The problem with pink

Fall is a season characterized by a change in colors. In nature, leaves fade from bright green to yellow, red and brown. In our shopping carts, everything from oven mitts to gourmet popcorn changes to a deep Pepto-Bismol pink for Breast Cancer Awareness Month. Despite the cheeriness of the pink items, in its current incarnation Breast Cancer Awareness Month is increasingly being co-opted by corporate interests at the expense of public health.

When you look at the history of breast cancer, the importance of a movement promoting breast cancer awareness is clear. Seemingly unthinkable now, breast cancer and its treatments were at one point considered unmentionable and unseemly. An article from the New York Times emphasizes how different attitudes were in 1974 when First Lady Betty Ford was diagnosed with breast cancer. The First Lady was candid and open about her treatments during a time when “many Americans still considered mastectomy a taboo subject, too fearful or even shameful to be discussed openly.” The book “The Emperor of All Maladies: A Biography of Cancer” details a vignette from the early 1950s. When a breast cancer survivor and advocate tried to place an ad for a breast cancer support group in the New York Times she was told by the society editor that they were not willing to print the words “breast” and “cancer,” but would instead print an ad about “diseases of the chest wall.” In the years following the development of mammography, public education was critical to widespread adoption of the screening test.

Yet the current climate is saturated with messages about breast cancer. In the early 1990s, when the breast cancer advocacy movement was in its early grassroots years, Breast Cancer Awareness Month would be followed by an increase in breast cancer diagnoses in November, suggesting that more awareness led to women seeking medical attention and getting screened, thus leading to a higher rate of breast cancer diagnoses. This increase in diagnoses however has not been seen in subsequent years as knowledge of breast cancer has became well established nationally.

Corporations and businesses utilize the current manifestation of Breast Cancer Awareness Month as a tool to advance their public image and increase profit. While many assume that funds used to purchase a pink tote bag, dog collar or traffic cone support research and care, the reality is that the generic pink ribbon symbol is neither regulated or trademarked and many pink products devote no proceeds towards either research or care. Of those corporations that do contribute a portion of profits to the cause, many donate only a small portion. This small donation may be dwarfed by the increase in profit that the corporation itself experiences from the sale of these feel good products. Other corporations have set a cap on the amount that they will donate to charity, regardless of how many pink items are sold. Once that cap is met, none of the profits are donated, but consumers are not informed of this fact.

The NFL is a prime culprit in using Breast Cancer Awareness Month to spiff up its public image and make some money in the process. Women make up 45 percent of the NFL’s viewership and represent the league’s greatest area of growth. For years the NFL has turned everything from flags to cleats pink for games in October, because nothing says “I care about women” like a pink chinstrap. In the wake of recurrent controversies, such as the handling of domestic violence incidents, the league is facing even greater pressure to appeal to female fans. The reality is that the NFL realizes significant direct financial gain from the sale of pink products. In 2013, Business Insider reported that while the NFL donates 90 percent of royalties from pink products to the American Cancer Society, 50 percent of the cost of merchandise is distributed to the company that sells the merchandise, which is typically the NFL or individual teams. If the “pink” brand increases sales, then the NFL may be taking in much more than it gives away.

Another concern is that some information disseminated by breast cancer charities in the name of “awareness” is not supported by medical evidence. On its website, the Keep A Breast Foundation states that it aims to “empower young people around the world with breast health education and support,” although they are probably better known for their controversial slogan of “I heart boobies” which has been criticized for reducing women to the sum of their sexually attractive parts. As part of its work, the foundation created a Breast Self-Exam smartphone App. This despite the fact the breast self exams do not improve breast cancer survival, and despite the fact that the United States Preventative Services Task Force and the American Academy of Family Physicians no longer recommend teaching breast self exams. An analysis by the American College of Physicians questions the benefits of both breast self exams and clinical breast exams performed by a medical provider.

Keep a Breast purposefully targets youth and young adults in their outreach efforts. A lump that a young woman finds in her breast is overwhelmingly more likely to be benign than cancerous. Because the risk of breast cancer is so low in the youthful demographic that Keep a Breast targets, self breast exams are much more likely to result in unnecessary, painful, and expensive testing than they are to save a life (or a booby, since that’s what matters, apparently).

So ditch the pink gear. If you want to help fight breast cancer, give the money directly to a credible organization that funds research or care. But don’t be fooled into letting a corporation take advantage of the breast cancer narrative and your generosity to line their own pockets.