Research focus

The ‘Angelina Jolie effect’

Three studies evaluating the effect of the film star’s disclosure that she was a carrier of a mutated gene associated with an increased risk of developing breast and ovarian cancer.

Three studies evaluating the effect of the film star’s disclosure that she was a carrier of a mutated gene associated with an increased risk of developing breast and ovarian cancer


Angelina Jolie underwent a preventive bilateral mastectomy in 2013
Picture: Alamy

Inherited mutations in the known breast cancer susceptibility genes (BRCA1 and BRCA2) are associated with an increased risk of developing breast and ovarian cancer. In May 2013, Angelina Jolie disclosed she was a carrier of one of these mutations and announced she had undergone a preventive bilateral mastectomy (PBM). Two years later, she announced she had undergone a laparoscopic bilateral salpingo-oophorectomy. This research digest summarises three recent studies evaluating the effect of her disclosure.


Seeking online health information in the wake of a celebrity disclosure

Celebrity health narratives generate significant media attention. This study explored the types of information people are exposed to when searching online about Angelina’s Jolie’s announcement.

In November 2013, the terms ‘Angelina Jolie and medical decision’ and ‘Angelina Jolie and preventive mastectomy’ were used to search Google, Yahoo, and MSN.  A total of 92 unique websites were identified. Content analysis found that all of the websites provided some information about the BRCA1 gene, reasons and alternatives to undergoing PBM, and healthcare services in general. Some websites also discussed Jolie’s gender identity, noting her role as a sex icon, mother and humanitarian. 

The author concluded that Jolie’s announcement provided a plethora of online information about genetics, mastectomies and healthcare, and argued that coverage of her story in terms of gender identity has implications for notions of femininity and sexuality in a breast-conscious society. Finally, the announcement directed attention to a new cancer population – previvors, people who are highly susceptible to cancer due to a genetic mutation. 

Dean M (2016) Health Communication. 31, 6, 752-761.

Changes of social-demographic data of clients seeking genetic counselling for hereditary breast and ovarian cancer 

This prospective cohort study sought to evaluate the socio-demographic characteristics of clients seeking genetic counselling for hereditary breast and ovarian cancer and to explore whether there was a change in the characteristics of attendees after Jolie’s disclosure. 

Consecutive clients seeking genetic counselling for hereditary breast and ovarian cancer at the Medical University of Vienna in Austria between June 2012 and June 2014 were included in the study. A total of 268 clients participated. Socio-demographic data and source information about hereditary breast and ovarian cancer were evaluated. 

Subjects were younger and more highly educated than Austria’s general population. Furthermore, subjects seeking genetic counselling before Jolie’s disclosure were found to be more highly educated than subjects seeking counselling after her disclosure. Most subjects were informed about genetic counselling by their doctor.

However, after Jolie’s admission, subjects were more frequently advised to seek counselling by social media and family or friends than before. The authors concluded the presence of issues pertaining to hereditary breast and ovarian cancer in the media following Jolie’s disclosure led to greater awareness among a wider audience. 

Staudigl C, Pfeiler G, Hrauda K et al (2016) BMC Cancer. 16, 1, 436.

 

Managing the ‘Angelina Jolie effect’ with tea and biscuits

After Jolie’s revelation, the Nottingham Breast Institute had a 100% increase in new referrals. To manage increased demand and to support women diagnosed as carriers of one of the breast cancer susceptibility genes, a forum was set up to enable women to access information and support via a larger network.

The Institute launched a private closed Facebook group and regular tea party events for women at different stages of their treatment (including women who were recently diagnosed, pre-surgery and post-surgery) in 2014. The tea parties run every two months with short presentations and question and answer sessions with genetic counsellors, breast surgeons and gynaecologists.

The first tea party event had 21 attendees, with subsequent parties attracting approximately 18 attendees. To date, nine parties have been hosted.  Evaluations have indicated that all participants found them useful. The Facebook group has 40 members and is updated with comments, support and people sharing ideas.

The authors conclude that group sessions with clinical staff provide an alternative means of managing the exponential increase of demand for support for women with high-risk family history.

Macmillan D, Scott N (2016) European Journal of Surgical Oncology. 42, 5, S6.

Implications for practice

  • Women should be given the opportunity to discuss concerns about their family history of breast or ovarian cancer if it is raised in a consultation
  • Women with histories consistent with hereditary breast or ovarian cancer should be referred for genetic counselling

     

    About the author

    Caroline McGraw is a lecturer in public health at the School of Health Sciences, City, University of London

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