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The Media's Role in Cancer Prevention
Max Gomez, PhD
Medicine and Science Correspondent
WNBC-TV
New York, New York
At first glance, it would seem that the role the media can play in cancer prevention is limited and perhaps even counterproductive when you consider the negative health messages often conveyed by the mass media. I hope to persuade you that the media can play not only a positive, but also an essential role, if we are truly going to prevent cancer.
The American Cancer Society (ACS) sets as a goal in its annual report, Cancer Prevention and Detection, 2002, a 25% drop in cancer incidence rates by 2015. To achieve this goal, the report states that we need to lower adult tobacco use to 12% and youth tobacco use to 10%; raise the proportion of people following the ACS dietary guidelines to 75% of the population; and increase physical activity, another powerful cancer preventative, to 90% in high school students and 60% in adults. Other organizations are even more ambitious, and estimate that up to 70% of all cancer is preventable.
The message here is that, even allowing for factors over which we have limited control (air and water pollution, pesticides, ionizing radiation, etc.), many, perhaps most, of all cancers are in some way self-inflicted. What I mean by that is lifestyle: smoking, sun exposure, terrible diets, lack of exercise, excessive drinking, and so on. That's the bad news. The good news is what that implies: these are all things we can change, we can control ourselves, right now--no waiting for FDA approval, no depending on your physician to prescribe a chemopreventive medication. What we are talking about is essentially large-scale behavior modification... getting people to behave in a manner that will minimize their chances of developing cancer. That's not easy but it has been done in other areas of public health.
In the 1980's, the Gay Men's Health Crisis (an AIDS advocacy group) successfully convinced a generation of men to practice safe sex in order to reduce HIV infection rates. Likewise, how many millions of Americans now know their cholesterol, blood pressure, and prostate-specific antigen (PSA) numbers? And the same awareness and behavioral changes can be wrought in the area of cancer prevention. But several things have to happen in order for such an effort to be successful.
First, the only effective and efficient way to disseminate information to an entire population is via the mass media. And that means, for better or for worse, television. The Internet is gaining but it still pales in comparison with television when it comes to sheer numbers of people with access to the two technologies.
A poll by the Roper Center for Public Opinion Research showed that half of the American public cites television as its only source of news. Greater than 40% look to television first for health information and 55% say that television is the most credible medium. An ACS survey found that the mass media were mentioned more often than any other source for cancer information. That survey is more than ten years old. If anything, those numbers have become even more skewed towards television.
That's why television stories about cancer prevention through lifestyle changes can be so effective. The key is to also persuade viewers of the value of prevention as opposed to cure.
We can also have an indirect effect on behavior. When the President gets skin cancer, dermatologist visits go up... when Suzanne Summers gets breast cancer, mammograms numbers go up... when Robert De Niro gets prostate cancer... more men get PSA blood tests and digital rectal exams.
Clearly, the primary reason that the mass media is essential to this mission is its reach.... the sheer number of people that can be exposed to a message through radio, television, and to a lesser extent, print media. Our weakness in the news media is, in most cases, our inability to deal with a topic in depth. But does that disqualify us from being useful, even helpful? Absolutely not!
We simply act as the "Paul Reveres" of medical information. Think about Paul Revere: he didn't ride through the streets of Concord shouting that King George's troops were on their way because the King felt he had a right to protect his investment in a rich new world... and that the colonists had better pay their taxes and obey the Crown if they knew what was good for them. No! He shouted: "the British are coming" and that was enough.
Similarly, we, the media, provide the distillation, the bare facts of a topic, which in many cases will be enough to get an individual to act - to get that person into the health care system where the message can be reinforced and amplified.
Now so far you have probably understood me to be referring to the media's role in educating the lay public. But, in fact, the media can play a role in the education of health care professionals as well... and this includes physicians.
A study commissioned by the National Institutes of Health (NIH) examined how NIH consensus conferences have altered the practice of medicine in the specific areas addressed by the conferences. The conclusion was that there had been virtually no change in the standard of practice in those fields despite specific recommendations made by the NIH consensus conferences.
The lesson here is that there are many physicians and health care providers who are not up to date with the latest research findings and that the media can effectively both reach them directly with information they may not be aware of... as well as reach their patients so that, at the very least, they can ask about what they saw on the news last night.
The media are already, and will continue to be, a major source of health and medical information for the general public. I strongly believe that the media and medical professionals working together can be a powerful force in the battle to prevent cancer.
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