title: Is public communication about end-of-life care helping to inform all? Cancer news coverage in African American versus mainstream media.
abstract: BACKGROUND
  Because cancers are a leading cause of death, these diseases receive a great deal of news attention. However, because news media frequently target specific racial or ethnic audiences, some populations may receive different information, and it is unknown whether reporting equally informs all audiences about the options for care at the end of life. This study of news reporting compared "mainstream" (general market) media with African American media, which serves the largest minority group. The specific goal of this study was to determine whether these news media communicate differently about cure-directed cancer treatment and end-of-life alternatives.
  
  
  METHODS
  This content analysis included 660 cancer news stories from online and print media that targeted either African American or mainstream audiences. The main outcome measures included whether reporting discussed adverse events of cancer treatment, cancer treatment failure, cancer death/dying, and end-of-life palliative or hospice care.
  
  
  RESULTS
  Unadjusted and adjusted analyses indicated that the news stories in the African American media are less likely than those in mainstream media to discuss each of the topics studied. Comparing the proportions of news stories in mainstream versus African American media, 31.6% versus 13.6% discussed adverse events (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.51-5.66; P = .001); 14.1% versus 4.2% mentioned treatment failure (OR, 3.79; 95% CI, 1.45-9.88; P = .006); and 11.9% versus 3.8% focused on death/dying (OR, 3.42; 95% CI, 1.39-8.38; P = .007). Finally, although very few news stories discussed end-of-life hospice or palliative care, all were found in mainstream media (7/396 vs 0/264).
  
  
  CONCLUSIONS
  The African American news media sampled are less likely than mainstream news media to portray negative cancer outcomes and end-of-life care. Given media's segmented audiences, these findings raise concerns that not all audiences are being informed equally well. Because media content is modifiable, there may be opportunities to improve public cancer communication.
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. fishman1@mail.med.upenn.edu
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Fishman
authors.forename: Thomas
authors.initials: T
authors.lastname: Ten Have
authors.forename: David
authors.initials: D
authors.lastname: Casarett
mesh_terms: D001741:Black or African American; D003142:Communication; D006738:Hospices; D006801:Humans; D008402:Mass Media; D008913:Minority Groups; D009369:Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D010166:Palliative Care; D013727:Terminal Care; D017211:Treatment Failure