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The Guardian - UK
The Guardian - UK
Politics
Andrew Gregory Health editor

Global awareness of women’s health being ‘hijacked by vested interests’

A radiologist checking mammograms for breast cancer.
A radiologist checking mammograms for breast cancer. The experts said that breast density notifications that accompany screening are being used to promote additional screening without robust evidence that it prevents breast cancer deaths. Photograph: Damian Dovarganes/AP

The global drive to increase awareness of women’s health is being hijacked by major corporations promoting flawed or ineffective tests, treatments and technology, doctors and public health experts have warned.

Boosting advocacy around female medical conditions is seen as crucial to reverse decades of sex inequalities in healthcare worldwide.

But feminist health narratives are increasingly being co-opted by commercial interests to market products or interventions that are not backed by evidence, said researchers writing in the BMJ.

One example cited is a hormone test marketed to women with phrases such as “information is power and lets you take charge of your fertility” – despite clear evidence that the test cannot reliably predict a woman’s chances of conceiving.

The surge in marketing risks harming women through inappropriate medicalisation, overdiagnosis and overtreatment, said Dr Tessa Copp, a public health researcher at the University of Sydney, Dr Minna Johansson, a GP in Gothenburg, and colleagues.

They raised concerns about over-simplistic health messages claiming that any knowledge is power, and urged health professionals and governments to ensure that easily understood, balanced information was available based on high quality scientific evidence.

“Women’s health is vital and cannot be allowed to be hijacked by vested interests,” the group of public health researchers, GPs and women’s health advocates wrote.

“Health consumers and clinicians need to be wary of the simplistic narratives that any information and knowledge is always power. We need to ensure the goals of feminist advocacy are not undermined through commercially driven use of feminist discourse pushing non-evidence-based care.”

Companies have historically exploited health agendas by co-opting messaging about female autonomy to encourage women’s consumption of unhealthy commodities like tobacco and alcohol, they wrote. But this phenomenon has now expanded across women’s health.

“Importantly, the problem is not with the use of health technologies, tests and treatments per se, as many women benefit greatly and gain improved quality of life from them,” they said.

“The problem lies in the way commercial marketing and advocacy efforts push such interventions to a much larger group of women than is likely to benefit without being explicit about their limitations.”

They cited two examples of how feminist discourse was being hijacked to push non-evidence-based healthcare to healthy women.

The first was the anti-müllerian hormone (AMH) test, which measures levels of AMH in the blood, linked to the number of eggs in a woman’s ovaries.

The test does not reliably predict the chance of conceiving but fertility clinics and online companies globally are marketing it to the general public suggesting as much, the experts warned.

The researchers pointed to examples of feminist rhetoric promoting the AMH test online. “You’re not ovary-acting,” one website said. “Understand your hormones and fertility, be the boss of your symptoms and get the expert care you deserve-every step of the way.”

Misleading marketing encouraging women with no signs or symptoms of infertility to seek AMH testing to check their fertility or inform family planning “ultimately undermines empowerment and informed decision making as the evidence to date shows the test is invalid for these purposes,” the researchers wrote.

The second example cited was the view that all women having screening should be notified about their breast density, one of several independent risk factors for breast cancer.

Arguments emphasise women’s “right to know” but the researchers warned that breast density notification was being used to promote additional screening without robust evidence – and without mentioning the lack of evidence – that it prevents breast cancer deaths.

Breast density notification can also increase women’s anxiety, confusion and intention to seek additional screening, while the unreliability of breast density measurement is another concern, they added.

Some have argued that technological advances, more information and increasingly individualised care can still advance women’s knowledge and health even when there is no clear evidence that the benefits outweigh the harms.

But while the researchers said they fully supported stronger patient autonomy, they suggested that marketing for interventions without stating the limitations or unclear evidence of benefit “risks causing more harm than good and therefore may go against the empowerment being sought”.

In conclusion, they say: “We need to ensure the goals of feminist health advocacy are not undermined through commercially driven use of feminist discourse pushing non-evidence based care.”

In a linked editorial, Sarah Hawkes, a professor of global health at University College London, said that in recent years “a different perspective on women’s health has taken hold” across medicine, namely “women’s health as a source of profit”. She argued that women “should draw on the power of collective action” to hold major corporations promoting non-evidence-based medical tests or treatments to account.

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