Sunday, December 14, 2008

Women Concentrate on the Wrong Organ (too)

Fear is an interesting concept that I hope to explore more in the future.

In a 2005 study by Women's Health Research, over 1000 women were asked - which disease they feared the most. I was rather surprised they found the fear of Breast Cancer more than doubled Heart Disease. While Breast Cancer caused approximately 3% of the US deaths in 2005, over 22 percent have the most fear for the disease. On the other hand, heart disease accounts for 28.6 percent of diseases and only 9.7 percent consider their top fear!! I know the US society has placed a higher emphasis of breasts over heart, but I can't say I expected this.

Fear Rank

Disease Women's Most Feared Diseases

Cause of Death in Women


Cancer (unspecified) 24.00%



Breast Cancer 22.10%



Heart Disease 9.70%



HIV/AIDS 9.30%



Alzheimer’s Disease 4.60%



Ovarian Cancer 2.70%



Lung Cancer 2.40%



Diabetes 2.40%



Colon Cancer 1.60%



Stroke 1.20%



So what are the possible explanations for this?

High Incidence?

-While the mortality of breast cancer is low, there is a significant amount of women living and bravely battling the disease. On the other hand, the same can be said about heart disease.

Feeling of Control
-While risk factors such as diet, obesity, and hormones have been established, the cause for breast cancer can still be considered quite a mystery. So most women likely believe that she could develop BC and don't have the power to control it. The risk factors for heart disease - (diet, physical activity, smoking) are a bit more established, so women's feeling of control may be stronger for CHD.

Public Exposure
-Another explanation is that breast cancer has had stronger activists, fundraisers, and lobbyists that push the disease into the mainstream. The general wisdom may be that since Breast Cancer is getting the same or more ad time than Heart Disease - women's risk of death are great for BC.

Age of Disease
Women may believe that they are more likely to get Breast Cancer at a younger age than Heart Disease. According to SEER the median age of dianosis is 61, while the median age of death is 69. For heart disease the average age of a first heart attack is around 70 years old (though the disease can be caught at a much earlier stage).

Women still believe it's a male disease
The stereotypical person with heart disease (at least in my mind) is an overweight, red faced guy in a suit. Women only comprise of about 25 percent of heart studies, and things like this need to change.

Heart disease kills about 8 times the women than Breast Cancer. The medical community needs to do a better job about expressing this risk. Maybe when people go to their primary doc, they should be asked this "what disease do you fear the most" question. Then the education can begin. Another idea is instead of counseling by doctor, people should have a "medical counclier" who discuss peoples risk of disease and what they can do for prevention. According to the Women's Heart fact sheet only 2 percent of the NIH budget is spent on prevention, and that is just flat out wrong .

2005 data from:
Women's Health Research

Women's Heart Fact Sheet


Demers said...

Lack of control would be my top choice for causing fear. Same reason people don't like flying on airplanes even though they are way safer than cars.

The other reasons you offer are good, too, such as publicity and age of disease onset / threat of losing a part of womanhood.

Do you think medical counselors would work? How do you propose such a system be set up? Where would the funding come from?

Are you suggesting that the NIH budget should be allocated according to death rates of diseases?

Dan said...

yeah the airplane analogy is a good one, it makes a lot of sense.

thinking about it a bit more, i think nurses could easily be used as medical counselors. Prevenative care should definetely be emphaized and talked about at length during a year check-up.

The NIH budget shouldn't be based just on the death rates of the disease. Of course other factors like Incidence, years of quality life lost, and potiential for improvement need to be taken into account. I'll get into that more with future posts.

Demers said...

I'd like nurses to do more than say, "you should" do this or "you should" do that. When the doctor told me to drink less, I told him, "you're right." But it wasn't anything I didn't already know, and my behavior didn't change until I decided I wanted to change it.