously said there are lies, damn lies, and statistics. He was talking about politics, but the same could be said about medical research. There's no doubt that data can be - and often is - manipulated to support a certain position.
But there are also cases where the data are so overwhelming, so clear-cut, that's its hard to ignore. And that certainly seems to be the case with the recently released data on breast cancer rates
If you didn't see the news, here's the deal: in December, scientists at the San Antonio Breast Cancer Symposium presented the results of their retrospective analysis of breast cancer trends across the country. Their data showed that in the 1990s, rates climbed about 1.7 percent each year. After 1998, rates started to fall - about a one percent drop each year.
Then in 2003, the data did something unprecedented. Breast cancer incidence rates plunged seven percent overall - with declines as high as 12 percent in certain data sub-sets.
What could lead to such an amazing drop in one year?
Cast your memory back to 2002. That was the year that millions of women across the country stopped taking hormone replacement therapy, after preliminary data from the Women's Health Initiative study showed that women taking HRT were more likely to develop breast cancer. If you remember, the results were so compelling that the National Institutes of Health pulled the plug on the study five years early.
Since then the approach to HRT has changed dramatically. HRT used to be pushed on just about every women of a certain age, and women stayed on it for many years. Now, physicians generally only recommend it to women with severe side effects of menopause, and even then for only a few years at a time.
Now, four years later, we see the results of that change. Overall, rates of all types of breast cancer fell seven percent between 2002 and 2003. For women between the ages of 50 and 69 with estrogen receptor positive breast cancer (the type fueled by estrogen), the rates were even more dramatic - falling a full 12 percent in one year. Coincidence?
I was never a fan of HRT to begin with. What was always especially galling to my own way of thinking is that the Premarin and Prempro are estrogen and estrogen/progesterone formulations derived from the urine of penned-up pregnant mares. You don't have to be a militant animal rights activist to be disturbed by that fact. Moreover, these particular formulations, touted endlessly by drug giant Wyeth Pharmaceuticals over the years, are in fact a relatively ill-defined chemical soup they had the nerve to characterize as "natural" (because they're from animals, get it?). In reality, they include forms of estrogen shown probably to be cancer forming in breast tissue. Go figure.
Despite all this overwhelming evidence, health authorities still won't conclusively say that there is a link between breast cancer diagnoses and HRT use. And unfortunately, women can't go back and erase the years they took the drugs.
But this finding can serve as a cautionary tale for other drugs. Even the best studies don't catch everything. And even long term studies aren't long enough to track the effects of a decade or more of use. Think twice before you begin taking any drug, especially one that you'll need to take long term. You need to cut through the lies and damn lies to keep yourself from becoming a statistic.
