Journal of Behavioral Medicine

, Volume 37, Issue 6, pp 1242–1251 | Cite as

Have screening harms become newsworthy? News coverage of prostate and colorectal cancer screening since the 2008 USPSTF recommendation changes

  • Emily A. Elstad
  • Stacey L. Sheridan
  • Joseph G. L. Lee
  • Christine Rini
  • Jo Anne Earp
  • Noel T. Brewer


In 2008, the US Preventive Services Task Force updated its recommendations to discourage screening for prostate cancer in men over 75 and for colorectal cancer in adults over 85. We aimed to determine whether newspapers portrayed these screenings differently after these recommendation changes. A quantitative content analysis included articles on prostate-specific antigen (PSA) testing or colonoscopy in US newspapers from 2005 to 2012. Outcomes included the number of benefits and harms mentioned and the gist expert and lay readers might get from articles. Benefits in PSA articles (n = 222) and harms and benefits in colonoscopy articles (n = 65) did not change over time. Mentions of PSA harms increased after 2008 (p < .01). Expected expert gist of PSA articles became more negative after 2008 (p < .01). Expected lay gist was positive and did not change. News coverage of PSA testing harms increased without a decrease in the discussion of benefits. Consumers, especially lay consumers, are receiving unbalanced information on cancer screening.


Cancer screening Media Prostate-specific antigen test Colonoscopy Newspaper article 



This study was partially supported by Grant #T32-HS000032, a national Research Service Award Pre-Doctoral Traineeship from the Agency for Healthcare Research and Quality, sponsored by the UNC Cecil G. Sheps Center for Health Services Research; and grant #P01-HS21133-02.

Conflicts of interest

Emily A. Elstad, Stacey L. Sheridan, Joseph G. L. Lee, Christine Rini, Jo Anne Earp, and Noel T. Brewer declare that they have no conflict of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Supplementary material

10865_2014_9572_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)
10865_2014_9572_MOESM2_ESM.docx (16 kb)
Supplementary material 2 (DOCX 16 kb)


  1. ABIM Foundation. (2013). Choosing wisely. Retrieved 25 Oct 2013.
  2. Akhter, M. (2012, June 2). Letter to the editor: Prostate cancer test worth keeping in some situations. Washington post, pp. A14.Google Scholar
  3. Andriole, G. L., Crawford, E. D., Grubb, R. L., III, Buys, S. S., Chia, D., Church, T. R.,.et al. (2009). Mortality results from a randomized prostate-cancer screening trial. The New England Journal of Medicine, 360, 1310–1319. doi: 10.1056/NEJMoa0810696;  10.1056/NEJMoa0810696
  4. Andriole, G. L., Crawford, E. D., Grubb, R. L., III, Buys, S. S., Chia, D., Church, T. R., et al. (2012). Prostate cancer screening in the randomized prostate, lung, colorectal, and ovarian cancer screening trial: Mortality results after 13 years of follow-up. Journal of the National Cancer Institute, 104, 125–132. doi: 10.1093/jnci/djr500;  10.1093/jnci/djr500
  5. Arkes, H. R., & Gaissmaier, W. (2012). Psychological research and the prostate-cancer screening controversy. Psychological Science, 23, 547–553. doi: 10.1177/0956797612437428;  10.1177/0956797612437428
  6. Barry, M. J. (2009). Screening for prostate cancer—The controversy that refuses to die. The New England Journal of Medicine, 360, 1351–1354. doi: 10.1056/NEJMe0901166;  10.1056/NEJMe0901166
  7. Behavioral Risk Factor Surveillance System (BRFSS). (2011). 2010 National prevalence and trends data: Prostate cancer. Retrieved 25 Jan 2013.
  8. Boudioni, M., Mossman, J., Jones, A. L., Leydon, G., & McPherson, K. (1998). Celebrity’s death from cancer resulted in increased calls to CancerBACUP. BMJ (Clinical Research Ed.), 317, 1016.CrossRefGoogle Scholar
  9. Caire, A. A., Sun, L., Robertson, C. N., Polascik, T. J., Maloney, K. E., George, D. J., et al. (2010). Public survey and survival data do not support recommendations to discontinue prostate-specific antigen screening in men at age 75. Urology, 75, 1122–1127. doi: 10.1016/j.urology.2009.06.091;  10.1016/j.urology.2009.06.091
  10. Chapman, S., McLeod, K., Wakefield, M., & Holding, S. (2005). Impact of news of celebrity illness on breast cancer screening: Kylie minogue’s breast cancer diagnosis. The Medical Journal of Australia, 183, 247–250.PubMedGoogle Scholar
  11. Combs, B., & Slovic, P. (1979). Newspaper coverage of causes of death. Journalism Quarterly, 56, 837–849.Google Scholar
  12. Croswell, J. M., Kramer, B. S., Kreimer, A. R., Prorok, P. C., Xu, J. L., Baker, S. G., et al. (2009). Cumulative incidence of false-positive results in repeated, multimodal cancer screening. Annals of Family Medicine, 7, 212–222. doi: 10.1370/afm.942;  10.1370/afm.942
  13. Davila, R. E., Rajan, E., Baron, T. H., Adler, D. G., Egan, J. V., Faigel, D. O., et al. (2006). ASGE guideline: Colorectal cancer screening and surveillance. Gastrointestinal Endoscopy, 63, 546–557. doi: 10.1016/j.gie.2006.02.002
  14. Fowler, M. (2005). Inversion of control. Retrieved 25 Oct, 2013.
  15. Garcia, M. R., & Stark, P. (1991). Eyes on the news. St. Petersburg, FL: The Poynter Institute.Google Scholar
  16. Gersh, M. L. (2012, May 27). Letters to the editor: Why the prostate test is crucial. Washington post, pp. A26.Google Scholar
  17. Goodwin, J. S., Tan, A., Jaramillo, E., & Kuo, Y. F. (2013). Prostate-specific antigen testing in men aged 40–64 years: Impact of publication of clinical trials. Journal of the National Cancer Institute, 105, 743–745. doi: 10.1093/jnci/djt039;  10.1093/jnci/djt039
  18. Jorgensen, K. J., Klahn, A., & Gotzsche, P. C. (2007). Are benefits and harms in mammography screening given equal attention in scientific articles? A cross-sectional study. BMC Medicine, 5, 12. doi: 10.1186/1741-7015-5-12 PubMedCentralPubMedCrossRefGoogle Scholar
  19. Katz, M. L., Sheridan, S., Pignone, M., Lewis, C., Battle, J., Gollop, C., et al. (2004). Prostate and colon cancer screening messages in popular magazines. Journal of General Internal Medicine, 19, 843–848. doi: 10.1111/j.1525-1497.2004.30504.x PubMedCentralPubMedCrossRefGoogle Scholar
  20. Kelaher, M., Cawson, J., Miller, J., Kavanagh, A., Dunt, D., & Studdert, D. M. (2008). Use of breast cancer screening and treatment services by australian women aged 25–44 years following kylie minogue’s breast cancer diagnosis. International Journal of Epidemiology, 37, 1326–1332. doi: 10.1093/ije/dyn090;  10.1093/ije/dyn090
  21. Kirby, D. (2001). Understanding what works and what doesn’t in reducing adolescent sexual risk-taking. Family Planning Perspectives, 33, 276.PubMedCrossRefGoogle Scholar
  22. Krippendorff, K. (2004). Content analysis: An introduction to its methodology. Thousand Oaks: Sage.Google Scholar
  23. Kuran, T., & Sunstein, C. R. (1999). Availability cascades and risk regulation. Stanford Law Review, 51, 683.CrossRefGoogle Scholar
  24. Lawrentschuk, N., Daljeet, N., Trottier, G., Crawley, P., & Fleshner, N. E. (2011). An analysis of world media reporting of two recent large randomized prospective trials investigating screening for prostate cancer. BJU International, 108, E190-5. doi: 10.1111/j.1464-410X.2010.09983.x;  10.1111/j.1464-410X.2010.09983.x
  25. Lee, T. H., Kantoff, P. W., & McNaughton-Collins, M. F. (2009). Screening for prostate cancer (readers’ comments). The New England Journal of Medicine, 360, e18. doi: 10.1056/NEJMp0901825;  10.1056/NEJMp0901825
  26. Lichtenstein, S., Slovic, P., Fischhoff, B., Layman, M., & Combs, B. (1978). Judged frequency of lethal events. Journal of Experimental Psychology: Human Learning and Memory, 4, 551.Google Scholar
  27. Loeb, S., Carter, H. B., Berndt, S. I., Ricker, W., & Schaeffer, E. M. (2011). Complications after prostate biopsy: Data from SEER-medicare. The Journal of Urology, 186, 1830–1834. doi: 10.1016/j.juro.2011.06.057 PubMedCrossRefGoogle Scholar
  28. MacArthur, G. J., Wright, M., Beer, H., & Paranjothy, S. (2011). Impact of media reporting of cervical cancer in a UK celebrity on a population-based cervical screening programme. Journal of Medical Screening, 18, 204–209. doi: 10.1258/jms.2011.011092;  10.1258/jms.2011.011092
  29. MacKenzie, R., Chapman, S., Barratt, A., & Holding, S. (2007). “The news is [not] all good”: Misrepresentations and inaccuracies in Australian news media reports on prostate cancer screening. The Medical Journal of Australia, 187, 507–510.PubMedGoogle Scholar
  30. Mackenzie, R., Chapman, S., Johnson, N., McGeechan, K., & Holding, S. (2008). The newsworthiness of cancer in Australian television news. The Medical Journal of Australia, 189, 155–158.PubMedGoogle Scholar
  31. MacKenzie, R., Chapman, S., McGeechan, K., & Holding, S. (2010). ‘A disease many people still feel uncomfortable talking about’: Australian television coverage of colorectal cancer. Psycho-Oncology, 19, 283–288. doi: 10.1002/pon.1567;  10.1002/pon.1567
  32. Maddox, J., Hughes, P. F., & Levy, R. (2012, May 29). Letters to the editor: Routine PSA testing should be continued. The Wall Street Journal, A12.Google Scholar
  33. Metcalfe, D., Price, C., & Powell, J. (2011). Media coverage and public reaction to a celebrity cancer diagnosis. Journal of Public Health (Oxford, England), 33, 80–85. doi: 10.1093/pubmed/fdq052;  10.1093/pubmed/fdq052
  34. Moritz, O. (2009, June 21). It can save your life! Deadly scourge of prostate cancer is often curable if caught on time. Daily News (NY), pp. 26.Google Scholar
  35. Myrick, J. G., Willoughby, J. F., Noar, S. M., & Brown, J. (2013). Reactions of young adults to the death of Apple CEO Steve Jobs: Implications for cancer communication. Communication Research Reports, 30, 115–126.Google Scholar
  36. Noar, S. M., Willoughby, J. F., Myrick, J. G., & Brown, J. (2013). Public figure announcements about cancer and opportunities for cancer communication: A review and research agenda. Health Communication, 29, 445–461.Google Scholar
  37. Orenstein, P. (2013, April 28). The problem with pink: Our feel-good war on breast cancer. The New York Times Magazine, MM36.Google Scholar
  38. Parker-Pope, T. (2008, August 5). Panel urges end to screening for prostate cancer at age 75. The New York Times, pp. 1.Google Scholar
  39. Poplin, C., & Ball, R. H. (2008, August 7). Letters to the editor: Defending the prostate cancer blood test. Washington post, pp. A20.Google Scholar
  40. Rex, D. K., Johnson, D. A., Anderson, J. C., Schoenfeld, P. S., Burke, C. A., Inadomi, J. M., et al. (2009). American college of gastroenterology guidelines for colorectal cancer screening 2009 [corrected. The American Journal of Gastroenterology, 104, 739–750. doi: 10.1038/ajg.2009.104;  10.1038/ajg.2009.104
  41. Reyna, V. F. (2008). A theory of medical decision making and health: Fuzzy trace theory. Medical Decision Making, 28, 850.PubMedCentralPubMedCrossRefGoogle Scholar
  42. Reyna, V. F., & Lloyd, F. J. (2006). Physician decision making and cardiac risk: Effects of knowledge, risk perception, risk tolerance, and fuzzy processing. Journal of Experimental Psychology, 12, 179–195. doi: 10.1037/1076-898X.12.3.179 PubMedGoogle Scholar
  43. Rosario, D. J., Lane, J. A., Metcalfe, C., Donovan, J. L., Doble, A., Goodwin, L., et al. (2012). Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: Prospective evaluation within ProtecT study. BMJ (Clinical Research Ed.), 344, d7894. doi: 10.1136/bmj.d7894
  44. Rosoff, L. (2008, August 19). A debate over screening. The New York Times, pp. 4.Google Scholar
  45. Schroder, F. H., Hugosson, J., Roobol, M. J., Tammela, T. L., Ciatto, S., Nelen, V., et al. (2009). Screening and prostate-cancer mortality in a randomized European study. The New England Journal of Medicine, 360, 1320–1328. doi: 10.1056/NEJMoa0810084
  46. Schroder, F. H., Hugosson, J., Roobol, M. J., Tammela, T. L., Ciatto, S., Nelen, V., et al. (2012). Prostate-cancer mortality at 11 years of follow-up. The New England Journal of Medicine, 366, 981–990. doi: 10.1056/NEJMoa1113135;  10.1056/NEJMoa1113135
  47. Schwartz, L. M., Woloshin, S., Fowler, F. J., Jr, & Welch, H. G. (2004). Enthusiasm for cancer screening in the United States. Journal of the American Medical Association, 291, 71–78. doi: 10.1001/jama.291.1.71 PubMedCrossRefGoogle Scholar
  48. Smith, K. C. (2002). Coding the news: The development of a methodological framework for coding and analyzing newspaper coverage of tobacco issues. Research Paper Series no. 21: Impact Teen, Chicago.Google Scholar
  49. Smith, K. C., Kromm, E. E., & Klassen, A. C. (2010). Print news coverage of cancer: What prevention messages are conveyed when screening is newsworthy? Cancer Epidemiology, 34, 434–441. doi: 10.1016/j.canep.2010.02.006 PubMedCrossRefGoogle Scholar
  50. Squiers, L. B., Holden, D. J., Dolina, S. E., Kim, A. E., Bann, C. M., & Renaud, J. M. (2011). The public’s response to the US preventive services task force’s 2009 recommendations on mammography screening. American Journal of Preventive Medicine, 40, 497–504. doi: 10.1016/j.amepre.2010.12.027;  10.1016/j.amepre.2010.12.027
  51. Steenhuysen, J., & Orlofsky, S. (2012, November 21). Study reignites controversy over mammography. NBC News. Google Scholar
  52. The Chicago Sun-Times. (2008, April 16). Do the right thing, men. Take our prostate test. The Chicago Sun Times. Google Scholar
  53. Tyler, T. R., & Cook, F. L. (1984). The mass media and judgments of risk: Distinguishing impact on personal and societal level judgments. Journal of Personality and Social Psychology, 47, 693.CrossRefGoogle Scholar
  54. US Preventive Services Task Force. (2008a). Screening for colorectal cancer: US preventive services task force recommendation statement. Annals of Internal Medicine, 149, 627–637.Google Scholar
  55. US Preventive Services Task Force. (2008b). Screening for prostate cancer: US preventive services task force recommendation statement. Annals of Internal Medicine, 149, 185–191.Google Scholar
  56. US Preventive Services Task Force. (2012). Prostate cancer screening: Draft recommendation statement. Retrieved 19 Nov 2012.
  57. Vastag, B. (2012, May 29). Prostate cancer test is still popular. Washington post, pp. E01.Google Scholar
  58. Vu, M. B. (2012). Screening decisions study: Survey of primary care clinicians’ cancer screening decisions and practices. Unpublished manuscript.Google Scholar
  59. Wakefield, M., Flay, B., Nichter, M., & Giovino, G. (2003). Role of the media in influencing trajectories of youth smoking. Addiction (Abingdon, England), 98, 79–103.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Emily A. Elstad
    • 1
    • 2
  • Stacey L. Sheridan
    • 2
    • 3
  • Joseph G. L. Lee
    • 1
  • Christine Rini
    • 1
    • 4
  • Jo Anne Earp
    • 1
    • 4
  • Noel T. Brewer
    • 1
    • 2
    • 4
  1. 1.Department of Health BehaviorUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Cecil B. Sheps Center for Health Services ResearchChapel HillUSA
  3. 3.Department of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Lineberger Comprehensive Cancer CenterChapel HillUSA

Personalised recommendations