April 29, 2013 — "Before the pink ribbon, awareness as an end in itself was not the default goal for health-related causes," Peggy Orenstein -- an author and breast cancer survivor -- writes in a New York Times Magazine piece exploring the consequences of prioritizing "early detection" of breast cancer through screenings. Although Orenstein once thought "a mammogram saved [her] life," she has come to acknowledge that she might never know whether the outcome would have been the same if she discovered the cancer on her own years later.
Orenstein discusses how awareness campaigns, such as those backed by the Susan G. Komen Foundation, have fueled the public perception that mammograms and other methods aimed at early detection can reduce breast cancer deaths. This perception has persisted as "study after study reveal[s] the limits of screening -- and the dangers of overtreatment," she writes.
Arguing that women "are now well aware of breast cancer," Orenstein outlines suggestions from several experts on how money and resources typically devoted to awareness campaigns and early detection efforts could be better spent. Several suggested better-funded research on prevention and the role of environmental factors, while "[n]early everyone agrees there is significant work to be done" to improve diagnostics, she explains.
Although "[t]he idea that there could be one solution to breast cancer -- screening, early detection, some universal cure -- is certainly appealing" and purchasing pink products "feels good, even virtuous," the truth is that "making a difference is more complicated than that," Orenstein argues.
"[A]ll that well-meaning awareness has ultimately made women less conscious of the facts: obscuring the limits of screening, conflating risk with disease, compromising our decisions about health care, celebrating 'cancer survivors' who may have never required treating," she writes, adding, "And ultimately, it has come at the expense of those whose lives are most at risk" (Orenstein, New York Times Magazine, 4/25).