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Direct-to-Consumer Advertising in Oncology: A Content Analysis of Print Media

Gregory A. Abel, Stephanie J. Lee, Jane C. Weeks

From the Center for Outcomes and Policy Research, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; and the Fred Hutchinson Cancer Research Center, Seattle, WA

Address reprint requests to Jane C. Weeks, MD, MSc, Center for Outcomes and Policy Research, Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney St, Smith 271, Boston, MA 02115; e-mail: jane_weeks{at}dfci.harvard.edu

Purpose: Content analysis of cancer-related direct-to-consumer advertising (DTCA), with a focus on how benefit and risk/adverse effect information is presented, is essential to understanding its potential impact on oncology outcomes.

Methods: We reviewed all oncology DTCA appearing in three patient-focused cancer magazines and a sample of selected popular magazines from January 2003 to June 2006. We determined the Flesch reading ease score (FRES) for the text in each advertisement (a score 65 is readable for the average person). We also assessed the proportion, type size, and placement of benefits and risks/adverse effects, as well as the nature and content of advertising appeals.

Results: Of 284 advertisements identified, 49 were unique. Oncology-related DTCA was rare in the popular magazines, and appeared mostly in those aimed at female readership. About equal amounts of text were devoted to benefits and risks/adverse effects, and all text was difficult to read. The mean FRES for benefit text was 39.71; for risk/adverse effect text, it was 38.22, a difference of 1.49 (95% CI, –4.02 to 7.00). The largest font size for benefits was 4.60 mm on average; for risks/adverse effects, it was 2.38 mm, a difference of 2.22 mm (95% CI, 1.35 to 3.09). Appeals to medication effectiveness were frequent (95%) and often made with clinical trial data (61%).

Conclusion: Oncology print DTCA is prevalent in cancer-related, patient-directed magazines, and infrequent in the popular press. The information presented is considerably difficult to read, raising important questions about the appropriateness of direct-to-consumer marketing for oncologic medications.

Supported by a US Department of Health and Human Services Public Health Services Training Grant (G.A.A.).

Presented in part at the 42nd Annual Meeting of the American Society of Clinical Onoclogy, June 2-6, 2006, Atlanta, GA.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.