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28.05.2018 | Epidemiology | Ausgabe 2/2018 Open Access

Breast Cancer Research and Treatment 2/2018

Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect

Zeitschrift:
Breast Cancer Research and Treatment > Ausgabe 2/2018
Autoren:
Alexander Liede, Mona Cai, Tamara Fidler Crouter, Daniela Niepel, Fiona Callaghan, D. Gareth Evans
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10549-018-4824-9) contains supplementary material, which is available to authorized users.

Abstract

Purpose

In 2013, Angelina Jolie disclosed in the New York Times (NYT) that she had undergone risk-reducing bilateral mastectomy (RRBM) after learning that she was a BRCA1 mutation carrier. We examined the rates of BRCA testing and RRBM from 1997 to 2016, and quantified trends before and after the Jolie op-ed.

Methods

This observational study of insurance claims data representative of the commercially-insured US population (Truven MarketScan® database) measured BRCA testing and RRBM rates among females ≥ 18 years. Censoring events were breast cancer or ovarian cancer diagnosis, last follow-up date (September 2016), or death. Interrupted time series analyses were used to quantify trends before and after the op-ed.

Results

Angelina Jolie’s NYT op-ed led to a statistically significant increase in the uptake of genetic testing and in RRBM among women without previous diagnosis of breast or ovarian cancer in the US population, and in women who did not undergo testing for BRCA (P < 0.0001 for both). The rate (slope) of RRBM among women who were previously tested for BRCA (P = 0.70) was unchanged. After excluding women with in-situ tumors, the editorial’s effect became less pronounced, suggesting that high-risk women with in-situ breast cancers were most influenced by Jolie’s announcement.

Conclusion

The Angelina Effect—a term coined by Time magazine to describe the rise in internet searches related to breast cancer genetics and counseling—represents a long-lasting impact of celebrity on public health awareness as significant increases in genetic testing and mastectomy rates were observed and sustained in subsequent years.

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Zusatzmaterial
Supplementary material 1 (DOCX 28 KB)
10549_2018_4824_MOESM1_ESM.docx
Supplementary material 2 (DOCX 26 KB)
10549_2018_4824_MOESM2_ESM.docx
Online Resource 3. STROBE Diagram [&#x003C;link rid="bib12"&#x003E;12&#x003C;/link&#x003E;] for Study Population Identified in MarketScan Database (1997–2016) (online only) (EPS 809 KB)
10549_2018_4824_MOESM3_ESM.eps
Literatur
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