The news media play a role in educating the public about cancer risks (1
). In turn, cancer risk perceptions influence cancer-related health behaviors, according to established behavioral theories, such as the Health Belief Model (4
), the Extended Parallel Process Model (5
), and the Precaution Adoption Model (6
). These models state that behavior change is likely when a person believes that a given behavior poses nontrivial risks and when that person has self-efficacy. In addition to these conceptual frameworks, many empiric studies (7
) have suggested that holding beliefs that a given behavior poses nontrivial risks is a necessary (though not necessarily sufficient) condition for changing related behaviors (5
) and provoking policy change (9
Mass media communication, as well as personal experience and interpersonal communication, shape our perceptions of risk. Although each source is influential, media exposure is particularly influential under certain conditions (10
). For instance, mass media communication can be particularly influential when it is a primary source for health information, when direct experience is limited, or when perceptions of risk are low (11
The amount and type of media attention paid to particular risks influence risk perceptions. The salience of risk perceptions is highly associated with the extent of news coverage of instances of those risks (13
). Furthermore, media attention to a particular risk may contribute to a social amplification of risk perception (10
). Previous studies have also evaluated the quality of risk communication in news media. The news media have played a positive role by educating the public about health risks and influencing behavior change (15
), but the reporting often includes inadequate or incomplete information about risks (17
The interpretation of risk by physicians, consumers, and third-party payers may be influenced by incomplete presentations of risk (20
). For instance, reporting relative risk alone (without clearly specifying event rates) leads many to overestimate the magnitude of findings (22
). Alternatively, reporting absolute risk alone may lead to an underestimate of risk perceptions, particularly for groups at higher risk. Because the reporting of risk can be misleading, the news media and other health communicators have been urged to provide absolute risk or both relative and absolute risks when quantifying risks (24
Newspapers have been repeatedly cited by survey respondents as a trusted source of health information (1
). Because newspapers reach distinct segments of society (29
), whether quality risk communication is given to all groups should be monitored. Therefore, we evaluated cancer risk communication in newspapers targeting mainstream and ethnic audiences (those who share a country of origin, religion, or race). A recent poll showed that 45% of adults from ethnic minority groups surveyed preferred ethnic media to mainstream media, and an additional 35% accessed ethnic media regularly (29
). Culturally specific messages may resonate more with certain audiences and ultimately be more persuasive (30
Cancer news coverage might differ between mainstream and ethnic newspapers for several reasons. Mainstream media organizations are generally larger, more likely to report scientific research, and have the resources to support trained medical and science reporters. Smaller newspapers are more likely to report human interest stories and to lack the resources to support medical and science reporting (32
). Moreover, ethnic media serve a different role than do mainstream media. Ethnic media producers believe their role is to focus on culturally distinct aspects of the news (30
). Furthermore, given the homogeneity of their audiences, ethnic newspapers may be more likely to discuss health risks that are highly salient to their readers. Alternatively, certain beliefs that are widely held among particular ethnic groups, such as cancer fatalism (34
) or the taboo nature of discussing cancer, may influence cancer portrayals in ethnic media.
Cancer news coverage may influence cancer-related behavior. For example, news coverage can produce short-term increases in attention to particular issues, such as an increase in screening rates when a celebrity is diagnosed with cancer (35
). Alternatively, it can influence long-term secular trends in behaviors such as smoking (36
). However, little research has examined how cancer coverage may affect cognitive and psychosocial factors such as cancer risk knowledge or perceptions (37
). Our research attempts to fill that gap by examining how newspapers cover cancer risks.
The purpose of this study was to explore the frequency of articles about different types of cancer risks that are published by mainstream and ethnic newspapers, to assess the extent to which newspapers communicate cancer risks optimally, and to determine whether portrayals differ between the 2 kinds of newspapers. Given that few empiric tests of optimal risk communication (ORC) messages have targeted large audiences, the understanding of ORC strategies is limited. Our definition of ORC is derived from areas that appear to have a consensus: 1) that risk should be placed in context by providing both absolute and relative risk and 2) that discussions of risk may instill perceptions of threat, which could trigger reaction or denial if they are not countered with some discussion of response or prevention efficacy.
We also determined whether key story features were associated with ORC. Stories about particular types of cancer or particular types of cancer risks may be more likely to present cancer risks optimally. Since larger news organizations such as wire services have greater resources and trained health reporters, stories from a wire service may be more likely to use ORC. The same may be true for stories using expert sources. Finally, differences in ORC may be attributable to the basic story formats we identified for cancer news articles. For example, a profile of a person dealing with cancer may be more focused on developing a compelling narrative than on providing ORC. In contrast, a report of new research may be more likely to focus on scientific information and, hence, to communicate risk optimally.
We asked what types of cancer risks are discussed most frequently and whether mainstream and ethnic newspapers differ; how often cancer risks are communicated optimally in mainstream and ethnic newspapers; and whether certain features of the story or source are predictive of ORC in both mainstream and ethnic newspapers.