When it comes to the medical question of how much damage is caused by 300-pound men knocking their heads together, the NFL
doesn’t believe in drawing hasty conclusions
. Uncertainty is part of the scientific process.
But the league doesn’t mind staking out a firm position when a debate falls much further outside its expertise. All month, the players and coaches are wearing pink accessories—chinstraps, wristbands, sideline ball caps—in the name of breast cancer awareness.
For football fans curious about the pink gear, there’s a page at NFL.com to explain it all . Breast-cancer awareness slogans cycle through the screen, in giant letters: BREAST CANCER IS THE MOST COMMON FORM OF CANCER AMONG WOMEN IN THE U.S… . RIGHT NOW THERE ARE MORE THAN 2.5 MILLION BREAST CANCER SURVIVORS IN THE UNITED STATES …
And then: WOMEN 40 OR OLDER SHOULD GET A MAMMOGRAM EVERY YEAR.
They should? Well, the American Cancer Society, the NFL’s partner in the breast-cancer campaign does say so . The U.S. Preventive Services Task Force, on the other hand, says that most women should start mammograms at age 50 and should get them every other year .
Mammography for women under 50 seems to very slightly improve the chance of detecting cancer. It greatly increases the chance of false positives and unnecessary biopsies. The dispute has to do with how to weigh those two things against one another.
Last year, when the debate between the rival recommendations was at its most heated, Darshak Sanghavi wrote here on Slate about the underlying disagreement over theories of risk management:
There are two broad ways to handle mammography for women under 50 years old: to treat them as homogenous and statistically naive (the cookie-cutter approach, usually favored by policymakers) or to assume greater patient savvy (the personalized approach, increasingly favored by clinicians and patients).
Sanghavi suggested that the blanket recommendation of annual mammography for women over 40 underestimated the public’s ability to handle the nuances of case-by-case statistical decision-making. Doctors and the press should consider the way that Americans discuss sports:
If the sports media have no problem filling newspapers and the airwaves with complex statistics—and often discussing them clearly—why do the health media treat the same consumers like innumerate dolts, especially when women’s lives are at stake?
Instead, the NFL has gone the other way. The U.S. Preventive Services Task Force isn’t getting any colored chinstraps to put out its side of the debate. Mammograms for everyone over 40. The American Cancer Society is sure this is the whole answer, and millions of viewers are getting the message. Awareness trumps information.