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Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect
Ist Teil von
Breast cancer research and treatment, 2018-09, Vol.171 (2), p.435-442
Ort / Verlag
New York: Springer US
Erscheinungsjahr
2018
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
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.