The Couric-Jolie effect: When celebrities share their medical experiences

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publishing

Follow me on Twitter @RobShmerling

Some called it the Katie Couric effect. Soon after her husband died of colon cancer in 1998, the journalist and television personality had a televised colonoscopy to promote the test. Rates of screening colonoscopies soared for at least a year. Or, call it the Angelina Jolie effect. In 2013, the actress wrote an editorial in the New York Times about the tests she had for genes (called BRCA) linked with breast and ovarian cancer, and how the positive result led her to have a double mastectomy. Soon after, rates of BRCA testing jumped.

Whatever you call it, the effect is real. When it comes to matters of health, celebrities can have an enormous impact.

It’s good when celebrities do good

The impulse to take a challenging or tragic medical experience and turn it into something that helps others is commendable. It may be easier to keep such matters private or avoid talking about them in public. But time and again, we see celebrities joining forces with health-promoting organizations, speaking out, and sharing their stories to help others avoid what they’ve experienced. Many have credited Katie Couric with removing the embarrassment associated with colonoscopy and showing how easy it is.

Is there a downside?

There are a number of ways celebrity pronouncements on matters of health can go wrong. For example, the information can be faulty or confusing. The forays of Jenny McCarthy (who claimed vaccines cause autism) and Gwyneth Paltrow (who recommended vaginal steams to “cleanse the uterus”) into matters of health and illness are examples of influence most doctors would consider unhelpful or even dangerous.

When I heard about Katie Couric’s colonoscopy, I thought it was brave and certainly a unique way to get her message across. But as well-intended as it may have been, she was 43 years old at the time. Since guidelines suggest people begin routine screening at age 50, I wondered if she was a good candidate for the test. Unless she had symptoms (such as intestinal bleeding), a strong family history of early colon cancer, or some other special circumstance that put her at higher than average risk for colon cancer, her colonoscopy could be considered unnecessary testing. And that could have led others to have unnecessary testing as well.

A recent study raises a similar concern about Angelina Jolie’s BRCA testing. It found that in the weeks after her editorial was published, testing increased by more than 60% (at an estimated cost of $13.5 million). However, mastectomy rates actually fell over the next two to six months, leading the authors to suggest that most of the additional women who had testing had negative results and therefore may have been poor candidates for testing in the first place. Of note, the study did not confirm whether those having the BRCA test had risk factors (especially a family history of early breast or ovarian cancer) that would make the test appropriate. Critics of the study have suggested that mastectomy rates within six months of testing is not an adequate measure of whether the tests were appropriate. Still, the point is worth considering. When a celebrity recommends a medical test or treatment, the audience is not limited to those who are most likely to benefit.

The bottom line

For any medical test or treatment, ask whether it’s likely to be helpful. The answer may be straightforward. For example, a well-studied and well-accepted screening test may be recommended based only on your age and gender. But in many cases, the answer may rely on a considerable amount of judgement based on how likely it is that you have a particular condition, the ability of the test to detect it, and the impact of the test result on treatment decisions. For example, if a person has knee pain that’s mild and well-controlled with exercises, it may make little sense to have an MRI, as the results are highly unlikely to affect treatment.

If your doctor recommends a test or treatment, make sure you understand why. And if it’s a celebrity making the recommendation, do yourself a favor: run it by your doctor.

Comments:

  1. Sheldon Baker

    As a marketing professional, I have utilized celebrity spokespeople to help share information about their health issues or those of their loved ones. In each occasion, the public gained valuable first-hand information how a health issue could be addressed. I believe a celebrity’s honest experience is real and can help breakthrough the clutter of information available to consumer audiences.

  2. Ann

    What about BRCA screening for men? This is not only a female reproductive cancer issue.

  3. Thomas Turk

    It’s a great shame that no cancer cure is officially published in any Med J, as that makes it illegal for the doc to cure you. (77 holistic docs working with enzymatic macrophge boosters have been murdered). in the US Med Js simply refuse to publish as was with Dr Robert Good’s 1980s natural, enzymatic pancreatic cancer cure. Dr Good was the world leader in immunology with the 1st bone marrow transplant and over 2000 papers out. The Med Js informed him his ideas didn’t fit in wih the concepts of that time. In the UK they’re much stricter. The1939 UK Cancer Act prohibits the publication of any cancer cure. Luckily for those willing to gooutside the ‘box’ we have privately published the works of H R Clark PhD ND who carried out over 1/2 million reproducible bio-resonance tests to identify the precise causes and pathways of all cancers.

    For colon cancer prevention, ,Dr Clark advises avoiding 2 substances that inflame the colon. She states that an inflamed body part allows easy entry for the cancer nucleus and cancer complex to there start and fuel a malignancy, in the presence of nickel. The 2 colon inflammatory agents are burnt (from BBQs) and smoked meats, fish and even burnt veges, which develop inflammatory pyrroles, acrylamides. Hence the faulty red meat causing cancer theory. Also acetic acid, vinegar, apart from apple cider vinegar is colon colon inflammatory.

  4. Thomas Braxtan

    Amen! I can relate the experience of unnecessary testing that led to several ultrasounds with conflicting results, a CT scan and a liver biopsy to investigate mild hepatomegaly in a mild diabetic who was seronegative for all known hepatitis. Would a definitive diagnosis have changed treatment? Was the risk worth the benefit?

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