Evans D Gareth, Barwell Julian, Eccles Diana M, Collins Amanda, Izatt Louise, Jacobs Chris, Donaldson Alan, Brady Angela F, Cuthbert Andrew, Harrison Rachel, Thomas Sue, Howell Anthony, Miedzybrodzka Zosia, Murray Alex
Breast Cancer Res. 2014 Sep 19;16(5):442. doi: 10.1186/s13058-014-0442-6.
It is frequent for news items to lead to a short lived temporary increase in interest in a particular health related service, however it is rare for this to have a long lasting effect. In 2013, in the UK in particular, there has been unprecedented publicity in hereditary breast cancer, with Angelina Jolie's decision to have genetic testing for the BRCA1 gene and subsequently undergo risk reducing mastectomy (RRM), and a pre-release of the NICE guidelines on familial breast cancer in January and their final release on 26th June. The release of NICE guidelines created a lot of publicity over the potential for use of chemoprevention using tamoxifen or raloxifene. However, the longest lasting news story was the release of details of film actress Angelina Jolie's genetic test and surgery.
To assess the potential effects of the 'Angelina Jolie' effect, referral data specific to breast cancer family history was obtained from around the UK for the years 2012 and 2013. A consortium of over 30 breast cancer family history clinics that have contributed to two research studies on early breast surveillance were asked to participate as well as 10 genetics centres. Monthly referrals to each service were collated and increases from 2012 to 2013 assessed.
Data from 12 family history clinics and 9 regional genetics services showed a rise in referrals from May 2013 onwards. Referrals were nearly 2.5 fold in June and July 2013 from 1,981 (2012) to 4,847 (2013) and remained at around two-fold to October 2013. Demand for BRCA1/2 testing almost doubled and there were also many more enquiries for risk reducing mastectomy. Internal review shows that there was no increase in inappropriate referrals.
The Angelina Jolie effect has been long lasting and global, and appears to have increased referrals to centres appropriately.
新闻报道常常会使人们对某项特定的健康相关服务的兴趣短期内暂时增加，但这种报道能产生持久影响的情况却很少见。2013年，尤其是在英国，遗传性乳腺癌受到了前所未有的广泛关注，这是由于安吉丽娜·朱莉决定进行BRCA1基因检测并随后接受降低风险的乳房切除术（RRM），以及英国国家卫生与临床优化研究所（NICE）关于家族性乳腺癌的指南于1月预先发布，并于6月26日最终发布。NICE指南的发布引发了大量关于使用他莫昔芬或雷洛昔芬进行化学预防可能性的宣传。然而，持续时间最长的新闻事件是电影演员安吉丽娜·朱莉的基因检测和手术细节的公布。
为了评估“安吉丽娜·朱莉效应”的潜在影响，从英国各地获取了2012年和2013年乳腺癌家族史的转诊数据。一个由30多个参与了两项早期乳腺癌监测研究的乳腺癌家族史诊所组成的联盟以及10个遗传学中心被邀请参与。整理了每个服务机构的月度转诊数据，并评估了2012年至2013年的转诊增加情况。
来自12个家族史诊所和9个地区遗传学服务机构的数据显示，从2013年5月起转诊量有所增加。2013年6月和7月的转诊量从2012年的1981例增加到4847例，几乎增长了2.5倍，到2013年10月仍保持在两倍左右。BRCA1/2检测的需求几乎翻了一番，同时对降低风险乳房切除术的咨询也增加了很多。内部审查显示，不适当转诊没有增加。
“安吉丽娜·朱莉效应”具有持久和全球性的影响，并且似乎适当增加了向各中心的转诊量。
