Healthcare professionals have speculated for some time that Angelina Jolie’s decision to have a mastectomy in 2013 to reduce her risk of developing breast cancer prompted a lot of other women to do the same.
A joint American-Australian study is offering hard statistics that appear to show that speculation about what news organizations call the Angelina Jolie Effect was right.
The star of many movies, Jolie is one of the most recognizable people in the world. In addition to acting, she’s known for her philanthropy, including being a United Nations Goodwill Ambassador.
Jolie decided to have a mastectomy because tests showed she had a gene mutation associated with the development of breast cancer. She publicized the decision, she said, in hopes of prompting other women at risk of developing the cancer to consider this preventive option.
Researchers at Weill Cornell Medicine in New York State and the University of New South Wales in Australia decided to search for evidence that would demonstrate that the Jolie Effect was more than just speculation.
An examination of hospital discharge data in New York State and New South Wales between 2004 and 2014 showed a significant increase in risk-reducing mastectomies starting in May 2013, three months after Jolie’s announcement.
Twenty months after Jolie’s announcement, the average rate of preventive surgical breast removals in New York State was 6.3 cases every two months, researchers found. That was almost twice the rate of 3.3 cases every two months 20 months before her announcement. This meant that In just over three years, the number of preventive surgery cases per million women had nearly doubled.
The results In New South Wales were virtually identical.
Researchers published their findings in Health Services Research. Their article was titled “Trends in Use of Risk-Reducing Mastectomy in a Context of Celebrity Decisions and Media Coverage: An Observational Study in the United States and Australia.”
The results suggested that celebrities can have a major influence on the public’s healthcare decisions, the researchers said.
Their decision to track rates in two countries helped rule out the possibility that the results stemmed solely from local influences in one country. One implication was that the Jolie Effect was likely a global phenomenon.
“This is an important area of research that healthcare providers and policy makers need to pay attention to,” Art Sedrakyan, a professor of healthcare policy and research at Weill Cornell Medicine, said in a Weill Cornell Medicine news story. “If celebrities are going to act on genetic testing and announce their treatment choices, then we should get prepared on our end to assess public health impact.”
The study validated findings that singer Kylie Minogue’s breast cancer diagnosis in 2005 led to a surge in Australian women aged 25 to 44 obtaining x-ray and other imaging tests to detect breast cancer.
Louisa Jorm, director of the University of New South Wales’ Centre for Big Data Research, said the message from the American-Australian study is clear: The healthcare system should encourage celebrities to discuss their health as a way of helping the public obtain information about risks, treatments and cost. Jorm was co-leader of the study.
Harvard researchers reached a different conclusion in a study published in December 2016. They asserted that having celebrities talk openly about their health could put a strain on the healthcare system without helping those who need it.
Their study investigated the Jolie Effect by looking at the rates of genetic testing for BRCA gene mutations, which are associated with the development of breast cancer.
The team acknowledged in the British Medical Journal that after Jolie wrote an opinion piece in the New York Times called “My Medical Choice,” there was a spike in genetic testing for the BRCA gene. They titled their article “Do celebrity endorsements matter? Observational study of BRCA gene testing and mastectomy rates after Angelina Jolie’s New York Times editorial.”
The surge in genetic testing may not have led to increased rates of breast cancer surgery, the team asserted. They speculated that most of the women who were tested were at low risk of having BRCA mutations anyway, so the tests likely failed to increase breast cancer diagnoses.
They considered this an example of how celebrity endorsements can fuel the use of healthcare services, but not necessarily among those most in need of the services.