title: Direct-to-consumer advertising in oncology: a content analysis of print media.
abstract: OBJECTIVE
  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 > or = 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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Outcomes and Policy Research, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Abel
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
mesh_terms: D000329:Advertising / Q000639:trends*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000188:drug therapy*; D010506:Periodicals as Topic
chemical_list: D000970:Antineoplastic Agents