Celebrity endorsements skirt screening recomendations

Celebrities have always endorsed commercial products, but now they're increasingly touting diagnostic imaging screening exams. These endorsements aren't without drawbacks, according to a study in the May issue of the Journal of the National Cancer Institute.

Celebrity endorsements of cancer screening tests typically give a one-sided message that either the celebrity's life was saved by a cancer screening test or the life of a loved one was lost due to a failure to be screened, according to lead author Dr. Robin J. Larson, an instructor of medicine at Dartmouth Medical School.

"These types of well-meaning efforts to promote cancer screening have contributed to an environment in which people believe that screening is a responsibility and that there are no downsides to being screened," Larson said.

But making a snap decision to undergo a medical screening procedure based on celebrity testimony goes against current recommendations that thoughtful, balanced conversations are needed to facilitate informed decision making about cancer screening, she said.

Larson and colleagues conducted a random-digit dialing survey in the U.S. A total of 360 women aged 40 and over and 140 men 50 and over participated in the survey with the following results:

• 73% of women reported hearing a celebrity talk about getting mammography, with 25% of those respondents saying they were more likely to get a mammogram because of the endorsement.

• 52% of the adults 50 and over said they had heard endorsements for sigmoidoscopy or colonoscopy, and 37% of the respondents said they were more likely to get one because of the endorsement.

Researchers were surprised at the high degree of celebrity influence. They now want to know how these endorsements affect people for whom screening is not recommended.

"Do these messages influence people most likely to benefit from screening, or do they influence people for whom the potential benefits are not thought to outweigh the potential harms, such as Katie Couric, who was not of screening age or high risk?" she said.

Larson was referring to Couric's high-profile televised virtual colonoscopy in 2000, shortly after her husband suddenly died of colon cancer at the age of 42. A study by researchers at the University of Michigan Health System in the July 14, 2003, issue of the Archives of Internal Medicine found that colonoscopy rates nationwide jumped more than 20% in the days and months after Couric's on-air test. The higher rate of colonoscopies was sustained for nearly a year after Couric's exam.

Echoing Larson's concern, the Michigan researchers found that the proportion of colonoscopies performed on people under age 50 increased, reflecting "Today Show" audience demographics. Current national guidelines recommend the test every 10 years mainly for people age 50 and over, who face the highest risk.

Celebrity endorsements can also complicate the patient/physician relationship, according to Larson. Doctors treating patients who have come in because of a celebrity endorsement may have difficulty dissuading them from getting an inappropriate screening exam.

"Some would argue that getting the patient talking to the doctor about screening is all that matters, but it's not that simple," she said. "Helping the public to understand there can be downsides to screening and doing our best to promote conversations about screening, rather than just imploring or scaring people into getting screened, would be a real public service."

For more information from the online Diagnostic Imaging archives:

Copenhagen study confirms mammo screening benefit

AAA screening concept gains ground but faces funding challenge

Screening centers squelch balanced information

Study refuels debate over whole-body CT screening