Monday, February 21, 2011

Scare Tactics

TAG of the Week:   "Breast Cancer Screening and the Perception of Risk"

News Headline highlights "one in eight women 'will' develop breast cancer"...  At a first glance, this number, "1 in 8" women, looks astonishing and scary; however, individual and societal perception of risk can influence the receiver's interpretation of health risk, communicated in a positive or negative way.  What is also important to understand is that this "risk" is associated with the woman's age, family history of breast cancer, and their environmental/lifestyle/behavioral factors.

Screening for BRCA 1/2 has become an option for women to make life choices at an earlier stage before late stage of metastasis; on the other hand, having the chance to make these decisions which can have lifetime impact is not any easier.  This article piece from the UK talks about the risk of BRCA 1/2 being a rare disease of old age and describing risk as a life-time risk. How much do we really know about the risk of developing breast cancer? Suggest ways to advertise screening to those who really need it but at the same time not causing unnecessary anxiety.

Click here for the current event:
http://www.guardian.co.uk/society/2011/feb/08/breast-cancer-one-in-eight

28 comments:

  1. I believe that we actually know a lot about the risk of developing breast cancer. I am not one who is skeptical about “new scientific breakthroughs.” However, I am obviously more skeptical about the legitimacy of source’s findings. For instance, I am more likely to believe what is concluded in a notable scientific journal that is peer-reviewed, rather than a newspaper/magazine’s headlines. Unlike scientific journals, these secondary sources have their own agendas where accuracy is not necessarily their main concern, as is number of readers. That said, numerous scientific studies are published concerning risks to breast cancer. They all highlight the three most basic breast cancer risks: gender, age, and family history. Even so, there exist smaller risks that are fervently discussed in the scientific field: lifestyle, little exercise, obesity, advanced age at pregnancy, number of children, breastfeeding, small/moderate alcohol intake, etc... These are not as strong as significant family history, for example, but we continue to learn about new risks that could influence our chances. Therefore, I believe that at this point in time we have reached a point where we now know a lot about the risk of developing breast cancer. The real concern is how much we have yet to learn about the CURE for breast cancer, so in that sense, we’re half-way there.


    To advertise for breast cancer screening I would utilize a mass-media awareness campaign, namely commercials, because it hits right home. I would try to coordinate the commercials around TV channels and shows that are the most popular among women ages 30 to 60. However, the article pointed out that current media coverage regarding breast cancer made a big issue of lifestyle risks, which left women who had already been diagnosed with breast cancer feeling as if they were to blame for their poor lifestyle choices. Therefore, in order to reduce this blame/anxiety I would suggest to launch an ambitious media campaign similar to that of Gardasil’s “one less” (…death due to HPV/cervical cancer) television ads. What I would do differently however is that I would put less emphasis on advertising Gardasil as a product, and be more educational by mentioning breast cancer screening’s benefits and risks.

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  2. I very much agree with the previous comment.
    Although knowledge of breast cancer is nowhere near complete, the scientific community does have a lot of extremely valuable information regarding breast cancer risks, prevention and treatment. I think the problem now lies in the translation of that knowledge from the scientific community to the general public. There is a huge problem with the general public seeking health information from the wrong sources. As noted in T.Contreras's comment, many secondary sources have their own agendas when reporting news. I think, therefore, that it is the task of health professionals to take a more active role in passing along information directly to patients. Possibly integrating screening advertising more closely with gynecology and obstetrics could be a way to reach women who are already seeking medical services at an age prior to high risk. Also, placing advertising in gyms, beauty salons, or other health related/ personal care facilities and promoting screening as another form of maintaining women's overall health could be a way to reach women without unnecessary anxiety.

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  3. I thought the two previous posts made great points, and that a combination of the two would be really effective in communicating the importance of screening to women without producing unnecessary anxiety. As L. Laverty said, many people seek health information from sources that may have their own agendas in reporting such information. A much more reliable and trustworthy source of information is an individual's PCP - therefore, physicians need to be knowledgeable about the risks and benefits of screening as well as proactive in discussing screening with their patients. In addition to this, a media campaign, as T. Contreras mentioned, would also be a good way to communicate with women about screening. The campaign, which would include things such as commercials, ads in magazines, and posters in hospitals, needs to be blame-free and positive. The focus should be on prevention and being informative.

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  4. I would be very careful when advertising for BRCA 1/2 screening. I think as mentioned above that an education campaign about breast cancer screening and overall breast health should be the main agenda. I think it would be important to encourage women to take control of their lives and stay active and eat healthy. Just these two actions can reduce their risks and it is important to tell women especially right around menopause. This is the time when the risks for a woman to get breast cancer start to rise. I think that the campaign should teach that regular screening at the doctors and at home will greatly reduce their risks and they should just focus on a healthy lifestyle. I would then include that with age the risk really increases and that at a certain age cutoff it might be beneficial for them to get screened for BRCA1/2 but that the majority of american women who do not have a strong family history of breast cancer do not need to be tested. The genetic testing has the potential to save lives but it additionally has the potential to almost ruin others if a person who was not assumed to be at great risk got tested and found to have a mutation. They still might never get breast cancer but they have to decide what to do with that information that they now know. I would focus on promoting the campaigns at places where women (specifically but not only ages 40 and above) go like doctors offices, gyms, and health stores like L. Laverty said. I think if women know what kind of risk they have and how to interpret the risk women will be better off overall because they will be able to get screened and monitor their health or get the genetic testing done only after a certain age if they really think it is necessary.

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  5. I believe that there is still a lot to learn about breast cancer and the role of genes and environment in the risk for developing breast cancer. I also believe that we may never fully understand how our genes and exposures interact to create our risk for developing the disease.
    I would advertise for screening through the use of ads in woman's magazines as well as on television channels directed towards women such as TLC or Lifetime. I would inform individuals that there is genetic testing available to determine if they have the BRCA1/2 gene which would greatly increase their risk for developing breast cancer. I would advise that individuals who have a family history of breast or ovarian cancer consider being tested for the gene since those individuals are more likely to have the gene than the general population. I would also have inform the reader/viewer that they should consider being screened for breast cancer through the use of self breast exams, professional breast exams, and, if over the age of 50, regular mammograms to aid in early diagnosis and early treatment which would increase the individual's likelihood of combating the disease. I would also explain that as women age they are at an increased risk for breast cancer and should consider living a healthy lifestyle including eating properly and exercising regularly as this may help prevent breast caner, as well as many other health issues. I would be sure to make these ads up beat and informative as opposed to trying to scare individuals into getting tested. I believe that given the proper information women would be able to make educated decisions about their health and how they can learn of their individual risk for developing breast cancer.

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  6. As the article shows, it is difficult to present science to the general public without some sort of mass hysteria. Especially when media can portray a story, the research itself can be misconstrued. When presenting scientific evidence, especially when it deals with hot topics such as breast cancer, all depends on how it is framed. As stated in the article, women became quite anxious when they would perform self-examinations and can end up self-prescribing. Personally, I think breast cancer is the most popular disease seen across all media, from television, to movies, and commercials. With such public attention, I feel that any type of research that deals with breast cancer in any way, becomes news for discussion. As seen with the genes BRCA 1 and 2, genes have a large factor in whether or not an individual can have breast cancer. Nevertheless, there are other areas in women's lives that they can control to prevent cancer. As said by L.Laverty and Meghan, there should be a focus on women's overall health.

    Besides cancer being the second largest killer of females over 50, according the CDC website,(http://www.cdc.gov/women/lcod/ ) heart disease is the number one killer. Rounding out the rest of the top 5 include stroke chronic respiratory disease, and Alzheimer's. The majority of occurrences of these diseases especially cancer can be reduced significantly just by a healthy diet and exercise. In regards to advertising, commercials should serve as an empowering tool for females and not something to scare them. Along these lines, commercials should focus on female health, mental and physical stressing the that a healthy lifestyle can help prevent a number of diseases. By having commercials working as tools of empowerment then women can be more relaxed and feel confident in themselves to pursue a healthy lifestyle.

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  7. I think that first and foremost individuals must be given an accurate estimate of their own personal risk, based on their own family history, environmental exposures, and lifestyle factors. Although everyone has a slightly different risk based on these factors in combination with their unique genetic makeup, there has to be a more reliable estimate than the intimidating and largely misleading statistic of "one in eight women WILL develop breast cancer..." With a reasonable degree of risk in mind, individuals will be better equipped to judge whether or not their personal circumstances warrant a genetic test for breast cancer. This means that advertisement should not begin with "Get your genetic test for breast cancer today!", but rather, "Everyone is different; Is a genetic test for breast cancer right for you?"
    After having a personal consultation to pinpoint degree of risk as best as possible, regardless of their risk individuals should be given lifestyle and prevention tips in staying cancer-free, no matter their current pre-disposition. For those who appear to be at substantial risk for breast cancer, the next step should be a genetic counseling session, during which potentially high-risk individuals are given the reality of the situation, and given realistic expectations for what a genetic test will provide for them. They should be allowed to discuss their feelings and concerns, and from there should be granted the freedom to decide whether they should get a genetic test, having been given all the appropriate information regarding what to expect, while keeping in mind their feelings regarding the subject. Those who realize the potential anxiety that goes along with a genetic test would not be conducive to their future can forego the test, while others who are prepared for the results and feel it will help them in the future can choose to have it performed.
    Overall, advertising genetic tests appropriately is key to minimizing unnecessary testing and unwarranted anxiety within the population.

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  8. I believe screening for breast cancer, or any type of cancer, is very important. It's smarter, in my opinion, to get screened and tested for breast cancer at an early age than it is to be oblivious until the age of 50. Not only will it increase the woman's chances of survival, but she also has time to recognize what it is in her life that needs changing. As the article stated, life style choices such as drinking, over-eating, and lack of physical exercise may increase the risk of developing breast cancer. Though genetics plays an important role in developing breast cancer, staying healthy can prevent one from developing other chronic diseases. By finding out about breast cancer early, not only can the woman help herself at an earlier stage, but pass on the knowledge of family history to the rest of her family, including her daughter(s).

    The article stated that many women felt as if they were targeted by the media due to their disease. However, I believe television and commercials is a great way to advertise breast cancer screening to women, though the tone of voice in said commercials should be slightly more docile than the current ones. I'm not too sure what kind of programs women ages 30-50 watch are, but having commercials about breast cancer screening and the importance behind it, in between programs can definitely help save some lives. Magazine ads and maybe even little post-its talking about breast cancer screening in new bras can help. Albeit the post-its may discourage some women from buying a hot piece of clothing from Victoria's Secret, it may help keep them on their toes about their overall well-being.

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  9. I think that a combination of information from a woman's PCP and an aggressive but positive media campaign could greatly increase awareness about screening. Many women get their information regarding screening from less than reliable sources that may have their own reasons for presenting information in a certain way - think of the "cheating gene" segment we saw on Good Morning America. A more reliable source would be an individual's PCP, who will have the knowledge and expertise to provide screening information. Physicians, therefore, need to become thoroughly informed about the risks and benefits of screening as well as be able to point women to appropriate resources. Additionally, PCPs have to be much more proactive about recommending and discussing screening options. In addition to this, a strong and positive media campaign could potentially increase awareness about breast cancer screening. Since many women feel that current advertisements blame them for their condition (by focusing too much on preventable risk factors), this campaign will focus on screening and its benefits. Television commercials, magazine advertisements, and posters in doctor's offices and hospitals will help to get the word out. All of these should be informative, empowering, and free of blame or finger-pointing.

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  10. Considering that the article mentions women feeling like current media for breast cancer is blaming them on lifestyle, I do not know that big ad TV/magazine campaigns that people are suggesting are the best way to go about it. Although I agree that if there were a big ad campaign, it should focus on education rather than the product (the product in this case is the screening), I still think that even educational ads may unnecessarily scare women. According to the article, the 3 main risk factors are age, being female, and family history. With an aging population, it makes sense that breast cancer is becoming more prevalent, yet statistics like 1 out of 8 are scaring too many younger women. For most people, we really do not know what their risk will be. The reason that avoiding risk factors is advertised is because it is something that people can control, whereas age, genetics, etc., are not controllable.
    To reach people that screening would benefit, the ads would have to target women with a significant family history of breast cancer. But as I said before, big TV ads or magazine ads might be taken too seriously by the wrong people and all of a sudden every young to middle aged woman will be wanting genetic screening. The best way to advertise these tests would be in doctor's offices, so that if the idea of a genetic test is in a woman's head, she is in a place where she can talk to a doctor or nurse and become fully informed and educated before making any life-altering decisions. Decisions on how to avoid risk factors can be made from there, rather than big campaigns that make women with cancer blame themselves when their cancer had nothing to do with lifestyle. -Becca Adlman

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  11. I agree with some of the other responses in that there is still much to be learned about breast cancer, the BRCA mutations, and the human genome as a whole. The gene-environment interaction is complex and far from fully understood, so determining an individual's risk can be very difficult, even with results of BRCA testing. That being said, the article seems to pull headlines and generalized information from a number of sources without really addressing the scientific research findings behind them. It is one of many examples of how media can misrepresent or omit details when presenting information about science/health. For this reason, I think mass media campaigns should be used with great care to raise awareness about breast cancer, screening, and genetic testing without creating unnecessary fear or panic.
    I think a great model to follow would be the Get Yourself Tested campaign that aired on MTV to raise awareness and encourage young adults to get tested for STDs. The aim was to present facts and statistics to encourage people to get tested without creating a state of panic about whether or not they may have a disease. The campaign targeted a specific audience at risk, which is something that should be replicated in an ad campaign regarding breast cancer screening and BRCA testing. While every woman is at some risk of developing breast cancer, the ads should target women with a strong family history who would be good candidates for genetic testing, to avoid a situation in which every woman demands genetic testing. The ads should also follow GYT's approach and air on networks that would reach the most women at risk--networks like Lifetime, TLC, HGTV, or WE that many women frequently watch. The ads should present information about increased risk without presenting numbers that women may interpret as their own individual level of risk, since no one number can apply to everyone, as well as encourage women to first and foremost consult their doctors with any concerns they may have, since they would be most equipped to offer the information they need to evaluate individual risks.

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  12. The risk of developing breast cancer depends on a number of factors, such as, age, family history, and health, meaning every woman their own scale of risk. Most advertising that I’ve seen about breast cancer is to make donations or to attend charity events, but I do not recall seeing any advertising that specifically advises the public to get screened for breast cancer. There should be commercials on popular women’s television channels and ads in women’s magazines that give a brief explanation of how screening works and how it can save lives through early diagnosis. Some women may not know that they are at risk because they may not have a close connection with family members so they do not know their family history, therefore, the advertisements should also touch upon this. In order to avoid unnecessary anxiety, it should focus more on the benefits of knowing and how it can help make decisions, especially for those who plan to have children, and how just as there is a chance of having breast cancer, there is also a chance of not having it and leading a normal lifestyle. The advertisements should aim to be more informative and motivational to get screened rather than scaring women to know they may have breast cancer.

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  13. I believe that we know a significant amount of information about breast cancer. I think that it is just hard for us to use this knowledge to the best of our ability to help prevent or detect against breast cancer. Just like in the article, it stated some people are at more of a risk of developing breast cancer because of age, family history, and so forth, but also a large part has to do with the way individuals live their lives. For instance, diet, exercise, and the environment we live in also have an influence on whether or not breast cancer is going to occur. Thus, there are so many different factors that come into play that figuring out which risk factors have the most influence is hard. This makes prevention and detection of the disease that more difficult. We just need to find a way to utilize all this information so that it will help as many people as possible in the end.

    I also agree with the previous comments about advertizing screening for breast cancer in a mass media campaign. The ads such as commercials should target the older age groups and should remind people that screening should be a regular thing. Or they can also have commercials about showing a person the right way to perform self examines. This can let people know that they are doing it the right way and in general just remind them it is good to do this every once and a while. Or instead of targeting the population at risk, we could take the other side of targeting younger individuals. For instance, we could incorporate knowledge about breast cancer, prevention methods, screening, and leading a healthy lifestyle into a high school health class. This makes teenagers aware at a younger age that there is this problem of rising rates or breast cancer and they may be able to do something about helping to prevent against it from a young age.

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  14. Although breast cancer is one of the top leading causes of deaths in females, it is important to recognize that there is no need for immediate panic. Studies do show that having the BRCA1/2 gene makes you more likely to get breast cancer, but there are numerous other factors that can also play an important role in the percentage an individual is at risk, such as socioeconomic status, environment, and lifestyles. I agree with the above statements that there is certainly a lot that remains unknown about breast cancer, but the more we learn the less daunting the disease can be. More important however, is how we educate the public about the disease and ways to take as many preventative measures as are often in the control of the individual (environment, lifestyle, etc). With regards to advertising screening, I feel like it is certainly very important to screen for diseases, cancer in particular. However, family history and other key elements should be taken into account before a screening test because once the test is performed, there is no going back. If media were to advertise screenings, they should make clear that such an expensive screening test is more important for those particularly with a family history of breast cancer. If those without family histories also want to take the screening, they should consult their physician to see what the physician has to say about the matter first, because there is no need to get a test that, based on various factors, seems unnecessary to that individual and instead just ends up making that individual really anxious about the results. Again, once a screening is done, there is no way of going back. Additionally, unlike what the article mentioned, I feel as though if you are to get tested, it is better to know early on (in a person’s late 20’s or early 30’s) so as to be more prepared for what is to come. I agree with Becca in that television shows are not a good way to communicate such tests because individuals may get the wrong idea about what these tests are actually trying to do. The best way to advertise such screenings is in doctor’s offices where if the individual has a question, they can ask their doctor, who should be educated about the screening and able to answer all questions an individual may have about the test.

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  15. While I believe it is prudent to screen for breast cancer and other detectable cancers, I think the headline in this article is a little bit alarmist. To introduce a statement like "one in eight women 'will' develop breast cancer" without qualification is reckless and tantamount to fear-mongering. The fact is that this statement applies to women in the 70 yr old range and not to young women. Granted, the authors go on further to explain the complexity of cancer and the influence of age, gender, and familial history as potent forces can influence the incidence and prevalence of cancer, but the initial statement is still too strong and likely to induce anxiety.

    Even when a woman has mutations in BRCA 1 and BRCA 2, it is not fixed or written in stone that she will have breast cancer. What scientists have recognized is that the interaction between genetic factors and environmental factors is what determines if a person develops cancer. After all, there is the issue of penetrance: where a person with a harmful mutation may not show the phenotype (where penetrance is less than 100%).
    Given the complexity of breast cancer and given our limited understanding of its etiology, with respect to lifestyle and the environment, I think scientists should exercise restraint when they attempt to quantify the risk of breast cancer to the general public.

    Thus, in order to advertise screening to those who really need it but at the same time not causing unnecessary anxiety, scientists should qualify their estimates to allow women to estimate their real risk. For instance, I think it is better to say something like, "one in eight women over 70 yrs with a family history of breast cancer is likely to develop breast cancer" as opposed to a categorical statement like "one in eight women 'will' develop breast cancer."

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  16. Although I agree with some of the previous posts that we know a lot about the risk of developing breast cancer, it almost appears that nothing has been ruled out as a potential risk. Sure the risk can be due to a combination of factors, but it’s hard to imagine possible preventative measures when there are so many components here at play. The article mentions lifestyle factors including having fewer children, increased drinking and obesity; age, family history, on top of the possibility of carrying the BRCA1/2 gene. There is still so much research that needs to be conducted in narrowing what causes the risk of developing breast cancer even more before significant precautionary measures can be taken by women. The article concludes with a statement, “A 6% increased risk from drinking a glass of wine a night is maybe worth taking if you have only a 10% risk of breast cancer to begin with – 6% of 10% is very slight.” This summarizes exactly how I feel and that without knowing for sure, how are we to gage which behaviors are having how much of an impact on our risk for developing breast cancer, and further how to change our behaviors if it does mean putting ourselves at a lessened risk.

    It’s hard to devise an appropriate way to advertise screening without making everyone feel as though they’re at risk, similar to how Fernando explained. The first line in the article states, “One in every eight women will get breast cancer in her lifetime.” With a claim as strong as this, it’s bound to grab the attention of all the female readers, but as it explains later on, this statistic is rather misleading. Initially using the shocking statistics like this will get the reader interested, but once they see that it was an exaggeration and that the risk is more dependent on age, the younger readers may not understand the message that even though they’re at a lesser risk for now, in the future they will be at higher risk. The age that screening begins at is age 50, so it makes sense that advertising should be targeted towards the older audiences. I agree with what everyone else has said about using positive, informative media messages that explain that screening is normal, healthy and should be conducted regularly.

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  17. I believe our health professionals know a significant amount about breast cancer risk but society’s interpretation of such information can be misleading. The most influential breast cancer risks are age, family history and age. However, secondary risks are emphasized in society: lifestyle, exercise, pregnancy and number of children, breastfeeding, excess weight, alcohol, hormone replacement therapy, etc. Screening for breast cancer or any cancer in general is vital to the public’s betterment of health. As the article stated, "at the end of the day, all cancers are genetic, but they need other triggers in lifestyle and the environment.”
    I agree with T. Contreras’ comment that sufficient information has been gathered but the general public needs to know how to properly interpret it. Lifestyle changes will not protect said individual from breast cancer but will benefit them. As L.Laverty stated, women's overall health should not be disregarded. Although some women may deal with psychological distress due to guilt, mass media campaigns are probably the most effective way to communicate with the general public. Initially, a focus on women who have a strong history of breast cancer should be required to be tested. Commercials on popular TV shows for women aged 25 + would inevitably raise awareness. In addition, advertising campaigns in beauty salons, gyms, grocery stores, doctor’s offices, movie theatres, etc will give women a greater understanding of risk factors. High schools or college campuses should incorporate awareness about risks of breast cancer, healthy lifestyles, and screening so individuals can utilize more appropriate preventative measures and treatment. These are all relevant tools to empower and assure women. Health professionals should take a more active role in the interpretation of information and minimize unnecessary anxiety within the population.

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  18. Deception is a prevalent feature that the media ultimately plays into. By running headlines like “1 in every 8 women will get breast cancer,” a clear message is being sent. Facts aren't being verified and the public takes what they hear at face value. Im not saying that Breast cancer isn't a serious matter, but I am saying that all the hype surrounding it isn't warranted. Up until the age of 29, the risk of developing Breast Cancer is 1 in 2000. This translates to .0005%. Cancer remains largely a disease of old age. While Breast cancer is a serious illness that should be taken seriously, the media creates a lot of unnecessary worrying and anxiety.
    Watching the movie, “In the Family,” there was a scene above all others that stuck out in my mind. It was the Myriad Genetics scene where Joanne Rudnick was speaking with the founder of the company. When asked while the tests were still thousands of dollars per person, he had no response and it got me thinking.... What is the real reason behind this push for women to get tested? I wouldn't be surprised if Myriad Genetics or other companies affiliated with them were responsible for these ads, which urge women to get tested. These ads are supposedly to better the quality of women's lives and are supposed to ultimately increase public health and awareness, but I truly believe that it all comes down to one issue: money. Myriad owns the exclusive right to process the DNA samples and perform the tests that illuminate the BRCA 1/2 mutation. Myriad is engaging in doublespeak by claiming that they have the best interest of women at heart, when their main objective is to procure large profits.

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  19. I agree with all of the statements provided above. I believe it has been about 30 years since the BRCA gene was discovered and science has had time to take an in-depth look at BRCA1/BRCA2 mutations. We have the information we need to postulate and advertise on how to deal with having the mutation and the person’s chances of getting breast cancer. The problem becomes explaining that information to the general public. I believe it should be presented by people’s clinicians; people who can give the patient proper statics on the risk of breast cancer and give them all the facts they would need for the future. Advertising through the media will cause unnecessary panic because the general public does not know enough information about the BRCA1/BRCA2 mutation and will not know how to read the statics provided properly. The public must be made aware of the difference between having breast cancer and being at risk for breast cancer. Early age prevention can allow patients to live long, healthy lives. Although the procedures may be invasive, they will lower the patient’s chances to that of someone who doesn’t have the mutation for getting breast cancer. The public should also be made aware of the role of environmental factors as well as family history, which can play a major part in one’s risk of getting the mutation for BRCA1 or BRCA2.

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  20. I definitely agree with everything written above. One interesting campaign that ASchonenberg wrote about is targeting high school and college age women in these media campaigns. I think the greatest way to reduce mass media mania is to make whatever is being advertised a normal, every day product or service. Despite the wealth of information on breast cancer and proven successful treatments for some women, the general population, for good reason, is still very scared when they hear the word. Not saying that the fear will go away, but by promoting women to frequently complete breast exams, way before the age of menopause, would hopefully increase the number of women who are noticing something, and especially, potential carriers to be screened. The key to overcome the disparities in screening is to reduce both the cost and fear associated with breast cancer screening. The whole purpose of early screening is to identify an asymptomatic, potential disease. Therefore, if with positive test results, women should not feel like they are receiving a death sentence, instead it would be a way that they could actively improve their health outcome. Until cancer is no longer foreign and scary, screening rates will not increase. However, by targeting the younger population, eventually screening will become a normal part of developmental medicine, and treatment and survival rates will drastically improve

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  21. Obviously, breast cancer is a very touchy subject in the general public. It doesn’t make things any better either when statistics are so easily manipulated in whatever way suits the people distributing the information. That “one in eight women will develop breast cancer” statement, for example, is very misleading. It may be accurate as a crude average, but every individual does NOT have a one in eight chance of developing the disease; for many people, the risk is much lower, and for some who may have inherited BRCA ½, the risk could be much higher.

    Advertisements for breast cancer screening shouldn’t downplay the risk, but they also shouldn’t scare the bajeezus out of people. They should very carefully explain how the women at the highest risk are those with a hereditary mutation, and that it would be most beneficial to get tested if there is a history of breast cancer among relatives. Hopefully, it would reach the target audience without panicking a bunch of people worried about the mutation popping up out of nowhere.

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  22. The way in which statistics are presented regarding breast cancer, as well as many other diseases, can have a significant influence on whether people feel that they have a risk of developing the disease or not. For instance, when our guest speaker came she handed out the sheet that gave various scenarios describing risks of developing a disease. Two different scenarios about developing cystic fibrosis were given. The first stated, "Neither you nor your spouse/partner has a family history of cystic fibrosis. Your chance of having a child with the disease is 0.05%." The second claimed, "There are 1 in 2,000 Caucasian babies born with cystic fibrosis in the US each year." Both statements give the same statistic, however, they present it in very different ways. Personally, I would feel that there was a greater risk for my child to develop the disease if I was given the second statistic. It is important that information regarding risks for developing cancer is presented in a manner that does not mask the true risks and seriousness of the disease, but also highlights the fact that if breast cancer is prevalent in one's family it would be wise to be tested for a hereditary mutation and receive annual mammograms.

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  23. It is not uncommon to see headlines as such in the media. Exaggerations are not only limited to scientific research and publications like this one of breast cancer, though. You see it touch upon every aspect of advertising, ranging from headlines that read, "How to lose 10 pounds in 1 week" to "make $10,000 in a month" to "1 in 8 women will develop breast cancer." When readers come across articles like the first two, it is very easy to question the legitimacy of the argument. I've been told not to believe everything you hear hundreds of times. Why is it, then, that people do not respond the same way to scare tactics about such issues as breast cancer?

    The every-day person has not done personal research on cancer incidence and biomedical research, which makes the threat of cancer unknown in multiple levels. First, these people do not know many risk factors that could contribute to the development of cancer. Second, they do not know any actual statistics or details of the statistics given to them. Lastly, they do not know what their personal chance is of getting cancer. However, I think it is safe to say that many people have been touched by cancer in some form at some point of their life. This makes it very easy to see the horror cancer can bring about to an individual and to their loved ones. This knowledge also makes it extremely easy to scare people further of their own individual risk.

    These tactics seem to be the ones employed by companies promoting such widespread screening and genetic testing. These tests, however, are how the company makes money. It is to their benefit to promote testing so they can maximize their profits. It is important for doctors and the public to realize this. It is important doctors see this because it is their responsibility to inform their patients accurately of their risk of cancer, without skewing rates of cancer and taking into account personal risks such as environment, lifestyle, and family history. Then, after a professional does a more individualized risk assessment, if screening and/or testing seem appropriate it should be sought out.

    Directly advertising the screening to the general public, who is uneducated on the topic, is dangerous because it makes so many people unnecessarily scared. People seeing these advertisements do not say "these ads are put out by companies who are trying to make a profit by selling cancer screening," but rather "I could be that eighth woman, I should get screened." Because of this, I do not think that pharmaceutical companies should be allowed to directly advertise to consumers, but rather only to doctors who have the knowledge and training to make the most informed decisions for their patients.

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  24. The issue of breast cancer and genetic testing is a sensitive issue to discuss. I think it is difficult looking at it from both aspects. Many women suffer from this awful disease but knowing at a young age you have the gene and are more susceptible to getting breast cancer could be life altering. The decisions that come a long with knowing about this gene are extensive and could change ones life forever. I understand the aspect of wanting to completely protect yourself against the risk of cancer but at what cost to your life should you take that risk. I believe genetic testing can be good in a sense but it can be very harmful in another sense. If one finds out they have the gene and go through with life changing surgery cancer could still develop. You run so many risks doing that and sometimes I believe what you don't know can't hurt you. I don't think advertising for genetic testing of this gene should be made public. I understand people need to know what they can do to prevent this disease but I believe it should be an individualized personal thing. These companies who advertise this idea receive a large amount of money to do this. Genetic testing is extremely personal and should not be seen as a way to make money. I would not go get genetic testing done because I saw a commercial for it on television. I believe this could be extremely harmful to the public. It could cause unnecessary anxiety and fear.

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  25. The movie we watched in class really put the situation into perspective for me. Women have tough decisions to make if you are a carrier. I don't think that BRCA 1/2 genetic testing should be widely advertised, because it may put societal pressures on women to get tested when they are really not ready for the possible results. As with the previous comment, I agree and do think it could cause unnecessary fear and harm to the public. Also, younger children would be exposed which could cause another set of anxiety issues.

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  26. I think it is important for people to know the risks. I do not think any of the facts or probabilities of getting the cancer should be kept from the people because i think it is important for them to know the truths. I do, however, believe that there would be an appropriate way to convey the risks in a manner that would not cause mass hysteria of people related to those with the mutation or the cancer. Gently informing the people who have family with the mutation or the disease that it would be very beneficial for them to get genetic testing would be the best approach. A possible pamphlet with all the needed information that highlights the fact that it is just a risk and not a certainty would work. I think it would be important for the pamphlet to demonstrate the need to seek a physician if you have any history of these things in order to talk about possible tests that could be done.
    I do understand what flipflopaly is saying when she writes about how it will cause too much anxiety and that it is best for people to avoid the anxieties associated with it, but i think it is better to know what could happen and make attempts in order to avoid any negative outcomes. Why would anyone want to put generations and generations at risk just in order to alleviate anxiety? But i do agree that it should not be in a television ad, i feel that if a doctor hears of a past history of the mutation, than they should be obligated to inform their patient of the possibilities with genetic testing. And maybe on tv or billboards they can stress the importance of seeing a doctor for everyone but especially of these people with the cancer or the mutation in the family.

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  27. I believe that we've come a long way in research and the expansion of knowledge about breast cancer risks and treatment. Breast cancer is no longer the 'mysterious disease' that it used to be, though it is still frightening in its nature. Extensive research combined with the fierce determination to find the ultimate cure have enabled women and men to become more aware of their predispositions as well as what actions they can take to potentially prevent the illness and even treat it at an earlier stage to prolong their healthy lives. Clearly, genetics and family history play a large role, given by how prevalent breast cancer has been among fellow relatives. Age is also a huge determinant, seeing as how older women have been more likely to develop the disease. The environment and individual behaviors have also been shown to affect breast cancer development. It is difficult to determine which risks are the greatest but I personally believe that all of them should be taken seriously. Screening is a necessary precautionary measure for potential carriers and should be taken into consideration also by women who do not appear to be at risk. I think it should be recommended by all doctors to their patients, whether they have a family history or not, and although certain advertisements, like those described in the article, do tend to overexaggerate the risks, it is certainly the better alternative to not emphasizing the risks at all. Screening advertisements should convey the most accurate information possible about the risk of developing breast cancer, describing the many different factors that contribute to the risk. Not only will this make people more aware of the specifics, but it will also likely reduce anxiety. The information being portrayed, whether through television commercials, billboards, or magazines, should not be too convoluted but more simplified to be effective and clearly understood by people.

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  28. I’m not sure that the statement “one in eight women will develop breast cancer” sends the right kind of message. With no given pre-text about the nature of that statistic, this may lead women to think that there is little they can do to prevent this inevitable disease from affecting them, instilling a fear of hopelessness. The truth, however, is that there are many factors that can influence whether or not a person develops breast cancer. And while I don’t oppose statistics, I believe that without some form of clarification, they can be very misleading. Similarly, having the BRCA 1/ 2 mutation does not ensure that one will develop breast cancer, although it may indicate a higher risk.
    Screening and early detection is always the best way of combating the effects of breast cancer before it worsens. As such, I think all women should be informed about the risk of breast cancer, regardless of whether or not they have a family history of breast cancer. In this instance, I think fear, though unnecessary or unwarranted as it may be, can turn out to be a positive influence and provoke individuals to have screenings done.

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