Angelina Jolie’s breast cancer message may not have reached women most at risk

Three years ago, actress Angelina Jolie wrote in a The New York Times op-ed that she had a preventive double mastectomy after breast cancer susceptibility gene testing (BRCA) revealed she was at an increased risk of breast and ovarian cancer.

Her news resulted in a nationwide increase in genetic testing, but did the so-called Angelina effect save lives? Maybe not, according to a new study by Harvard Medical School researchers published in The BMJ. Their analysis concluded that it was mostly women at low-risk for breast cancer who got the BRCA test, estimated to cost $3,000, not the high-risk population for whom testing is recommended.

Jolie’s editorial, which went viral, was associated with an estimated increase of 4,500 BRCA tests and $13.5 million in costs in the 15 days after it was published, the study found.

“Celebrity announcements can have a large and immediate effect on use of health services. Such announcements can be a low cost means of reaching a broad audience quickly, but they may not effectively target the sub-populations that are most at risk for the relevant underlying condition,” the study concluded.

Check out some of our past coverage on how celebrities can impact healthcare awareness and trends: 

Doctors respond to Angelina Jolie's breast cancer media bombshell

'Angelina Jolie effect' lingers over breast cancer

Aetna, Anthem and Cigna don't cover genetic tests made popular by 'Angelina effect'

How celebrities shape our healthcare decisions--for good or for ill

After diagnosis, Ben Stiller urges men to talk to their doctors, get prostate cancer test

Cigna requires counseling before genetic tests

Ray Rice fallout fuels healthcare's domestic violence prevention efforts

Quaid draws attention to health IT, but do people really care?

The researchers analyzed data from more than 9.5 million U.S. women between ages 18 and 64 with private health insurance. In the 15 working days before Jolie’s announcement, there were about 7 BRCA tests per million women. In the 15 says after the news, there were about 11 tests per million, an increase of 57%.

The researchers then looked at the number of women who had BRCA tests and underwent mastectomies. The number was 10% in the months before the announcement, but only 7% in the months after. Researchers said that suggests Jolie’s news inspired women with a lower pre-test probability of having the BRCA mutation to get tested, not women with a family history of breast or ovarian cancer.

Jolie has a family history of breast cancer, which claimed the life of her mother. While her doctors estimated she had a high risk of breast and ovarian cancer, Jolie was careful to say that only a fraction of breast cancers result from an inherited gene mutation.

Jolie is the not the only celebrity to bring attention to a health issue. In October, the actor Ben Stiller went public with the news that he was diagnosed two years ago with aggressive prostate cancer and urged men to go to their doctor and discuss the prostate-specific antigen (PSA) test, which he credited with saving his life. Actor Tom Hanks has also talked about his Type 2 diabetes diagnosis.