Early detection of skin cancer contributes to better prognosis and survival (Mayer, Swetter, Fu, & Geller, 2014). The popular media is an important source of skin cancer information for the public (Dixon, Warne, Scully, Dobinson & Wakefield, 2014). Media articles are often accompanied by images, and images influence patient knowledge and behaviours related to early detection (McWhirter & Hoffman-Goetz, 2013b). Little is known about how, and how often, early detection for skin cancer is reported in the media.
Using a directed content analysis, we examined popular U.S. men’s (n = 10) and women’s (n = 10) magazines based on high circulation numbers (2012) for information about early detection in skin cancer and tanning articles (n = 608) and accompanying images (n = 930) published from 2000-2012 (inclusive). Magazines included: Good Housekeeping, Family Circle, Ladies Home Journal, Cosmopolitan, Glamour, Vogue, Elle, Women’s Health, Shape, Self, GQ, Esquire, Details, Sports Illustrated, Golf Digest, Popular Science, Field and Stream, Men’s Health, Men’s Fitness, and Muscle and
Fitness. We looked for information about skin self-examination, physician-led skin examination, and the ABCD (asymmetry, border irregularity, color, diameter) criteria.
Chi-square and Fisher’s exact tests determined coverage differences.
During the 13-year study timeframe, there was little information about early detection published in articles and images about skin cancer and tanning (Table 8).
Articles, compared to images, more often encouraged early detection through skin self-examination (18.3% vs. 7.0%, 2 = 46.06, p < .0001), physician-led examination (21.1%
vs. 1.2%, 2 = 176.56, p < .0001), and the ABCD criteria (7.1% vs. 2.0%, 2 = 24.04, p <
.0001). In addition, 3.0% of images depicted other visual examples of skin cancers (e.g.,
“ugly duckling”). Example images of skin cancer are important tools for frequent and accurate melanoma detection by patients; text descriptors alone are often ineffective (McWhirter & Hoffman-Goetz, 2013b). The absence of these images in magazines is troubling.
There were no statistically significant differences in early detection coverage between men’s and women’s magazines (Table 9). While the proportions of women’s vs.
men’s content covering early detection did not differ significantly, the absolute numbers did. For example, 87 articles in women’s magazines encouraged skin self-examination vs.
22 in men’s magazines. Similarly, 98 articles encouraged physician-led skin examination in women’s vs. 28 in men’s magazines. This suggests men may be receiving less information about early detection for skin cancer compared to women.
Table 8. Early detection information in popular U.S. magazines (text vs. image)
Content from Women’s Health Magazine was unavailable for 2000 through 2006 and was therefore not included in these results.
*Statistically significant
ABCD, asymmetry, border irregularity, color, and diameter df = degrees of freedom
Table 9. Early detection information in popular U.S. magazines (women’s vs. men’s magazines) Total article and image counts are lower than in Table I because content from Men’s Health Magazine for 2000 through 2006 was excluded for the target audience comparison in order to match the fact that content from Women’s Health Magazine for the same period of time was unavailable.
ABCD = asymmetry, border irregularity, color, and diameter df = degrees of freedom
Despite the established importance of early detection for melanoma, rates of physician and patient skin examination are low (Mayer et al., 2014). The lack of magazine content about early detection noted here and elsewhere (Stryker, Solky, &
Emmons, 2005) may contribute to low rates of patient skin self-examination and requests by patients for physician-led skin examination.
This research has limitations. We included only a subset of English-language U.S.
popular magazines; other magazines may have had different results. Only articles retrieved by the search strategy were included; we did not track excluded articles.
Temporal changes in coverage were not determined, but these have been reported elsewhere (McWhirter & Hoffman-Goetz, 2014b). We did not assess whether reader’s early detection behaviours were influenced by the content.
It is important for dermatologists to be aware that mediated information about skin cancer contains little information about early detection in article text and especially in images. This may influence patients’ knowledge, attitudes, and behaviours regarding important screening behaviours.
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CHAPTER 6: COVERAGE OF SKIN CANCER AND RECREATIONAL