Predicting Changes in Patient Choice of Preventive Health Care after Celebrity Diagnoses

There is a debated phenomenon in health care whereby some doctors believe that patients engage more in medical testing following a celebrity medical announcement. Popularly known by anecdotal incidences such as the Angelina Jolie effect, the Katie Couric effect, and the Nancy Reagan effect, as a generalizable theory it is not widely agreed upon among health-care providers and insurers. Here we use longitudinal data to test whether there is a generalizable effect for celebrity breast cancer diagnoses and population screening behaviors. Over a 19-year period, we find no evidence that celebrity cancer incidence alone impacts screening rates. On the other hand, we do find that the amount of news coverage (i.e., the number of news stories) generated by celebrity diagnoses significantly increases breast exams and mammogram rates; every 100 stories about a celebrity's cancer increase the percentage of women getting mammograms by 0.77 percentage points, an effect several orders of magnitude larger than that of other news stories about cancer. At an average $300 per mammogram, every 100 celebrity cancer news stories would cost insurers an extra $76.23 million. Thus, understanding how celebrity cancer can, but does not always, impact subsequent testing rates is important for theory building, cost prediction, and clinical insight.