Advertising by US cancer centers soars over the past decade, new analysis shows

Researchers at Indiana University School of Medicine and the University of Pittsburgh School of Medicine and Graduate School of Public Health reported that 890 cancer centers spent $173 million for advertising in 2014, and just 20 centers accounted for 86 percent of the spending.

One company, Cancer Treatment Centers of America, a for-profit firm with a national network of five hospitals, spent $101.7 million, 59 percent of the total. In contrast, 25 of the nation's 60 National Cancer Institute-designated cancer centers spent no money on advertising, and of those that did, half spent less than $4,000, the authors said.

Of the 20 centers that accounted for the bulk of spending, five were for-profit institutions, 17 were Commission on Cancer-accredited and nine were NCI-designated centers.

The report was published by the journal JAMA Internal Medicine.

"Spending on cancer center advertising has more than tripled since 2005, and a small percent of cancer centers are responsible for the majority of spending. Patients should be aware that cancer centers that spend the most on advertising may not necessarily provide the highest quality of cancer care," said study first author Laura Vater, MPH, a fourth-year medical student at the IU School of Medicine.

Additional work is needed to better understand how advertising may affect the cost and quality of care, she said.

In a 2014 study published in the Annals of Internal Medicine, Vater and colleagues analyzed the content of cancer center advertising and concluded that "clinical advertisements by cancer centers frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability."

For the new study the researchers used data from Kantar Media, an agency that tracks advertising and calculates expenditures. They obtained data for television, magazine, radio, newspaper, billboard and Internet advertising. The expenditures were adjusted to 2014 U.S. dollars using the Consumer Price Index.

The researchers also identified the centers that were National Cancer Institute-designated, accredited by the Commission on Cancer, were not-for-profit versus for-profit organizations, and by location.

Spending in all advertising categories grew from 2005 to 2014, led by television where $37 million was spent in 2005, rising to a peak of $107 million in 2011. Television spending declined somewhat after that, but still stood at $87 million in 2014. Print media spending rose from $11 million to $34 million. In a time when Internet advertising was growing, cancer center online ads were among them -- Internet display advertisements rose from $300,000 in 2005 to $9 million in 2014.

"More work is needed to understand the effects of cancer center advertising on the web, as more and more people search for health information on line," said senior author Yael Schenker, M.D., assistant professor in the University of Pittsburgh School of Medicine. "One concern is that when advertisements are listed at the top of internet search results, patient may have trouble finding and recognizing good information."

After Cancer Treatment Centers of America, the two biggest advertisers in 2014 were MD Anderson Cancer Center, which spent $13.9 million, and Memorial Sloan Kettering Cancer Center at $9.1 million.

The authors noted that the expenditure calculations could be low because advertising in cancer-specific magazines was not included, nor was advertising by affiliated organizations designed to encourage charitable donations.