Cancer news coverage should also focus on hospice and end-of-life care

Mar 17 2010

Newspaper and magazine reports about cancer appear more likely to discuss aggressive treatment and survival than death, treatment failure or adverse events, and almost none mention end-of-life palliative or hospice care, according to a report in the March 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

The report is one of three in the issue being released early to coincide with a JAMA media briefing on cancer in Washington, D.C. The March issues of Archives of Pediatrics & Adolescent Medicine, Archives of Neurology, Archives of Ophthalmology, Archives of Dermatology, Archives of Surgery, Archives of Facial Plastic Surgery and Archives of Otolaryngology-Head & Neck Surgery have also published articles on this topic.

It is estimated that one in two men and one in three women will be diagnosed with cancer in their lifetime, according to background information in the article. Of these, approximately half will die of cancer or related complications; more than half a million Americans are expected to die of cancer every year. "These figures have given cancer a prominent place in news reporting," the authors write.

Jessica Fishman, Ph.D., and colleagues at the University of Pennsylvania, Philadelphia, conducted a content analysis of cancer news reporting between 2005 and 2007 in eight large U.S. newspapers and five national magazines. Of 2,228 cancer-related articles that appeared, a random sample of 436 was selected (312 from newspapers and 124 from magazines). Trained coders determined the proportion of articles devoted to various cancer-related topics.

The articles were most likely to focus on breast cancer (35.1 percent) or prostate cancer (14.9 percent), and 87 (20 percent) discussed cancer in general. A total of 140 (32.1 percent) focused on individuals surviving or being cured of cancer, whereas 33 (7.6 percent) focused on one or more patients who were dying or had died of cancer. Ten articles (2.3 percent) focused on both survival and death.

"It is surprising that few articles discuss death and dying considering that half of all patients diagnosed as having cancer will not survive," the authors write. "The findings are also surprising given that scientists, media critics and the lay public repeatedly criticize the news for focusing on death."

In addition, few articles (57, or 13.1 percent) reported that aggressive cancer treatments can fail to extend life or cure the disease, or that some cancers are incurable. Less than one-third of the articles (131, or 30 percent) mentioned adverse events associated with cancer treatments, such as nausea, pain or hair loss.

Most articles (249, or 57.1 percent) discussed aggressive treatments exclusively, but almost none (two, or 0.5 percent) discussed end-of-life care only and only 11 (2.5 percent) discussed both. "For many patients with cancer, it is important to know about palliative and hospice care because this information can help them make decisions that realistically reflect their prognosis and the risks and potential benefits of treatment," the authors write.

After adjusting for article length, there were no differences between magazine and newspaper articles in regards to any of these factors, the authors note.

"How often should the news media discuss treatment failure, adverse events, end-of-life care and death and dying? Although there is no quantifiable answer, the same educational goals that ideally drive news coverage of cancer treatment and survival should also compel news organizations to address these topics," the authors conclude. "The media routinely report about aggressive treatment and survival presumably because cancer news coverage is relevant to a large portion of the population, and, for the same reason, similar attention should be devoted to the alternatives."

Source: JAMA and Archives Journals