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The truth about abortion
Where on the web Indian cancer website lacks originality At the height of the internet boom 2 years ago, a number of general purpose health websites were launched in India, but few survived the subsequent bust. More recently, a few special interest websites were launched. One such site is www.indiacancer.org, which celebrated its first anniversary in July this year. A first look at the site led me to conclude that it was perhaps one of the best Indian websites on cancer – it is very attractive by Indian standards. However, looking closely at the content, I have changed my mind. The stated purpose of the website is very broad – to provide professionals, patients, and the general public with information on cancer and its treatment. However, considering the vast amount of cancer information that is available on the web, one assumes the real objective of the exercise is to reach out to the Indian professionals, patients, and public. If that is so, the website does not achieve its objective. There is a lot of basic information
about various types of cancers (about 70 tumour types are listed), detection techniques, and treatment regimens, etc. But it is not tailored to Indian audiences. The information given is easily accessable elsewhere on the internet and wherever locally relevant content is available, it is of poor quality and sometimes unnecessary. Under sections like “Search for specialists” and “Charitable organizations, hospitals & NGO’s” one would expect a fairly decent number of entries, for a country of India’s size and disease burden. The gaps are obvious. To begin with only three specialties are mentioned – medical oncology, radiation oncology, and surgery. A search for specialists in the Indian capital city, New Delhi, reveals that for a population of over 10 million, there is apparently only one medical oncologist, no radiation oncologist, and just one non-governmental organisation (Mamta Breast Cancer Help Group) – which has been listed three times – working in cancer-
related areas! The quality of listings is very poor – basic information like phone numbers and e-mail addresses are missing from most entries. Other sections such as research news updates for professionals are stale and not updated for weeks at a time. And on the professional side, there are no Indian case studies, research data, or clinical information. One positive aspect of the website is that it is translated into two other regional Indian languages (Telugu and Marathi). Here again, however, the quality of information is poor. But this is the very area where the site should have excelled. There is currently no cancer or health-related content (foreign or local) available in regional languages. It would be a useful exercise to have mirror sites of leading cancer portals in Indian languages (India has nearly a dozen major regional languages) and try and customise the content, rather than create ‘me-too’ products in English like indiacancer.org. Dinesh Sharma
The truth about abortion http://www.abortionfacts.com/ For a woman considering an abortion, finding unbiased information is no easy task. The website “Abortion facts: abortion information you can use” should satisfy an important need, but by using a single book (Why we can’t love them both by Dr and Mrs Willke) as the sole source of its information, it does not achieve it’s promise. The home page invites you to state your stance on the issue of abortion by choosing between ‘pro-life’ and ‘prochoice’. This recognition of both sides initially lifted my expectations, however, the links you are taken to tell a different story. The pro-life pages are headed by a picture of a toddler and some flowers and lead to positive statements that are backed up by support from the Willkes’ book. But the pro-choice link takes you to a page headed by a judge’s hammer and seems to be a thinly veiled attack on the pro-choice movement. Continuing through the website, it THE LANCET Oncology Vol 2 December 2001
becomes clearer that the authors are staunchly anti-abortion. There are distastefully graphic descriptions of abortive methods and a picture gallery of cute babies, each of whose parents proudly proclaim their joy at not aborting their child. To me, such ploys are entirely unhelpful for women who must make this difficult decision. I was not surprised, therefore, that the pages on abortion and breast cancer offer a similarly one-sided view. One article cites three studies that found a positive relationship between abortion and breast cancer, with no cautionary word that this may not be the whole picture. It was preceded by a story of a woman who “increased her chances of breast cancer by as much as 800%” by having an abortion. Where this figure comes from is not stated, but it is likely to be the upper confidence limit of an imprecise relative risk. One wonders what the lower limit was…
Finding such biased information infuriates me. Although other pages are more cautionary, none provides the balanced view that I would expect of any serious attempt to synthesise summary data. An extract from the Willkes’ book notes that the “ominous relationship” between abortion and breast-cancer risk is unproven, but references six positive studies and no negative ones. A later page notes nine reasons to disregard a large population-based study with negative findings. No such criticisms of positive studies are provided. Despite the lack of a proven relationship, they calculate that abortion could be responsible for a total 15 000 deaths from breast cancer each year in the US. Epidemiology is often badly reported in the lay media and this website is a deplorable example of the mis-reporting of scientific data to promote a cause. Mona Okasha
771
For personal use. Only reproduce with permission from The Lancet Publishing Group.
about various types of cancers (about 70 tumour types are listed), detection techniques, and treatment regimens, etc. But it is not tailored to Indian audiences. The information given is easily accessable elsewhere on the internet and wherever locally relevant content is available, it is of poor quality and sometimes unnecessary. Under sections like “Search for specialists” and “Charitable organizations, hospitals & NGO’s” one would expect a fairly decent number of entries, for a country of India’s size and disease burden. The gaps are obvious. To begin with only three specialties are mentioned – medical oncology, radiation oncology, and surgery. A search for specialists in the Indian capital city, New Delhi, reveals that for a population of over 10 million, there is apparently only one medical oncologist, no radiation oncologist, and just one non-governmental organisation (Mamta Breast Cancer Help Group) – which has been listed three times – working in cancer-
related areas! The quality of listings is very poor – basic information like phone numbers and e-mail addresses are missing from most entries. Other sections such as research news updates for professionals are stale and not updated for weeks at a time. And on the professional side, there are no Indian case studies, research data, or clinical information. One positive aspect of the website is that it is translated into two other regional Indian languages (Telugu and Marathi). Here again, however, the quality of information is poor. But this is the very area where the site should have excelled. There is currently no cancer or health-related content (foreign or local) available in regional languages. It would be a useful exercise to have mirror sites of leading cancer portals in Indian languages (India has nearly a dozen major regional languages) and try and customise the content, rather than create ‘me-too’ products in English like indiacancer.org. Dinesh Sharma
The truth about abortion http://www.abortionfacts.com/ For a woman considering an abortion, finding unbiased information is no easy task. The website “Abortion facts: abortion information you can use” should satisfy an important need, but by using a single book (Why we can’t love them both by Dr and Mrs Willke) as the sole source of its information, it does not achieve it’s promise. The home page invites you to state your stance on the issue of abortion by choosing between ‘pro-life’ and ‘prochoice’. This recognition of both sides initially lifted my expectations, however, the links you are taken to tell a different story. The pro-life pages are headed by a picture of a toddler and some flowers and lead to positive statements that are backed up by support from the Willkes’ book. But the pro-choice link takes you to a page headed by a judge’s hammer and seems to be a thinly veiled attack on the pro-choice movement. Continuing through the website, it THE LANCET Oncology Vol 2 December 2001
becomes clearer that the authors are staunchly anti-abortion. There are distastefully graphic descriptions of abortive methods and a picture gallery of cute babies, each of whose parents proudly proclaim their joy at not aborting their child. To me, such ploys are entirely unhelpful for women who must make this difficult decision. I was not surprised, therefore, that the pages on abortion and breast cancer offer a similarly one-sided view. One article cites three studies that found a positive relationship between abortion and breast cancer, with no cautionary word that this may not be the whole picture. It was preceded by a story of a woman who “increased her chances of breast cancer by as much as 800%” by having an abortion. Where this figure comes from is not stated, but it is likely to be the upper confidence limit of an imprecise relative risk. One wonders what the lower limit was…
Finding such biased information infuriates me. Although other pages are more cautionary, none provides the balanced view that I would expect of any serious attempt to synthesise summary data. An extract from the Willkes’ book notes that the “ominous relationship” between abortion and breast-cancer risk is unproven, but references six positive studies and no negative ones. A later page notes nine reasons to disregard a large population-based study with negative findings. No such criticisms of positive studies are provided. Despite the lack of a proven relationship, they calculate that abortion could be responsible for a total 15 000 deaths from breast cancer each year in the US. Epidemiology is often badly reported in the lay media and this website is a deplorable example of the mis-reporting of scientific data to promote a cause. Mona Okasha
771
For personal use. Only reproduce with permission from The Lancet Publishing Group.