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Angelina Jolie has been very public about her choice to undergo a preventive double mastectomy. Her very honest, and descriptive opinion piece in the New York Timesthis past May even outlined the risk factors unique to her physiology and genetic makeup, which prompted her actions.
Many oncologists and genetic specialists believe that Jolie made a well-educated decision under the guidance of competent medical counsel. Jolie tested positive for mutations in her BRCA1 gene and her biological mother fought breast cancer for a decade before passing at the age of 56.
These combined risk factors gave her an estimated 87% chance, at the highest end of the range, of developing breast cancer, which was reduced to 5% post mastectomy.
But, as it turns out, most people have completely missed out on the medically relevant details, Dina L.G. Borzekowski, EdD, of Johns Hopkins School of Public Health, and colleagues reported online in Genetics in Medicine.
Borzekowski and colleagues surveyed 2,572 adults, men and women, across the nation about their awareness and understanding of Jolie's health and breast cancer risks, as well as hypothetical questions about how they would handle a similar situation.
After assessing the surveys, the researchers found that three out of four responders knew of Jolie's surgery, but fewer than 10% had an accurate understanding of what Jolie's risk factors actually were for developing breast cancer in relation to women who do not have BRCA1gene mutations.
Nearly half of all responders were able to recall Jolie's estimated risk for breast cancer prior to her surgery. And 57% of the women said they would also have had a prophylactic double mastectomy if they tested positive for a BRCA gene mutation.
"Awareness of the Angelina Jolie story was not associated with improved understanding .... In fact, among those who followed the story, women were less accurate than men, almost always overestimating the contribution of the BRCA mutation to breast cancer and the average women's lifetime risk of breast cancer," Borzekowski and colleagues wrote.
In conclusion, Borzekowski and colleagues noted that celebrities may have the capacity to heighten awareness of a particular health issue, but that those messages should be sandwiched between useful and purposeful communications to help the public understand exactly what is going on in these individual cases.
Without purposeful communication to put individual cases in public context, the "Couric Effect" may spike misplaced health concerns, and therefore unnecessary screenings for low-risk individuals.
In 2000, Katie Couric underwent an on-air colonoscopy, after her husband died from colon cancer. Researchers at the University of Michigan did a population-based observational study on increases in colonoscopy screenings in the general public. Overall, a 20% increase, and in women alone, a 4% increase, in colonoscopies occurred during the 9 months following Couric's televised event.
For years now, researchers have been reporting on overscreening; it's expensive, invasive, and stressful.
Even 8% of responders to Borzekowski's survey said they had increased anxiety for several weeks after hearing about Jolie. Although no uptick in mammograms were reported by survey participants, 9% said they felt more motivated to get the mammogram they had been putting off.
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More about women's health can be access on this Louise Habash blog site.
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