BROOKE: There is often a sizable gap between what we we believe to be true about about cancer and its treatment, and the reality. For instance, the public perception of leukemia that its the fourth most common cancer. But how common is it, really?

Jakob Jensen: Tenth. leukemia receives a lot of news coverage, and it receives a lions share of federal funding, whereas again bladder cancer is very rarely depicted in the news and it receives almost no funding relative to other cancers.

Brooke: Jakob Jensen focuses on cancer communication at the University of Utah, so I asked him why our perception is so skewed. Does leukemia rank so high because its victims are young, and bladder cancer so low, because its victims are old? We’ve never really faced that question, we just know the rankings.

And we know them because Jenson and his fellow researchers assessed a year’s worth of cancer coverage -- more than 6,000 articles from the top 50 newspapers, and found that the public’s ranking of common cancers tracks more with the coverage than actual incidence rates. What’s more, so does federal research funding.

Jensen: In fact when I ask people to rank the cancers in order, from most common to least common, the one they tend to rank last is bladder cancer. And in fact its 6th. It's very very common.

Brooke: Why do you think that is?

Jensen: Here's what I want to rule out off the bat. It's not as simple as, "It's the media's fault." Why is breast cancer one of the most heavily discussed cancers in news coverage, in fiction? Well a lot of that has to do funding. Funding drives research. Research drives breakthroughs. Breakthroughs drive press releases. Press releases drive news coverage. But of course the public plays a role in driving what gets funded. One of the forces that influences the public is the media. But of course what influences the media? The funding, right? So they all are sort of participating together in constructing a reality that seems very natural. When I say to people that bladder cancer is the 6th most common cancer, their reaction to me is often, "Is that true?" If bladder cancer was 6th, wouldn't it feel that way. You know, the goal of my research is not to argue that some cancers deserve less funding - in fact all cancer needs more funding. But what I would say is that there's clearly a handful of cancers that are receiving funding that is far less than you would expect relative to the number of people that are affected by those cancers.

Brooke: So what do you think needs to be done to solve it?

Jensen: I think the national cancer institute would serve us well by coming out with a lucid statement that says, ok, how do we actually allocate funding by cancers. What is the logic behind that. Second solution I would argue comes into play in media. If you want to be a health journalist, you're going to see way  more leukemia stories, way more breast cancer stories, the press releases are going to be running into you, there's going to be a lot more research coming in for that. And unless you know that for example there are cancers that a rarely depicted but are very common, how do you actively start to interject your own frame on it. The third thing is the role I think the public might have. A lot of cancer funding also comes from local or regional organizations. lets make sure that our local efforts don't mirror those same distortions. If you were to raise something like 20,000 dollars for bladder cancer, it would have a significant effect on the research. In a way that it might not in breast cancer. Because bladder cancer is struggling to even get off the ground from a research area. So 20,000 dollars might take a young faculty member who's just starting their research line somewhere - well now that person has a 40-year career studying bladder cancer because of that initial seed grant.

Brooke: What about the coverage of treatment? Has there  been any media effect there?

Jensen: Oh yeah, definitely. The bulk of news coverage of cancer is about innovative cancer treatments. And there are lots of distortions. And the reason its a problem we have to get away from is that early clinical research is often a failure. There's a survey called the health information and national trends survey - its put out by the national cancer institute - and what it finds every single years is that 3 out of 4 Americans are frustrated and confused. "Oh they got a thing that's gonna cure cancer but then you never hear about it again." And I think that's a byproduct of covering research too quickly. And its unfortunate because there is a lot of cancer research that is very far along. One of the things I can't believe we're not talking more about in the press right now is where we're at with colon cancer screening. That's research that's ready for public consumption, and yet there's more stories in any given year about noni juice, and how it might prevent cancer.

Brooke: And you've referred to something that researchers call "cancer fatalism." 

Jensen: Cancer fatalism is the belief there's nothing you can do. It has two components - you can be fatalistic about prevention: "I'm either going to get it or I'm not, everything causes cancer so its just pick your carcinogen." And then there's cancer fatalism about treatment - that if you get cancer you're either going to live or die, what you do after you're diagnosed is irrelevant. As you might guess, fatalism about prevention is very very common. Fatalism about treatment less so. There's something a little self-serving about that if you unpack that. "If I get cancer, I want to believe there's something I can do to stop it. But I don't want to believe that what I'm doing right now is causing cancer." How do start talking about cancer prevention with a public that just thinks everything you're telling them is going to be contradicted tomorrow. They told us that margarine was bad, then they told us it was good. Which one's better - margarine or butter?

Brooke: It's butter.

Jensen: Well here's what the epidemiological research really says. There's not many studies and they find very small differences, and the difference keeps flipping back and forth, and the first couple of times it flips, its a story. But now its almost become a tragedy. Because its an exemplar of what they perceive all cancer news coverage to be. I'll give you an example. I'm working with the Huntsman cancer institute at the university of Utah to start developing a message about low-dose aspirin and how it prevents colorectal cancer. There is a lot of data supporting it. So we're trying to develop a message for the public. But when we start running surveys with people, the first thing I get back is, "oh, pshhhh." I'm just tired of hearing this.

Brooke: Margarine.

Jensen: Yeah, margarine or butter, man. Tomorrow you're going to tell me low-dose aspirin causes colorectal cancer. We have allowed cutting edge research to be the topic of too much conversation and then it flip flops or it fails. And unfortunately when we come forward with really strong research they’re going to be understandably skeptical because we have failed them before.

Brooke: Thank you very much.

Jensen: You’re welcome.

Brooke: Jakob Jensen specializes in cancer communication at the University of Utah.