A content analysis of cancer survivorship coverage in a representative sample of US news outlets

Background. Media are popular sources of cancer information, yet little is known about how survivors are depicted. Methods. This study analyzes coverage of cancer survivors in a nationally representative sample of newspapers and television newscasts. Stories were coded for cancer type, gender, age, survivorship length and status, treatment types, and spirituality, among other variables. Results. Media provide limited information about survivors. Also, although breast cancer coverage was close to survivorship rates, nearly every other cancer type was underreported for both incidence and survivorship rates. Conclusions. Inaccurate media coverage may be contributing to public misunderstanding about cancer survivorship.     

‘A disease many people still feel uncomfortable talking about’: Australian television coverage of colorectal cancer

Objective: To examine the coverage of colorectal cancer on Australian television news over a 3 year period commencing May 2005, and compare it with that given to other cancers. Methods: News reports on colorectal cancer broadcast on Sydney's five free‐to‐air television channels between 3 May 2005 and 30 May 2008 were reviewed for statements by news actors. The frequency of coverage was compared with that for other cancers. Results: Colorectal cancer news reports accounted for 4.1% (95% CI 2.9–5.1%) of all cancer news reports while the cancer represents 13.5% of cancer incidence and 11.5% of cancer deaths. Compared to cancers receiving greater television news coverage, there was a near total absence of reports of celebrity diagnoses, and of representations by colorectal advocacy groups. A national colorectal screening programme received limited coverage. Conclusions: Media neglect of colorectal cancer may be an important factor in explaining low participation in the Australian colorectal screening programme. Those advocating for colorectal cancer screening face ingrained cultural challenges in gaining broad media coverage, but investment in efforts to generate news and commentary would appear to be overdue. Copyright © 2009 John Wiley & Sons, Ltd.     

Is public communication about end‐of‐life care helping to inform all? Cancer news coverage in African American versus mainstream media

BACKGROUND:

Because cancers are a leading cause of death, these diseases receive a great deal of news attention. However, because news media frequently target specific racial or ethnic audiences, some populations may receive different information, and it is unknown whether reporting equally informs all audiences about the options for care at the end of life. This study of news reporting compared “mainstream” (general market) media with African American media, which serves the largest minority group. The specific goal of this study was to determine whether these news media communicate differently about cure‐directed cancer treatment and end‐of‐life alternatives.

METHODS:

This content analysis included 660 cancer news stories from online and print media that targeted either African American or mainstream audiences. The main outcome measures included whether reporting discussed adverse events of cancer treatment, cancer treatment failure, cancer death/dying, and end‐of‐life palliative or hospice care.

RESULTS:

Unadjusted and adjusted analyses indicated that the news stories in the African American media are less likely than those in mainstream media to discuss each of the topics studied. Comparing the proportions of news stories in mainstream versus African American media, 31.6% versus 13.6% discussed adverse events (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.51‐5.66; P = .001); 14.1% versus 4.2% mentioned treatment failure (OR, 3.79; 95% CI, 1.45‐9.88; P = .006); and 11.9% versus 3.8% focused on death/dying (OR, 3.42; 95% CI, 1.39‐8.38; P = .007). Finally, although very few news stories discussed end‐of‐life hospice or palliative care, all were found in mainstream media (7/396 vs 0/264).

CONCLUSION:

The African American news media sampled are less likely than mainstream news media to portray negative cancer outcomes and end‐of‐life care. Given media's segmented audiences, these findings raise concerns that not all audiences are being informed equally well. Because media content is modifiable, there may be opportunities to improve public cancer communication. Cancer 2012. © 2011 American Cancer Society.     

Frequently cited sources in cancer news coverage: a content analysis examining the relationship between cancer news content and source citation

The media are a frequent and sometimes sole source of cancer information for many people. News coverage of cancer can be influential to cancer-related practices such as prevention or detection behaviors, and sources cited by journalists may be influential in shaping this coverage. A content analysis (n = 3,656 stories) revealed that the most frequently cited sources in cancer news articles—research institutions and medical journals—receive disproportionately more attention compared to the National Cancer Institute (NCI), the American Cancer Society (ACS), and pharmaceutical companies. Research institutions were cited twice as frequently as medical journals, and more than three times as frequently as pharmaceutical companies. Most clinical trial stories were optimistic or neutral in tone, and tone was significantly related to citations of pharmaceutical companies and medical journals. Implications for effects of cancer coverage on behaviors, and the influence of sources such as research institutions and pharmaceutical companies, are discussed.     

Differences in cancer information-seeking behavior, preferences, and awareness between cancer survivors and healthy controls: A national, population-based survey

Background. No research has examined how cancer diagnosis and treatment might alter information source preferences or opinions. Methods. We examined data from 719 cancer survivors (CS group) and 2012 matched healthy controls (NCC group) regarding cancer-related information-seeking behavior, preferences, and awareness from the population-based 2003 Health Information National Trends Survey. Results. The CS group reported greater consumption of cancer-related information, but the CS and NCC groups did not differ in information source use or preferences. The CS group was more confident of their ability to get cancer information, reported more trust in health care professionals and television as cancer information sources, but evaluated their recent cancer information-seeking experiences more negatively than the NCC group. Awareness of cancer information resources was surprisingly low in both the CS and NCC groups. Conclusions. Cancer diagnosis and treatment subtly alters cancer information-seeking preferences and experience. However, awareness and use of cancer information resources was relatively low regardless of personal history of cancer.     

Cancer Risk Factors in Korean News Media: a Content Analysis

Background: Little is known about the news coverage of cancer risk factors in Korea. This study aimed toexamine how the news media encompasses a wide array of content regarding cancer risk factors and relatedcancer sites, and investigate whether news coverage of cancer risk factors is congruent with the actual prevalenceof the disease. Materials and Methods: A content analysis was conducted on 1,138 news stories covered duringa 5-year period between 2008 and 2012. The news stories were selected from nationally representative mediain Korea. Information was collected about cancer risk factors and cancer sites. Results: Of various cancer riskfactors, occupational and environmental exposures appeared most frequently in the news. Breast cancer wasmentioned the most in relation to cancer sites. Breast, cervical, prostate, and skin cancer were overrepresentedin the media in comparison to incidence and mortality cases, whereas lung, thyroid, liver, and stomach cancerwere underrepresented. Conclusions: To our knowledge, this research is the first investigation dealing with newscoverage about cancer risk factors in Korea. The study findings show occupational and environmental exposuresare emphasized more than personal lifestyle factors; further, more prevalent cancers in developed countrieshave greater media coverage, not reflecting the realities of the disease. The findings may help health journalistsand other health storytellers to develop effective ways to communicate cancer risk factors.     

“No Respecter of Youth”: Over-representation of Young Women in Australian Television Coverage of Breast Cancer

Ninety four percent of new breast cancer cases in Australian women occur in those aged over 40. Mammographic breast screening programs target women over 40, especially those aged 50-69, but participation rates in this age group have recently declined. To test the hypothesis that young women, at low risk for breast cancer, are overrepresented in television news, we analyzed all televised news reports on age and breast cancer shown on five free-to-air Sydney television stations, from 3 May 2005 to 28 February 2007, to determine the age of women shown with, or at risk for, the disease. Over half (55%) of statements about age and breast cancer referred to young women stated or known to be aged under 40. Sixty seven percent of images of women in breast cancer reports were known or judged to be women aged under 40. Three cases in young celebrity women accounted for 53% of all statements and 24% of all images about young women and breast cancer. Overrepresentation of young women with breast cancer in television news coverage does not reflect the epidemiology of the disease. This imbalance may contribute to public uncertainty regarding screening policy.     

A qualitative study of Canadian Aboriginal women’s beliefs about “credible” cancer information on the internet

Background. Criteria for evaluating the quality of cancer information on the Internet include source credibility and accuracy and currency of content. Cultural relevance of cancer resources is often overlooked in assessments of quality of Internet Web sites.Methods. Interviews with senior Aboriginal women (n=25) were conducted in Ontario Canada to determine their beliefs about “high quality” and “credible” cancer prevention resources.Results. Participants did not regard online cancer information from the medical community to be completely credible. They recommended that cancer resources include contact information for traditional healers in addition to local cancer agencies.Conclusions. Cultural appropriateness of cancer information should be assessed. Web resources considered credible according to published criteria may not be as relevant for Aboriginal populations.     

“Breaking Bad News”: Standardized Patient Intervention improves communication skills for hematology-oncology fellows and advanced practice nurses

Background. Breaking bad news is 1 of cancer specialists’ most common and difficult duties, yet hematology-oncology fellowship programs typically offer little formal preparation for this daunting task. We designed the Breaking Bad News Standardized Patient Intervention (BBNSPI) as a standardized patient educational intervention to improve the communication skills of hematology-oncology fellows (HOFs) and advanced practice nurses (APNs) in breaking bad news to cancer patients. Methods. A total of 6 HOFs and 2 APNs participated in the preintervention test and an educational session designed to improve communication skills. A total of 5 HOFs and 1 APN participated in the postintervention test 1 week later. Results. The average test score of the participants improved from 56.6% in the preintervention test to 68.8% (P<.005) in the postintervention test. The preintervention perception survey showed that 2 of 6 subjects (33%) expected the intervention to improve their communication skills in breaking bad news compared to 5 of 6 subjects (83%) in the postintervention survey (P<.08). The long-term intervention perception survey showed that all 6 subjects (100%) thought the intervention improved their communication skills in breaking bad news to cancer patients^* (P<.048). Conclusions. BBNSPI improved HOFs’ and APNs’ communication skills in breaking bad news to cancer patients. The perception of the subjects about BBNSPI was positive.     

Living can be hazardous to your health: how the news media cover cancer risks

For more than two decades, the news media has bombarded the public with often conflicting information about health risks, contributing to an atmosphere of hype and hysteria about cancer and other diseases. Improvements in media reporting of health risks require greater efforts by both those who cover the news and those who create it. Guidelines for bringing more perspective and balance to media coverage of risk are provided. These include putting cancer in context with other diseases, explaining absolute and relative risks, differentiating between individual and population risks, stressing the degree of uncertainty of new research and how it fits with previous data, covering the process as well as end results of science, understanding different media constraints and needs, and taking into account the diverse backgrounds and needs of the target audience-the general public.     

Quality of life after thyroid cancer: An assessment of patient needs and preferences for information and support

Background. In this article, we desscribe the quality of life and central information and support needs of people with thyroid cancer. We also describes patients’ preferences for services to address their needs. This report may help patients to anticipate how thyroid cancer will affect them and inform physicians on useful ways to help address their patients’ needs. Methods. We collected data through a survey (n=62) of people who had been treated for thyroid cancer. Results. Most respondents indicated that quality of life was quite good, and most of their information needs were adequately addressed during routine care. However, respondents also indicated a desire for ongoing access to information, including information about lifestyle factors that might affect risk of recurrence, signs and symptoms of recurrence, and recent developments in thyroid cancer diagnostics and treatments. They also reported some unmet social and emotional support needs. Respondents reported a strong preference for gaining access to information through convenient resources such as the Internet. Conclusions. Patient care following thyroid cancer treatment could be improved by providing ongoing education about lifestyle factors related to cancer risk, disease surveillance, and resources for treating and coping with cancer. Health care providers should become familiar with local and Internet-based sources of information and support related to thyroid cancer to improve patient access to this information.     

Barriers to seeking cancer information among Spanish-speaking cancer survivors

Background. Hispanics face barriers in seeking cancer information from sources such as the National Cancer Institute’s Cancer Information Service. Their cancer screening rates are lower than those for whites. Methods. Three focus groups were conducted with 40 Spanish-speaking cancer survivors. Results. Few patients had used a toll-free telephone number to get cancer information. Only five had used the Internet. Fear of feeling worse was a common concern in seeking cancer information, as was trying to discuss their cancer in English. Spanish language media promotions were recommended. Conclusions. Beliefs and attitudes about cancer must be taken into account when developing culturally competent education programs for Spanish speakers.     

Developing competencies for training practitioners in evidence-based cancer control

Background. Competency-based education allows public health departments to better develop a workforce aimed at conducting evidence-based control cancer. Methods. A 2-phased competency development process was conducted that systematically obtained input from practitioners in health departments and trainers in academe and community agencies (n=60). Results. Among the 26 competencies developed, 10 were rated at the beginner level, 12 were intermediate, and 4 were advanced. Community-level input competencies were seen as beginner level, whereas policy-related competencies were rated as advanced. Conclusion. Although adaptation to various audiences is needed, these competencies provide a foundation on which to build practitioner-focused training programs.     

Beliefs about heritability of cancer and health information seeking and preventive behaviors

Background. Individuals' beliefs about cancer heritability could affect their health information seeking and health behaviors. Methods. Data from 5813 English-speaking adult respondents to the 2003 Health Information National Trends Survey were analyzed. Results. Individuals who believed that knowledge of family history or genes can reduce cancer risk were significantly more likely to have ever looked for cancer information. Ever smokers who believed that genes are the main cause of lung cancer were significantly more likely to smoke currently. Conclusions. Patients need to be educated about genetic susceptibility to cancer in ways that support information seeking and engagement in protective behaviors.     

Cancer-related information sought by the general public: Evidence from the National Cancer Institute’s Cancer Information Service, 2002–2003

Background. We examined the main topics of inquiry (Subjects of Interaction—SOI) of calls made by the general public to the National Cancer Institute’s Cancer Information Service’s (CIS) 1-800-4-CANCER telephone information service.Methods. We analyzed data from 37,620 callers to the CIS between September 2002 and August 2003. We conducted frequencies, chi-squares, and logistic regressions to ascertain sample characteristics and sociodemographic correlates of each SOI.Results. We found differences in discussion of the 7 main SOI by age, sex, ethnicity, race, and education.Conclusions. Findings inform the CIS’ and other organizations’ efforts to develop and disseminate cancer information.     

Overcoming cultural barriers to giving bad news: Feasibility of training to promote truth-telling to cancer patients

Background. In many countries, physicians are reluctant to disclose unfavorable medical information to patients with advanced cancer and instead give the bad news to the family. Methods. The authors modified standard communication workshops to help Italian senior oncologists overcome cultural, social, and attitudinal barriers to disclosure of diagnosis and prognosis. Results. Fifty-seven physicians participated; 88% believed the workshops would improve their medical practice. Many pursued further training and organized communication skills programs of their own. Conclusions. Communication skills workshops can be modified to meet educational and social norms and help clinicians acquire the interpersonal skills needed for honest communication with patients.     

What makes cancer survivor stories work? An empirical study among African American women

Introduction Cancer survivors play a vital role in cancer control as messengers of hope and information, and advocates for prevention and screening. Understanding what makes survivor stories effective can enhance survivor-delivered programs and interventions. Methods By random assignment and using a cross-classified design, 200 African American women viewed videotaped stories (n = 300) from 36 African American breast cancer survivors. Analyses examined effects of story attributes (narrative quality, health message strength), participant characteristics (ways of knowing, experience with breast cancer) and identification with the survivor on women’s: (1) level of engagement in the story; (2) positive thoughts about the story; and, (3) remembering key messages about breast cancer and mammography in the story. Results Participant characteristics were significant predictors of all three study outcomes, accounting for 27.8, 2.6 and 22.2% of their total variance, respectively. In comparison, the variability in these outcomes that could be attributed to differences in the stories was small (0.6, 1.1 and 2%, respectively). The effects of participant characteristics on level of engagement and positive thoughts were mediated by identification with the survivor. Conclusions The best predictor of a woman becoming engaged in a breast cancer survivor’s story and having positive thoughts about the story was whether she liked the survivor and viewed her as similar to herself (i.e., identification). Implications for cancer survivors Survivor stories may be most effective when audience members identify with the survivor. Finding key characteristics that can reliably match the two will advance cancer communication science and practice.     

Communicating with women about mammography

Background/Methods. We report survey results of the types of tools used to communicate with women about breast cancer screening and the content areas included in each tool for member countries of the International Breast Cancer Screening Network (IBSN).Results. In addition to using pamphlets and invitation letters, new technologies are being used such as the Internet which allows for easy updating of information and can provide interactive modules. Several countries have addressed the needs of specific populations such as indigenous populations or blind women. All countries provide basic information, although they do not provide all the same information.Conclusion. More research is needed to understand what women need to make an informed decision about mammography and to learn what the best modalities are to provide this information.