Doc HollywoodIf celebrities insist on using their fame to bring awareness to health problems, they should follow these guidelines.

Suzanne SomersCancer has a cure. That breakthrough medical news is not the result of grueling medical research published in the New England Journal of Medicine. Instead, it is brought to us via fading actress-cum-Thighmaster queen-cum-New Age health guru Suzanne Somers. In her new book, Knockout: Interviews With Doctors Who Are Curing Cancer and How To Prevent Getting It in the First Place, Somers claims, "There are doctors out there who are curing cancer," contrasting her findings with the "debilitating, often deadly fraud" of mainstream medicine that wants "to keep cancer alive and well" since it's "big business" for doctors and pharmaceutical companies.

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While many surely see Somers as a quackadoo, more than a few may see her as a pioneer: Upon its release, Knockout became a New York Times best-seller and ranked No. 284 in sales on Amazon. Not bad for a fading actress-cum-Thighmaster queen-cum-New Age health guru.

Somers is just the latest in storied history of stars who have shone a spotlight on medicine. The list includes fellow celebrities Christopher Reeve (spinal cord injury) and Farrah Fawcett (anal cancer), as well as famous athletes like Magic Johnson (HIV) and Lance Armstrong (testicular cancer). For them, and countless other celebrities who have dished about disease, the public has been, and remains, a keen and attentive audience.

There are many reasons celebrity health stories resonate with us. Since they always seem to be in front of us—on TV, in the movies, on the Web—they seem familiar, even trustworthy. Their stories of illness are very emotional, earning them our sympathy and empathy. Then there's their aura of invincibility: Whether it's the image of Armstrong winning the Tour de France (seven times!) or Reeve soaring as Superman, their swing from health to illness makes them underdogs we root for. Finally, celebrities are effective. Studies have shown that celebrity disclosure of an illness can increase public interest in the specific disease and lead to changes in the public's behavior. Many go on to form organizations and raise millions of dollars in support of research into their diseases.

Still, celebrity medical advice can be hazardous. Their messages have led some doctors and patients to make inappropriate health decisions, at times increasing risks for patients and driving up health care costs. Their advocacy, while informative and inspiring, often oversimplifies complex medical issues. Finally, the first-class advantages most celebrities enjoy can create false hope for their economy-class public.

Perhaps the best example of both the benefits and risks of celebrity medical advice is journalist Katie Couric. After her husband died from colon cancer at the young age of 42, Couric took up the fight against the disease. In 2000, she underwent a colonoscopy on TV as a way of urging others to get screened. The public followed: A 2003 study showed a 20 percent increase in colonoscopy rates in the months after Couric's TV segment. The study's authors labeled this phenomenon the "Couric Effect."

Yet colonoscopy, which Couric and her foundation call the gold standard of screening, remains controversial. Theodore R. Levin, a gastroenterologist at Kaiser Permanente in Northern California and a national authority on colorectal cancer screening, offers caution about her message. He agrees that Couric's advocacy has been very helpful. But by pushing colonoscopy, the most invasive and expensive screening method, he worries that the public may not learn about safer and more convenient options. One of them is the FIT test, a highly sensitive yet noninvasive test to detect blood in the stool. Patients can perform this test by themselves at home. In studies by the U.S. Preventive Service Task Force that compare FIT testing with colonoscopy, outcomes are similar. Another controversy Couric has caused, probably as the result of her own experience, is her past advice that people in their 40s be routinely screened for colon cancer. That's something Levin and other experts agree makes no sense unless a person has a family history of the disease.

The simplicity of celebrity health messages also creates problems. Celebrity sound bites often don't include pertinent information. Colonoscopy, for example, carries the risks of bleeding, infection, or perforation of the colon. All screening tests can also result in misleading false positive or false negative rates and a whole host of other drawbacks the public really ought to know more about.

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