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Undue Influence

DMS study finds celebrity endorsements of cancer screening may influence public to ignore possible harms

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 Veterans Administration (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.

Study co-authors, L-R, are faculty members in Medicine and Community and amily Medicine Steve Woloshin, Gilbert Welch and Lisa Schwartz. Robin Larson is an Instructor in Medicine. (photo by Jon Gilbert Fox)

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.

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, the authors said. They are often delivered in the context of stories about a celebrity's own cancer diagnosis or that of a loved one.

The authors pointed to some potential problems with these types of messages. "These one-sided, highly persuasive messages run counter to U.S. Preventive Services Task Force recommendations encouraging thoughtful, balanced discussions about both the benefits and harms of screening," said co-author 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 of women age 40 and older reported that they had seen or heard celebrities talk about mammograms, and, of these women, 25 percent said it made them more likely to undergo screening mammography. Nearly two-thirds of men age 50 and older reported that they had seen or heard celebrities talk about PSA tests and, of these men, 31 percent said it made them more likely to undergo PSA testing. About half of adults age 50 and older reported that they had seen or heard celebrities talk about sigmoidoscopy or colonoscopy and, of these people, thirty-seven percent said 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 wrote. "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."


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Last Updated: 12/17/08