risk science center bad luck and cancer - did the media get it wrong_ - risk science center
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Estudio sobre la relevancia del factor aleatorio sobre el desarrollo del cáncer, con independencia de cualquier otra variable relevante controlable.TRANSCRIPT
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Badluckandcancerdidthemediagetitwrong?
January2,2015
AndrewMaynard
Thechancesarethat,ifyoufollownewsarticlesaboutcancer,youllhavecomeacrossheadlineslikeMostCancersCausedByBadLuck(TheDailyBeast)orTwothirdsofcancersareduetobadluck,studyfinds(CBSNews).ThestorybasedonresearchoutofJohnsHopkinsUniversityhasgrabbedwidespreadmediaattention.Butitsalsoraisedtheireofsciencecommunicatorswhothinkthattheheadlinesandstoriesare,inthewordsofacoupleofwriters,justbollocks.
Withallthecoverageofthepaper,andthesubsequentcoverageofthecoverage,Iwasinterestedinjusthowoffbasethenewsarticleswere,andtowhatextentthiswasdowntolazyreporting.
ThepaperinquestionisVariationincancerriskamongtissuescanbeexplainedbythenumberofstemcelldivisionsbyCristianTomasettiandBertVogelstein,publishedthismonthinthejournalScience.Attheheartofthepapertheauthorslookathowstemcelldivisionsindifferenttissuescorrelatewithlifetimeriskofdevelopingcancerinthosetissues.Thestudyshowsaclearcorrelationwiththecancertypesconsideredthefasterthestemcellsdivideinaparticulartissue,thegreaterthechanceofdevelopingcancerinthattissue.
Thetworesearchersthenteaseoutthedegreethattheythinkrandomgeneticmutations,asopposedtoenvironmentalandlifestylefactors,influencecancerrisk.Theyconcludethat,outof31cancertypesconsidered,22wereprimarilyassociatedwithrandomgeneticmutations(theycalledtheseRtumorstheRstandingforrandom),andninewereassociatedwithenvironmentalfactorsontopoftheserandommutations(deterministictumors,orDtumors).
Intheauthorswords,
WerefertotumorswithrelativelylowERS[extrariskscore]asRtumors(RforreplicativegreenclusterinFig.2)becausestochasticfactors,presumablyrelatedtoerrorsduringDNAreplication,moststronglyappeartoaffecttheirrisk.
Inotherwords,outofthe31cancertypesstudied,theauthorsanalysisshowedthat70%ofthemjustovertwothirdswerepredominantly
2020SCIENCEABOUTAndrewMaynardisaProfessorofEnvironmentalHealthSciencesattheUniversityofMichigan,anddirectstheUMRiskScienceCenter.Hisinterestsfocusoneffectivesciencecommunicationtheresponsibledevelopmentanduseofemergingtechnologiesmostnotablynanotechnologyandsyntheticbiologyandhowunderstandingriskcanhelpinformsmartdecisions.
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determinedbyrandommutationsandnotenvironmentalfactorswhattheauthorsterminthepaperasbadluck.
Theinferencethatmanycancersandevencancertypescannoteasilybepreventedbyreducingenvironmentalexposuresorchanginglifestyles,provedtobeamediamagnet.Headlinesresultedalongthelinesof
CancerIsMoreBadLuckThanBadBehavior,StudySays(Bloomberg)
TwoThirdsofCancerCasesAreSimplyDowntoBadLuck(Gizmodo)
Twothirdsofadultcancerslargelydowntobadluckratherthangenes(TheGuardian)
Mostcancertypesjustbadluck'(BBCNews)
Mostcancercasesduetobadluck'(DailyMail)
Andsomecommentatorswerentamused.
MichaelHeadforinstancetweeted
No, media, twothirds of #cancers are not 'due to bad luck'. Crap reporting. Again. statsguy.co.uk/aretwothirds9:50 AM 2 Jan 2015
Michael Head @michaelghead
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Inresponsetomanyoftheheadlinesandarticles,AdamJacobs(linkedtointhetweetabove)wroteonhisblogTheStatsGuy
ApaperpublishedinSciencehasbeenwidelyreportedinthemediatoday.Accordingtomediareports,suchasthisone,thepapershowedthattwothirdsofcancersaresimplyduetobadluck,andonlyonethirdareduetoenvironmental,lifestyle,orgeneticriskfactors.
Thepapershowsnosuchthing,ofcourse.
concludingwith
Weknowthatlifestyleishugelyimportantnotonlyforcancer,butformanyotherdiseasesaswell.Forthemediatoclaimthatlifestyleisntimportant,basedonamisunderstandingofwhattheresearchshows,ishighlyirresponsible.
OveratTheGuardian,themediaquestioningwastakenupbyBobOHaraandGrrlScientistundertheheadlineBadluck,badjournalismandcancerrates.Notpullingtheirpunches,theywrote:
Thebigscience/healthnewsstorythisweekisaboutcancerrates,withnewsoutletssplashingheadlineslikeTwothirdsofadultcancerslargelydowntobadluckratherthangenes(forexample,here)orMostcancertypesjustbadluck(here).(Imnoteven
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How likely are you to die if you get measles? Two analyses that challenge accepted wisdom: riskscience.umich.edu/riskdyingcat riskscience.umich.edu/measlesmortal
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goingtolooktoseewhattheDailyMailhastosayaboutthis.)Buttheseheadlines,andthestories,arejustbollocks.Thework,whichisveryinteresting,showednosuchthing.
Atthispointmycuriositywaspiqued(eggedonmysciencebloggerslikeEdYongwhosimilarlyquestionedthemediacoverage).Wasthisjustaparticularlyegregiouscaseofwidespreadlazyjournalism,ordidthestorieshaveacommonroot?
Readingtheoriginalpaper,theauthorswereclearlybuildingacaseforthemajorityofthecancerstheystudiedhavingpredominantlyrandomorigins.Thisisparticularlyclearinfigure2inthepaper(seebelow)wheretheyclustercancersintorandomversusdeterministictypes.Butthelanguageisstillsomewhatcautiousinthepaper.
Figure2fromTomasettiandVogelstein(2015).Cancertypesareclusteredbythosewherestochastic(replicative)factorsdominate(green),versusthosewhereenvironmentaland
inheritedfactorsaresubstantial(blue).ERStheadjustedriskscoreistheproductofthelifetimeriskandthetotalnumberof
stemcelldivisions(log10values).Fromthepaper:TheadjustedERS(aERS)isindicatednexttothenameofeach
cancertype.Rtumors(green)havenegativeaERSandappeartobemainlyduetostochasticeffectsassociatedwithDNA
replicationofthetissuesstemcells,whereasDtumors(blue)havepositiveaERS.Importantly,althoughtheaERSwas
calculatedwithoutanyknowledgeoftheinfluenceofenvironmentalorinheritedfactors,tumorswithhighaERS
provedtobepreciselythoseknowntobeassociatedwiththesefactors.
TheassociatedpressreleasefromJohnsHopkinsUniversityismoredirect.UndertheheadlineBadLuckofRandomMutationsPlaysPredominantRoleinCancer,StudyShows,thepressreleasestates
By[theauthors]measure,twothirdsofadultcancerincidenceacrosstissuescanbeexplainedprimarilybybadluck,
Atthispoint,thepressreleaseisreferringtotherolethatrandomeventsplayindeterminingwhetheracancerwilldevelop.Asthereleaseclarifies,
Usingstatisticaltheory,thepaircalculatedhowmuchofthevariationincancerriskcanbeexplainedbythenumberofstemcelldivisions,whichis0.804squared,or,inpercentageform,approximately65percent.
Inotherwords,theyconcludethatrandomgeneticmutationbadluckasstemcellsdivideisanimportantfactorunderlyingthenumbersof
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cancercasesobservedandasaresultthelifetimeriskofdevelopingcancer.
Thereleasegoesontonote:
Finally,theresearchduoclassifiedthetypesofcancerstheystudiedintotwogroups.Theystatisticallycalculatedwhichcancertypeshadanincidencepredictedbythenumberofstemcelldivisionsandwhichhadhigherincidence.Theyfoundthat22cancertypescouldbelargelyexplainedbythebadluckfactorofrandomDNAmutationsduringcelldivision.Theotherninecancertypeshadincidenceshigherthanpredictedbybadluckandwerepresumablyduetoacombinationofbadluckplusenvironmentalorinheritedfactors.
Thisdirectlymirrorsthefindingspresentedinthepaperthatofthecancersstudied,70%werelargelyexplainablebyrandommutationsduringcelldivision.
Comparingthistotheheadlinesabove,themediaarticles,releaseandpaperalignsurprisinglywell.Badluckistheauthorsphrase,andtheydoemphasizethedominanceofrandomgeneticeventsinthemajorityofcancers,andcancercases.
Inthisrespect,itshardtobetootoughononthemediacoveragesure,someofthestatsmayhavegotalittletwisted,butthedominantmessageseemstohaveitsrootsinthepaperandtheinstitutional(andauthorsanctioned)pressrelease.
Soisthereaproblemhere,orhavethemediaactuallydonegood,contrarytoperceptionsfromsomequarters?
Frommyreadingofthepaper,thepressreleaseandthemediacoverage,thisisntasstraightforwardasitmightseem.Certainly,itseemsthatmanyreportersmadeanhonestefforttofaithfullyrepresentwhattheauthorsweresaying.Andyet,sciencereportingismorethanjustreportingthefactsitsalsocontextualizingthosefactsinawaythatisusefultoreadersandsocietymoregenerally.
GoingbacktoAdamJacobspiece,itsworthrepeatinghisconclusion:
Weknowthatlifestyleishugelyimportantnotonlyforcancer,butformanyotherdiseasesaswell.Forthemediatoclaimthatlifestyleisntimportant,basedonamisunderstandingofwhattheresearchshows,ishighlyirresponsible.
Ifyoutakethestanceashedoesthatenvironmentalandlifestylefactorsarecriticaltodetermininggoodandbadhealth(andasapublichealthprofessor,itsastanceIamprofessionallyexpectedtotake),newsarticlesthatimplywedontneedtoworrysomuchaboutthepollutionweemit,thechemicalsweexposepeopletoorthewayweliveourlives,canbeseenashighlyirresponsibleunlessbackedupbyrocksolidevidence.Theyopenthedoortoanabdicationofresponsibilitywhenitcomestoenvironmentalhealth.Whyspendafortuneonpreventingenvironmentalemissionswhentheydontmatter?Whyundergocripplinglyexpensiveproductsafetytestingifingredientsdontreallycausecancer?Whysupportinconvenientregulatoryagenciesifalltheydoiscripplecommercewithoutpreventingcancerandotherdiseases?
Thisisavalidfear,backedupbyalonghistoryofenvironmentalhealthdisasters.Anditsafearthatrequiresresearchersandresearchinstitutionstotakeatleastsomeresponsibilityforhowtheypitchand
Whatistheriskofdyingifyoucatchmeasles?February3,2015
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promotetheirwork.
Inthecaseofthispaper,itshardtoseeclearevidenceofbadreporting.Thereisalackofbalanceandcontextualizationthoughthat,itseems,hasitsrootsintheoriginalpaper.
Thisisnotacriticismofthepaper.Butitsveryeasyforthesignificanceofresearchthatbeginstochallengethestatusquotobeinappropriatelyamplifiedinthemedia.AsInotedinarecentarticleinNaturenanotechnology,
whensurprisingnewinsightsemergeonpossiblematerialhealthrisks,wheredoestheresponsibilitylieforensuringthatnewresearchisconductedonmaterialsafety,withoutthisresearchinfluencingconsumersandregulatorsbeforethereisplausiblejustificationforaction?Ortoputitmoresuccinctly,howcanweencourageexploratoryriskresearchwithoutitprematurelyimpactingconsumerandregulatorydecisions?
Thisreferstoresearchonengineerednanomaterials,butthepointisjustasrelevanthere:itsextremelyeasyforexploratoryresearchtotakeontheauraofauthoritative,actionableknowledgethroughthelensofthemedia.
Sowheredoesresponsibilitytotempersuchamplificationlie?Clearlythereneedstoberesponsiblereportingateverypointinthecommunicationchain.Butbytheverynatureofamplification,careisneededatthesourceofastorytohelpensurethatthefinalreportingisbothaccurateandresponsible(anissueIlookatmorecloselyhere)
Inthiscase,itwasperhapsinevitablethatresearchindicatingenvironmentalfactorsmaynotbeasimportantaspreviouslythoughtincausingcancerwouldleadtojustbadluckheadlines.Butthoseheadlinesdrawexplicitlyonthelanguageusedinthepaperandthepressrelease.
Wouldthemediacoveragehavebeendifferentiftheworkwaspitcheddifferently?ItshardtotellbutinthisinstanceIdcertainlybehesitanttoputalltheblameonbadjournalism.
Paper:Variationincancerriskamongtissuescanbeexplainedbythenumberofstemcelldivisions(2015)CristianTomasettiandBertVogelstein.Science,Vol.347no.6217pp.7881DOI:10.1126/science.126082
UpdatedJanuary4toincludeFigure2fromTomasettiandVogelstein(2015)
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38comments Taggedwith:badluck,Cancer,Environment,Media,reporting in2020Science,Chemicals,EnvironmentalHealth
Timberati /January2,2015at7:19pm
Thanks,Andrew.ThereportIsawintheDailybeastthismorningsaidtheauthorshadalargecaveatforsmokinganditslinktolungcancer.
So,recognizingthisissomethingofaoneoff,theauthorsseemtosaythatwhileenvironmentalfactorshaveanaffect,thesemaybeonlyonethirdoftherisk?
AndrewMaynard /January2,2015at8:25pm
Yestheyclearlysaythatinsomecasesenvironmentalfactorsareimportantthesearethecancerswheretheirbadluckpredictionsdonthold.
DavidColquhoun /January3,2015at5:31am
Ifearthattheinternetattackdogswentforthewrongvictiminthiscase.Thepaperaddsweighttosimilarestimatesforthecontributionofchancethathavebeenaroundforyears,butwhichtheauthorsofalltheattacksseemtobeunaware.PleasereadGeorgeDaveySmithsexcellentJohnSnowlectureforagoodsummary.
Imbaffledbytheindignationengenderedbysuggestionthatchanceplaysabigpartinyourfate.Lifeisstochastic,toquitealargeextent.Ontwitter,AliceRobertsmadeaninterestinganalogy.
ProfAliceRoberts@DrAliceRoberts@david_colquhounImstruckbysimilarityinresistancetoacceptingroleofchanceinourindividuallives&healthandinevolution
Itsoddthatthesceptics,inthiscase,arebehavingabitlikecreationists,orthosewhobelievethatitsyourownfaultifyougetill.
AndrewMaynard /January3,2015at5:56am
ThanksforthecommentsDavidamincludingthelinktoGeorgeDaveySmithspaper:http://www.dcscience.net/DaveySmith2011.pdf
Beyondquestionsofblamehere,therearetwodeeplyrootednarrativesthathavebeentouchedinthisdialogue:
1.Badcompanies,badpeopleandbadactionscausecancerand2.Themediacynicallysensationalizeandmisreportscience
Isuspectthat,becauseofthis,thecoveragehasraisedirebecauseitseemstochallenge#1andseemstosupport#2.Andwhatwegetasaresultisadiscussionaboutdogmas,notdata.
Comments(38)
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DavidColquhoun /January3,2015at6:14am
Themediacynicallysensationalizeandmisreportscience
WhilenottryingtoexoneratetheDailyMailfrommisreportingscience,Ifearthatthetruthisworsethanthat.Inmanycases,itisthepressreleasefromthejournal,orfromtheuniversityPRdepartmentthatsensationalisesthescience(andsincetheauthorswillnormallyapprovethesereleases,theymustacceptsomeoftheblame).Ihavegivenseveralexamplese.g.athttp://www.dcscience.net/2014/11/02/twomorecasesofhypeinglamourjournalsmagnetscocoaandmemory/
Inthisparticularcase,though,Imontheotherside.IwasastonishedwhenAdamJacobsmadetheassertionWeknowthatlifestyleishugelyimportantnotonlyforcancerbecausethatispreciselywhatwedontknow(andIwaspleasedtogetthesupportoftheoncologistandskeptic,DavidGorski,onthat).Inordertojustifythisclaim,hechoseoneofthepapersthatIdpreviouslysingledoutasbeingoneofthemostghastlyhypeddietpapersIdencountered.Seethediscussionathttp://www.statsguy.co.uk/aretwothirdsofcancersreallyduetobadluck/
michaelkenward /January3,2015at11:43am
ThankyouDavidColquhounforcommentingfromthesanersideofthisfeedingfrenzy.
ThefirstattackonthemediathatIsawcamefromsomeonewhodidnotevenbothertotelltheirreadersthatmuchofthehypeandoverstatementtheycomplainedofinthemediacoverageofthispaperwasinthepressreleasethatheraldedthepublicationinthejournalScience,itselfapowerfulPRmachine.Asyousaid,itishighlyunlikelythatthispressreleasegotoutwithoutresearcherclearance.
EventheabstractinSciencecontainedsomeofthecrimesagainsthumanitythatsoupsettherabidhordes.No,theevilscribblersdidnotsuddenlyconjureupthebadluckbit.
Itisinterestingthatmanyofthescientificexpertswhoweighedinfailedtodowhattheydemandofjournalists,digabitdeeperandfindtheevidencetosupportyourstory.IwonderhowmanyofthecriticsdidwhatIdidwhenafirstsawtheircomplaints,whichwastorushofftothesourceofthestorytoseewhatithadsaid.Thatimmediatelytoldmethatmanyflawsinthereportingowedmoretothesourcesthantothejournalists.
Butwhybothertodiluteyourbilewithfactswhenitismuchmoreconvenienttohammerawaywiththesametiredoldmediadoesntgetscienceline?Whynotbehavejustliketherightlyloathedand,assomeoneelsehassaid,possiblycarcinogenic,DailyMail,andwritesomethingthatfitsyourownagendaratherthanthefacts?
Icantbebotheredtoploughthroughallthetoshoutthereonthisone,soIhavenotfoundoutifthereareanycommentsaboutthepeerreviewofthepaper,inparticular,ofthestatisticalanalysis.GivendodgystatisticsisuptherewithplagiarismandcookedupdatawhenitcomestoretractedpapersIjustmadeupthatstatisticitisabitrichtocriticisejournalists,assomeofthecommentshave,fornotbeingexpertsinstatistics.
Therearemanystoriesouttherewherejournalistsdogetthingswrong.Byconstantly
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gunningforstoriesthatowemuchtothetenoroftheoriginalmaterial,thetwitterlooniesfallintothecryingwolfcamp.
Now,hadtheycriticisedthemediaforchurnalism,parrotinggarbagefedtothembyaPRmachine,Imighthavejoinedinthefunandgames.
Timberati /January3,2015at10:24am
Iwontbeabletosaythisquiteright,statistically,butthisrandomnessisthen(partof)thereasonwhycancersshowuplaterinlife.Yes?Morethrowsofthedice,sotospeak.
AndrewMaynard /January3,2015at10:26am
Thiswouldmakesenseiftheprobabilityofgeneticmutationscorrelateswithcelldivisionsthemoredivisioncycles,thegreaterthecumulativechanceofaharmfulmutationoccurring
KatherineK.Moore /January3,2015at2:47pm
whatIfindinterestingishowpeoplerespondtocancernews,asthoughthatistheONLYbadnewsthatoccursinhealthcare?Manypeople,includingmanymanyhealthcareprovidersconsidercancertojustbetheworst,butreallymostchronicdegenerativediseasesareprettyawfulandmostofthemappeartobeduetorandomluckaswellIsupposeitcomesdowntowewillalldieofsomething.
KatherineK.Moore /January3,2015at2:48pm
butnoonewantstobelievethat.
BradleyJ.Fikes /January3,2015at3:59pm
HiAndrew,
Imoneofthereporterswhowroteaboutthestory.Thankyouforanevenhandedlookatthestudy,thepressrelease,andmediareports.OneobservationIdaddisthattheimpendingNewYearsholidayprobablymadeithardtogetindependentevaluations.(Itcertainlydidinmycase,althoughIeventuallysucceeded).
AdamJacobsmadeamisleadingstatementabouttherandommutationriskhypothesisaspresentedinthestudy:
Theproblemisthatitappliesonlytoexplainingthevariationincancerriskfromonetissuetoanother.Ittellsusnothingabouthowmuchoftheriskwithinagiventissueisduetomodifiablefactors.Youcouldpotentiallyseeexactlythesameresultswhethereachspecifictypeofcancerstruckcompletelyatrandomorwhethereachspecifictypewerehugelyinfluencedbyenvironmentalriskfactors.
Buttheauthorsaddressedthispoint,throughtheERSmethodyouquotedabove.MaybetheERSmethodisflawed,butJacobsblogpostdoesntevenacknowledgeitsexistence,
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letaloneattempttorefuteit.
Themediareportsusuallystressedthatevenaonethirdriskfromenvironmentalfactorsisstillsignificant.SoJacobsclosingline:Forthemediatoclaimthatlifestyleisntimportant,basedonamisunderstandingofwhattheresearchshows,ishighlyirresponsible,issimplyfalse.EvenJacobslinktotheIndependentarticleonthestudybeliesthatstatement.
Best,
Bradley
DavidColquhoun /January3,2015at7:27pm
Thankstoyou,andtoMichaelKenwardfordefusingsomeofthehysteria.Ihaventseenyourreport,butitsoundsfromyourcommentthatyouvedelveddeeperthanmanyofthecritics.
Imquitebaffledaboutwhythereshouldbesuchastrongreactionagainsttheideathatchanceplaysasubstantialroleinyourfate.That,afterall,ishowevolutionworks.AndtheideawasformulatedquiteclearlybynoneotherthanRichardPetoin1977.
BradleyJ.Fikes /January3,2015at8:10pm
Ithinkthereactionstemsfromafearthatthepublicwillbehaveirresponsiblyiftoldchanceplaysapredominantroleincancer.Whilethatmayormaynotbetrue,itsaseparateissuethanthestudysscientificvalidity.Justbecauseascientistpersonallydislikeshowastudymaybeinterpretedisnotanargumentagainstitsaccuracy.
ThestudyitselfincludesstatementslikeThus,thestochasticeffectsofDNAreplicationappeartobethemajorcontributortocancerinhumans.Thatdoesntsay2/3ofallcancerscomefromrandommutation,ofcourse.Idliketoseethatquestionspecificallytackled,usingthestudydata,togettheproportionmorepreciselyquantified.Whilethepressreleasedidgivethe2/3numberasapplyingtoallcancers,Irecognizethatsnoexcuse.
PZMyersgaveathoughtfullookathowthestudycanbeusedtoimprovecancerpreventionandcare:j.mp/pzmyerscancer
AndrewMaynard /January4,2015at3:35pm
ThanksBradleyfrommyexperienceitshardtogettimelyacademicinput/commentatthebestoftimescantimaginetheadditionalchallengesoftryingoveraholidayperiod!
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MichaelKenward /January4,2015at8:17pm
Indeed.Notrelatedtothisparticularsaga,Ihaveknownresearcherstoputoutapressreleaseandthentodisappearforalongvacationwithoutleavingcontactdetails.Dothatandyouhavenogroundstocomplainaboutsloppycoverage.
InoticedthatoneofthemorethoroughjournalisticarticlesonthepaperappearedinScienceitself.Iassumethatthewriterhadearlieraccesstothepaperthanlessermortals.
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Jy /January3,2015at10:01pm
Makesmewonderiftheyeverevaluatedstochasticratesofcellmutationastheresponsevariableandtheenvironmentalvariablesasthecovariatesintheirregression.Inotherwords,whatpercentofthislabelledbadluckisexplainedbyenvironmentalvariables?Aretheseseeminglyrandommutationsperhapsdependent,toahighextent,onenvironmentalvariables?
LDP /January5,2015at1:26am
Iwaswonderingmuchthesamething.Dotheydeterminerandomnessvsenvironmentalfactorsthroughcellularisolationfromexposurestoexternalradicalsandsoon?Howdoesthiswork?
DavidColquhoun /January4,2015at5:14am
@BradleyJ.FikesThanksverymuchfordrawingmyattentiontoPZMyersblogonthistopic.http://freethoughtblogs.com/pharyngula/2015/01/03/cancerbadgenesorbadluck/
ItsthebestpieceIvereadonthetopic.
VanyaLoroch /January4,2015at7:08am
IsntoneoftheunderlyingproblemsintheinterpretationoftheresultsofVogelsteinandTomasettisworktheverydefinitionofcancer?Foramedicaldoctor,cancermeansmetastaticdisease(oratleastdiseasethathasahighprobabilityofbecomingmetastatic).Thisisaclinical,reductionistdefinition.Buttoaddressthequestionoftheoriginsofcancer,oneneedstobroadenthisdefinitiontobiology.Andthisisacompletelydifferentstory,muchmorefuzzy,muchmorecomplexandusuallyaverylongone.Just
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thinkaboutinsitutumors,alltheundiagnosedcancers,spontaneousremissions,etc.
VogelsteinandTomasettionlylookedatclinicallydiagnosedneoplasms,thevisibletipoftheplasmsiceberg.Butthecausesofcancerareburiedinthehugeinvisiblepart.Andthereisonethingweknowforsurenow:thepredominantprotectiveroleplayedbytheimmunesystem(thespectacularresultsobtainedbynontargetedimmunotherapiesillustratethiswell).Wealsoknowthatthestateoftheimmunesystemdependsstronglyonenvironmentalandbehavioralfactors.
Ifso,isntthestatusoftheimmunesystemTHEMAJORlinkbetweenenvironmentandbehaviorandtheriskofcancer?
VogelsteinandTomasettisworkdidnotlookatanyofthis.ThisisOK,Iguessbecausethescopeofthepaperisquitelimited.Butthemessagerelayedbythemediaiswronganddangeroussinceitdevaluespreventionandhealthpromotion.
Itslikesayingthatthemoretimesanairplanetakesoffandlands,thehighertheriskofcrashing.Andtoremainaliveweneedtofly,Ofcourseitstrue.Butitsaverypartialview,becausewhatpreventsairplanecrashesareALSOalltheothersmalleraccidentsthatbuilduptoairdisasters.VogelsteinandTomasettisworkonlylookedatcrashstatistics.
Thanksforreadingmylongcomment.
JG /January6,2015at2:34am
Oneshallnotignoreabouttheinfluenceofgrantsprovidersandlackofdatavalidationwithinthecashstrappedresearchcommunities.WeshouldnotblamethemediafordoingwhatauniversitylikeJ.H.shouldnothavedone,i.e.,throwawaytheprinciplesoffurtherscientificdiscussionforthesakeofPR.Asithashappenedinmanycasesinthepast,thesamePRmaycomebacktothemaseggsonthefaceoftheirreputation.
Cancerhasmanyfaces,andevenastoday,noonecansaysimplybecauseithappensincertainpartsofbodythatisnecessarythesamethingfurtherawayfromevenbeingatype.
Aretheauthorssurethestatistical/mathematicalmodelstheyhaveusedisthefinalverdictwithinthescientificcommunitiesbothaliveandinthefuture[ifyes,whytheykeepprintingnewtextswithnoendtothem?]Or,arethecellbiologistsjobisdonebysimplifyingallkindsofcelldivisionsunderasinglebiologicalsystem?
Onethingatruescientistmustknowisinanyanalysis,thenullhypothesisprovidesnoguarantythatherorhisresultsareright!Andthatisevenifthevalidityofdataarekosher.
Andbytheway,lifeitselfisarandomphenomenawithinarandommedium,influencedbyrandomambientthatisconstantlyinfusedbyrandomenvironmentalfactorscomingfromrandomdirections.Itistheheightofstupiditytotryexplainrandombyadefinitenumber.
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FrankSchauder /January7,2015at2:56pm
Thakyouforthecommentsonthepaperandtheresultingmediaheadlines.Butevenif2/3oftheexamined31cancertypesseemtodependonrandom(genetic)effectsastatementsuchasTwoThirdsofCancerCasesAreSimplyDowntoBadLuckissimplywrongandclearlymisleading.Theincidenceofeachcancerhastobeetakeninconsideration(breast,colon,prostatecancerisbefarmorefrequentthanduodenumcancer).
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Steve /January11,2015at6:01pm
Whatdotheauthorssayabouttheroleoftheimmunesystemininfluencingwhetheracancerousmutation,onceithasoccurred,developsintoalifethreateningtumor?Afterall,oneofthefunctionsoftheimmunesystemistodestroycancerouscellsbeforetheygrowintolargetumors.Andmuchresearchhasshownthatenvironment,lifestyle,andgeneticshaveabigeffectontheefficacyoftheimmunesystem.Sowhileitmightbethecasethatmanycancercellsarecreatedbychance,surelyhealthbehaviors,theenvironment,andgeneticsstillhaveanimportantrole,mediatedthroughtheimmunesystem,indetermininghowdeadlythosecancersbecome.Ifthatsright,thentheheadline2/3ofcancersarerandomshouldnotbeinterpretedas2/3oflifethreateningcancersarerandom.Rathertheheadlineshouldbe2/3ofcancerousmutationsdevelopbychance.
Paulcatherall /January12,2015at6:33pm
WellsaidSteve,with60trillioncellstherearealwayscellsnotformingcorrectly.Theprogressionfromatransformedcelltoafullblowntumourcellisnotinstant.Ageneticpredispositiontoacancercanbeviewedasjuststartingfurtheralongthelineoftransformation.Theimmunesystemincludestransformedcellsselfdestructingorbeingdestroyedbyneighbouringcells.Thissignallingisimportanttounderstandandisinfluencedbyenvironmentalfactors.OneimportantexampleistheoldesthormonesystemofthebodycalledEicosanoids,whichisthesignallinggatewaytotheimmunesystem.HarvardmedicalschoolquoteEicosanoidsmayrepresentamissinglinkbetweeninflammationandcancerandthuscouldserveastherapeutictarget(s)forinhibitingtumorgrowth.OneformofEicosanoidiscalledResolvinsandthesecanonlybemadefrom20carbon(longchain)omega3andtheseendtheinflammatorycycle.Thismechanismisadverselyimpactedbyexcessiveomega6,transfats,andhighinsulinlevelswhichcanbecontrolled.
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DavidHammond /January14,2015at3:52pm
Idontgethowtheauthoristryingtosaythatthepressmisrepresentedtheauthors?TheyCLEARLYstatedthatbadluckisalargefactor.Sohowisreportingthisbacksuchacrime?Itswhattheysaidthemselves!
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Furthermore,whattheauthorofthisarticlemissesisthattheconclusionofthisstudyisacompletejoke.Itispurescientificlazinesstosaythattwothirdsofcancerarecausedbybadluck.WhydontwetackonthewrathofGodwhilewereatit?Basically,thescientistshavehitawallwheretheycannolongerexplainsomething.Yetunlikeeverylegitimatescientistinhistorywheretheysimplyadmittheydontknowandthencontinueresearchingthesepeopleinsteadsaythattheydohavetheansweranditsduetobadluck.Sowhatexactlyisthescientificdefinitionofbadluck?AndhowonEarthisbadlucknowconsideredtobealegitimate,measurablescientificinfluence?Didtheyeverconsiderthatperhapsemotionalwellbeingmayprovidekeylinks?Thisissobeyondabsurdyouhonestlycouldntmakeitup.Wakeuppeople.Yourebeingduped.
DavidColquhoun /January14,2015at6:37pm
Imafraidthatyouhavenocomprehensionatallofrandomprocesses(inthiscaserandomerrorsinDNAreplication).Atthelevelofsinglemolecules,everythingisrandom.Ithinkperhapsyoushouldreadupaboutstochasticprocessesbeforegettingsoindignant.
DavidHammond /January15,2015at1:32pm
Nothingisrandominthisuniverse.Everythingisbasedoncauseandeffect,whetherwehappentounderstandityetornot.Electrons,forexample,actasparticleswhenobservedwithacamera.However,whennoequipmentobservestheelectrons,theyactaswavesandparticlessimultaneously.Soevensimpleobservationchangesthings.Butwhowouldknowthisifithadntbeendeterminedthroughscience?Ifithadntbeen,someonewouldcomealongandcallitrandomluck,simplybecausetheydontknow.Itisonethingtosaythatyoudontunderstandacausetoaneffect,andquiteanothertosaythatyoudoknow,andthatisbecauseofluck.Imsorry,butthatsjustabsurd.ThatisNOTscience.Factoringinluck,somethingthathasnoscientificdefinitionwhatsoever,isabsolutelyirresponsibleatbest,andfraudulentatworst.Everythingisbasedoncauseandeffect,whetherwehappentounderstandityetornot.
DavidColquhoun /January15,2015at6:13pm
Notagoodexample.Everyindividualelectronmovesrandomly.IsuggestsomereadingaboutBrownianmotion,oraboutstatisticalmechanics.Thingslooksmoothonlywhenaveragedoverlargenumbersofparticles.
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mars /January17,2015at3:53am
David,Itdependswhatmeaningisgiventorandom.Ifyoumean,notpredictable,thensure,manyphysicalprocessesaredeeplyrandom.Butthatkindofrandomnessisanepistemicmatter,ratherthananontologicalone.Inthatsenserandomnessisacontingentfactaboutourknowledge(and,beyondthat,ourcognitivelimitations),ratherthanafactaboutnatureingeneral.Butifbyrandomyoumeannotcaused,thenIthinkthediscussionmovesontoamorephilosophicalterrainGoddoesntplaydice,thatkindofthinginwhichwewouldhavetogetsomeaccountofwhatwemeanbycausation.IsuspecttheconceptofrandomnessthatMr.Hammondisobjectingtoistheontologicaloneratherthantheepistemicone.ButIalsosuspectthatwhattheauthorsmeanbyrandomisnotnotcausedbutnotpredictableinawaythatcouldleadtomeaningfulintervention.Mars
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