Celebrities can not only influence our fashion and diets but also our medical decisions, according to a study that analyzed breast cancer gene testing rates after Angelina Jolie did an opinion piece advocating testing in 2013.
The study, led by Harvard Medical School Researchers, was published in the British Medical Journal.“ It was titled “Do celebrity endorsements matter? Observational study of BRCA gene testing and mastectomy rates after Angelina Jolie’s New York Times editorial.”
After Jolie’s op-ed in The New York Times, there was a spike in testing for the BRCA gene, which increases the risk of breast cancer. The spike did not lead to an increase in breast-cancer surgery rates, however.
A possible interpretation is that the BRCA tests failed to increase breast cancer diagnoses, most likely because those who tested were at low risk of BRCA mutations to begin with.
Researchers considered this a good example of how celebrity endorsements can fuel the use of health care services, but not necessarily among those most in need of the services.
“Our findings underscore celebrity endorsements as a powerful influence on health-related behaviors, but they also show that such endorsements do not necessarily target those most at risk for developing a disease,” Sunita Desai, a Seidman Fellow and researcher in the Department of Health Care Policy at Harvard, said in a press release.
Jolie discussed her decision to get tested for the BRCA1 gene after she lost her mother, grandmother, and aunt to breast cancer. When she discovered she had the disease-promoting mutation, she decided to have a preventive double mastectomy.
Many women appeared to heed her call for testing. An insurance database covering the medical records of more than nine million women between 18 and 64 showed a 64 percent increase in genetic testing for breast cancer in the two weeks after Jolie’s op-ed.
To help validate their conclusion, researchers checked on whether there were spikes in the same period the previous year. They found none.
The research estimated that the op-ed led to 4,500 more tests than normal, despite the significant cost of the procedure — $3,000.
The authors said BRCA testing may be the first celebrity-driven medical trend worth looking at carefully. That’s because rapid advances in understanding diseases is likely to make new genetic testing available for them.
People should not consider genetic testing without seeing a doctor, however, the researchers said. The reason is that testing reveals only a person’s likelihood of developing a disease – it does not mean that the disease is certain.
“While there are clear benefits to advances in genetic testing, a positive genetic test could also create anxiety and compel patients and clinicians to perform further testing or undergo premature or unnecessary clinical interventions,” Desai said.
Doctors need to determine why a patient wants a test or procedure, the researchers said. If they learn that a celebrity’s opinion has influenced the request, they should assess the patient’s medical and family history, then discuss the pros and cons of the test before asking the patient to make a final decision.
Aware of her influence on the public, Jolie published another op-ed in 2015 calling for testing and treatment decisions to be made on a case-by-case basis under the supervision of a physician. While surgery was right for her, non-surgical options might be better for other women, Jolie said in her second piece.
“There’s no right or wrong answer to whether a patient should get a genetic test,” said Anupam Jena, study author and a physician at Massachusetts General Hospital. “But it’s important to get a full understanding of the situation to make a well-informed decision.”