The Jolie effect – increasing options for patients

Angelina Jolie 2 June 2014 (cropped)" by Foreign and Commonwealth Office
Angelina Jolie 2 June 2014 (cropped)” by Foreign and Commonwealth Office

Celebrity endorsements for campaigns are so common they can feel meaningless – see the ‘stars’ who added their Yes or No in the run up to the Scottish referendum or, more pertinently the array of hot twenty-somethings who will line up in pink T-shirts for Breast Cancer Awareness Month.

Occasionally though something happens that has a genuine effect on patients’ – or prospective patients’ – lives.

Last summer, actress and human rights campaigner Angelina Jolie published a moving article, ‘My medical choice’, in the New York Times about her decision to be tested for the BRCA gene mutation and subsequently to have a double mastectomy to protect against her 87% chance of developing breast cancer.

A BRCA mutation confers a high risk of breast and ovarian cancers and Jolie’s own mother fought the former for a decade before her death. Her emphasis, and indeed the subject of her article, is patient choice.

Though news stories can raise awareness of health issues, and can have benefits, these benefits are often short lived. Research published today in Breast Cancer Research suggests that Jolie’s choice to publicise her choice had a longer lasting effect.

Jolie’s impact

Led by Gareth Evans, from Genesis Breast Cancer Prevention and St Mary’s Hospital, Manchester, a team of academics assessed data from twelve family history clinics and nine regional genetic centres in the UK. Referrals from GPs in June and July 2013 were two and a half fold higher than the same months in 2012.

The rise in referrals continued to October with a two-fold increase over the same period the previous year. The research also suggests that during this period of increased interest, there was no greater proportion of inappropriate referrals by GPs.

Back in summer 2013, there was some concern that the increase in attendance following Jolie’s announcement might have been from the ‘worried well’ coming back for an early repeat screen, the team found that those who were referred were often women who were late for their test. The team also believe that during this period of increased interest, there was no greater proportion of inappropriate referrals by GPs.

A voice for choice

Jolie’s announcement seems to have made people more aware of the risk of a family history of cancer and also that knowledge can mean choice. Evans says: “Angelina Jolie stating she has a BRCA1 mutation and going on to have a risk-reducing mastectomy is likely to have had a bigger impact than other celebrity announcements, possibly due to her image as a glamorous and strong woman. This may have lessened patients’ fears about a loss of sexual identity post-preventative surgery and encouraged those who had not previously engaged with health services to consider genetic testing.

Someone once sang: ‘Fame! I’m gonna live forever!’ This may not be true, but the power of celebrity may just give some of us longer and healthier lives.

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