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Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect
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 Jo...
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| Published in: | Breast cancer research and treatment 2018-09, Vol.171 (2), p.435-442 |
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| container_title | Breast cancer research and treatment |
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| creator | Liede, Alexander Cai, Mona Crouter, Tamara Fidler Niepel, Daniela Callaghan, Fiona Evans, D. Gareth |
| description | 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
|
| doi_str_mv | 10.1007/s10549-018-4824-9 |
| format | article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6096880</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A548869029</galeid><sourcerecordid>A548869029</sourcerecordid><originalsourceid>FETCH-LOGICAL-c634t-9be113b950a70522e89ad2c38384fcf8bcefd6b7d0584f9337dc520d3ef0eec23</originalsourceid><addsrcrecordid>eNp1kl1rFTEQhhdR7LH6A7yRgCDebJ1kN7uJF8Kh1C8KgtorL0I2OzkndTepya60_96sp7Y9ooQQmHnmDTPzFsVTCkcUoH2VKPBalkBFWQtWl_JesaK8rcqW0fZ-sQLatGUjoDkoHqV0DgCyBfmwOGBSgGCiXRXfPrv0vYzYz8b5DRl1mtBMYbwiUU-YiPNk2iI5-_KaaGKGkDASvNSj83pywZNgf-fXfoNDjpGPYXBI0Nqs8rh4YPWQ8Mn1e1icvT35evy-PP307sPx-rQ0TVVPpeyQ0qqTHHQLnDEUUvfMVKIStTVWdAZt33RtDzwHZFW1veEM-gotIBpWHRZvdroXczdib9BPUQ_qIrpRxysVtFP7Ge-2ahN-qgZkIwRkgZfXAjH8mDFNanTJ4DBoj2FOikHdNPlymtHnf6HnYY4-t7dQXICUnN9SGz2gct6G_K9ZRNWa10I0EpjM1NE_qHx6HJ0JHq3L8b2CF3cKtqiHaZvCMC-bSPsg3YEmhpQi2pthUFCLddTOOipbRy3WUUvNs7tTvKn445UMsB2QcirvO962_n_VXzHczSs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2045809955</pqid></control><display><type>article</type><title>Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect</title><source>Springer Nature</source><creator>Liede, Alexander ; Cai, Mona ; Crouter, Tamara Fidler ; Niepel, Daniela ; Callaghan, Fiona ; Evans, D. Gareth</creator><creatorcontrib>Liede, Alexander ; Cai, Mona ; Crouter, Tamara Fidler ; Niepel, Daniela ; Callaghan, Fiona ; Evans, D. Gareth</creatorcontrib><description>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.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-018-4824-9</identifier><identifier>PMID: 29808287</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; BRCA1 protein ; Breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - epidemiology ; Breast Neoplasms - etiology ; Breast Neoplasms - surgery ; Cancer diagnosis ; Cancer research ; Databases, Factual ; Diagnosis ; Epidemiology ; Female ; Gene mutation ; Genes, BRCA1 ; Genetic screening ; Genetic testing ; Genetic Testing - statistics & numerical data ; Heterozygote ; Humans ; Incidence ; Jolie, Angelina ; Mastectomy ; Medicine ; Medicine & Public Health ; Middle Aged ; Mutation ; Oncology ; Ovarian cancer ; Prophylactic Mastectomy - statistics & numerical data ; Public health ; Public Health Surveillance ; Statistical analysis ; Surgery ; Trends ; Tumors ; United States - epidemiology ; Womens health ; Young Adult</subject><ispartof>Breast cancer research and treatment, 2018-09, Vol.171 (2), p.435-442</ispartof><rights>The Author(s) 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Breast Cancer Research and Treatment is a copyright of Springer, (2018). All Rights Reserved. © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c634t-9be113b950a70522e89ad2c38384fcf8bcefd6b7d0584f9337dc520d3ef0eec23</citedby><cites>FETCH-LOGICAL-c634t-9be113b950a70522e89ad2c38384fcf8bcefd6b7d0584f9337dc520d3ef0eec23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29808287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liede, Alexander</creatorcontrib><creatorcontrib>Cai, Mona</creatorcontrib><creatorcontrib>Crouter, Tamara Fidler</creatorcontrib><creatorcontrib>Niepel, Daniela</creatorcontrib><creatorcontrib>Callaghan, Fiona</creatorcontrib><creatorcontrib>Evans, D. Gareth</creatorcontrib><title>Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>BRCA1 protein</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - etiology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer diagnosis</subject><subject>Cancer research</subject><subject>Databases, Factual</subject><subject>Diagnosis</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gene mutation</subject><subject>Genes, BRCA1</subject><subject>Genetic screening</subject><subject>Genetic testing</subject><subject>Genetic Testing - statistics & numerical data</subject><subject>Heterozygote</subject><subject>Humans</subject><subject>Incidence</subject><subject>Jolie, Angelina</subject><subject>Mastectomy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Oncology</subject><subject>Ovarian cancer</subject><subject>Prophylactic Mastectomy - statistics & numerical data</subject><subject>Public health</subject><subject>Public Health Surveillance</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Trends</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kl1rFTEQhhdR7LH6A7yRgCDebJ1kN7uJF8Kh1C8KgtorL0I2OzkndTepya60_96sp7Y9ooQQmHnmDTPzFsVTCkcUoH2VKPBalkBFWQtWl_JesaK8rcqW0fZ-sQLatGUjoDkoHqV0DgCyBfmwOGBSgGCiXRXfPrv0vYzYz8b5DRl1mtBMYbwiUU-YiPNk2iI5-_KaaGKGkDASvNSj83pywZNgf-fXfoNDjpGPYXBI0Nqs8rh4YPWQ8Mn1e1icvT35evy-PP307sPx-rQ0TVVPpeyQ0qqTHHQLnDEUUvfMVKIStTVWdAZt33RtDzwHZFW1veEM-gotIBpWHRZvdroXczdib9BPUQ_qIrpRxysVtFP7Ge-2ahN-qgZkIwRkgZfXAjH8mDFNanTJ4DBoj2FOikHdNPlymtHnf6HnYY4-t7dQXICUnN9SGz2gct6G_K9ZRNWa10I0EpjM1NE_qHx6HJ0JHq3L8b2CF3cKtqiHaZvCMC-bSPsg3YEmhpQi2pthUFCLddTOOipbRy3WUUvNs7tTvKn445UMsB2QcirvO962_n_VXzHczSs</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Liede, Alexander</creator><creator>Cai, Mona</creator><creator>Crouter, Tamara Fidler</creator><creator>Niepel, Daniela</creator><creator>Callaghan, Fiona</creator><creator>Evans, D. Gareth</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180901</creationdate><title>Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect</title><author>Liede, Alexander ; Cai, Mona ; Crouter, Tamara Fidler ; Niepel, Daniela ; Callaghan, Fiona ; Evans, D. Gareth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c634t-9be113b950a70522e89ad2c38384fcf8bcefd6b7d0584f9337dc520d3ef0eec23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>BRCA1 protein</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - etiology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer diagnosis</topic><topic>Cancer research</topic><topic>Databases, Factual</topic><topic>Diagnosis</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gene mutation</topic><topic>Genes, BRCA1</topic><topic>Genetic screening</topic><topic>Genetic testing</topic><topic>Genetic Testing - statistics & numerical data</topic><topic>Heterozygote</topic><topic>Humans</topic><topic>Incidence</topic><topic>Jolie, Angelina</topic><topic>Mastectomy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Oncology</topic><topic>Ovarian cancer</topic><topic>Prophylactic Mastectomy - statistics & numerical data</topic><topic>Public health</topic><topic>Public Health Surveillance</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Trends</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liede, Alexander</creatorcontrib><creatorcontrib>Cai, Mona</creatorcontrib><creatorcontrib>Crouter, Tamara Fidler</creatorcontrib><creatorcontrib>Niepel, Daniela</creatorcontrib><creatorcontrib>Callaghan, Fiona</creatorcontrib><creatorcontrib>Evans, D. Gareth</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liede, Alexander</au><au>Cai, Mona</au><au>Crouter, Tamara Fidler</au><au>Niepel, Daniela</au><au>Callaghan, Fiona</au><au>Evans, D. Gareth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>171</volume><issue>2</issue><spage>435</spage><epage>442</epage><pages>435-442</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29808287</pmid><doi>10.1007/s10549-018-4824-9</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2018-09, Vol.171 (2), p.435-442 |
| issn | 0167-6806 1573-7217 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6096880 |
| source | Springer Nature |
| subjects | Adolescent Adult Aged Aged, 80 and over BRCA1 protein Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - epidemiology Breast Neoplasms - etiology Breast Neoplasms - surgery Cancer diagnosis Cancer research Databases, Factual Diagnosis Epidemiology Female Gene mutation Genes, BRCA1 Genetic screening Genetic testing Genetic Testing - statistics & numerical data Heterozygote Humans Incidence Jolie, Angelina Mastectomy Medicine Medicine & Public Health Middle Aged Mutation Oncology Ovarian cancer Prophylactic Mastectomy - statistics & numerical data Public health Public Health Surveillance Statistical analysis Surgery Trends Tumors United States - epidemiology Womens health Young Adult |
| title | Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect |
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