Affiliations of authors: C. W. Lee, Fraser Valley Cancer Centre, Surrey, BC, Canada; L. Weir, K. A. Gelmon, Vancouver Cancer Centre, BC.
Correspondence to: Christopher W. Lee, M.D., Fraser Valley Cancer Centre, 13750 96th Ave., Surrey, BC, Canada V3V 1Z2 (e-mail: clee{at}bccancer.bc.ca).
The communication of cancer risks to the public was reviewed in an article in the Journal of the National Cancer Institute Monographs in 1999 (1), and a recent study published in the New England Journal of Medicine supports the view that news media coverage of the benefits and risks of medications is inadequate or incomplete (2). We report the effect of news media coverage of the paper by Li et al. (3) in the July 4 issue of the Journal of the National Cancer Institute on one aspect of clinical oncology practice.
The Memo to the Media prepared by the staff of the Journal of the National Cancer Institute was embargoed for release on July 3 at 4 PM Eastern Daylight Time (4). The memorandum summarized the study results and outlined Dr. Sandra Swain's editorial comments regarding the limitations of the study (5). The first news media report of the study appeared the evening of July 3.
The Breast Tumour Group (BTG) of the British Columbia Cancer Agency (BCCA) includes 43 medical and radiation oncologists, the majority of whom practice at one of four regional cancer centers in the province. Members of the BTG began receiving questions about the news story from concerned breast cancer patients on July 4. A plan was devised on July 4 to tally the number of telephone or e-mail contacts from patients to each oncologist.
Twenty-three (53%) of the 43 oncologists in the BTG participated in this survey. From July 4 to July 11, the participating oncologists received and reported a total of 64 patient contacts. Sixteen (70%) of the 23 oncologists had at least one contact (Table 1). The mean number of contacts per oncologist was 2.78, and the median was 1. The chair of the BTG (K. A. Gelmon) received the greatest number of contacts, 30. Three oncologists did not record the dates on which they were contacted, but the majority of contacts were within 3 days of the first news media reports (Fig. 1
).
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Patients are encouraged to contact their health care professionals with questions about their medical care, and it is obvious that news media coverage in this case served as an impetus for patients to do so. However, the fact that the findings of Li et al. have no immediate impact on current clinical management of breast cancer patients may have been inadequately or incompletely represented by the news media or misunderstood by the public. We have no way of determining the number of patients who did not seek medical advice and inappropriately discontinued tamoxifen in response to the news media reports of the study by Li et al.
The impact of news media coverage of biomedical research on the workload of health care professionals warrants further investigation. Of greater interest and potential concern is the effect of the news media on patient decision making.
NOTES
On behalf of the Breast Tumour Group of the British Columbia Cancer Agency.
REFERENCES
1 Russell C. Living can be hazardous to your health: how the news media cover cancer risks. J Natl Cancer Inst Monogr 1999;25:16770.[Medline]
2
Moynihan R, Bero L, Ross-Degnan D, Henry D, Lee K, Watkins J, et al. Coverage by the news media of the benefits and risks of medications. N Engl J Med 2000;342:164550.
3
Li CI, Malone KE, Weiss NS, Daling JR. Tamoxifen therapy for primary breast cancer and risk of contralateral breast cancer. J Natl Cancer Inst 2001;93:100813.
4 Arnold K, Eckstein D. MEMORANDUM FOR: Science writers and editors on the Journal press list. Tamoxifen therapy for breast cancer reported to increase risk of estrogen receptor-negative tumors in the contralateral breast. J Natl Cancer Inst (serial online) 2001 (cited July 3, 2001);93. Available from: URL: http://jnci.oupjournals.org/cgi/content/full/93/13/961-a.
5
Swain SM. Tamoxifen and contralateral breast cancer: the other side. J Natl Cancer Inst 2001;93:9635.
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