Hollywood celebrities influence more than our choices about what clothes to wear and what perfume to buy — they also influence what health care we seek out. And they don't necessarily leave us better informed about our own health decisions.
Those are the conclusions of studies following Angelina Jolie's 2013 op-ed about her decision to undergo a double mastectomy to prevent breast cancer. They give a clue about the likely public health impact of the actress's latest New York Times piece, in which she discusses having her ovaries and fallopian tubes removed to lower her risk of ovarian cancer — a disease that killed her mom at the age of 56.
One study, in the journal Breast Cancer Research, looked at referrals for genetic counseling and testing for breast cancer in the UK before and after Jolie went public about testing positive for the BRCA1 gene mutation and choosing to remove her breasts.
The researchers found that referrals to clinics for genetic counseling for breast cancer risk more than doubled over the previous year.
Breast cancer referrals doubled across the UK
Genetic mutations in genes called BRCA1 and BRCA2 are linked to a heightened risk for breast and ovarian cancers. To understand whether a patient is at a higher-than-normal risk for these diseases, a doctor can order a genetic test to look for those mutations.
The researchers wrote, "Demand for BRCA1/2 testing almost doubled, and there were also many more inquiries for risk-reducing mastectomy." They also concluded the effects were long-lasting, since the rate of referrals appeared to remain elevated long after Jolie's announcement.
"Angelina Jolie stating she has a BRCA1 mutation and going on to have a [double mastectomy] is likely to have had a bigger impact than other celebrity announcements possibly due to her glamorous image and relationship to Brad Pitt," the researchers wrote.
The science of the "Jolie effect"
This wasn't the first study to find that the actress had an impact on public health.
Another article looked at the effect Jolie's 2013 announcement had on public awareness about the science behind her health issues.
The researchers, who published in the journal Genetics in Medicine, found that Jolie's story did not improve people's understanding of breast and ovarian cancer risk. "While three of four Americans were aware of Angelina Jolie's double mastectomy," they wrote, "fewer than 10 percent of respondents had the information necessary to accurately interpret Ms. Jolie's risk of developing cancer relative to a woman unaffected by the BRCA gene mutation."
This lack of an increased understanding may also be a result of the news media's failure to report on her health choices in context.
Another study, also published in Genetics in Medicine, found that journalists took an overwhelmingly positive slant on Jolie's preventive surgeries, instead of discussing the relative rarity of her condition and the fact that most women would have many other options besides the extreme procedures.
Tim Caulfield, one of the researchers behind the article and author of Is Gwyneth Paltrow Wrong About Everything?, said that even though Jolie's latest op-ed is "thoughtful and devoid of tabloid noise, [it] can have unintended consequences, as we saw after her first announcement."
You can read more about genetic testing in the Vox card stack here.