December 8, 2014
Young dermatologist Chris Adigun had just returned from the American Academy of Dermatology annual meeting in Miami, where she’d delivered a presentation of her research on the safety of gel manicures. A tiny portion of her talk dealt with the UV lamp exposure that happens during the manicures and the associated risks such as photoaging and thinning of the nails.
That morning, in early March of 2013, she climbed on Manhattan’s Number M34A cross-town bus to head to work at New York University Langone Medical Center, where she was an Assistant Professor of Dermatology. Across from her, a fellow rider was reading the morning copy of the New York Post. On the cover, the headline screamed these words: “Doc Warns That Popular Gel Manicure Is a ‘Cancer Risk.’” Fearing the worst, Adigun asked to see the paper. The article confirmed her fears.
The Post, along with other media outlets all over the country, had latched onto a small nugget of her talk. Adigun had presented two cases of skin cancer arising on the hands of gel-manicure enthusiasts in order to show—ironically—that the risk of cancer associated with the UV lamps was incredibly low. Yet the Post and other outlets—including ones in Canada and England—used her research to splash scary, inaccurate headlines that gels cause cancer, attributing the inaccuracies to Adigun.
“I used my expert analysis of the data we had,” Adigun says, “and I gave my clinical opinion on the data. And then they just jumped on one tiny spec of the data to sell papers.”
Within hours, her employer, NYU, was fielding calls from all sorts of press outlets seeking a quote or an interview with the doctor who had said gel manicures caused cancer.
Trying to correct the misinformation, Adigun quickly taped interviews for Good Morning America, Univision, and a variety of other outlets, indicating that there is only a minuscule cancer risk associated with gels, and one that is easily preventable.
But despite her attempts to correct the original inaccurate reporting of her research, many people today still associate gel manicures with a high cancer risk.
The scary headlines prevailed.
Although this particular controversy only remained in the headlines for a year or so, other misreported health science has had much greater staying power and much greater impact on people's health.
Take, for example, the debate over whether vaccines cause autism. Professor Jordynn Jack, whose latest book addresses the autism debates, specializes in science communication (and miscommunication). Although the headlines connecting gel manicures to cancer might seem a far cry from the writings of anti-vaxxers, the miscommunications fall on the same spectrum—that of medical research finding new life in the hands of the media and, in turn, the public.
When I asked Dr. Jack why scary headlines seem to stick even after the debunking of incorrect scientific reporting or research she pointed out a concept called “risk society.”
Risk society has two parts. First, there’s “the idea that risks are everywhere,” propagated by the Internet and the phenomenon of click-bait. The latest risks are perpetually popping up as a headline on your phone or your Facebook feed. They’re inescapable.
Second, Dr. Jack notes that risks today “are individualized,” meaning that people believe that they “can’t depend on others, like the government, to manage” risks for them. Rather, the onus is on each of us, individually, to do so. “We each have to weigh these different risks and decide what to do, constantly. We are simply bombarded” by these individual attacks on our personal safety or the safety of our families.
To work through all of the risks and determine which are real takes a lot of effort. “At a certain point there’s a cognitive and emotional overload that occurs,” she says.
This cognitive-overload of risk means that people will cling to a scary headline and simply avoid the risk associated with it rather than take the time to process whether the risk is real. Avoidance just takes less energy. Gel manicures might cause cancer? Simply avoid gel manicures. If you weren’t a person who often got gel manicures, this decision wouldn’t affect your life much anyway. And avoiding gel manicures is an easier way to deal with risk than studying the misrepresented original research presented by someone named Dr. Chris Adigun at some dermatology conference somewhere in Florida.
In the case of autism, Dr. Jack points out, risk management becomes even more difficult because of the many unknowns related to the disorder. “Scientists are sure there’s a genetic component, but they don’t know what genes or what combination of genes causes autism, and what combination of environmental factors work alongside those genes,” she says. “Neuroscientists see structural differences in autistic people’s brains, but they disagree on which regions or types of connections are different.” Basically we just don’t know what causes autism. And “whenever there’s a lack of knowledge, there are spaces for theories to emerge, and some of those turn out to be wrong.” Place this lack of knowledge within a risk society, and, according to Dr. Jack, “you get a perfect storm.”
This storm means that the “risks” associated with autism can be overwhelming. Dr. Jack points out, “New headlines come out every day about studies that have found connections between autism and any number of factors, like certain drugs the mother has taken during pregnancy, or pollution levels, or exposure to specific chemicals.” Because we live in a risk society, “people don’t trust the government or scientists, even, to help us sort through those risks. So they are suspicious when one of those risks is debunked.”
In a risk society, non-scientists—laypeople—resist believing that what was once touted as a risk is actually safe. They cling to their belief in the risk instead, and simply avoid the risk. You see this with pregnancy advice all the time. When you’re pregnant, you don’t know whether cheese, or hair dye, or deli meat, or any number of things might be harmful to your baby, and trying to get a straight answer seems nearly impossible. And what pregnant woman wants to hurt her baby? So she avoids it all. (Professor Marika Seigel of Michigan Tech has written a great book on the rhetoric of pregnancy advice that every woman should read.)
In the case of vaccines—as opposed to hair dye while pregnant or gel manicures—avoiding the pseudo-risk can have deadly consequences, as the recent outbreaks of previously controlled diseases have shown.
If you are a scientist, then, you want to do the best you can to ensure that your work is shared accurately with the public. I asked Chris Adigun how she could prevent something like the “perfect storm” of gel manicures miscommunication from happening again. Has she changed the way she presents health information to the public? “No,” she says. “I feel like I have no control because I was already careful when I presented my data on gel manicures. I was calculated and precise, and still some journalists found a way to manipulate my words for their benefit.”
When asked what she learned from this experience, her first words are quick: “The fragility of your reputation.” She shakes her head with what looks like regret. “I was really afraid that the headlines would hurt my reputation.” She wasn’t wrong to be afraid.
After the original article came out, another quickly followed in the New York Post with the headline “Everything Gives You Cancer” in which the author raked Adigun over the coals. The author wrote, “Recently women were warned that the UV light used to dry gel manicures causes skin cancer,” before stating that Adigun’s research wasn’t research at all (misunderstanding the purpose of a literature review), and that Adigun backpedaled her warning when she said that the risk was “low. Not zero, but low.” But here’s the problem: the writer hid the fact that it was her own newspaper that gave the cancer warning with its screaming headlines in the first place.
Reviewing these articles again, Adigun is reminded how often “fear is so easily exploited.” She can’t believe how much journalists would “use cancer to create fear for the media’s gain and use that fear to control people. That was most upsetting to me.”
Adigun is clear-eyed about her job now. “The only thing I can do is to continue in my work as a physician and a scholar and do the best I can to educate my patients and the media,” she says. “The rest I have no control over.”