News media coverage of screening mammography for women in their 40s and tamoxifen for primary prevention of breast cancer
News media coverage of screening mammography for women in their 40s and tamoxifen for primary prevention of breast cancer
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DOI：
10.1001/jama.287.23.3136
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发表时间：
2002-06-19
影响因子：
120.7
通讯作者：
Woloshin, S
中科院分区：
文献类型：
--
作者：
Schwartz, LM;Woloshin, S
背景在20世纪90年代末，3个与乳腺癌预防有关的事件在美国新闻媒体中受到了相当大的关注：美国国立卫生研究院（NIH）的一个共识小组建议40多岁的女性不要进行常规的乳房X光检查（1997年1月），美国国家癌症研究所（NCI）随后推翻了建议，（1997年3月），一项由国家癌症研究所赞助的研究证实了他莫昔芬在乳腺癌一级预防中的有效性（1998年4月）目的了解美国主流媒体对2种乳腺癌预防策略的报道情况。报道乳腺癌预防活动的新闻故事。我们使用LICH-Nexis搜索美国发行量最高的10家报纸的印刷新闻报道，并要求3家主要电视网络提供转录本，以获得每个事件发生后2周内的所有相关新闻报道。主要结果测量对预防策略的态度（鼓励、中立、劝阻）;结果27个关于NIH共识小组的故事，24个关于NCI逆转的故事，34篇关于他莫昔芬的报道在每次事件发生后的两周内出现在备受瞩目的新闻媒体上。67%的NIH共识小组故事给人的印象是，40至49岁的女性是否应该接受筛查存在很大的不确定性，但59%的人认为女性可能或肯定应该接受筛查。只有4个故事表明，妇女面临着真正的决定做什么。在NCI逆转后，报告的不确定性水平大幅降低（21%表示存在很多不确定性），大多数故事（96%）建议女性应该进行筛查。相比之下，他莫昔芬的故事突出了高风险女性应该做什么的不确定性（62%的人认为有很多不确定性），没有人留下女性绝对应该服用药物的印象（24%的人认为他们可能应该）。这些故事的65%建议，妇女面临着真正的选择，将不得不权衡风险和好处themself.Conclusions大多数新闻报道赞成常规使用筛查乳房X光检查，并敦促谨慎使用他莫昔芬。几乎所有人都注意到了每种预防策略的潜在危害;然而，他莫昔芬的负面影响受到了更大的重视。服用他莫昔芬被认为是一个艰难的决定，而接受乳房X光检查则被认为是女性应该做的事情。
Context In the late 1990s, 3 events pertaining to breast cancer prevention received considerable attention in the US news media: a National Institutes of Health (NIH) consensus panel recommended against routine screening mammography for women in their 40s (January 1997), the National Cancer Institute (NCI) subsequently reversed the recommendation (March 1997), and an NCI-sponsored study demonstrated the efficacy of tamoxifen in the primary prevention of breast cancer (April 1998).Objective To examine how the major US news media covered the potential benefits and harms of 2 breast cancer preventive strategies.Design and Setting Content analysis of US news stories reporting on the breast cancer prevention events. We used Lexis-Nexis to search for print news stories in the 10 highest-circulation US newspapers and requested transcripts from 3 major television networks to obtain all relevant news coverage in the 2 weeks following each event.Main Outcome Measures Attitude toward preventive strategy (encourage, neutral, discourage); level of uncertainty about benefit and how benefits and harms were presented.Results Twenty-seven stories about the NIH consensus panel, 24 about the NCI reversal, and 34 about tamoxifen appeared in high-profile news media within 2 weeks of each event. Sixty-seven percent of NIH consensus panel stories left the impression that there was a lot of uncertainty about whether women aged 40 to 49 years should undergo screening, but 59% suggested that women should probably or definitely be screened. Only 4 stories suggested that women faced a genuine decision about what to do. The level of uncertainty reported was substantially lower following the NCI reversal (21% suggested a lot of uncertainty), and most stories (96%) suggested that women should be screened. In contrast, tamoxifen stories highlighted uncertainty about what women at high risk should do (62% suggested there was a lot of uncertainty), and none left the impression that women should definitely take the drug (24% suggested they probably should). Sixty-five percent of these stories suggested that women faced a genuine choice and would have to weigh the risks and benefits themselves.Conclusions Most news stories favored routine use of screening mammography and urged caution about using tamoxifen. Almost all noted the potential harms of each preventive strategy; however, the negative aspects of tamoxifen received greater emphasis. Whereas taking tamoxifen was presented as a difficult decision, having a mammogram was presented as something women ought to do.