Evaluating a campaign to detect early stage breast tumors in the United States.

Growing concern over failure to detect early stage breast cancer has led communities across the United States to participate in the Breast Cancer Awareness Month program. This program mobilizes local public and private institutions, particularly the media, to reach a large audience each October with information on salutary behaviors, including screening, and on resources that can assist newly motivated audiences to adopt the behaviors. Although the scholarly literature includes no assessments of the effect of the program on the actual detection of early stage breast tumors, similar programs targeting other illnesses (e.g., AIDS) are quickly emerging. We attempt such an assessment by applying time-series designs to 92 quarters (beginning January, 1975) of data obtained from cancer registries in the Atlanta and Detroit metropolitan areas as well as in the San Francisco Bay Area. We find that the detection of in situ and local breast tumors increased in all three communities during the quarters that included Breast Cancer Awareness Month. We conclude that community mobilization may have its intended benefit but suggest that community organizers not ignore unintended costs including the emotional and physical sequelae of false positives.