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NIH IS PLAYING FAST AND LOOSE WITH THE TRUTH
We’ve been reviewing some of the official documents from the National
Institutes of Health, and compared these statements with the actual facts.
What we found shocked even me. I’ve included full references at the end for
persons who want to see them.
Ed
Men's Health America
http://www.egroups.com/group/menshealth/
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What NIH Is Saying:
1. The Women's Health Initiative was established to "address many of the
inequities in women's health research," such as the areas of heart disease,
cancer, and osteoporosis. (WHI Backgrounder, http://www.nhlbi.nih.gov/whi/)
2. The Office of Research on Women's Health (ORWH) was established "in
response to a report by the U.S. General Accounting Office...that women
were routinely excluded from medical research supported by NIH." (Vivian
Pinn, NIH News and Features, Fall 1997, p. 3)
3. "Historically, research studies were conducted only with men." (National
Institute of Mental Health: Women Hold up Half the Sky. Publication No.
99-4607)
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What Our Research Reveals:
Our research demonstrates that these three statements are not merely
exaggerated or one-sided; they are simply false. These are the facts:
CANCER
Cancer research has always favored women:
• An analysis of 1989 enrollees in NCI research reported only 43% male
participation (1).
• A report from the Southwest Oncology Group revealed only 42% were males (2).
• The recent GAO report stated that men now compose only 29% of
participants in NCI research (3).
• A Medline search under the term "malignancy" for the years 1966-1990
reveals 139 clinical trials for men and 191 for women.
• Sex-specific funding patterns reveal that prostate cancer has lagged
behind breast cancer research by a 4:1 margin (4).
HEART DISEASE
A. 55% of participants in the early Framingham Heart Study were female (5).
B. An analysis of major hypertension studies conducted in the 1970s and
1980s found that women made up nearly half of these studies (6).
C. A search of the Medline database for Heart Disease clinical trials
during the period 1966-1990 turns up 137 studies on men, and 78 studies
with women (7). In 1980, men's risk of dying from heart disease was
280.4/100,000, while women's risk was only 140.3/100,000 (8). Men were at
twice the risk of heart disease mortality, and represented the high-risk
population.
When we consider that men have historically faced twice the risk of death
from heart disease, there is no evidence that overall, women have been
underrepresented in heart disease research. As the Institute of Medicine
put it, "The literature is inconclusive about whether women have been
excluded or importantly underrepresented in clinical trials" (9).
OSTEOPOROSIS
According to the Medline database, there were 18 female clinical trials on
osteoporosis published 1966-1999, compared to only 7 studies for men (7).
This represents more than a 2:1 disparity in women's favor.
MENTAL HEALTH
Mental health research sponsored by the NIH has long included women. During
the period 1966-1990, the number of clinical trials with women has
approximated the number of clinical trials with men (7).
The Underrepresentation of Men in NIH Research:
As documented above, men have been and continue to be underrepresented in
cancer research. Three other areas with substantial inequities affecting
men's health are reproductive health, contraception, and sex hormones.
An analysis of the NIH sex-specific budget 1988-1990 reveals that women's
health research received twice the funding of men's health research (10),
which further discredits the argument that women have been shortchanged by
medical research.
Conclusions:
Overall, the evidence overwhelmingly points to the conclusion that women
were not routinely excluded from NIH research. Rather, women were routinely
included.
The situation with regard to cancer research is particularly troubling.
Whether based on NCI enrollment figures, sex-specific budget allocations,
or number of studies published, it is clear that it is men who have been
shortchanged. Yet the justification for the Women's Health Initiative
suggests that it is women who have subject to "inequities" in cancer
research. This inversion of the truth is scientifically indefensible.
Finally, other areas with demonstrated inequities affecting men, e.g.,
reproductive health, contraception, and sex hormones, have not received any
attention or remediation for past neglect.
NIH, it's time to come clean with the truth.
References
1. Ungerleider RS, Friedman MA: Sex, trials, and datatapes. J National
Cancer Institute 1991; 83: 16-17.
2. Hutchins LF, Unger JM, Crowley JJ et al: Underrepresentation of patients
65 years of age or older in cancer-treatment trials. New Engl J Med 1999;
341: 2061-2067. Table 1.
3. General Accounting Office: Women's Health. GAO/HEHS-00-96, May 2000, p. 17.
4. National Cancer Institute: Research Dollars by Various Cancers.
http://www.nci.nih.gov/public/factbk97/varican.htm
5. National Heart, Lung, and Blood Institute Advisory Council: Women’s
Health Issues. Presented at the 159th Meeting. National Institutes of
Health: Bethesda, MD Sept. 6, 1990.
6. Young C, Satel S. The Myth of Gender Bias in Medicine. Washington, DC:
Women’s Freedom Network, 1997, p. 6.
7. Search terms: United States, Human subjects, Clinical trials
8. Department of Health and Human Services: Health, United States, 2000,
Table 30.
9. Bennett JC: Inclusion of women in clinical trials. New Engl J Med 1993;
329: 288-291.
10. NIH Office of Research on Women’s Health. NIH Support for Research on
Women’s and Men’s Health Issues, Fiscal Years 1988, 1989, and 1990.
