Respectful Insolence

Remember Sharyl Attkisson?

She’s the CBS reporter who can really bring home the crazy when it comes to vaccines and autism, laying down some serious crankery (complete with many logical fallacies) and hit pieces on Dr. Paul Offit. Indeed, at times she gives Mike Adams a run for his money when it comes to laying down the pseudoscience and crankery. Worse, she appears to be in bed with at least one of the bloggers at the antivaccine propaganda blog Age of Autism for the purpose of bringing antivaccination lunacy to the masses by assisting them in smearing Voices for Vaccines. Indeed, aside from Steve Wilson, I can’t recall a reporter for a mainstream news outlet who regularly sides with the anti-vaccine movement and helps them promote their propaganda, and the bad thing is that she’s national.

I have to be honest. I didn’t know if this was just a single blind spot on Attkisson’s part. There are many people who appear perfectly reasonable–and, in fact, are perfectly reasonable in most areas–but have a major blind spot in just one area. On the other hand, the principle of crank magnetism observes that people who are prone to one area of pseudoscience and crankery are very often attracted to other areas of pseudoscience and crankery. The reason is that they have no mental filter. The same defects in their reasoning and critical thinking abilities that lead them to fall for one form of woo leave them open to many forms of woo. So, is Attkisson prone to crank magnetism?

You betcha.

She’s back repeating bad science that purports to have found that aluminum containing antiperspirants cause cancer. It’s a bad, bad, bad report. In fact, it’s as bad as anything Attkisson’s ever written about vaccines. (Well, almost as bad.) Get a load of this:

An interesting follow-up to our investigative report from April 20, 2006 examining research on a possible link between antiperspirants and breast cancer.

A scientist we interviewed for our original report, Dr. Kris McGrath of Northwestern University Feinberg School of Medicine, recently published a new article in the Journal of Medical Hypotheses.

Here’s a hint. Although Medical Hypotheses is not quite as bad as the Journal of American Physicians and Surgeons, it’s still pretty bad. Medical Hypotheses is, in essence, a vanity journal that is not peer reviewed. Indeed, the editor of Medical Hypotheses himself showed up in the comments and described his journal as “editorially reviewed,” which to my mind was an admission that it’s not peer-reviewed.

Worse, at least for purposes of being cited as “evidence” for anything, it publishes speculation. Now don’t get me wrong. There’s nothing inherently wrong with publishing interesting speculation about scientific hypotheses. The problem is that most lay people (and even some doctors and scientists) don’t realize that Medical Hypotheses exists to publish articles speculating about controversial hypotheses. Unfortunately, cranks take full advantage of this, letting lay people labor under the misconception that Medical Hypotheses is a peer-reviewed journal that publishes original research. It’s not and was never intended to be. Worse, in the name of “speculation” and “controversial hypotheses,” Medical Hypotheses has become a go-to repository for some of the worst anti-vaccine crankery that I’ve ever seen, including the infamous article by Mark and David Geier in which they first proposed their Lupron quackery for autism. This article is still listed on anti-vaccine websites as though it were scientific evidence supporting the contention that vaccines cause autism and that treating autistic children with, in essence, chemical castration is a promising strategy to treat autism.

Suffice it to say, I would not trumpet a Medical Hypotheses paper as anything more than more than someone pulling it of their nether regions. But let’s see the background that brought about this speculation:

When we first reported on his work, Dr. McGrath had published peer-reviewed research in which he investigated a group of women with breast cancer. He found that the sooner they began using antiperspirants in their youth, the more frequently they used them, and the more frequently they shaved under their arms; the earlier they were diagnosed with breast cancer. The possible culprit, said Dr. McGrath, is the metal aluminum: the ingredient in antiperspirants that stops sweating.

The study was considered compelling, but by design was not conclusive. In his latest article, Dr. McGrath discusses hormonal similarities in breast cancer and prostate cancer.

I know that study. It was published in the European Journal of Prevention. It had an enormous flaw in it, a flaw so obvious that I’m surprised this article got published. There was no control group. It’s a single-arm study that only looked at women who got breast cancer and didn’t control for a variety of confounders. It didn’t look at women who didn’t get cancer. Worse, a study that did look at women both with and wtihout cancer (and twice as many of each) had been published the year before that found no correlation between the risk of breast cancer and the use of antiperspirants.

McGrath summarized his paper in his interview with Attkisson thusly:

“Breast and prostate cancer share similarities and likely represent homologous cancers in females and males, respectively. The role of hormones such as testosterone and estrogen in carcinogenesis is well established. Despite worldwide research efforts, the pathogenesis of these diseases is largely not well understood. Personal care products containing estrogens or xenoestrogens have raised concern as a breast cancer risk, especially in young African-American women. In the United States (US) there is a parallel rise in the incidence in breast and prostate cancer compared to selected non-hormone dependent tumors. Observed US and global breast and prostate cancer incidence increases were occurring before exogenous hormone replacement and xenoestrogen exposure were commonplace. An unintentional,inadvertent, and long term hormone exposure may occur from transdermal absorption of sex hormones
and pheromones (androgens) from axillary apocrine sweat gland obstruction by aluminum-based antiperspirants.The global rise in antiperspirant use parallels rises in breast and prostate cancer incidence and mortality rates. A multi-disciplinary literature based set of evidence is presented on how such a link is possible, to prompt confirmatory investigations in the pursuit of unmet needs in breast and prostate cancer etiology and prevention.”

In other words, according to McGrath, underarm antiperspirants clog the pores of apocrine sweat glands and cause the absorption of sex steroids into the blood. It’s a pretty implausible hypothesis at best. The reason is that the amount of sex hormones made by the skin is dwarfed by what is made by the ovaries in women and the testicles in men. Indeed, one of the main enzymes responsible for the production of estrogen in the peripheral tissues is aromatase. In the treatment of breast cancer, aromatase inhibitors don’t work in premenopausal women. The reason is that the ovaries of premonopausal women are still cranking out estrogens, which far outweigh the amount of estrogen produced in peripheral tissues. That’s why aromatase inhibitors are only used in postmenopausal women, where the ovaries have in essence shut down, leaving the aromatase in peripheral tissues as the only source of estrogen, which aromatase inhibitors shut down quite nicely. From a biological standpoint, it’s highly implausible that blocking the apocrine sweat glands can lead to a backup of sex hormones and their absorption into the body at concentrations sufficiently high compared to the normal levels made by the ovaries in women and the testicles in men.

Of course, “implausible” doesn’t mean “impossible,” and McGrath’s concept, although quite implausible biologically, is not as implausible as, say, homeopathy or reiki. However, because of its implausibility, it would take some pretty compelling evidence to make us as scientists reconsider our understanding of the biology. So does McGrath have compelling evidence or even highly suggestive evidence? Let this graph from the his Medical Hypotheses paper speak for itself:

i-ecef83e5b8dd0fe7a6cbe11cf8f623ec-figure1.jpeg

This is a plot of antiperspirant sales in the U.S. versus the incidence of selected cancers, including prostate, breast, and a couple of others. Doe this remind you of anything? Oh, this, maybe? It’s a beautiful example of the fallacy of confusing correlation with causation. It’s also amazingly sloppy in that the incidences of breast and prostate cancer were clearly increasing for at least two decades before the sales of antiperpirant started to take off. I also wonder if there was any attempt to control for age of menarche and number of live births per woman. Early age at menarch, increasing age of first childbirth, and decreasing numbers of children and up to nulliparity, all correlate with a higher risk of breast cancer. Regarding these factors, what have three major trends been over the last century? Earlier age of menarch, fewer children per woman, and an older age at first childbirth. Add to that the use of hormone replacement therapy during the 1980s and 1990s, and there are multiple huge confounders far more likely to explain the increasing incidence of breast cancer not even addressed in McGrath’s hypothesis.

That doesn’t stop McGrath from taking the fallacy of confusing correlation with causation to a ridiculous extreme:

The available birth cohort data in Figure 3 and Figure 4 suggest that the incidence of breast and prostate cancer for those born around 1870, 1880, and 1890 was relatively stable. The data also indicate a clear and continuing upward shift of rates beginning with those individuals born around 1900. The first antiperspirant was introduced in the US in 1902 and achieved enough sales volume to support national advertising in 1914 [62]. Antiperspirant sales rise as breast and prostate cancer incidence increases as seen in Fig. 1, suggesting antiperspirants may have facilitated and augmented a process already in play (progressive underarm occlusion) in the pathogenesis of these two pre-existing diseases. Global breast and prostate cancer incidence and mortality rates also rise with kg/1000 person usage of antiperspirant as seen in Figure 2 and Figure 3. Additionally, these US increases in incidence rates occurred before the introduction of hormone replacement therapy (1950s), Bisphenol A usage (1940-1950s) and xenoestrogens (1960s) in personal care products [17], [109] and [110].

Yes, and global warming is most definitely due to the decreasing number of pirates over the last three centuries.

Sure, McGrath does throw in the caveats about confounders and how his observations aren’t conclusive, only hypothesis-generating. The problem is that not only is the hypothesis highly implausible but all the available evidence other than McGrath’s one paper from 2003 appears to be against it. He hasn’t followed up with another paper reporting a more rigorous study. In fact, he’s only published two articles since 2003, one of which is the Medical Hypothesis paper. Searches of PubMed fail to find any evidence to support McGrath’s view. His whole Medical Hypothesis paper is nothing more than one prolonged exercise in datamining for correlations that can be somehow related to antiperspirants and either breast cancer or prostate cancer and then going off the deep end with repeated exercises of confusing correlation with causation. For more discussion, check out this article on the American Cancer Society website. (I know, I know, the ACS must be in cahoots with big deodor.)

And, not surprisingly, Sharyl Attkisson laps it up with wagging tail, asking for more, more, more. She concludes her “followup report” with a beautiful misunderstanding of how science works:

Three years ago, the FDA (which regulates over-the-counter drugs including antiperspirants) told us that the research on an antiperspirant-cancer link provided conflicting results and it hoped “definitive studies will be conducted in the near future.” The antiperspirant industry, FDA, CDC and NIH all said there is no reason to throw away your antiperspirant in fear, but would not definitively rule out a link. Where do the government’s health scientists stand today? It appears little has changed.

The current guidance on CDC’s Web site remains as it was in 2006: “Because studies of antiperspirants and deodorants and breast cancer have provided conflicting results, additional research is needed to investigate this relationship and other factors that may be involved.”

[...]

For further reading, see the below excerpt from the FDA Docket in 2003. At that time, the agency didn’t rule out a cancer link, but stated there was “insufficient evidence to support these theories.”

Attkisson is using a classic argument from ignorance here. She also confuses normal scientific caution, in which scientists are very reluctant to state definitively that there is no correlation between two variables, even though there are multiple studies that have failed to find any. That’s because science can never conclusively prove a negative. What it can do is to combine prior plausibility based on science with clinical observations and say that a correlation is highly unlikely. I am disappointed, though, in that these statements that “studies are conflicting” remains. These studies are not “conflicting.” Except for one glaring standout (McGrath’s study) the studies of antiperspirant use and breast cancer are all in remarkable agreement.

I wonder why that is.

The bottom line is that, when it comes to science, Sharyl Attkisson is a crank par excellence. She doesn’t understand science; she has an agenda; and she tortures the evidence to make it agree with her biases. All of this wouldn’t matter so much if she weren’t a national correspondent for CBS. Unfortunately, there her crank magnetism allows her to engage in fear mongering on a national level on both vaccines and breast cancer.

Why CBS keeps this scientific ignoramus on, I have no idea.

Comments

  1. #1 HowdyOrac
    July 1, 2009

    You have your science. And then you have your mob desires.

    “In Henryk Ibsen’s 1882 stage play An Enemy of the People, a scientist, Dr Stockmann, finds out that his small Norwegian community’s chief tourist attraction, its public baths, are dangerously polluted.

    “The source is poisoned, man! Are you mad? We are making our living by retailing filth and corruption! The whole of our flourishing municipal life derives its sustenance from a lie! … The whole bath establishment is a whited, poisoned sepulchre, I tell you – the gravest possible danger to the public health! … all that stinking filth.”

    But the mob turned against Stockmann, much as the real-estate industry has turned against Andrew Cuomo. Too bad. There’s more than just the moldy Chinese drywall that’s now rotten and filth sodden in US real estate.”

    Think about that story the next time you see someone with an unpopular claim that is being refuted by scientists.

  2. #2 Epinephrine
    July 1, 2009

    In a matter related to the anti-vaccine movement (but not to Atkinson), Eric London resigned from Autism Speaks. Each such repudiation of organizations that warn against vaccines is another blow against the crackpots who ignore the sience in favour of their pet theories.

    After three years of great hopes for Autism Speaks being the optimal vehicle to advance autism science and treatment, I regretfully and sadly must announce my dissociation from this organization, including resignation from the Scientific Affairs Committee.

    Despite the very excellent work that Autism Speaks has done in the area of awareness and legal advocacy, there are many differences which I have with the organization, mostly concerning the direction and prioritization of the science program. There have been numerous decisions made which I believe have adversely impacted autism research and none of those decisions were made upon the advice of the Scientific Affairs Committee. The processes with which science decisions have been made have been contrary to my hopes and expectations when the NAAR-AS merger was effectuated.

    If this were the only issue, I might have continued to try to work from within the organization to influence science policy and direction. However, the pivotal issue compelling my decision is the position which Autism Speaks is taking concerning vaccinations. The arguments which Dr. Dawson and others assert– that the parents need even further assurances and there might be rare cases of “biologically plausible” vaccine involvement –are misleading and disingenuous. Through its website and other communications, Autism Speaks has been influential and contributory in encouraging parents’ doubts. By preferentially investing and advocating for the use of limited financial resources on the “biological plausibility” argument, the organization is adversely impacting the advancement of autism research.

    Recent reports have documented significant outbreaks of measles and other infectious diseases which could have been controlled and even eradicated. The lowering of the vaccination rate has already led to deaths. If Autism Speaks’ misguided stance continues, there will be more deaths and potentially the loss of herd immunity which would result in serious outbreaks of otherwise preventable disease. I further fear that if and when herd immunity is lost, there may be a societal backlash against the autism community.

    In my role as an Autism Speaks Scientific Affairs Committee member, I would be lending credibility to an organization whose scientific agenda and positions I can no longer ethically support. Please accept my resignation, effective immediately. If anyone would like to discuss this with me further, please do not hesitate to contact me.

    Sincerely, Eric London MD

    http://autismsciencefoundation.wordpress.com/2009/06/30/naar-founder-eric-london-resigns-from-autism-speaks-citing-disagreement-over-autismvaccine-research/

  3. #3 Richard Eis
    July 1, 2009

    I wouldn’t say she is a crank yet, more of a person looking for an interesting story who isn’t good with graphs. McGrath is the one who should know better.

    So Howdy…you want me to compare a fictional play with a not very convincing attack on antiperspirants? I would be interested in seeing further studies but the relevance of your story is a bit weak.

  4. #4 Rev Matt
    July 1, 2009

    My mother in law, who is highly susceptible to any woo that comes along, bought into this completely and has thrown out all her deodorant and replaced it with ‘organic’ deodorant that costs twice as much and is less effective.

    @Howdy: ever the defense of cranks “they laughed at DaVinci/Einstein/whomever as well”. Being derided by scientists isn’t sufficient to warrant such a comparision: you also have to be right.

  5. #5 Orac
    July 1, 2009

    I wouldn’t say she is a crank yet, more of a person looking for an interesting story who isn’t good with graphs.

    I disagree. She is a crank. Have you read her articles on vaccines and autism that I linked to? Start with this one:

    http://scienceblogs.com/insolence/2007/06/antivaccination_crankery_on_the_cbs_news_1.php

    Then tell me again how she isn’t a crank.

  6. #6 Pierce R. Butler
    July 1, 2009

    At least it would seem that Attkisson hasn’t fallen for the abortion -> breast cancer schtick – yet.

  7. #7 Kate
    July 1, 2009

    Woo-Hoo! Somebody else finally gets it that Autism Speaks is speaking to the wrong freaking people about the wrong freaking things!

    In the general public I mean. *sigh* How many charities are being corrupted by woo-meisters, I wonder? Konen? Livestrong (much as I detest Lance Armstrong, charities that fund cancer research I can’t have too much of a problem with.)? What else is working counter to progress and science in favor of woo that we don’t know about because thier issue dosen’t have an Attkisson?

  8. #8 Sid Offit
    July 1, 2009

    The lowering of the vaccination rate has already led to deaths.

    I don’t know what this fool is talking about. Vaccination rates are at all time highs

  9. #9 daedalus2u
    July 1, 2009

    The correlation with age of menarche and breast cancer is pretty strong. In cultures where women shave under their arms and use antiperspirants those women would only start using antiperspirants after menarche so there would be a strong correlation between time of first use of antiperspirants and breast cancer.

    The main regulator of aromatase is nitric oxide, which inhibits it. Nitrate and nitrite inhibit steroid synthesis because they are metabolized to NO which binds to the heme.

    http://www.ncbi.nlm.nih.gov/pubmed/11133344

    Hair growth under the arms is regulated by androgens. That hair growth starts at puberty, and is positively correlated with androgen levels in both men and women. Increased levels of androgens increase underarm hair growth, which (my hypothesis) increases the niche for the bacteria I am working with under the arms, where they convert more ammonia into nitrite and increase the NO/NOx status of the individual which feeds-back and inhibits androgen synthesis which then decreases underarm hair growth.

    If there is an association of underarm shaving with breast cancer, it is likely either due to age of menarche, or hormone status which affects underarm hair growth, or (perhaps) feedback increases in steroid hormone levels following shaving of underarm hair.

  10. #10 Dangerous Bacon
    July 1, 2009

    Dammit people, you’re missing the forest for the trees.

    The obvious conclusion from Dr. McGrath’s research is that deodorants cause autism!

    Think about it – after an expected lag period, autism incidence increases in parallel with the rising sales of antiperspirants. It should be easy to cook up a retrospective study showing whatever correlation is desired – it’ll be conclusive if use of Mitchum is linked to the highest rate of autism.

    I’m surprised no one has publicized this link before. Action is urgently needed! (Attkission’s followup report practically writes itself).

    I’m just glad I don’t take the bus anymore.

  11. #11 Richard Eis
    July 1, 2009

    Ok. I was going to say 3 strikes and then she’s a crank but then that first paragraph on scientists being wrong was all I could take.

    But honestly, the above is what i would expect from basic science journalism these days. I’m that jaded about it now.

    They have made it harder to be seen as a crank.

  12. #12 Brian
    July 1, 2009

    It’s unfortunate that Dr. McGrath, Ms. Asskisson, and Orac are all missing the bigger story:

    Antiperspirants prevent gastric cancer!

    It’s clear as can be from that graph.

  13. #13 Jennifer B. Phillips (aka Danio)
    July 1, 2009

    Ms. Asskisson

    ISWYDT
    ———–
    Sigh. Time to write yet another letter to another network about another travesty of science reporting. I really need to make a template for these occasions.

  14. #14 Dr. P
    July 1, 2009

    HowdyOrac

    Think about that story the next time you see someone with an unpopular claim that is being refuted by scientists.

    Deep. Except the mob in Ibsen’s play was an self interested mob representing a public unwilling to listen to a scientists voice of concern, not other scientists with a specific issue regarding a poorly designed study.Your point would be…..? Oh yeah we’re all getting rich off the teat of BIG PHARMA,I need to remember that. Oh and at #8; don’t I remember you stating in another post about 6 weeks ago that vaccination rates were dropping? Decide which truth is more convenient and stick to it.

  15. #15 LibraryGuy
    July 1, 2009

    HowdyOrac, I understand your point. Just because someone has a novel hypothesis, doesn’t mean he/she is wrong. In this case though, the evidence and the science mean McGrath is wrong.
    By the way, I played Peter Stockman (the mayor and leader of the people who crushed Dr. Stockman in Arthur Miller’s translation of “Enemy”) and we never said his science was wrong. We knew he was right but we also knew that if we said so our town was ruined.
    And why are CBS and Ms Attkisson throwing out this silliness? Because it’ll be a big topic of conversation around the water cooler the next day. “Didja hear that thing on CBS last night? Deodorant causes cancer! (Insert joke at unpopular coworker’s expense here).” It doesn’t have to be right, it just has to make people talk about CBS. Remember 60 minutes and the Audi controversy? They just throw this stuff out, people talk about it, they get a little ratings bump, and life goes on.
    All too often it ain’t news ’cause it’s true, it’s news ’cause it’s new.

  16. #16 snerd
    July 2, 2009

    Happeh sockpuppet detected.

  17. #17 DLC
    July 2, 2009

    Proof that you can find a ‘scientist’ or a report to back any crazy idea.

  18. #18 Militant Agnostic
    July 2, 2009

    Does the abrupt jump in prostate cancer incidence correspond to the introduction of PSA screening?

    My graphs show that the increase in breast cancer and prostate cancer are due the increases in the prevalence of two abominations; automatic transmissions and front wheel drive.

  19. #19 Mr Jack
    July 3, 2009

    I think you rather missed the ball on that graph – look at the axis for deoderant sales – US sales. Now look at the axis for the rest – incidence per 100,000…

    In other words one corrects for population, the other doesn’t.

  20. #20 Pablo
    July 3, 2009

    Mr Jack – actually, the bigger effect is that of inflation. I have just pulled some inflation numbers, and have also corrected for population. Here are the inflation corrected, relative sales over the years

    1949: 1
    1954: 1.6
    1959: 2.6
    1964: 3.7
    1969: 7.0
    1974: 7.7
    1979: 6.9
    1984: 6.9
    1989: 7.6
    1994: 7.2
    1999: 7.3
    2004: 7.0

    Notice that the per capita sales in real dollars have actually been pretty much constant since 1970. Meanwhile, the cancer rates have increased by about 50% since then.

    No basis for claiming any correlation, much less a cause.

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