January 18, 2017

PSA Celebrity Trouble

The Prostate Screening Celebrity Controversy

If we think about Bill Cosby, we will quickly match his comical personality to the fun product Jell-O.

That is also the case for Wilfred Brimley’s grandfatherly tone for healthy Quaker Oats.

Or,  for Dennis Haysbert’s imposing frame and booming voice for the “Good Hands People” at Allstate.

Some products show they solve a problem, like for celebrities endorsing Jenny Craig’s weight loss system.

Researchers from the prestigious Dartmouth Medical College have produced one of the first rigorous investigations of how celebrities affect enthusiasm to seek screening services, especially for PSA (prostate specific antigen) testing for prostate cancer.

According to their studies, about half of the adult population have seen celebrity endorsements for  prostate screening.  This would include former New York City Mayor Rudy Giuliani‘s statement about PSA testing for prostate cancer, “Of course, we probably wouldn’t be talking about this if I hadn’t gotten screened…” and his following plea, “If you’re over 50 or in a high risk group, please get screened—now.”

But efforts of celebrities for prostate screening only perform rhetoric, which is only  a form of emotional persuasion.  “Selling” prostate screening by a celebrity  is designed to “bypass the science” and create an atmosphere where politicians and celebrities could accuse the scientists of “dragging their feet” by insisting on rigorous, but slow, assessments of potentially valuable new technologies.

But, as the science of screening unfolds, we learn more every week that the costs, harms, and benefits of screening programs are complex and uncertain. As the Dartmouth researchers make clear, there are many people who will benefit from these tests, but there are others for whom the early detection of cancer will bring unnecessary testing and treatment: “Screening is increasingly recognised as a two-edged sword.”

The problem is that celebrities don’t tend to make statements based on evidence. Just because Mayor Giuliani believes his life was saved by PSA prostate screening is of no evidentiary value.

Because many cases of prostate cancer do not become clinically evident, medical experts disagree about whether prostate cancer screening is right for all men. It is not clear if the benefits of screening outweigh the risks.

“A few people will experience benefits, such as early diagnosis, but many will experience some harm—anxiety, further testing, and costs, or even unnecessary surgery as a result of being screened.” He also has a strong message for the authorities: “While governments or other bodies may promote the benefits of screening, not enough attempts are being made to present an accurate picture of what the downsides are.” ~ Professor Bruce Armstrong, Sydney University

Dartmouth researchers have concluded with a powerful call for reform: “We see no obvious role for celebrity endorsement of prostate cancer screening.”

Which celebrity has impacted you most by his or her endorsement?  Has one celebrity in particular influenced how you think or act about your prostate?

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