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What Are Cancer Centers Advertising to the Public? A Content Analysis #MMPMID24863081
Vater LB; Donohue JM; Arnold R; White DB; Chu E; Schenker Y
Ann Intern Med 2014[Jun]; 160 (12): 813-20 PMID24863081show ga
Background: Although critics have expressed concerns about cancer center advertising, the content of these advertisements has not been analyzed. Objective: To characterize the informational and emotional content of cancer center advertisements. Design: Systematic analysis of all cancer center advertisements in top U.S. consumer magazines (N=269) and television networks (N=44) in 2012. Measurements: Using a standardized codebook, we assessed (1) types of clinical services promoted; (2) information provided about clinical services, including risks, benefits, and costs; (3) use of emotional advertising appeals; and (4) use of patient testimonials. Two investigators independently coded advertisements using ATLAS.ti. Kappa values ranged from 0.77 to 1.0. Results: A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%; p<0.001). Benefits of advertised therapies were described more often than risks (27% vs. 2%; p<0.001) but rarely quantified (2%). Few advertisements mentioned insurance coverage or costs (5%). Emotional appeals were frequent (85%), most often evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and evoking fear (30%). Nearly half of advertisements included patient testimonials, usually focused on survival or cure. Testimonials rarely included disclaimers (15%) and never described the results a typical patient might expect. Limitations: Internet advertisements were not included. Conclusions: Clinical advertisements by cancer centers frequently promote cancer therapy using emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, or costs. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments.