When Celebrities Disclose a Cancer Diagnosis: Does That Lead To Greater Public Health Awareness?

Angelina Jolie, Actor and Advocate

Celebrities are a diverse group of people whose actions are tracked and discussed in traditional and social media. Fans or followers often emulate celebrities in a variety of ways such as fashion, purchases, and even health choices. Many celebrities have gone public about their health status and may share their own opinions about their illnesses and treatment choices. That raises questions about whether the public can benefit from publicity surrounding a relatively common and serious disease.

Cancer, a disease of abnormal cell growth, can appear in virtually every tissue of the body including the most common malignancies such as the breast, prostate, colon, and lung. In addition, cancer can occur in the blood (leukemia), lymph nodes (lymphoma).

Cancer is the second leading cause of death in the U.S. behind heart disease and, among cancers, lung cancer has the highest mortality. Cancers detected earlier, such a breast and prostate cancer have a relatively lower mortality rate than cancers detected late such as lung and pancreatic cancer.

A subject of research asks the question whether a cancer diagnosis among a high-profile celebrity can bring awareness to the disease and potentially spur fans or follows to seek early screening and diagnosis.

Celebrity Stories Highlight Earlier Cancer Diagnoses

A wave of news stories and research results have noted that several cancers were affecting younger adults before age 50. The medical community has responded by revisiting prevention guidelines. Before 2021, colorectal cancer screening was recommended for people ages 50 or older, if there were no risk factors; except African Americans who have a greater risk of colorectal cancer should get screened at 45 years of age. The American College of Gastroenterology now recommends that those without risk factors be screened at age 45. And those with risk factors should receive their first screening by age 40.

However, the change in guidelines would likely not have saved actor Chadwick Boseman. Boseman died at age 43 in 2020 from complications of stage IV colorectal cancer. The news of the celebrated actor's death came to a shock to the public because he chose to keep his health private and continued to act in major films, including Black Panther. Colorectal cancer grows relatively slowly and it took approximately 10 years for a precancerous polyp to become an invasive malignancy, which meant Boseman likely had cancer in his 30s.

With screening, Boseman's life may have been saved. But had the tragic news spur others, especially African American men to seek screening? As the cause of death became public, there was increased awareness of colorectal screening. However, a study found significant barriers for African-American men to seek screening due to the perception that screening was un-masculine. Another study found that interest in colorectal cancer screening was fleeting.

Breast Cancer Awareness and Angelina Jolie

Angelina Jolie's disclosed that she had the BRCA1 gene, which meant she had a 87% chance of being diagnosed with breast cancer in her lifetime and a 50% chance of contracting ovarian cancer. He public statements, including an Op Ed in the New York Times, indicated that she was interested in providing education about heritable breast cancer. She cautioned that her decision to undergo a double mastectomy to lower her risk of breast cancer to about 5% was one she made with her medical team.

Inherited breast cancer is a minority cause of malignancy, but it is a significant one. Approximately, 5% to 10% of breast and 10% to 15% of ovarian cancers are related to genetic inheritance.

Jolie's disclosure led to a spike in cancer genetic tests, but the overall outcome was that virtually no women had the gene. What that meant was that low-risk women were getting tested and that higher-risk women were not reached. Another study looked at mastectomy rates of women already diagnosed with breast cancer. Rates of mastectomy did increase after Jolie's disclosure, but they fell after years had passed.

Celebrity Disclosure Alone is Not Enough

Prevention and treatment of cancer is a sustained effort with shared decision-making among patients and physicians. Celebrity disclosures can cast light on important health issues, but the information is incomplete and fleeting. However, celebrities can frame the cancer conversation in a way that is clear and potentially can sway health choices or decisions about cancer screening.

Assessed and Endorsed by the MedReport Medical Review Board