The White House went pink this month, awash for a night in rose-colored light. Delta Air Lines painted a huge pink ribbon on one of its planes, dressed flight attendants in pink, and has been selling pink lemonade to passengers. Police departments started using pink handcuffs. Ford is selling "pink warrior" car decals. Dick's Sporting Goods is offering free shipping on pink products including football cleats and batting gloves. Its slogan: "Sport your support. Together we'll turn the sports world pink."
Pinkwashing, as some breast cancer activists call it, has become an October rite, to "raise awareness" of breast cancer during what has for years been called National Breast Cancer Awareness Month. Those who promote the pink campaigns say they raise millions of dollars to fight the disease.
"When I see Delta flight attendants dressed in pink, I thank them," said Daniela Campari, senior vice president for marketing at the American Cancer Society.
But many women with breast cancer hate the spectacle.
"I call it the puke campaign," said Marlene McCarthy, the director of the Rhode Island Breast Cancer Coalition, who has metastatic breast cancer.
"Breast cancer awareness," critics charge, has become a sort of feel-good catchall, associated with screening and early detection, and the ubiquitous pink a marketing opportunity for companies of all types. For all the awareness, they note, breast cancer incidence has been nearly flat and there still is no cure for women whose cancer has spread beyond the breast to other organs, like the liver or bones.
"What do we have to show for the billions spent on pink ribbon products?" asked Karuna Jaggar, the executive director of Breast Cancer Action, an activist group whose slogan is "Think before you pink."
She concluded: "A lot of us are done with awareness. We want action."
Some broader women's health groups agree. "The pinkification of the month of October, from football cleats to coffee cups, isn't helping women," said Cindy Pearson, the executive director of the National Women's Health Network, an advocacy organization.
Such questions and skepticism come as some organizations are dialing back recommendations for the very screening measures the campaigns promote, recognizing that mammograms can lead to harm like overdiagnosis — finding and treating cancers that would never have become life-threatening — and false-positive results.
Others are starting to refine their message. On Oct. 2, the start of this year's Breast Cancer Awareness Month, the National Breast Cancer Coalition, a nonprofit group representing breast cancer groups across the country, put out a news release calling for "action, not awareness," and for channeling billions of dollars that pay for awareness campaigns toward research instead.
When it comes to pink, said Fran Visco, the group's director, "we don't want to be part of it."
The coalition's new campaign is called Breast Cancer Deadline 2020 and has a research component, the Artemis Project, that involves working with scientists and funding agencies on developing effective prevention measures (including a vaccine) — both primary prevention and prevention of metastasis in those who do get the disease. While the chance of success may be slim on the group's 2020 timetable, it is part of the organization's emphasis on science and research.
Certainly some organizations that receive money from pink campaigns spend at least part of it on research, but the campaigns have rarely made science their main focus. And how much of the money from pink products goes to any breast cancer cause at all is also unclear.
The Dick's Sporting Goods website notes, in fine print, that some of the companies selling the pink products it offers do not donate any money to breast cancer charities. (Dick's did not respond to a request to comment.) Some companies have a cap on how much they will donate, but consumers, when they buy the products, usually do not know if that cap has been reached.
The idea for a pink ribbon, which soon turned into extending pink to anything and everything, began 25 years ago with a 68-year-old California woman, Charlotte Haley, whose sister, daughter, and granddaughter had had breast cancer. Ribbons had by this time become a popular symbol of other causes — the AIDS red ribbon, the yellow ones to remember hostages. Haley decided to make her own peach-colored ribbon to draw attention to what she felt was paltry funding for breast cancer research.
Companies like Estee Lauder and Avon and organizations like the Susan G. Komen Foundation quickly realized that ribbons for breast cancer could be a powerful symbol. They substituted pink ribbons for Haley's peach ones.
A movement was born.
But the message has not always been consistent. The pink lights bathing the White House were supposed to make Americans aware that the Affordable Care Act covers recommended mammograms, Katie Hill, an assistant White House press secretary, said. And of course, to promote "awareness" of screening.
Some groups have a broad definition of awareness. In addition to the usual mammogram message, the American Cancer Society's goal is to promote the importance of exercise and the risk of obesity, and to heighten awareness of the group's programs to help women get the treatment they need, Campari said.
The cancer society's Making Strides walks for breast cancer raise $60 million a year to support breast cancer research, programs and services, reported Elissa McCray, the group's managing director for media relations. In the last six years, she added, the National Football League's "Crucial Catch" program contributed $8 million for screening, raising the money by selling pink merchandise.
At Avon, said Cheryl Heinonen, the president of the Avon Foundation, the money raised goes toward screenings for women who cannot afford them, and to providing care and support for women with breast cancer, including child care and transportation to medical appointments.
While Avon's campaign has an awareness component, Heinonen said, "our biggest emphasis is on care."
"I have concerns when I see programs focused only on awareness," she said.