The online version of this article (https://doi.org/10.1007/s10549-018-4824-9) contains supplementary material, which is available to authorized users.
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.
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.
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.
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.
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 [<link rid="bib12">12</link>] for Study Population Identified in MarketScan Database (1997–2016) (online only) (EPS 809 KB)10549_2018_4824_MOESM3_ESM.eps
Jolie A (2013) My medical choice. New York Times, May 14, 2013. http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html. Accessed 20 May 2013
Antoniou AC, Hardy R, Walker L, Evans DG, Shenton A, Eeles R, Shanley S, Pichert G, Izatt L, Rose S et al (2008) Predicting the likelihood of carrying a BRCA1 or BRCA2 mutation: validation of BOADICEA, BRCAPRO, IBIS, Myriad and the Manchester scoring system using data from UK genetics clinics. J Med Genet 45(7):425–431 CrossRefPubMed
US Census Bureau. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_16_1YR_B01001&prodType=table. Accessed 5 Dec 2017
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, Initiative S (2007) Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 335(7624):806–808 CrossRef
Logue LJ (2003) Genetic testing coverage and reimbursement: a provider’s dilemma. Clin Leadersh Manag Rev 17(6):346–350 PubMed
Mues KE, Liede A, Liu J, Wetmore JB, Zaha R, Bradbury BD, Collins AJ, Gilbertson DT (2017) Use of the medicare database in epidemiologic and health services research: a valuable source of real-world evidence on the older and disabled populations in the US. Clin Epidemiol 9:267–277 CrossRefPubMedPubMedCentral
National Human Genome Research Institute (NHGRI): The Genetic Information Nondiscrimination Act (GINA) of 2008. https://www.genome.gov/27568492/the-genetic-information-nondiscrimination-act-of-2008/. Accessed 21 Dec 2017
U.S. Department of Health and Human Services: Affordable Care Act. https://www.hhs.gov/healthcare/about-the-aca/index.html. Accessed 21 Dec 2017
Gregorowitsch ML, van den Bongard H, Young-Afat DA, Pignol JP, van Gils CH, May AM, Verkooijen HM (2017) Severe depression more common in patients with ductal carcinoma in situ than early-stage invasive breast cancer patients. Breast Cancer Res Treat
Dorval M, Gauthier G, Maunsell E, Dugas MJ, Rouleau I, Chiquette J, Plante M, Laframboise R, Gaudet M, Bridge PJ et al (2005) No evidence of false reassurance among women with an inconclusive BRCA1/2 genetic test result. Cancer Epidemiol Biomark Prev 14(12):2862–2867 CrossRef
Ertmanski S, Metcalfe K, Trempala J, Glowacka MD, Lubinski J, Narod SA, Gronwald J (2009) Identification of patients at high risk of psychological distress after BRCA1 genetic testing. Genet Test Mol Biomark 13(3):325–330 CrossRef
Liede A, Fairchild A, Friedman S, Amelio J, Hallett DC, Mansfield CA, Metcalfe KA (2016) Abstract P2-09-09: risk-reducing surgery and cancer-related distress among female BRCA1 and BRCA2 mutation carriers, vol 76
- Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect
Tamara Fidler Crouter
D. Gareth Evans
- Springer US
- Breast Cancer Research and Treatment
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
Neu im Fachgebiet Onkologie
Mail Icon II