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Sexualization of awareness: Catchy, but does it actually increase knowledge about breast cancer?

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campaigns about breast cancer. Many of these campaigns are highly sexualized, focusing on the breasts as an object of fun, as opposed to focusing on information about prevention/diagnosis/treatment. In spite of their popularity, it is unknown what effect they actually have on knowledge about breast cancer, particularly in their target audience relationship of awareness of breast cancer campaigns and their knowl-edge of the risk factors, symptoms, and detection of breast cancer and ness of campaigns was positively correlated with knowledge of symp-toms and diagnostic methods, it was not related to accurate knowledge of risk factors. Further, there was a difference in knowledge between awareness is an admirable goal, it does not appear that the sexualized campaigns are doing more than titillating young adults, while the more staid but informative campaigns do appear to improve knowledge. Fu-ture research should examine whether the sexualized campaigns in-crease interest in attaining knowledge. Since Betty Ford's announcement that she was undergoing treatment for breast cancer in versal public silence about the disease, there has been a tremendous increase in public awareness is proactive behavior by women: women today are likely to discuss breast health with their doctors, receive screening measures regularly such as an annual mam-mogram, and breast cancer is most often diagnosed in the earliest, most treatable stages women will be diagnosed with breast cancer a distressingly high number, and the number of women diagnosed annually has been steadi-certainly due to the increase in women receiv-ing annual mammograms. Mammography, the screening of choice for most American women and their health insurance providers,
234
SEXUALIZATION OF AWARENESS:
CATCHY, BUT DOES IT ACTUALLY INCREASE KNOWLEDGE
OF BREAST CANCER?
MELINDA C. R. BURGESS
ASHLEY B. MURRAY
Southwestern Oklahoma State University


campaigns about breast cancer. Many of these campaigns are highly
sexualized, focusing on the breasts as an object of fun, as opposed
to focusing on information about prevention/diagnosis/treatment. In
spite of their popularity, it is unknown what effect they actually have
on knowledge about breast cancer, particularly in their target audience
    
relationship of awareness of breast cancer campaigns and their knowl-
edge of the risk factors, symptoms, and detection of breast cancer and
-
ness of campaigns was positively correlated with knowledge of symp-
toms and diagnostic methods, it was not related to accurate knowledge
of risk factors. Further, there was a difference in knowledge between
        
        
awareness is an admirable goal, it does not appear that the sexualized
campaigns are doing more than titillating young adults, while the more
staid but informative campaigns do appear to improve knowledge. Fu-
ture research should examine whether the sexualized campaigns in-
crease interest in attaining knowledge.

Since Betty Ford’s announcement that she
was undergoing treatment for breast cancer in
       -
versal public silence about the disease, there
has been a tremendous increase in public
 
  
awareness is proactive behavior by women:
women today are likely to discuss breast
health with their doctors, receive screening
measures regularly such as an annual mam-
mogram, and breast cancer is most often
diagnosed in the earliest, most treatable stages

   
women will be diagnosed with breast cancer

a distressingly high number, and the number
of women diagnosed annually has been steadi-

        
certainly due to the increase in women receiv-
ing annual mammograms. Mammography,
the screening of choice for most American
women and their health insurance providers,
Sexualization of Awareness / 235
has been hailed as the one tool guaranteed to
save women’s lives by diagnosing cancer in

As screening has become more common
and there has been an associated increase in
    

not nearly as clear-cut. Some sources point to

-
knowledge that the death rate, approximate-
     
      
       
     
precisely this disparity between one tumor
diagnosed and whether one life will be saved
that is so concerning.
    
questions the oncology community grapples
with, our primary question was whether the
increased public discussion of breast cancer
and proliferation of awareness campaigns,
particularly those utilizing sexualization, has
actually increased the young adults’ knowl-
edge and understanding of breast cancer.
     
sexualization of girls and women in the me-
    
when “a person’s value comes only from
their sexual appeal or behavior”, and when
they are “made into a thing for other’s sexual
      

 
      
been labeled as such by schools, journalists,

Mass media can claim a portion of the
responsibility for facilitating the discussion
of breast health, but not all media coverage
      
coverage is clearly linked to increased fear
and misinformation as opposed to accuracy.
For example, unbalanced and incomplete
coverage of vaccinations by the media has
been linked to parents’ decreased belief about
    
  

have almost certainly been a factor in the re-
cent increase in cases of whooping cough and

If one looks at breast cancer media cov-
    
breast cancer awareness campaigns may be
more common, but that does not mean their
information is accurate or that the information
related to treatment and diagnosis is included
in the messages. An early content analysis
of American women’s magazines found that
breast cancer coverage followed three general
themes: coping, personal experiences and risk
     
     

  -
bered lung cancer and tobacco use aware-
ness articles. And, consistent with American
women’s misperceptions that breast cancer is
more dangerous than lung cancer, despite the
increase in lung cancer mortality, there was no
corresponding increase in lung cancer/tobacco
articles. There was however an increase in
breast cancer articles during this time when
breast cancer mortality was not increasing.
Also, a recent content analysis of commercials
purporting to raise awareness about breast
      
the commercials for breast cancer, as opposed
to heart disease, were less likely to report sta-
tistics, but more likely to portray women in

A more recent trend in the literature is to
examine what women actually know about
     
surveyed several thousand women through
two surveys and found a number of misun-
derstandings about breast cancer in American
women. First, women incorrectly applied the
236 / College Student Journal
lifetime incidence statistics of developing
breast cancer to their own age group. Second,
over two thirds of the women mistakenly
believed that breast cancer was the leading
cancer killer of women, as opposed to lung
cancer. Third, the women also erroneously
believed that breast cancer killed more wom-
en than heart disease. Fourth, over half of the
women believed that mammography reduced
the incidence of breast cancer, as opposed to
merely detecting it. These errors are particu-
larly troubling given that heart disease is the
leading killer of women in America and kills
 -

leading cancer killer and both of these condi-
tions have numerous preventable risk factors.
  
erroneous perceptions of risk from breast
cancer would lead women to neglect the more
threatening health conditions of heart disease
and lung cancer, and this was indeed support-
ed in their data.
     
     
        
thirds of their sample erroneously named
breast cancer as the leading cancer cause of

that awareness of anti-smoking messages was
related to an increased accuracy in identifying
the leading cancer killer of women.
     -
veyed college women and their mothers to
examine perceptions of breast cancer risk and
the relationship between those perceptions
and various media messages. They found that
women who had been exposed to media re-
ports about genetic contributions to breast can-
cer were more likely to agree that breast cancer
has a strong genetic component. The women
who were exposed to media messages touting

likely to underestimate risk, suggesting that
perhaps they were making a similar mistake
       -
takenly believing that mammography reduces
the incidence of breast cancer, as opposed to
merely providing earlier detection.
Only recently have there begun to be cri-
tiques of the media coverage of breast cancer.
One line of criticism is focused on the political
message behind much of the breast cancer
presentations. Increasingly there appears to
be a ‘correct’ way to be someone diagnosed
      

    
the disease are to be cheery heroes who have
emerged as victorious ‘survivors’ through their
courage, faith in the medical community and
they should proudly present us with their new

through the use of the plethora of pink products
to be purchased by willing corporate sponsors.
One of the more socially distressing compo-
nents of these portrayals is that the survivors
are nearly always “youthful, ultra-feminine,
   
      
of one of the more perplexing components of
breast cancer: the death rate for Black wom-


A second line of criticism focuses on the
increasing consumer mentality of breast can-
    
       
breast cancer. Millions of dollars are spent
each year, particularly in October, which has
     
   
it is not possible to know how much money
companies are raising, nor to what purpose


  
       
chin straps, sell sporting goods doused in
        
Sexualization of Awareness / 237
      
     
       

Part of this increasing consumer mental-
ity surrounding breast cancer is the virtual
cottage industry of breast cancer awareness

      
     
the well-established, and long running com-
munity fundraisers with a well documented
 
        
to the more questionable things such t-shirts
and bracelets sold to high school and college
students with such clever slogans as “Save
Second Base” or “
    
raised awareness that breast cancer is a signif-
icant concern for women, with the afore-men-
tioned common misunderstandings about
      

to investigate how much actual knowledge
about breast cancer/health was associated
with familiarity with these campaigns.
Our research questions were as follows:
      -
ness campaigns are young adults fa-

 R2: How many breast cancer aware-
     

 R3: How many breast cancer risk fac-
  
   -
lated to awareness of the breast cancer

 R4: How many breast cancer symp-

   -
lated to awareness of the breast cancer

 R5: How much do young adults know
about breast self-exam and mammog-
     
this knowledge related to awareness of

      
symptoms and breast self-exam/mam-
mography differ by familiarity with
the prototypical sexualized campaign
       -
   
     
     

chosen as prototypes because of their
popularity as well as the disparity of
their websites at the time these data
    
featured a plethora of information about
breast cancer while at the time these data
    
   

where to purchase the bracelets.
Methods
Participants. 285 psychology and health
and physical education students from a me-
dium sized southwest regional university
completed the survey as credit for partial
completion of a course requirement or extra
credit. To receive credit, students simply
had to sign the consent form, which resulted
      
which had to be excluded from the analyses.
 
SD =

  
      
These demographics are consistent with both
      

Materials. Students were given a packet
     
238 / College Student Journal
the two primary risk factors for breast cancer

to check correct breast cancer symptoms
embedded in a list with distracter, incorrect


correct items were “A breast lump,” “Bloody
     
the skin over the breast, such as dimpling.”
Examples of the distracter items include


questionnaire to assess their knowledge
about breast self-exam, mammography and
    
      
as “If you are post menopausal how often
    
“Mammography can detect tumors that can’t
be felt.,” “Breast self-examination should be
performed during your period when lumps
are most easily detected.”
To test whether students were aware of
breast cancer campaigns, they were asked to
   
     -



Finally, they were asked to provide the
following demographics: age, race, sex, and
to check from a list the products they owned
     
breast cancer in some way, and to name any
   
supported.
      
correlational study measuring the relationship
between knowledge of breast cancer aware-
ness campaigns and knowledge of breast
cancer and breast health. All participants were
treated in accordance with APA’s guidelines
for the ethical treatment of human subjects
and the university human subjects review
board approved the study.
Results:
     
     

    
SD = 
cancer awareness campaigns listed.
 M   SD =   -

MSD = t 
p
R2: How many breast cancer awareness


    SD = 
cancer awareness products on average. This
also differed by sex, t p
 M  SD =  
MSD = 
R3: How many breast cancer risk factors

Students were overwhelmingly unaware
of the 2 biggest risk factors for breast cancer


 
knew only one risk factor and none of the stu-
dents knew both risk factors. The most com-
 

   
     
females correctly identifying one risk factor
df     p >
Cramers V 
r
p
R4: How many breast cancer symptoms
 -


     SD =
       
    
did not differ by sex t p
Sexualization of Awareness / 239
but knowledge of symptoms was related to

r 
R5: How much do young adults know

      
SD =    -
ed to breast self-exam and mammography.
    t   
p   SD
=      -
SD = 

the campaigns, r p
-
toms and breast self-exam/mammography
differ by familiarity with the prototypical sex-
 
-
   


did not differ by type of campaign awareness
  F    -
mography Fp
-
mography did differ depending on which
campaigns students were aware of F
 p    -
 SD =

      
SD =     
 SD
= 
Men were disproportionately more likely

     
were disproportionately less likely to know
    
      
 df      p <
Cramer’s V

This study found that knowledge of breast
cancer awareness campaigns overall is incon-
sistently related to knowledge about breast
      
identify, the more symptoms they could accu-
rately identify, and the more they knew about
mammography and breast self-exam. Howev-

correctly identifying risk factors. Addition-
ally, when campaigns were examined using

    
     
      
        
Boobies were more knowledgeable, and this
knowledge was limited to a better understand-
ing of mammography and breast self-exam,
which makes sense, considering that increas-
ing both of these are two central missions of



a substantive increase in knowledge, outweigh
the cost of sexualizing and objectifying wom-

      


message couldn’t be seen while they were at
    
     
some judges agreed that the bracelets were too

Previous research has not looked at the
association between breast cancer awareness
campaigns and knowledge of breast cancer.
Although breast cancer affects predominately
women, awareness is solicited to both women
and men. Additionally, many awareness cam-
paigns seem to be geared towards young men
with the use of ever-increasing sexualization
     -
tic. It has been suggested that the advertisers
240 / College Student Journal
    
sexualized advertisements to sell products to

It is important to note that our results indi-
cated that virtually none of our students could

factors for developing breast cancer: age and

  
       


able to indicate understanding about these
      -
cally interested in what they perceived as the
two most important risk factors. By wording
the question the way we did, we were able
to gain some valuable insight into what col-
lege-aged adults have absorbed about breast
cancer. A clear majority believed that family
history is the most important risk factor. This
is important knowledge for two reasons. First,
      
       
     
important, if young women believe that he-
redity is the most important risk factor, and
they themselves do not have a relative with
breast cancer, do they develop a false sense
of security and become unconcerned with be-
haviors that are in fact linked to breast cancer

     
campaigns which emphasize the breasts and
appearance as opposed to health, contempo-
rary breast cancer television commercials
      
      
appearance focus alters the perceived compe-
tence of a woman by others. Further, viewing
sexualized imagery of women leads people
   
-

   
    
treatment of breast cancer patients by medical
 

are important issues to consider in light of the

Furthermore, research should investigate if
 
to breast cancer campaigns affect the way peo-
ple think about women in general. Additionally,

change women’s view of treatment options.
For example, choosing between mastectomy
versus lumpectomy, or mastectomy followed
by breast implants afterwards, even though
the implications of this are that breast implants

breast cancer screenings to be administered
-
search has found that some women may choose
to undergo a less radical treatment if they are
     -
ture research needs to examine whether there
is a difference in how young adults think about
treatment options depending on whether they
are presented with a more knowledge based
campaign or the more sexualized campaigns.
This is particularly important to examine since
breast cancer is particularly deadly in young

the very women for whom breast preservation
might be most concerning given child-bearing
issues and the emphasis on appearance for

It could be argued that the use of sexual
imagery helps memory of the product and
by sexualizing breast cancer awareness more
people will pay attention and remember the
advertisements. However, previous research
has found that using sexualized imagery in ad-
vertising is not associated with better memory
   -
ly, something like a shirt that says “Treasure
     
for people to remember.
Sexualization of Awareness / 241
    
have been seemingly ineffective in increasing
     

campaigns have been shown to be effective in
changing consumers’ behaviors. An analysis of
state and local tobacco cessation awareness cam-
paigns found that these awareness campaigns
have in the past led to a decrease in tobacco

health campaign has reduced drunken driving
      

In some instances, a reduction of drunk-driving

    
true understanding and change risky behav-
iors. Breast cancer campaigns should use
these successful programs as models. Al-
though breast cancer awareness campaigns
do not appear to increase people’s knowledge
about breast cancer, future research should
examine whether these campaigns change
women’s health behaviors, such as increasing
breast self-exams, exercise, and healthy diets.
The enthusiasm and effort expended in
promoting breast cancer awareness and the
research is commendable. Much of this is due
to the grass roots efforts of those who sought
to make breast cancer information available
to everyone, and to raise awareness of the
need for increased funding and research for
the disease. Early pioneers in this process
worked to remove the stigma from the disease
thereby encouraging women to discuss breast
health with their doctors, to engage in breast
self-exams, and to talk to other women about
the condition, and more recent campaigns
have worked to further the original efforts.
The results of our study and previous re-
searches suggest that the advertisements and
campaigns might be more effective if they
    
recommendations for screening and other
healthy behaviors.

A crucial catch    
com/pink

     
  http://www.cancer.org/acs/groups/cid/

    Breast can-
cer - mammography statistics. Retrieved
    http://www.cancer.org/
research/cancerfactsfigures/cancerfactsfigures/
breast-cancer-mammography-statistics

health with a sense-making approach: Magazine
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munication, 13
       
programs do not sell products in advertisements.
Psychological Science, 16
      -
  

or Radically Refashion Fraser. Denv. UL Rev., 90,

Cancer bracelets raise debate over school
codes     

cancer-bracelets-raise-debate-school-codes/
Cause marketinghttp://thinkbefo-

-
tions of the risks of age-related diseases, including
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       
MissRepresentation


       -
   
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
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  -
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    
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     -
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State and county quickfacts.
Retrieved from website: http://quickfacts.census.
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     

Report of the APA Task Force on the Sexualization
-
 
pi/wpo/sexualizationrep. pdf.
... Hierbij spelen gezondheidsprofessionals en media een belangrijke rol, maar ook opleidingen zouden studenten moeten informeren en moeten stimuleren tot gezondheidsbevordering [3] . Het blijkt dat verschillende vrouwelijke studenten wereldwijd (te) weinig kennis hebben over borstkanker en zijn risicofactoren [5][6][7][8][9][10][11][12][13][14][15][16][17] . Ook is er nauwelijks sprake van risicoreducerend gedrag omtrent dit onderwerp [8,9,13,16] . ...
... De enquête is opgesteld en geoperationaliseerd aan de hand van de bestudeerde literatuur [2,3,[5][6][7][8][9][10][11][12][13][14][15][16][17] . Door een informed consent formulier werd men geïnformeerd over het onderzoek. ...
... Met een marge van 3,8 tot 97,5% per factor zegt 37,3% kennis over risicofactoren niet zoveel, behalve dat kennis hierover matig is. Velen wisten vaak niet met zekerheid het juiste antwoord en vulden daarom 'weet ik niet' in, net als in eerdere studies [8,11,14] . 'Zeker weten' is in dit onderzoek trouwens relatief, want er kon ook sprake zijn van goed gokken, ondanks dat werd gevraagd dit niet te doen. ...
Article
SAMENVATTING Dit cross-sectionele onderzoek beschrijft de mate van kennis en gedrag van vrouwelijke studenten ten aanzien van risicofactoren voor borstkanker. Aan dit onderzoek deden 158 van de 532 studenten van de academies voor Zorg & Welzijn en Educatie & Pedagogiek van de HZ mee. Bij de meerderheid van de respondenten is er een gebrek aan kennis over de borstkankerrisicofactoren. Professionals kunnen door voorlichting te geven kennis vergroten en aanzetten tot gezonder gedrag. Dit kan bijdragen aan leefstijlaanpassing en resulteren in risicoreducerend gedrag. Het advies is om het risicobewustzijn te vergroten op en door de hogeschool.
Article
Full-text available
Background: Many misconceptions about breast cancer exist. College students have the opportunity to perform breast cancer risk-reducing behaviors. Purpose: The purpose of this study was to assess breast cancer knowledge among university students and examine the influence of breast cancer knowledge on health behaviors for breast cancer prevention. Methods: Data were collected via survey in which students were asked about health behaviors and 20 true/false statements about breast cancer. Results: College students were unable to accurately identify all truths and myths about breast cancer. The overall mean knowledge score for the sample was 10.59 (SD = 2.865), based on a potential range of 0–20 correct answers. Breast cancer knowledge was significantly influenced by race. Results of Pearson correlation coefficients indicated an inverse correlation between breast cancer knowledge and health behaviors. Discussion: Lack of accurate breast cancer knowledge is consistent with current literature. Health communication alone may not be enough to effect behavior change. Translation to Health Education Practice: This study provides valuable insights into knowledge about breast cancer and associated behaviors among college students. Knowledge, as well as other determinants of behavior, should be examined for their effects on breast cancer prevention. Sources of knowledge available to college students should contain valid information.
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