Skip to main content
Download PDF

The impact of objective/sensationalist media on young women’s concern and misconceptions about breast cancer: an experimental study

BMC Women's Health volume 25, Article number: 215 (2025) Cite this article

Abstract

Background

Young women are overrepresented in sensationalist media stories about breast cancer, which has been associated with heightened breast cancer concern within this population. Recent research has also revealed that young women show significant misconceptions about breast cancer, and that these seem to have been increasing over the last two decades. Accordingly, the present study sought to gather experimental evidence on the impact of media messages on negative affect, fear of breast cancer, fatalism, and misconceptions about breast cancer among young women.

Methods

186 females aged 18 to 40 were randomly allocated into one of three experimental conditions, designed to recreate the nature of breast cancer information typically presented in government health websites (i.e. objective information, condition 1) and women’s magazines (i.e. sensationalist information); as part of the sensationalist information, participants were either exposed to a photograph of a young woman (i.e. condition 2) or a middle-aged woman (i.e. condition 3) featured as a cancer patient.

Results

Participants exposed to sensationalist information (i.e. conditions 2 and 3) reported significantly higher levels of negative affect, fear of breast cancer, and fatalism than participants exposed to objective information, after statistically adjusting for relevant covariates. No statistically significant differences were observed between participants exposed to sensationalist information featuring women of different ages. Overall, participants held important misconceptions about breast cancer. First, they greatly overestimated the risk of receiving a breast cancer diagnosis, especially participants exposed to sensationalist information featuring a young woman. Second, they also believed that breast cancer was most often diagnosed among women just under 50 years of age; participants exposed to sensationalist information (i.e. conditions 2 and 3) estimated the age at diagnosis as significantly lower than those exposed to objective information.

Conclusions

This study provides experimental evidence that sensationalist media increases concern and contributes to misconceptions about breast cancer. Concern and misconceptions may by further exacerbated when sensationalist messages feature a young woman as a cancer patient, thus offering a distorted view of the women typically diagnosed with breast cancer. Overall, participants revealed important misconceptions about breast cancer, which has significant implications for preventive behaviors and health communication.

Peer Review reports

Introduction

Breast cancer mortality rates within the European Union have significantly declined over the last three decades [1]. This trend, largely attributed to lower use of hormone replacement therapy and improvements in diagnosis and treatment [2], has been most pronounced within Northern European countries, where mortality rates were highest in the past [1]. Based on recent data from NORDCAN [3, 4], the age-standardized mortality rate and the 5-year survival rate of breast cancer among women in Norway -the setting of this study- are now among the lowest and highest in Europe, respectively (i.e. 19 per 100,000, and 91.1). Also based on data from NORDCAN, these constitute positive indicators relative to other commonly diagnosed types of cancer among Norwegian women, such as colorectal (i.e. age-standardized morality: 23 per 100,000; 5-year survival: 73.2) and lung (i.e. age-standardized morality: 32 per 100,000; 5-year survival: 35.6) [4]. Despite such optimistic epidemiological trends, previous research has documented that breast cancer remains a highly concerning disease for many women [5, 6], even more so than more prevalent and/or lethal conditions (e.g. lung cancer, cardiovascular disease) [7, 8]. Recent research also shows that many European women hold misconceptions about breast cancer and overestimate their risk of diagnosis [9, 10].

Misconceptions and concern of breast cancer bear important health-related implications. First, fear, anxiety, and/or worry have been often referred to as facilitators or barriers to breast cancer screening [11]. This discrepancy can be attributed to a variety of factors, some of them methodological in nature (e.g. differences in operational definitions and in the use of measures) and others specifically related to the nature and object of the fear, anxiety, and/or worry. For example, several studies have focused on fear/anxiety/worry of very specific aspects (e.g. pain/discomfort, a diagnosis, radiation) while others have focused on general and/or unspecific fear/anxiety/worry (e.g. fear of the medical establishment, fear of cancer). Also, whether fear/anxiety/worry constitutes a facilitator or barrier to screening behavior has been associated with their intensity [11]. Some studies have reported a positive linear relationship between fear/anxiety/worry and the likelihood of screening behavior [12], whereas others have reported an inverted u-shaped relationship [13], wherein only moderate levels seem to facilitate screening behavior. Further, other studies show that it is important to consider the role of moderators when considering the nature of the relationship between fear/anxiety/worry and screening behavior [14]. Notwithstanding these nuanced findings, a substantial amount of research suggests that heightened fear of breast cancer constitutes a barrier to screening behavior across many countries [5, 15, 16], including Norway [17]. Second, a recent survey fielded in five European countries revealed that most women overestimate their breast cancer age-specific risk; previous studies suggest that this may narrow women’s focus regarding prevention, shifting attention away from other conditions that may also pose a high health threat (e.g. lung cancer, cardiovascular disease) [7, 18]. Third, many women show important gaps in knowledge related to the risk factors and prevention of breast cancer. Except for the risk associated with hormone replacement therapy, a study carried out in Germany observed that knowledge about other risk factors declined from 2006 to 2016 [9]. Fourth, several studies have also revealed that many women hold fatalistic beliefs about breast cancer, that is, beliefs that receiving a diagnosis or dying is predetermined/inevitable. Such inaccurate beliefs may further discourage women from learning about or engaging in preventive practices, as preventive practices may be viewed as ineffective [5, 19].

Previous research suggests that heightened concern of breast cancer cannot be accounted for by medical risk factors alone, or the threat posed by breast cancer relative to that posed by other chronic conditions [20]. Breast cancer has received more media attention over the last three decades than any other chronic condition, both in Norway and abroad [10, 21, 22, 23]. Moreover, several studies have reported that breast cancer information in the mass media is often sensationalist in nature (i.e. information that exploits, distorts, or exaggerates facts) [24]. For example, breast cancer stories often feature women of a much younger age than what may be expected based on the average age of diagnosis; such young women are often celebrities, which can readily attract much public attention [25, 26]. Drawing from exemplification theory [27], the representation of atypical and vivid exemplars can exert powerful and long-lasting effects on impressions and beliefs. This seems corroborated by previous studies showing that such skewed representations may lead to unwarranted alarm among young women [19, 21, 26]. Further, the relative contribution of different risk factors is frequently not accurately presented. Coverage of breast cancer often emphasizes the role of genetic factors, even though these play a relatively minor role compared to the risk associated with age and modifiable factors (e.g. alcohol, smoking, diet). Such coverage, therefore, may increase concern and even discourage preventive practices, given that it portrays breast cancer as a largely unpredictable and unpreventable condition [25, 28, 29].

The link between media attention and heightened breast cancer concern can be partly accounted for by several psychological mechanisms. First, a recent study provided experimental evidence suggesting that heightened concern of and misconceptions about breast cancer may be a function of availability bias [30], that is, a function of the frequency with which women remember threatening information about breast cancer, relative to other chronic conditions. Second, breast cancer can exert a unique impact on women’s sexuality, body image, and sense of femininity [31, 32], an impact that is commonly highlighted in breast cancer stories in the mass media [33, 34]. Thus, the way in which breast cancer is portrayed in this type of stories may in itself exacerbate concern. Third, heightened breast cancer concern may be further amplified by women’s propensity to become entangled with the sort of narratives they may be frequently exposed to in the mass media (e.g. “I would feel less of a woman if I had breast cancer”), given the abundance of information on breast cancer and its consequences. Such a process, often referred to as cognitive fusion, has been associated with increased concern about breast cancer [35], as well as with negative affect and difficulties to effectively respond to life’s challenges [36]. Fourth, heightened concern about breast cancer following exposure to sensationalist information may be function of perceived health competence, as health competence is associated with outcome and behavioral expectancies [37]. In other words, women who believe they could effectively engage in preventive behaviors, and thus, reduce the likelihood of receiving a breast cancer diagnosis may be expected to show relatively low level despite exposure to sensationalist information about breast cancer.

The present study

This study sought to gather experimental evidence on the impact of media messages on (a) negative affect, fear of breast cancer, and fatalism; and (b) misconceptions about breast cancer (i.e. perceptions about average age of breast cancer diagnosis, and estimated probability of receiving a diagnosis and survive breast cancer). The population of interest was young women (i.e. aged 18 to 40), given that they are overrepresented in sensationalist media stories about breast cancer [25, 26, 38]. Breast cancer incidence rates among Norwegian women aged 40 or less have been steadily increasing over the last five decades. Such incidence, however, is still below 50 cases per 100.000, considerably lower than that observed among women in upper age groups [39].

The experimental manipulation was designed to recreate the sort of breast cancer information typically presented in government health websites (i.e. objective information) and women’s magazines, both print and digital (i.e. sensationalist information). By experimentally manipulating the type of information women were exposed to, and observing the impact thereof on the outcome variables, this study aimed to fill a gap in this area of research, wherein most previous studies have followed nonexperimental designs. Further, to our knowledge, no studies of this nature, design, and focused on young Norwegian women had been conducted. Based on previous research, it was hypothesized that:

  1. 1)

    Women exposed to sensationalist information, relative to objective information, would report higher levels of negative affect, fear of breast cancer, and fatalism.

  2. 2)

    Women exposed to sensationalist information, relative to objective information, would report a higher degree of misconceptions regarding breast cancer.

  3. 3)

    Women exposed to sensationalist information featuring a young woman as a cancer patient would report higher levels of negative affect, fear of breast cancer, and fatalism, relative to women exposed to sensationalist information featuring a middle-aged woman as a cancer patient.

  4. 4)

    Women exposed to sensationalist information featuring a young woman as a cancer patient would report a higher degree of misconceptions regarding breast cancer, relative to women exposed to sensationalist information featuring a middle-aged woman as a cancer patient.

Methods

Participants

Inclusion criteria comprised females between the ages of 18 and 40 who were fluent in both Norwegian and English. Exclusion criteria comprised females with a personal history of cancer. Two hundred and forty-one participants completed the study. However, based on the exclusion criteria, data from 43 to 9 participants were excluded because of a personal history of cancer and being over 40 years of age, respectively. Three participants were further excluded for failing an attention check. Therefore, data from 186 participants were included in the data analyses. Demographic information about participants is presented in Table 1.

Table 1 Demographic characteristics of the sample divided by group
Full size table

Instruments

A questionnaire was specifically designed to obtain information about basic demographic characteristics. Participants were also requested to report whether they or a close family member had ever been diagnosed with breast cancer.

Cognitive Fusion Questionnaire (CFQ) [40]. The CFQ comprises 7 items (e.g. I tend to get very entangled in my thoughts) answered on a 7-point Likert scale ranging from 1 (“never true”) to 7 (“always true”). Higher scores indicate higher levels of cognitive fusion. The internal consistency (Cronbach’s alpha) within the current sample was 0.96.

Perceived Health Competence Scale (PHCS) [37]. The PHCS comprises 8 items (e.g. I succeed in the projects I undertake to improve my health) answered on a 5-point Likert scale ranging from 1 (“strongly disagree”) to 5 (“strongly agree”). Higher scores are indicative of higher levels of perceived self-efficacy regarding general health-related behaviours. The internal consistency (Cronbach’s alpha) of the scale within the current sample was 0.84.

Positive and Negative Affect Scale (PANAS) [41]. The PANAS comprises two subscales measuring positive and negative affect, of ten items each. Responses are provided using a 5-point Likert scale ranging from 1 (“very slightly or not at all”) to 5 (“extremely”). In this study participants were only presented with the negative affect subscale, conceptualized as a general dimension of subjectively perceived stress and aversive mood states (e.g. distressed, upset, scared). High scores indicate high levels of distress. The scale has previously been used to evaluate positive and negative affect within different time frames (e.g. today, previous week); in the present study, participants were asked to rate their negative affect right after they finished reading the information about breast cancer presented as part of the experimental manipulation, taking into consideration their feelings while reading such information. The internal consistency (Cronbach’s alpha) in the current sample was 0.91.

Champion Fear of Breast Cancer Scale (CFBCS) [42]. The CFBCS comprises 8 items (e.g. The thought of breast cancer scares me) answered on a 5-point Likert scale ranging from 1 (“Strongly disagree) to 5 (“Strongly agree”). Higher scores are indicative of higher levels of fear of breast cancer. The internal consistency (Cronbach’s alpha) in the current sample was.91. Champion et al. [42] conceptualized fear of breast cancer as low, medium, and high based a score of 8–15, 16–23, and 24–40, respectively.

Fatalism Scale (FS) [43]. The FS comprises 20 items measured on a 5-point Likert scale ranging from 1 (“strongly disagree”) to 5 (“strongly agree”). The scale is divided into three subscales: predetermination (10 items) (e.g. If someone is meant to get breast cancer, they will get it no matter what they do), luck (4 items) (e.g. My health is a matter of luck), and pessimism (6 items) (e.g. I will suffer a lot from bad health). Items 1–6 were slightly reworded within this study to refer to “breast cancer” instead of “disease.” Higher scores are indicative of higher levels of fatalism. The internal consistency (Cronbach’s alpha) in the current sample was 0.87.

Misconceptions regarding breast cancer. Participants were requested to provide estimates on (a) the average age at which women are diagnosed with breast cancer, (b) the probability of receiving a breast cancer diagnosis in their life time (0% probability to 100% probability), and (c) the probability of surviving if diagnosed with breast cancer (0% probability to 100% probability).

Procedure

The Ethics Committee of the European University of Madrid approved this study. Participants were recruited by means of an online survey publicly posted on social media platforms (i.e. Facebook, Snapchat, Instagram, and LinkedIn); the survey was broadly framed as a study seeking to evaluate women’s attitudes and perceptions about general health and breast cancer. All participants provided written consent.

The study’s procedure followed the sequence below, wherein participants.

  1. 1)

    Provided information about demographic characteristics and personal and family history of breast cancer.

  2. 2)

    Completed the CFQ and PHCS.

  3. 3)

    Were randomly allocated to one of three experimental conditions.

Participants in condition 1 were presented with objective information about breast cancer, including causes, treatments, prevalence, and prognosis. This information was retrieved from the American Cancer Society (2019) and the Norwegian Health Informatics webpages (2020), and was written in an objective manner, meant to recreate the type of information presented in official health websites such the ones just mentioned (see appendix) [44].

Participants in condition 2 were presented with a picture of a fictitious young woman with breast cancer, that is, a picture of a 27-year-old woman dressed up to mimic the appearance of a cancer patient (e.g. wearing headscarf, pale skin, dark shadows under the eyes). The picture was presented along a narrative highlighting the negative physiological and psychological impact of breast cancer and its treatment process on several life domains. The story was based on -and meant to represent- the type of sensationalist information found in Norwegian newspapers and women’s magazines [45, 46, 47, 48].

Participants in condition 3 were presented with the same picture and narrative as participants in condition 2. The only difference was that the face of the woman appearing in the picture was aged to resemble a middle-aged woman.Footnote 1 The rest of details in the picture remained the same.

  1. 4)

    Participants completed the negative affect scale from the PANAS, the CFBCS, and the FS.

  2. 5)

    Participants reported on the estimated average age at which women are diagnosed with breast cancer, and on the perceived probability that they received a diagnosis of breast cancer during their lifetime and they survived breast cancer if diagnosed.

Statistical analyses

Preliminary data analyses

Data were screened to detect outliers, missing values, and to ensure compliance with the statistical assumptions of Analysis of Covariance (ANCOVA; i.e., normally distributed data, homogeneity of variance, and homogeneity of regression slopes). Frequencies and descriptive statistics were calculated to assess the sample’s demographic characteristics and provide descriptive information about the study variables.

Baseline group differences

A series of ANOVAs were performed to assess whether there were baseline differences in cognitive fusion and perceived health competence among participants in the three experimental conditions.

Group differences in breast cancer concern

A series of ANCOVAs were performed to test whether there would be group differences in negative affect, fear of breast cancer, and fatalism, while taking into consideration the effect of relevant covariates (i.e. age, history of cancer among first-degree relatives, cognitive fusion, and perceived health competence). Effect size was calculated using eta square (η2), wherein the values 0.01, 0.06, and 0.14 represent a small, medium, and large effect size, respectively [49]. A priori power analyses using G*Power [50] indicated that a sample size of 158 would be required to provide 80% power to detect a medium effect size (f = 0.25) with an alpha level of 0.05.

Group differences in misconceptions

A series of ANCOVAs were performed to assess whether there would be group differences in the average age participants estimated breast cancer is first diagnosed, and the perceived probability of receiving a breast cancer diagnosis and surviving if diagnosed. Age, history of cancer among first-degree relatives, cognitive fusion, and perceived health competence were included as a covariates in these analyses.

Results

Preliminary analyses

There were no missing values. No univariate or multivariate outliers were detected, based on the use of the outlier labelling rule [51] and Mahalanobis distance. The assumption of normally distributed data was satisfied, as values of skewness and kurtosis fell within the recommended values of|2| and|7|, respectively [52]. The assumption of homogeneity of variance was satisfied: the results of Levene’s test of homogeneity of variance yielded statistically non-significant results (i.e. p >.05) in all cases. The assumption of homogeneity of regression slopes was also satisfied: interactions terms (i.e. experimental group * covariates) predicting outcome variables yielded non-significant results.

Baseline group differences

No baseline differences in cognitive fusion (F (2, 183) = 0.34, p =.715) or health competence (F (2, 183) = 0.75, p =.475) were observed across experimental conditions.

Group differences in breast cancer concern

The results of three ANCOVAs revealed a statistically significant main effect of breast cancer information on negative affect, fear of breast cancer, and fatalism, after statistically adjusting for the covariates age, history of cancer diagnosis among first-degree relatives, cognitive fusion, and perceived health competence. Post hoc analyses revealed that participants within conditions 2 and 3 (i.e. exposed to sensationalist information) reported significantly higher levels of negative affect, fear of breast cancer, and fatalism than participants in condition 1 (i.e. exposed to objective information). No statistically significant differences in the aforementioned variables were observed between participants in conditions 2 and 3 (Table 2). This offered support to hypothesis 1 but not hypothesis 3.

Table 2 Analyses of covariance (and planned comparisons) examining the impact of media information on breast cancer concern
Full size table

Group differences in misconceptions

Three ANCOVAs were performed to assess misconceptions as a function of media exposure (Table 3). The results of a first ANCOVA revealed a statistically significant main effect of breast cancer information on the average age at which participants estimated breast cancer diagnoses are established, after statistically adjusting for the covariates age, history of cancer diagnosis among first-degree relatives, cognitive fusion, and perceived health competence. Post hoc analyses indicated that participants exposed to sensationalist information (i.e. conditions 2 and 3) estimated that breast cancer diagnoses are established on average at a younger age than participants in condition (1) This offered support to hypothesis (2) There were no differences between participants exposed to sensationalist media featuring a young and middle-aged woman.

Table 3 Analyses of covariance (and planned comparisons) examining the impact of media information on misconceptions
Full size table

The results of a second ANCOVA revealed a statistically significant main effect of breast cancer information on the perceived probability of receiving a breast cancer diagnosis, after statistically adjusting for the covariates age, history of cancer diagnosis among first-degree relatives, cognitive fusion, and perceived health competence. Post hoc analyses revealed that participants exposed to sensationalist information featuring a young woman as cancer patient (i.e. condition 2) reported a higher perceived probability of receiving a breast cancer diagnosis than participants exposed to objective information (i.e. condition 1) and those exposed to sensationalist information including a middle-aged woman as a cancer patient (i.e. condition 3). This offered partial support to hypotheses 2 and full support to hypothesis 4.

The results of a third ANCOVA revealed no significant main effect of breast cancer information on the perceived probability of surviving breast cancer. This failed to offered support to hypotheses 2 and 4.

Discussion

This study sought to gather experimental evidence on the impact objective and sensationalist information about breast cancer may have on young women’s level of concern and misconceptions about breast cancer. The stimuli used as part of the experimental manipulation were designed to recreate the sort of information frequently transmitted through two types of sources: health institutions’ websites and women’s magazines, both print and online. Altogether, the results presented here support those of previous non-experimental [21, 26] and experimental studies [53]: exposure to sensationalist information is associated with increased concern and misconceptions regarding breast cancer.

Participants exposed to sensationalist information reported higher levels of negative affect and fear of breast cancer than those exposed to objective information (Table 2); this offered support to hypothesis 1. These results are consistent with previous research [25, 26] and with exemplification theory [27], according to which vivid narratives are expected to exert a stronger impact on viewers’ emotionality than neutral information. Participants in condition 1 were presented with a text of facts about breast cancer: what it is and what the risk factors and treatment options are. This type of information was meant to resemble that found in official health websites [54]. In contrast, the sensationalist information participants were exposed to in conditions 2 and 3 consisted of a narrative told by an ordinary woman, meant to be relatable for participants. The narrative was designed to highlight aspects frequently presented in news stories [45, 46, 47, 48]: the idea that breast cancer can emerge out of nowhere and early on in a woman’s life, the burdensome nature of treatment, the long and difficult process of recovery, the risk and fear of recurrence in case of survival, and the feelings of uncertainty and loss of purpose. Altogether, these aspects seem to have brought to the forefront a myriad of aversive emotions and images associated with breast cancer, eliciting increased negative affect and fear of breast cancer. It is worth noting, however, that there were no differences in negative affect and fear of breast between the two groups exposed to sensationalist information; this suggests that the images of a young and middle-aged women used within these two groups did not have an impact on the aforementioned outcome variables, not above and beyond the eliciting and evoking functions of the narrative itself.

Relative to participants exposed to objective information, participants exposed to sensationalist information reported higher levels of fatalism regarding breast cancer (Table 3). This is congruent with previous studies [53] and offers support to hypothesis 1. The narrative presented to participants within conditions 2 and 3 did not mention anything related to modifiable risk factors or effective coping strategies; rather, it presented a perspective of helplessness, despair, and lack of control over breast cancer and its treatment. Several studies have observed that this is often the way in which breast cancer stories are represented in the mass media [25]. Modifiable risk factors, however, are associated with a reduced likelihood of developing breast cancer, especially among women at higher risk due to nonmodifiable risk factors [55]. Therefore, messages such as these, that understate the significance of modifiable risk factors and preventive practices, may lead young women to believe that developing breast cancer is predetermined and surviving is entirely a matter of luck. This is not to say there that there is not an element of randomness around cancer diagnoses or that these stories do not accurately represent the experiences of many women diagnosed with breast cancer; these findings simply suggest that such messages may shape young women’s outlook about breast cancer. Previous research has established that cancer fatalism can discourage individuals from engaging in a variety of protective behaviors and thus can negatively impact health outcomes. For example, cancer fatalism has been associated with beliefs about the futility of cancer screening for early detection, delays in seeing health care practitioners when symptoms first emerge, nonadherence to cancer treatment, and difficulties coping following diagnosis [5, 19].

It is worth highlighting that breast cancer concern was not entirely predicted by the type of information participants were exposed to. The results revealed that higher levels of health competence were inversely associated with lower negative affect, fear of breast cancer, and most significantly, with fatalism. These results appear consistent with previous research [56], and suggests that women that take a proactive stance towards taking care of their health are less likely to believe that health outcomes and predetermined and to be negatively impacted by sensationalist media.

Participants in this study also held important misconceptions about breast cancer (Table 3). First, they overestimated the risk of receiving a breast cancer diagnosis, well above the 9.2% risk for Norwegian women [4]. Such overestimation was significantly more pronounced among participants exposed to sensationalist information featuring a young woman (i.e. 39% risk), in comparison to those exposed to objective information or sensationalist information featuring a middle-aged woman (i.e. 29% and 32% risk, respectively). It is plausible that being exposed to a breast cancer story featuring a young woman may have driven participants to believe that breast cancer is more commonly diagnosed among young females than they may have previously thought, which may have led them to reassess their own susceptibility of being diagnosed. Second, participants estimated the average age of breast cancer diagnosis at 44–49 years, even though breast cancer is most often diagnosed among women over 50 years of age; the median age at diagnosis among Norwegian women is 62 [54]. Again, the margin of such inaccurate estimations was largest among participants exposed to sensationalist information featuring a young woman. Third, it is worth noting that even though no group differences were observed, participants underestimated the probability of surviving breast cancer if diagnosed; estimated survival rates ranged between 73% and 76%, considerably below those for Norwegian women (i.e. relative five-year survival rate = 91.1%) [4]. Altogether, although not tested within this study, such misconceptions could further increase the level of breast cancer concern and cognitive biases, for example, by guiding participants’ attention to sensationalist information about breast cancer. Previous studies highlight that disease-related information plays an essential role in shaping individuals’ representations of health threats, which in turn can account for the nature of health and coping behaviors directed at solving health problems [57].

Implications

The findings presented here have implications for prevention and health education. The results of this study offer experimental evidence that sensationalist information may lead to heightened concern of breast cancer; even though participants exposed to objective information seemed to hold misconceptions about breast cancer, exposure to sensationalist information featuring young women as cancer patient was further associated with a higher perception of risk to developing breast cancer. Altogether, in accord with previous research [57], this is something that can hinder preventive behaviors and negatively impact health outcomes. For example, cancer fatalism has been identified as a barrier to screening and health-care-seeking behaviors, and as a factor interfering with adjustment following diagnosis [5, 19]. Most importantly, however, these results also highlight that higher levels of health competence seemed to inoculate participants against the negative impact of sensationalist information, which manifested in lower levels of negative affect, fear of breast cancer, and fatalism (Table 2). This suggests that information leading to higher levels of health and competence, and thus that empowers women, should be more frequently included within in official health websites. Higher empowerment may be attained by underscoring the relevant role of modifiable risk factors and breast self-examination in breast cancer prevention, and the importance of seeking timely health care. Importantly, the promotion of such behaviors should also incorporate demonstrations and guided practice, particularly if addressed to less confident or knowledgeable populations, such as young women.

The findings of this study, together with those of previous research [9, 10], also highlight the existence of important gaps in knowledge regarding breast cancer. This, along with the growing incidence of breast cancer, calls for sustained attention and research within this area. Heightened concern and misconceptions about breast cancer have constituted a health problem for decades, and many studies have focused on this issue. However, higher awareness of breast cancer is something that is not necessarily passed on from one generation to another; further, today’s informational context, characterized by the widespread use of social media is different from that present even a decade ago.

Limitations

The results of this study should be interpreted in light of some limitations. First, the sample of participants recruited in this study was rather small, which limits the generalizability of the findings. Participants were also relatively well educated, and thus, may differ from other women with a lower education level, whom for example might report lower levels of health competence. Further, the stimuli used as part of the experimental manipulation cannot possibly represent the wide range of messages and stories about breast cancer found in the media, and more specifically, the social media.

Conclusions

The present study provides experimental evidence that sensationalist information about breast cancer leads to higher levels of concern and misconceptions about breast cancer. The stimuli used as part of the experimental manipulation were designed to recreate two major sources of information about breast cancer: official health websites and women’s magazines. The impact of sensationalist information the outcome variables, however, seemed to be mitigated to some extent by higher levels of health competence.

Appendix

Information read by participants in condition 1

What is breast cancer?

Breast cancer is a disease in which cells in the breast grow out of control. Almost all cases of breast cancer originate in the glandular tissue that either produces milk or provides passage for milk, while a minority of cases originate in the surrounding tissue. Breast cancer can spread to the breast through blood vessels and lymph vessels. When this happens, it means that the breast cancer has metastasized.

Causes and risk factors

The exact causes of breast cancer are largely unknown. However, there are genetic and environmental factors that are known to increase the risk, including: age (risk increases with age), family history of breast cancer, a previous benign breast lump, being overweight, early onset of menstruation (before age 12), late menopause (after 50), having your first child after age 30, never having been pregnant, alcohol intake. It is estimated that about 5–10% of breast cancers are linked to gene mutations passed down through generations of a family. However, this does not guarantee the development of breast cancer.

Treatment

Breast cancer is usually treated using a combination of surgery, chemotherapy, radiation therapy and, in some cases, hormone therapy.

  • Surgery can remove only the cancerous mass and a small amount of surrounding tissue (lumpectomy) or the entire breast (mastectomy). Partial or complete mastectomy is often followed by reconstructive surgery.

  • Cellulite involves the use of chemicals to kill cancer cells. However, it also attacks normal cells to some extent and causes side effects that include hair loss, a weakened immune system, mouth sores, fatigue and nausea.

  • Radiation is usually used either to shrink tumors before surgery, or to destroy small amounts of cancer tissue that remain after surgery. Side effects include breast swelling, vomiting, fatigue, diarrhea or skin irritations that resemble sunburn.

Information read by participants in conditions 2 and 3

This is Anne’s story: The phone call came on a completely normal day, when I was standing outside the store: “It’s cancer, and I would recommend that you remove your entire breast. We have to start treatment as soon as possible.” After this a long and difficult process began: surgery first removed all of my breast, and then came several long rounds of chemotherapy. A few weeks earlier I had found a lump but didn’t think much of it. After being urged I went to my family doctor and was very quickly referred to oncology. That’s when I experienced my life being turned upside down. Chemotherapy was at first the hardest part. I sat on the couch and felt like my body was working hard, and the side effects would come in quick succession. My hair started falling out, and I had poor appetite, dry skin, sore and dry mucous membranes, and a great need to sleep all the time. At first, I didn’t think too much about having lost a breast, but eventually I missed feeling like a woman, and it hurt a lot where my breast had once been. The most challenging thing right now is physical and mental fatigue. The things I used to enjoy doing now just became too much, and I went from being an active person to not being able to do anything. My memory, concentration, and reaction time were impaired, and sometimes I just felt stupid. Adjustment is difficult because my mind wants to live as before, but my body cannot keep up. I also feel very insecure, and I constantly wonder if I will ever get better. And if I do get better, will it come back again? Will I have the strength to go through all this one more time? I don’t want to think about it, and I don’t have the energy to think about it, but these thoughts keep coming back. I can’t find the meaning of this. I keep asking myself; “why me?” and “what now?” There are still many things I want to do, but now many of my dreams have just vanished. Life very often feels meaningless.

Photographs

As described in the methods section, participants in condition 2 were exposed to sensationalist information and a photograph of a young woman, and participants in condition 3 were exposed sensationalist information and a photograph of a middle-aged woman.

Young woman.

figure a

Middle-aged woman.

figure b

Data availability

The dataset from the current study are available from the corresponding author on reasonable request.

Notes

  1. A pilot survey was conducted with 10 young women (not included as participants in the study), and they estimated that the women in the images were approximately 30 and 60 years of age.

References

  1. Carioli G, Malvezzi M, Rodriguez T, Bertuccio P, Negri E, La Vecchia C. Trends and predictions to 2020 in breast cancer mortality in Europe. Breast. 2017;36:89–95.

    Article  PubMed  Google Scholar 

  2. Malvezzi M, Carioli G, Bertuccio P, Boffetta P, Levi F, La Vecchia C, et al. European cancer mortality predictions for the year 2019 with focus on breast cancer. Ann Oncol. 2019;30(5):781–7.

    Article  CAS  PubMed  Google Scholar 

  3. Engholm G, Ferlay J, Christensen N, Bray F, Gjerstorff ML, Klint A, et al. NORDCAN–a nordic tool for cancer information, planning, quality control and research. Acta Oncol. 2010;49(5):725–36.

    Article  PubMed  Google Scholar 

  4. NORDCAN. Fact sheets. Available at: https://nordcan.iarc.fr/en/factsheets. Accessed Feb 6, 2025.

  5. Özkan İ, Taylan S. Barriers to women’s breast cancer screening behaviors in several countries: A meta-synthesis study. Health Care Women Int. 2021;42(7–9):1013–43.

    Article  PubMed  Google Scholar 

  6. Aguirre-Camacho A, Hidalgo B, González-Cuevas G. Fear of breast cancer among young Spanish women: factor structure and psychometric properties of the champion breast cancer fear scale. PLoS ONE. 2021;16(4):e0249562.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Aguirre-Camacho A, Gandía-Abellán H, Tirado-Muñoz J. I think I do but I don’t: heightened (Breast) Cancer concern as a function of availability Bias. Women. 2024;4(2):201–15.

    Article  Google Scholar 

  8. Wang C, O’Neill SM, Rothrock N, Gramling R, Sen A, Acheson LS, et al. Comparison of risk perceptions and beliefs across common chronic diseases. Prev Med. 2009;48(2):197–202.

    Article  PubMed  Google Scholar 

  9. Poehls UG, Hack CC, Wunderle M, Renner SP, Lux MP, Beckmann MW, et al. Awareness of breast cancer incidence and risk factors among healthy women in Germany: an update after 10 years. Eur J Cancer Prev. 2019;28(6):515.

    Article  CAS  PubMed  Google Scholar 

  10. Wegwarth O, Widschwendter M, Cibula D, Sundström K, Portuesi R, Lein I, et al. What do European women know about their female cancer risks and cancer screening? A cross-sectional online intervention survey in five European countries. BMJ Open. 2018;8(12):e023789.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Consedine NS, Magai C, Krivoshekova YS, Ryzewicz L, Neugut AI, Fear. Anxiety, worry, and breast Cancer screening behavior: A critical review. Cancer Epidemiol Biomarkers Prev. 2004;13(4):501–10.

    Article  PubMed  Google Scholar 

  12. Hay JL, McCaul KD, Magnan RE. Does worry about breast cancer predict screening behaviors? A meta-analysis of the prospective evidence. Prev Med. 2006;42(6):401–8.

    Article  PubMed  Google Scholar 

  13. Andersen MR, Smith R, Meischke H, Bowen D, Urban N. Breast Cancer worry and mammography use by women with and without a family history in a Population-based Sample1. Cancer Epidemiol Biomarkers Prev. 2003;12(4):314–20.

    CAS  PubMed  Google Scholar 

  14. Miller SJ, O’Hea EL, Lerner JB, Moon S, Foran-Tuller KA. The relationship between breast cancer anxiety and mammography: experiential avoidance as a moderator. Behav Med. 2011;37(4):113–8.

    Article  PubMed  Google Scholar 

  15. Gesink D, Filsinger B, Mihic A, Norwood TA, Sarai Racey C, Perez D, et al. Cancer screening barriers and facilitators for under and never screened populations: A mixed methods study. Cancer Epidemiol. 2016;45:126–34.

    Article  PubMed  Google Scholar 

  16. Tavakoli B, Feizi A, Zamani-Alavijeh F, Shahnazi H. Factors influencing breast cancer screening practices among women worldwide: a systematic review of observational and qualitative studies. BMC Womens Health. 2024;24(1):268.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ivanova A, Kvalem IL. Psychological predictors of intention and avoidance of attending organized mammography screening in Norway: applying the extended parallel process model. BMC Womens Health. 2021;21(1):67.

    Article  PubMed  PubMed Central  Google Scholar 

  18. DiLorenzo TA, Schnur J, Montgomery GH, Erblich J, Winkel G, Bovbjerg DH. A model of disease-specific worry in heritable disease: the influence of family history, perceived risk and worry about other illnesses. J Behav Med. 2006;29(1):37–49.

    Article  PubMed  Google Scholar 

  19. Chen M, Kim HK. Cancer fatalism in the information age: A Meta-Analysis of communicative and behavioral correlates. Communication Res. 2024;51(1):83–111.

    Article  Google Scholar 

  20. Gerend MA, Aiken LS, West SG, Erchull MJ. Beyond medical risk: investigating the psychological factors underlying women’s perceptions of susceptibility to breast cancer, heart disease, and osteoporosis. Health Psychol. 2004;23(3):247–58.

    Article  PubMed  Google Scholar 

  21. Lemal M, Van den Bulck J. Television news exposure is related to fear of breast cancer. Prev Med. 2009;48(2):189–92.

    Article  PubMed  Google Scholar 

  22. Vraga EK, Stefanidis A, Lamprianidis G, Croitoru A, Crooks AT, Delamater PL, et al. Cancer and social media: A comparison of traffic about breast cancer, prostate cancer, and other reproductive cancers on Twitter and Instagram. J Health Communication. 2018;23(2):181–9.

    Article  PubMed  Google Scholar 

  23. Fonnes T, Telle IO, Forsse D, Falck R, Trovik J, Haldorsen IS, et al. Cancer awareness in the general population varies with sex, age and media coverage: A population-based survey with focus on gynecologic cancers. Eur J Obstet Gynecol Reprod Biol. 2021;256:25–31.

    Article  PubMed  Google Scholar 

  24. Sterling C, Fellow A. Sensationalism. The SAGE encyclopedia of journalism. SAGE Publications, Inc.; 2022. pp. 1477–9.

  25. Macdonald S, Cunningham Y, Patterson C, Robb K, Macleod U, Anker T, et al. Mass media and risk factors for cancer: the under-representation of age. BMC Public Health. 2018;18(1):490.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Mackenzie R, Chapman S, Holding S, Stiven A. No respecter of youth: Over-representation of young women in Australian television coverage of breast Cancer. J Cancer Education; New York. 2010;25(4):565–70.

    Article  Google Scholar 

  27. Zillmann D. Exemplification theory: judging the whole by some of its parts. Media Psychol. 1999;1(1):69–94.

    Article  Google Scholar 

  28. Kamenova K, Reshef A, Caulfield T. Angelina Jolie’s faulty gene: newspaper coverage of a Celebrity’s preventive bilateral mastectomy in Canada, the united States, and the united Kingdom. Genet Sci. 2014;16(7):522–8.

    Google Scholar 

  29. Atkin CK, Smith SW, McFeters C, Ferguson V. A comprehensive analysis of breast Cancer news coverage in leading media outlets focusing on environmental risks and prevention. J Health Communication. 2008;13(1):3–19.

    Article  PubMed  Google Scholar 

  30. Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases. Science. 1974;185(4157):1124–31.

    Article  CAS  PubMed  Google Scholar 

  31. Emilee G, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas. 2010;66(4):397–407.

    Article  Google Scholar 

  32. Fobair P, Stewart SL, Chang S, D’Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psycho-oncology. 2006;15(7):579–94.

    Article  PubMed  Google Scholar 

  33. Haines RJ, Bottorff JL, Barclay McKeown S, Ptolemy E, Carey J, Sullivan K. Breast cancer messaging for younger women: gender, femininity, and risk. Qual Health Res. 2010;20(6):731–42.

    Article  PubMed  Google Scholar 

  34. Dean M. Celebrity health announcements and online health information seeking: an analysis of angelina Jolie’s preventative health decision. Health Commun. 2016;31(6):752–61.

    Article  PubMed  Google Scholar 

  35. Aguirre-Camacho A, Rash JA, Hidalgo B, Wurz A, Garland SN. An experimental study revisiting the link between media attention and breast cancer concern: exploring the role of cognitive fusion. Women Health. 2021;61(10):976–85.

    Article  PubMed  Google Scholar 

  36. Assaz D, Assaz D, Roche B, Roche B, Kanter J, Kanter J, et al. Cognitive defusion in acceptance and commitment therapy: what are the basic processes of change?? Psychol Rec. 2018;68(4):405–18.

    Article  Google Scholar 

  37. Smith MS, Wallston KA, Smith CA. The development and validation of the perceived health competence scale. Health Educ Res. 1995;10(1):51–64.

    Article  CAS  PubMed  Google Scholar 

  38. Champion C, Berry TR, Kingsley B, Spence JC. Pink ribbons and red dresses: A mixed methods content analysis of media coverage of breast Cancer and heart disease. Health Commun. 2016;31(10):1242–9.

    Article  PubMed  Google Scholar 

  39. Brystkreft. 2024; Available at: https://www.kreftregisteret.no/kreftformer/Brystkreft/. Accessed Mar 24, 2025.

  40. Gillanders DT, Bolderston H, Bond FW, Dempster M, Flaxman PE, Campbell L, et al. The development and initial validation of the cognitive fusion questionnaire. Behav Ther. 2013;45(1):83–101.

    Article  PubMed  Google Scholar 

  41. Watson D, Clark L, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Personal Soc Psychol. 1988;54(6):1063–70.

    Article  CAS  Google Scholar 

  42. Champion VL, Skinner CS, Menon U, Rawl S, Giesler RB, Monahan P, et al. A breast cancer fear scale: psychometric development. J Health Psychol. 2004;9(6):753–62.

    Article  PubMed  Google Scholar 

  43. Shen L, Condit CM, Wright L. The psychometric property and validation of a fatalism scale. Psychol Health. 2009;24(5):597–613.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Norwegian Health Informatics. Brystkreft. 2001; Available at: https://nhi.no/sykdommer/kreft/brystkreft/brystkreft-en-oversikt/. Accessed Feb 6, 2025.

  45. Helland/Nordlys AØ. Tre uker etter dette, fikk Birgitte (24) den fryktelige beskjeden. 2015; Available at: https://www.nettavisen.no/12-95-8537118. Accessed Feb 4, 2025.

  46. Moe ED. Ann Jeanett (31) fikk brystkreft som 26-åring: - Det er ganske hardt og brutalt. 2016; Available at: https://trdby.adressa.no/livsstil/i/47EEm9/ann-jeanett-31-fikk-brystkreft-som-26-aring-det-er-ganske-hardt-og-brutalt. Accessed Feb 4, 2025.

  47. Majid S, Norman MG. Rammes hardere: Fikk brystkreft som 23-åring. 2013; Available at: https://www.vg.no/nyheter/i/G1mQVm/fikk-brystkreft-ble-ikke-trodd. Accessed Feb 4, 2025.

  48. Johns Kathrine. Camilla er alenemor til tre og har uhelbredelig kreft. 2018; Available at: https://tara.no/livsstil/kvinner/camilla-er-alenemor-til-tre-og-har-uhelbredelig-kreft. Accessed Feb 4, 2025.

  49. Cohen J. Statistical power analysis for the behavioral sciences. New York: Routledge Academic.; 1988.

    Google Scholar 

  50. Faul F, Erdfelder E, Lang A, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.

    Article  PubMed  Google Scholar 

  51. Hoaglin DC, Iglewicz B, Tukey JW. Performance of some resistant rules for outlier labeling. J Am Stat Assoc. 1986;81(396):991–9.

    Article  Google Scholar 

  52. Byrne BM. Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. Third Edition ed. New York: Routledge; 2016.

  53. Niederdeppe J, Lee T, Robbins R, Kim HK, Kresovich A, Kirshenblat D, et al. Content and effects of news stories about uncertain cancer causes and preventive behaviors. Health Commun. 2014;29(4):332–46.

    Article  PubMed  Google Scholar 

  54. Cancer Registry of Norway. Breast cancer. Available at: https://www.kreftregisteret.no/en/Cancers/Breast-cancer/. Accessed Feb 6, 2025.

  55. Maas P, Barrdahl M, Joshi AD, Auer PL, Gaudet MM, Milne RL, et al. Breast Cancer risk from modifiable and nonmodifiable risk factors among white women in the united States. JAMA Oncol. 2016;2(10):1295–302.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Hevey D, Smith M, McGee HM. Self-efficacy and health behaviour: A review. Ir J Psychol. 1998; 19(2–3):248–73.

  57. Decruyenaere M, Evers-Kiebooms G, Welkenhuysen M, Denayer L, Claes E. Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective. Psychooncology. 2000;9(6):528–36.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

N/A.

Funding

None.

Author information

Authors and Affiliations

  1. School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain

    Aldo Aguirre-Camacho, Amalie Akerø Hylland, Valeria Moriconi, Alberto Bellido-Esteban & Judit Tirado-Muñoz

  2. School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo, s/n. Urb. El Bosque, Villaviciosa de Odón, Madrid, 28670, Spain

    Judit Tirado-Muñoz

Authors
  1. Aldo Aguirre-Camacho
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Amalie Akerø Hylland
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Valeria Moriconi
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Alberto Bellido-Esteban
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Judit Tirado-Muñoz
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

A.A.C.: Conception; design; data analysis; data interpretation; drafted the work; substantively revised the workA. A: H.: Data acquisition; data analysis; data interpretation; drafted the work; substantively revised the workV. M.: Substantively revised the workA. B.E.: Substantively revised the workJ. T.M.: Substantively revised the workAll authors have approved the submitted version (and any substantially modified version that involves the author’s contribution to the study). All authors have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

Corresponding author

Correspondence to Judit Tirado-Muñoz.

Ethics declarations

Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki. Ethics approval was obtained from the Ethics Committee of Universidad Europea de Madrid. All participants signed written informed consent.

Consent for publication

Written informed consent for publication was obtained from the person whose photograph was used as part of the information shown to participants. Consent for publication was not required from participants because full anonymity was ensured; no images or any other type of identifying personal details are being published within this study, nor were gathered as part of data collection.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aguirre-Camacho, A., Hylland, A.A., Moriconi, V. et al. The impact of objective/sensationalist media on young women’s concern and misconceptions about breast cancer: an experimental study. BMC Women's Health 25, 215 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12905-025-03751-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12905-025-03751-x

Keywords

BMC Women's Health

ISSN: 1472-6874

Contact us