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Pleas are persuasive, but are they positive?

After seeing or hearing celebrity pitches for cancer screening, Americans are more likely to get screened, found a DMS study. But the authors of the paper, published in the Journal of the National Cancer Institute, say the well-meaning, passionate pleas of people like Katie Couric, Rosie O'Donnell, and Norman Schwarzkopf may not be good for the public.

"Celebrity endorsements of cancer screening tests typically consist of onesided 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," says Steven Woloshin, M.D., coauthor of the study.

Two-edged: But the decision to undergo screening is more complex than such ads imply. "Early detection of cancer will help some people, but it can create problems for others, such as unnecessary testing and treatment," the authors explain. "Consequently, screening is increasingly recognized as a two-edged sword." (For more on this subject, see page 40.)

To find out how influential celebrity messages about cancer screening are, the researchers surveyed a nationally representative sample of 360 women aged 40 or older and 140 men aged 50 or older. They asked the women if they'd "seen or heard celebrities like Rosie O'Donnell and Nancy Reagan talk about getting mammograms"; 73% said they had. Men were asked if they'd "seen or heard celebrities like Norman Schwarzkopf talk about getting PSA tests"; 63% said they had. And men and women over 50 were asked if they'd "seen or heard celebrities like Katie Couric talk about getting a sigmoidoscopy or colonoscopy"; 52% said they had.

Next, those who responded "yes" to the first questions were asked if the messages had made them more likely to have the screening test, less likely, or neither. It turned out the effect was significant—"more likely" responses totaled 25% for mammography, 31% for PSA, and 37% for sigmoidoscopy or colonoscopy.

Likely: "There's not a lot out there that can get 25% of people to say that they are more likely to get screened," says Robin Larson, M.D., M.P.H., lead author of the paper. The same team also just published a study on advertising by academic medical centers (see the facing page).

"Screening is really a complex issue," says Larson. "Americans are very enthusiastic about screening, and they don't perhaps understand that there are downsides." She and her coauthors are also concerned about the effect of celebrity endorsements on doctor-patient relationships. "It makes it harder for you," she says, "when you do go to your doctor and try to have a balanced conversation about something when you have this emotional, in- fluential person saying, 'Go get screened. I might not be alive now if I hadn't.'"

The goal of messages about screening "should not be to persuade but to inform," the authors conclude. "Thus, we see no obvious role for celebrity endorsements of cancer screening."

Jennifer Durgin

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