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Donated Television Airplay of Colorectal Cancer Education Public Service Announcements --- United States, 1999--2002

To help communicate the importance of colorectal cancer (CRC) screening, in 1999, the U.S. Department of Health and Human Services (DHHS) launched the "Screen for Life: National Colorectal Cancer Action Campaign" (SFL) ( (1) as one of many strategies addressing the prevention and early detection of CRC. As a central part of this campaign, public service announcements (PSAs) were developed to take advantage of the influence and reach of television to encourage Americans aged >50 years to get tested for CRC. This report summarizes an assessment of donated television airplay that SFL PSAs received during March 1999--February 2002. According to data obtained from Arbitron Inc., a research firm that monitors broadcast media in the United States, SFL PSAs were broadcast 41,624 times, amounting to approximately $4.3 million in donated television airtime. As DHHS and others promote CRC screening, CDC will continue to release and track airplay of SFL PSAs and examine the collective influence that SFL and other educational efforts and strategies have on CRC screening rates in the United States.

CDC, in collaboration with the Centers for Medicare & Medicaid Services, developed and launched SFL in March 1999 and released new campaign materials in July 2000 (Phase II) and March 2001 (Phase III). Each campaign phase builds upon the previous one and includes these messages: CRC is the second leading cancer killer, screening saves lives, and screening can find precancerous polyps that can be removed before they turn cancerous. To track campaign airplay, CDC uses the 24-hour monitoring services of Arbitron's Sigma system, which monitors PSA airplay on approximately 1,000 television stations in all 210 U.S. Designated Market Areas® (DMAs)* and approximately 75 regional and national cable channels. The Sigma system tracks airplay by embedding an electronic code in the video signal of PSAs before their distribution to television stations nationwide.

When a PSA airs, monitoring devices in that DMA detect the code and record the broadcast time, date, day of week; television station call letters; and PSA name and length. Arbitron links these data to estimates of the commercial dollar value of each airplay and the number of times the PSA was seen, known as "audience impressions." The data are transmitted monthly to CDC for analysis.

During March 1999--February 2002, the PSAs were broadcast nationwide 41,624 times, resulting in an estimated 749 million audience impressions worth an estimated $4.3 million. Phase II of the campaign had the highest number of audience impressions, and Phase III had the most airplay and highest value (Table). During each phase, total airplay for SFL PSAs peaked within 3--4 months of launch, then slowly decreased. Each phase has been associated with a higher airplay peak than the previous phase (Figure 1). The percent of DMAs airing the PSAs also increased with each phase. During the 3-year period, 94% of DMAs played the PSAs at least once, and airplay ranged from 1 to 4,578 per DMA (Figure 2).

Patterns of airplay over the three phases indicate that 17,061 (41%) of the total 41,624 SFL PSA plays occurred during daytime (6:00 a.m.-- 7:59 p.m.); 2,144 (5%) occurred during prime time (8:00 p.m.--10:59 p.m.); and 22,419 (54%) occurred overnight (11:00 p.m.-- 5:59 a.m.). The airplay that occurred during daytime accounted for 415 million (55%) of total audience impressions. Prime time airplay accounted for 97 million (13%) total audience impressions. Overnight airplay accounted for 236 million (32%) of total estimated audience impressions.

During each campaign phase, an increasing number of states incorporated SFL materials, including PSAs, into their CRC prevention programs. By Phase III, 23 states had adopted SFL. To assess whether CRC burden influenced the adoption of SFL, CDC compared the latest CRC mortality rates (1999) (2) in states that participated in SFL in 2002 with those that did not participate. No statistically significant differences were found. A comparison of airplay in participating and nonparticipating states is planned.

Reported by: Div of Partnership Development, Centers for Medicare & Medicaid Services. CM Jorgensen, DrPH, C Purvis Cooper, PhD, T Richards, MD, CA Gelb, Div of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note:

Media campaigns alone rarely change behaviors; however, when included as part of a multicomponent intervention strategy, they have a strong synergetic effect. Used in this manner, media campaigns can reach large numbers of people quickly, raise awareness about health issues, and reinforce communication between patients and health-care providers (3--7). The findings in this report indicate that the SFL campaign has benefitted from the donation of a substantial amount of airplay by television stations nationwide.

As the campaign progressed, each phase achieved an increasingly higher peak of airplay. This trend might be associated with several factors, including increased national attention to CRC as a major public health issue, designation by the U.S. Congress in 2000 of March as "National Colorectal Cancer Awareness Month," and increased state and local educational efforts. All these factors might have helped influence public attitudes and contributed to the increases in CRC screening rates observed in some states (8). However, additional research would be necessary to gauge the specific contribution of PSAs to these increases.

The findings in this report are subject to at least two limitations. First, Arbitron's Sigma system, the only PSA tracking system available, bases estimates of dollar value and audience impressions on advertising figures used by the commercial sector. These figures change weekly and are set according to a complex and proprietary system of perceived market value and demand. Second, the Sigma system provides a conservative estimate of airplay because it does not monitor many channels offered through local cable or satellite services.

Data analysis using the Sigma system and Geographic Information Systems technology can be useful in identifying media markets that have little or no airplay, allowing state and local health officials to increase promotion of SFL. CDC and its partners will continue to release new phases of SFL, including PSAs, as part of a multicomponent approach to prevention and early detection of CRC.


  1. Jorgensen CM, Gelb C, Merritt T, Seeff L. CDC's "Screen for Life Campaign: A National Colorectal Cancer Action Campaign." J Womens Health Gend Based Med 2001;10:417--22.
  2. American Cancer Society. Cancer Facts and Figures, 2003. Atlanta, Georgia: American Cancer Society, 2003; publication no. 5008.03.
  3. Flay BR. Mass media smoking cessation: a critical review. Am J Public Health 1987;77:153--60.
  4. Grilli R, Freemantle N, Minozzi S, Domenighetti G, Finer D. Mass media interventions: effects on health services utilisation. Cochrane Database Systematic Reviews 2000;2:CD000389.
  5. Marcus BH, Owen N, Forsyth LH, Cavill NA, Fridinger F. Physical activity interventions using mass media, print media, and information technology. Am J Prev Med 1998;15:362--78.
  6. Snyder L. How effective are mediated health campaigns? In: Rice R, Atkin C, eds. Public Communication Campaigns. Thousand Oaks, California: Sage, 2000.
  7. Sowden AJ, Arblaster L. Mass media interventions for preventing smoking in young people. Cochrane Database Systematic Reviews 2000;2:CD001006.
  8. CDC. Colorectal cancer test use among persons aged >50 years---United States, 2001. MMWR 2003;52:193--6.

* As defined by Nielsen Media Research (

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