Visual and Text Mass Media Content about Skin Cancer and Tanning

Theoretical Background and research questions/hypothesis: Skin cancer is the most common type of cancer in North America; however, it is largely preventable and, when detected early, survival is high. Indoor tanning remains popular, despite being carcinogenic. The mass media is a key source of skin cancer information for the public and has been linked to public attitudes, knowledge, and behaviors related to UV exposure and skin cancer. This study was informed by the Health Belief Model (HBM) and the Pictorial Superiority Effect (PSE). The HBM theory assumes that people will perform a health behavior if they perceive they are susceptible to the disease and that it is severe, if they expect taking action will help them to avoid the disease, and if they believe they can successfully perform a preventative action. The PSE suggests that people are more likely to remember ideas presented as pictures compared to words. We expected skin cancer and tanning coverage would increase over time, especially after 2006 as this was when the landmark International Agency for Research on Cancer was released linking indoor tanning to skin cancer. We also hypothesized that the frequency and nature (measured by HBM constructs) of media coverage would differ by magazine genre (e.g., women’s, adolescents’, men’s) and by content type (image vs. text). 

Methods: We conducted a mixed-methods content analysis of skin cancer and recreational tanning coverage in 31 popular Canadian and U.S. magazines between 2000 and 2012. We examined frequency and volume of coverage as well as the nature of that coverage (HBM constructs, skin cancer risk factors). 

Results: Our search resulted in 860 articles and 1367 images. Data retrieval was high: 99% of articles, and 95% of images, were successfully obtained. There was only a slight increase in coverage after the IARC report compared to before (54% vs. 46%), but the volume of coverage differed markedly by magazine genre (e.g., more than 3.5 times as much coverage in women’s vs. men’s magazines). Articles rarely contained information related to all HBM constructs, and focused more on prevention than detection. Women’s magazines emphasized the positive aspects of having a tan (e.g., attractiveness) more than men’s. Images and text conveyed discordant messages: imagery often encouraged UV exposure while accompanying text information discouraged it. 

Conclusions: The volume of coverage did not increase as we had expected it to, suggesting the 2006 IARC report may not have had a large impact on magazine coverage related to skin cancer and tanning. Although magazines discouraged tanning in article text, images encouraged UV exposure. 

Implications for research and/or practice: The divergent messages conveyed by the images vs. text should encourage researchers to consider visual mediums connected to health communication. The nature of media content related to skin cancer and tanning needs to be improved if the media is to have a positive impact on the public’s skin cancer knowledge, attitudes, and behaviors.