1. CONTENT ANALYSIS OF BREAST CANCER NEWS COVERAGE Presentation to National Communication Association, November 2006

2. Charles Atkin & Sandi Smith MSU Vanessa Ferguson, Eastern Mich U. Courtnay McFeters, NCI

3. Purpose Examine how news media portray breast cancer …measuring wide array of content …special attention to coverage of: -- risks of controllable environmental exposures -- preventive behavior

4. Risks and Prevention Environmental risks broadly encompass contaminants, pharmaceuticals, and lifestyle practices. Preventive measures range from: -- individual (avoiding exposure to pesticides) -- parental protection (encouraging daughter to avoid contaminants) -- collective action (supporting initiatives to restrict local chemical emissions).

5. NCI Comprehensive List 1.Age 2.Personal history of BC 3.Family history 4.LCIS 5.Gene changes (BRCA1 BRCA2) 6.Age of menarche 7.Age of first child birth 8.HRT (E+P)

6. Note at end of NCI list: “Other possible risk factors are under study…” “e ffect of diet” “physical activity” “whether certain substances in the environment can increase the risk of breast cancer”

7. Message Sample (2003-04) NEWSPAPERS (stories per year) 50 USA Today “America’s newspaper” 50 LOS ANGELES TIMES 20 NEW YORK TIMES

8. TV newscasts & Newsmagazines 10 ABC -- Peter Jennings 8 CBS -- Dan Rather 6 NBC -- Tom Brokaw 10 TIME 8 NEWSWEEK 6 US NEWS

9. RELATIVE EMPHASIS Treatment Awareness Risks Prevention Detection Prevalence

10. News Channel: Story Source and Topic SourceNewspapersMagazinesTelevision Government agency31% 46% 4% Medical Expert77%75%61% Personal cases25%12% 46% Foundation38%8%20% Corporation26%17%7% Medical journal 52% 41%11% Treatment35%25% 43% Prevention42%50%28% Detection19%8% 29% Prevalence35%29%27%

11. TOP STORIES 2003-04 HRT study discontinued British HRT report: E&P  BC JAMA HRT report: E&P  BC LETROZOLE effective as follow-up ASPIRIN reduces BC risk ANTIBIOTICS increase BC risk BRCA genes increase BC risk

12. Coverage of Environmental Risk Factors 12% Use Hormones/Estrogen/ P rogesterone /HRT 6% Use other pharmaceuticals 3% Obesity 2% Exposure to chemical contaminants 2% Eating certain unhealthy foods 1% Exposure to pesticides 1% Lack of exercise 1% Tobacco use 1% Exposure to second-hand smoke

13. Individual Prevention Methods 26% Taking pharmaceuticals 4% Avoiding obesity 3% Participating in exercise 3% Adopting dietary practices: avoid certain foods 1% Avoiding environmental contaminants 1% Adopting dietary practices: eat certain beneficial foods

14. Under-represented topics RISKS: Diet - Obesity – Inactivity Pesticides Other Environ Contaminants (esp. localized and occupational)

15. Under-represented topics PREVENTION: Weight loss - Exercise Protective parental actions Collective policy initiatives Comprehensive overview

16. Narrative vs. Stats 40% of the stories highlight a personal story of a survivor, advocate, or patient while only 20% of stories include statistical data. –Which type of story has the greatest impact on a women’s behavior?

17. Treatment vs. Prevention Heavy emphasis on treatment news rather than on prevention methods with an emphasis on chemotherapy regimens.  Does this belief in a higher survival rate reduce women’s likelihood to take preventative measures?

18. News Coverage & Perceived Risks MSU surveys: BC risk appraisal dominated by family history > E contamination …reflecting pattern of news coverage of risks Model persuasion strategy: -- challenge complacency among women with low perceived genetic BC susceptibility -- emphasize urgency to address E risks for those feeling vulnerable due to family history