"This troubling faith-based approach to science encapsulated in the idea that belief in a half-baked hypothesis trumps scientific truth, has reached the level of an epidemic in drug research."

The Cholesterolistas are at it again; spreading their usual brand of fear uncertainty and doubt about cholesterol levels in the human body. This time, the fear-mongering involves an Italian study that shows an alleged link between cholesterol and prostate cancer.

In a perfect parody of Chicken Little, the morning headlines have dutifully enlisted in the War on Cholesterol with variations of, "Cholesterol and Prostate Cancer Linked" in bold type for all the world to see. Is this an example of good science for the benefit of humankind or simply more fear-fueled advertising on the part of the medical/pharmaceutical industries to generate quarterly profits?

The answer may be found in an excellent series of articles published at the Public Library of Science. The articles focus on the roll of the pharmaceutical and medical industries in the science of disease mongering and marketing. One example of how drug marketing corrupts science and harms the public good is an April 12th article in the Washington Post entitled, "Comparison of Schizophrenia Drugs Often Favors Firm Funding Study." The article examines how conflict of interests can skew study results in favor of whoever is funding the study.

Another example is Avian Flu. The hysteria surrounding this 'potential pandemic' is truly remarkable. There is a deep difference of opinion over whether bird flu is something to be concerned about. Some experts believe the disease has been grossly oversold to the public. Between public and private efforts to stockpile Tamiflu, the drug being touted as a defense against the disease, Roche, the drug's maker, stands to rake in a pile of money. With less than 100 people dead from the disease the world over, it would make more sense, statistically, to develop a vaccine for drivers since far more people die on the highway everyday than have been killed by bird flu.

What are we to make of this new claim about a link between 'high' cholesterol and prostate cancer? First, it is important to remember that a 'link' means that there is an association between two or more observable facts, but an association does not prove that one causes the other. Firemen are associated with fires, but they don't cause fires. Policemen are associated with crime, but they don't commit crimes. In medical research, scientists have to sometimes tease out certain cofounding factors like age, diet and lifestyle that might impact outcome, but it's not easy.

This is why it is so important to make the distinction between association with causation. Don't feel bad if you sometimes get them confused. Well trained, highly paid scientists make this mistake all the time. In the prostate study, about 2700 men under the age of 75 participated. A little less than half of the men had prostate cancer. The men were interviewed between 1991 and 2002. The result of this effort was that researchers observed that about half the men with prostate cancer also had high cholesterol. Case closed. While none of the articles I read stated that cholesterol caused prostate cancer, they all concluded with advice for diet changes as if the study, did in fact, prove a causative connection.

Many people reading any one of these articles would likely make that conclusion, but a closer examination of what the articles really say is revealing. To begin, the articles established that the link between cholesterol and prostate cancer is associative, not causative. The study participants self reported their cholesterol status as high. Self reporting by study participants has always been regarded as a weakness in any study where it's used. The very act of defining high cholesterol is suspect these days since special interests within the scientific community have steadily lowered the bar on what constitutes high cholesterol-ostensibly to create a bigger market for cholesterol lowering drugs.

The study notes that half the men in the prostate group had high cholesterol. If this is so, it begs the question: What about the other half? If they don't have high cholesterol, clearly something else is the causative factor in their cancer. How can science ignore the 50% of the findings that disprove the hypothesis? Apparently, when cholesterol is involved, it's pretty easy to selectively ignore certain findings. This troubling faith-based approach to science encapsulated in the idea that belief in a half-baked hypothesis trumps scientific truth, has reached the level of an epidemic in drug research.

Statins, the drugs used to lower cholesterol are prominently mentioned in the articles. There have been attempts to show a connection between cholesterol and prostate cancer before. Those previous studies are said to have been 'inconclusive.' Inconclusive, in medical jargon, often means that a drug manufacture's attempt to inflate the value of a drug is being blocked by scientific truth. These inconclusive studies are typically followed up with more money and more studies until manufactures get the kind of biased results they want.

Once a study 'proves' a scientific claim, we get to see more of those vague TV commercials that end with people running through fields and a concerned voice soliciting you to, "Ask your doctor."

How can you protect yourself from predatory science?
Don't believe what you read about a study just because you saw an article in a newspaper or heard something on television. Many of the stories that get printed or broadcast are little more than press releases written by the companies that have a financial stake in the product. Employ the same kind of skepticism when evaluating a drug company's claims as you would the claims of a car salesman. There is NO DIFFERENCE between the two. Ignore this advice at your peril.

Understand the true nature of pharmaceutical companies. They are not altruistic organizations concerned with the welfare of the citizenry. Just like the automotive, entertainment and clothing industries, the pharmaceuticals are businesses that must continually look for ways to increase profits in order to meet Wall street and shareholder expectations. The only way they can do this is by raising the prices of existing product, preventing competition (and lower prices) in their market area and expanding market share by redefining health as illness and by creating new drugs and new customers, many of whom may be healthy people.

Realize that doctors are only human. Medical students are courted by drug companies while still in school. They are indoctrinated with the belief that the practice of medicine equates to little more than dispensing drugs. If your doctor's office looks like it's been co-opted by a drug company with branded coffee mugs, calendars and prescription pads and if your doctor makes patients wait in line behind drug reps, you may have a problem. Some doctors can't fathom the idea that they can be manipulated by the drug industry and predatory science. They incorrectly assume that their advanced knowledge of medicine someone provides them with immune. This mistaken sense of superiority, in fact, makes them more vulnerable as any con artist will attest. It is the mark that thinks he can't be conned that makes for the easiest prey.

Some doctors are in on the game and are more than willing to play along with the practice of pushing drugs based on dubious science. There are good doctors out there. Evaluate your doctor with the same care that you would evaluate your auto mechanic by seeking references and recommendations.

Finally, just eat good food and work toward achieving a life that makes you happy. This is the first line of defense and the best medicine you can use to prevent disease.

Public Library of Science: Disease Mongering