Sara M. Tamayo

10/22/20

Engl. 21003

Prof. Bolster

 

Scientific Rhetorical Analysis of the Association Between Atopic Eczema and Cancer in England and Denmark

            Atopic eczema is one of the most common skin diseases, and it affects both adults and children. In the same way, cancer is one of the diseases that currently causes the most deaths worldwide. The purpose of the research, Association Between Atopic Eczema and Cancer in England and Denmark, is to investigate the relationship between these two diseases and whether eczema is a risk factor that causes cancer. The overall goal is to avoid any possible hazard when making new drugs to treat eczema. This research summarizes investigations made by 12 professionals in total, among which are Kathryn E. Mansfield, Ph.D.; and Sigrún A. J. Schmidt, Ph.D. Both experts in Epidemiology. It is important to emphasize that the research was focus on population from England and Denmark only. It was published on June 24th, 2020, in the journal JAMA Dermatology, a journal dedicated to publishing articles from skin specialists such as dermatologists (doctors, surgeons, and aesthetic dermatologists).

This journal’s mission is “to explicate the structure and function of the skin and its diseases and the art of using this information to deliver optimal medical and surgical care to the patient.” In other words, the journal provides information regarding skin issues and treatments so patients can be accurately diagnosed and receive an appropriate solution. Its intended audience is dermatologists, veterinarians, pharmacists, cosmetologists, lab researchers, medical oncologists, surgical oncologists, and pediatric oncologists. All these professionals can use the journal’s information to improve their knowledge about skin-related topics and provide a better service for their patients, either creating new medicine or giving the correct treatment to a new patient.

Introduction

This research follows the IMRAD format (Introduction, Method, Results, and Discussion). The authors follow John Swales’ Creating A Research Space (CARS) model in the introduction section. Therefore, this section is divided into three moves. In the first move, they establish the importance of the research by providing relevant data about eczema and how this skin disease affects 2% to 20% of the population, including adults and children. This data is also an example of the rhetorical appeal Logos, which is used by the authors to show the logic behind their investigation. They also describe the significance of their research by explaining why this illness may be related to cancer. They state how some of the treatment, although most of them are harmless, may increase cancer risk factors in patients suffering from eczema. It is also stated how important the research is for health professionals since eczema is one of England’s most consulted skin-related illnesses. For this reason, the authors believe it is important to know the probability of getting cancer because of atopic eczema.

In the second move, the authors explain the poor evidence provided by past research, indicating a gap and the need for further investigation. They use the words lack and conflicting to show how these past investigations have not given enough results to relate eczema with cancer. They continue explaining two different theories that could prove the connection between these two conditions, these are, “increased immune surveillance decreases cancer risk and that immune stimulation increases cancer risk” (Mansfield, K. 2020). However, they use the word but to explain how the findings are inconclusive for these theories. The authors also mention that some experiments have been done with mice and the results supported the reduction of cancer in patients with eczema. However, they use again the words but and uncertain to show how these results still do not give enough evidence. 

In the third move, the authors provide a solution to the previous gap by doing their own research. They explain how they used data from research done in Denmark and England to assess past studies’ doubts and contradictions. Besides, they state that they also investigated the risk of cancer in people with atopic eczema and without atopic eczema.

Methods

In this section of the research paper, the authors explain the different methods they used for the investigation. They used data from two matched cohort studies that were done from “January 2, 1998, to March 31, 2016, in England and from January 1, 1982, to June 30, 2016, in Denmark” (Mansfield, K. 2020).  They also made their own analysis from July 2018 and July 2019. They separated patients with atopic eczema from those without atopic eczema and matched them depending on their age, gender, and calendar period. They compared them as well to check their overall cancer risk. All their studies were approved by the respective entity, such as the London School of Hygiene, the Tropical Medicine Research Ethics Committee, the United Kingdom Clinical Practice, etc.

            Furthermore, to reach the audience, they used different rhetorical strategies, such as Ethos for credibility and Logos for logic. Ethos is seen when they mention the London School of Hygiene’s approval or the approval of the Tropical Medicine Research Ethics Committee. It is also present since they attached trial protocols to the paper. These examples increase their investigation’s credibility because it shows how these entities are regulating and controlling their studies and analysis. Therefore, the results are more accurate and reliable. They appealed to Logos when condensing their information into graphs, tables, and synoptic tables. This appeal helps make the audience feel safer about the importance and reliability of what they are reading and use their reasoning to understand the investigation.

Results

For the results section, the authors used the information that was portrayed on the tables and graphs.  They noticed small evidence of any connection between atopic eczema and cancer. The final ratio after comparing both people with and without eczema was almost 1. Therefore, there was not big evidence to prove that there was a relation between both diseases. They found out instead that there was a link between people suffering from atopic eczema and lymphoma risk,  “In England, non-Hodgkin lymphoma (NHL) risk was 20% higher (HR, 1.20; 99% CI, 1.07-1.34) and Hodgkin lymphoma risk was 48% higher (HR, 1.48; 99% CI, 1.07-2.04) in people with atopic eczema compared with those without atopic eczema” (Mansfield, K. 2020). However, for Denmark, the percentages were not as precise, but they also showed a link between both diseases.

Discussion

In this section, the authors discuss the previous results and how there was no evidence found that showed an association between cancer risk and atopic eczema patients from both cohort studies. They also mentioned how there was actually a potential link between lymphoma risk and eczema. However, it needs to be further investigated in deeper research to accurately analyze this apparent connection. The authors also analyzed their Strengths and Limitations. They stated that one of their strength was the data they collected, and one of their weaknesses was the lack of quantitative measures.

 

Conclusion

I really enjoyed writing this assignment. I had a hard time trying to choose an appropriate research, and when I found this one through the CCNY database, I knew it was the one. I have had many skin issues since I was little; that is why this article caught my attention immediately. I was really curious. I divided each section into different paper sheets to write the paper, and I wrote down my thoughts and what I understood from each one of them. It was difficult to understand the vocabulary since they used very scientific words, so I used an online dictionary to improve my understanding. In my opinion, the hardest part was to understand the results because the data and graphs were very complex. It was also difficult for me to understand the use of the CARS model. However, with the resources provided by the Professor. I was able to improve my understanding and use it towards the paper. I learned a lot from this assignment. I learned about Journals and how each one of them has a particular audience. I learned about CCNY databases, and I improved my understanding of rhetorical strategies. Overall this was a hard but very enjoyable assignment.

References

JAMA Dermatology. (2014). JAMA Dermatology, 150(12), 1248. https://jamanetwork-com.ccny-proxy1.libr.ccny.cuny.edu/journals/jamadermatology/pages/for-authors

Mansfield KE, Schmidt SAJ, Darvalics B, et al. Association Between Atopic Eczema and Cancer in England and Denmark. JAMA Dermatol. Published online June 24, 2020.  doi:10.1001/jamadermatol.2020.1948

Swales, J. (1990). Creating A Research Space (CARS). ​Genre Analysis CUP http://www.cs.tut.fi/kurssit/SGN16006/academic_writing/cars_model_handout.pdf