For Release: May 3, 2005
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Celebrity Endorsements of Cancer Screening May Unduly Influence Public, Study Says:
Testimonials Present the Good, Ignore Possible Harms of Screening

Photo by: Jon Fox
Dartmouth Medical School
Authors of the study are, from left, Drs. Steve Woloshin, Gilbert Welch, Lisa Schwartz, and Robin Larson

HANOVER, NH and WHITE RIVER JUNCTION, VT -- Celebrity endorsements of cancer screening tests reach the majority of Americans adults and influence many of their decisions about cancer screening, according to a new study by researchers at Dartmouth Medical School (DMS) and the VA Outcomes Group. More than one-half of adults surveyed nationwide had seen or heard celebrity endorsements of cancer screening tests, and more than one-fourth reported that it made them more likely to undergo the promoted screening test, the researchers reported in the May 4 issue of the Journal of the National Cancer Institute.

"Celebrity endorsements of cancer screening tests typically consist of one-sided messages either asserting that the celebrity's life was saved by a cancer screening test or suggesting that the life of a loved one was lost due to a failure to be screened. These types of well-meaning efforts to promote cancer screening contribute to the public perception that screening is a responsibility and that there are no down-sides to being screened," said Dr. Steve Woloshin, associate professor of medicine and of community and family medicine at DMS and co-author of the study.

The researchers conducted a nationwide telephone survey to examine the extent to which adults of relevant cancer screening age had seen, heard, or been influenced by celebrity endorsements of various cancer screening tests—mammography, prostate-specific antigen (PSA) testing, and sigmoidoscopy or colonoscopy. According to the authors, this is the first study from a nationally representative survey to investigate how celebrity endorsements of cancer screening affect the public.

Dartmouth Medical School

Rosie O'Donnell's efforts to encourage women to get mammograms, former New York City Mayor Rudolph Giuliani's endorsement of the PSA test, and journalist Katie Couric's promotion of colonoscopy are examples of an increasingly common phenomenon of celebrities endorsing specific cancer screening tests, write the authors. The messages often include highly emotional pleas urging the public to, "Get screened now" and "Don't end up saying, 'if only'". They are often delivered in the context of stories about a celebrity's own cancer diagnosis or that of a loved one.

The authors point to some potential problems with these types of messages. "These one-sided, highly persuasive messages run counter to US Preventive Services Task Force recommendations encouraging thoughtful, balanced discussions about both the benefits and harms of screening," said co-author Dr. Robin Larson, instructor in medicine at DMS. "Emotional messages from highly engaging personalities may jeopardize a patient's ability to make an informed decision that best reflects how they personally value the tradeoffs involved."

Almost three-quarters (73%) of women age 40 and older reported that they had seen or heard celebrities talk about mammograms, and, of these women, 25% said that it made them more likely to undergo screening mammography. Nearly two-thirds (63%) of men age 50 and older reported that they had seen or heard celebrities talk about PSA tests, and, of these men, 31% said it made them more likely to undergo PSA testing. About half (52%) of adults age 50 and older reported that they had seen or heard celebrities talk about sigmoidoscopy or colonoscopy, and, of these people, 37% said that it made them more likely to undergo one of these tests.

"Whether to undergo cancer screening is a complex decision—early detection of cancer will help some people, but it can create problems for others, such as unnecessary testing and treatment," the authors write. "There is little question that celebrities can have a powerful impact on the public and that their influence can be put to good use. However, when it comes to public health endorsements, we feel that celebrities should be judicious in using their powers of persuasion.... [W]hen it comes to communicating about complex decisions such as cancer screening, the goal should not be to persuade but to inform. Thus, we see no obvious role for celebrity endorsement of cancer screening."

Co-authors of the study include Dr. Gilbert Welch and Dr. Lisa Schwartz, professor and associate professor, respectively, of medicine and of community and family medicine, and both members of the Center for the Evaluative and Clinical Sciences at DMS. The research was funded in part by grants from the Dept. of Defense Breast Cancer Research Program, the National Cancer Institute, and a Research Enhancement Award from the Department of Veterans Affairs awarded to the VA Outcomes Group. The research was conducted at the VA Medical Center in White River Junction, VT, where members of the VA Outcomes Group promote balanced information about risks and benefits of medical care and investigate the effects of expanding definitions of disease (more info here.)


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