“Check ’em Tuesday” and CoppaFeel campaign strong on promotion, weak on evidence

Newspapers that get involved in screening campaigns usually demonstrate that they don’t understand the limitations of screening.

The latest example is The Sun of the UK, with its “Check ’em Tuesday” campaign.

The Sun has a thing for breasts.  It puts topless women in its regular Page 3 feature.  And, as you see, it cross-promotes Page 3 toplessness and “Check ’em Tuesday.”

The Sun goes on to urge women to:

“Check ’em and share pics.”

ONCE you’ve checked ’em, post ’em.

Put your snaps on Facebook or on Twitter and Instagram using the hashtag #checkemtuesday

In the BMJ, Dr. Margaret McCartney wrote: “Why the Sun’s breast check campaign may actually harm women.” Excerpt:

Teaching women to examine their breasts regularly has been shown not to reduce deaths from breast cancer and actually increases the chances of a benign biopsy result. It is unfair to tell women that regular self examination will save their lives when it may simply incur anxiety and have the potential to harm. Sound bites, beyond the safety of scientific qualification, can denature evidence.

This is just one aspect of a bigger move to promote untested “breast awareness.” The charity Breakthrough Breast Cancer, which is not connected to the Sun‘s campaign, tells women to “touch, look, feel” regularly and advocates “knowing what your breasts look and feel like normally” as well as being able to name “the 5 signs of breast cancer.” NHS Choices suggests that women should examine their breasts at different times of the month in the shower or bath and lists nine changes to “look out for” and to “look and feel.” The charity CoppaFeel, which is involved with the Sun‘s campaign, offers text message reminders to prompt women to do a regular self examination.

The reason for so much confusion is the lack of acknowledgment of the current uncertainty. Yet it would be possible to run a randomised trial to see whether promoting “breast awareness” has benefits and what it should consist of.

Publicity campaigns that claim to be “against cancer” seem to get past much critical challenge, to our collective disadvantage. Public health messages should be based on evidence. Their effects need to be proved to affect behaviour in a way that is helpful and not harmful. When medicine mixes with public relations and media campaigns, citizens and patients risk being short changed because their interests are vastly different.

If we fail to critically evaluate campaigns on cancer, we create the appearance of doing something useful while potentially distracting from what might really help. In doing so we potentially harm the very women we’re purporting to help. The Sun‘s primary interest is in selling papers; so what are the charities’ and the NHS’s excuses?

The Sun responded to Dr. McCartney’s BMJ column, with a non-evidence-based rebuttal claiming that its campaign will, indeed, save lives. The campaign clearly demonstrates a mastery of promotion and marketing.  It’s too bad such efforts and energy aren’t redirected to disseminating evidence-based health care information to the public.

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