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Cancer-related direct-to-consumer advertising: a critical review

Nature Reviews Cancer volume 11, pages 142–150 (2011)Cite this article

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Abstract

The direct-to-consumer advertising (DTCA) phenomenon has received attention because of its attempt to reach out to consumers by bypassing important gatekeepers such as physicians. The emergence of new information platforms and the introduction of genetic tests directly to the consumer have heightened the concern with DTCA and its potential consequences. These effects of DTCA are particularly important given the communication inequalities among social groups, with class, race and ethnicity influencing how people access, seek, process and act on information. This Science and Society article reviews the major issues regarding general and cancer-related DTCA and also offers data from a national survey in the United States as an example of the communication inequalities in genetic testing awareness.

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Figure 1: Structural influence model of communication for cancer-related DTCA.
Figure 2: Persisting digital divide in the United States.

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Acknowledgements

The authors would like to thank the Dana-Farber/Harvard Cancer Center for support to K.V.

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Authors and Affiliations

  1. School of Public Health Department of Society, Emily Z. Kontos and K. Viswanath are at the Lung Cancer Disparities Center, Harvard University, Human Development and Health, 401 Park Drive, Room 403F, Boston MA 02215, USA.,

    Emily Z. Kontos & K. Viswanath

  2. K. Viswanath is also at the Dana-Farber Cancer Institute, 44 Binney Street, Boston MA 02115, USA.,

    K. Viswanath

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  1. Emily Z. Kontos
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Correspondence to K. Viswanath.

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Supplementary information

Supplementary information S1 (table)

Multivariable logistic regression of odds of being aware of genetic testing (model 1) and finding medical statistics hard/very hard to understand (model 2) (PDF 203 kb)

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FURTHER INFORMATION

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Glossary

Appalachia

A region in the eastern United States that has long struggled with poverty owing to the negative effect of logging and coal-mining firms that were established in the area, starting in the 1930s.

Behavioural Risk Factor Surveillance System

(BRFSS). A state-based system of health surveys fielded by the US Centers for Disease Control and Prevention starting in 1984 that collects information on health risk behaviours, preventive health practices, and health care access primarily related to chronic disease and injury.

Genetic counselling

An educational process by trained professionals providing information, support and referral to testing services to individuals with a family history of a variety of medical disorders.

Health Information National Trends Survey

HINTS. A system of national health surveys fielded by the US National Cancer Institute focused on reporting the cancer communication behaviours and trends of American adults. It has been fielded every 2–3 years, beginning in 2003.

Knowledge gap hypothesis

A communication theory that suggests that information flow into a society is more likely to be acquired by high socio-economic groups at a faster rate than lower socio-economic groups, thus widening gaps in knowledge between them.

Managed care organization

(MCO). A health care provider or group of medical service providers with contracts with insurers or self-insured employers to provide a wide variety of health care services to enrollees.

Patient-centred medicine

A philosophy of practicing medicine that is based on a partnership between clinicians and patients that is characterized by informed, shared decision making, development of patient knowledge, self-management skills and preventive behaviours.

Pure Food and Drug Act

A US federal law that provided federal inspection of meat products and outlawed the manufacture, sale or transportation of adulterated food products and poisonous patent medicines.

Tamoxifen and Raloxifene

Members of a drug class known as selective oestrogen receptor modulators (SERMs). Studies suggest that they might have a role in the prevention of breast cancer in women who have not yet developed breast cancer.

US Federal Trade Commission

(FTC). An independent consumer protection agency of the US government. Before 1962, the FTC had jurisdiction over all advertising, including prescription drug advertising.

US Food and Drug Administration

(FDA). A federal agency of the US government responsible for protecting and promoting public health through the regulation and supervision of several items, including food safety, tobacco products, vaccines, medical devices and prescription and over-the-counter pharmaceutical drugs.

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Kontos, E., Viswanath, K. Cancer-related direct-to-consumer advertising: a critical review. Nat Rev Cancer 11, 142–150 (2011). https://doi.org/10.1038/nrc2999

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