公共卫生学院的brooke nickel和tessa copp博士写道，鼓励女性负责健康的公司和行业宣传可能会导致过度诊断和不必要的治疗。 几十年来，企业一直在使用女权主义的语言来宣传他们的产品。 在20世纪80年代，公司选择了关于女性自主的信息，以鼓励女性消费不健康的商品，如烟草和酒精。 如今，围绕赋权和妇女权利的女权主义叙事被市场干预所采纳，而这些干预在许多妇女健康领域都没有证据支持。 这包括商业公司、工业界、大众媒体和善意的倡导团体。 其中一些健康技术、检测和治疗在某些情况下是有用的，对一些女性非常有益。 然而，将其推广给一大群不太可能受益的无症状健康女性，或者在不公开其局限性的情况下，有弊大于利的风险。 这包括不适当的药物治疗、过度诊断和过度治疗。 在我们今天发表在《英国医学杂志》上的分析中，我们在目前的两个例子中检验了这一现象：抗苗勒管激素（amh）测试和乳房密度通知。 amh测试amh测试是一种与女性卵巢中卵子数量相关的血液测试，有时被称为“卵子计时器”测试。 尽管amh测试经常用于生育治疗，但它不能可靠地预测怀孕的可能性、怀孕时间或特定的更年期年龄。 因此，美国妇产科学院强烈反对对不寻求生育治疗的女性进行检测。 尽管如此，一些生育诊所和在线公司向甚至没有试图怀孕的女性推销amh测试。 一些人使用女权主义的修辞，承诺赋予权力，将测试作为一种获得对生育能力的个性化见解的方式。 例如，“你应该知道自己的生育潜力”、“积极主动地了解自己的生育能力”和“了解自己的数字将使你能够在计划生育时做出最佳决定”。 女权主义营销的使用使这些公司看起来具有社会进步性，是女性健康的倡导者。 但他们正在销售一种除体外受精外没有任何益处的测试，也不能告知女性目前或未来的生育能力。 我们最近的研究发现，在澳大利亚进行amh测试的女性中，约有30%可能是因为这些原因而进行的。 误导女性相信该测试可以可靠地预测生育能力，会造成延迟怀孕的虚假安全感。 它也会造成不必要的焦虑、冷冻卵子的压力、提前怀孕或在不需要的时候开始生育治疗。 如果你继续阅读，有些公司提到了测试的局限性，但它们被积极主动的呼吁和赋权的信息所掩盖和反驳。 乳腺密度通知乳腺密度是乳腺癌症的几个独立危险因素之一。 与脂肪组织比例更高的乳房相比，在高密度组织乳房的乳房X光照片上也更难看到癌症。 虽然估计值各不相同，但在乳腺筛查人群中，约有25-50%的女性乳房致密。 出于对癌症风险增加的合理担忧，倡导工作围绕女性知情权使用了女权主义语言，如“女性需要知道真相”和“女性可以处理真相”，以支持广泛的乳腺密度通知。 然而，这种简单化的信息忽略了这是一个复杂的问题，还需要更多的数据来确定通知并为乳房致密的女性提供额外的筛查或检测的好处是否大于坏处。 现在建议对乳房致密的女性进行额外的检查（超声波或mri），因为她们有能力检测更多的癌症。 然而，没有或很少提到缺乏有力的证据表明它可以预防癌症死亡。 这些额外的检测也有自付费用和高假阳性率。 大型国际倡导团体也得到了公司的赞助，这些公司将从通知女性中获得经济利益。 虽然增强患者的自主性是至关重要的，但在不说明其局限性或益处证据不明确的情况下进行乳房密度通知的宣传活动可能会与所寻求的授权背道而驰。 确保女权主义不被劫持提高对妇女健康的认识和倡导是克服医疗保健中性别不平等的关键。 但我们需要确保女权主义健康倡导的目标不会因为商业驱动的使用女权主义语言推动非基于证据的护理而受到损害。 这包括提高卫生技术、检测和治疗的风险和不确定性的透明度，以及加强对利益冲突的审查。 卫生专业人员和政府还必须确保提供基于高质量科学证据的易于理解、平衡的信息。 这将使妇女能够对自己的健康做出更明智的决定。 这篇文章最初发表在对话中，内容是：女权主义叙事被劫持，用于营销没有证据支持的医学测试。 这本书由悉尼大学公共卫生学院的brooke nickel博士和tessa copp博士撰写。 这本书由悉尼大学公共卫生学院的brooke nickel博士和tessa copp博士撰写。
corporation and industry promotions encouraging women to take charge of their health could lead to overdiagnosis and unnecessary treatment, writes dr brooke nickel and dr tessa copp from the school of public health.corporations have used feminist language to promote their products for decades. in the 1980s, companies co-opted messaging about female autonomy to encourage women’s consumption of unhealthy commodities, such as tobacco and alcohol.today, feminist narratives around empowerment and women’s rights are being co-opted to market interventions that are not backed by evidence across many areas of women’s health. this includes by commercial companies, industry, mass media and well-intentioned advocacy groups.some of these health technologies, tests and treatments are useful in certain situations and can be very beneficial to some women.however, promoting them to a large group of asymptomatic healthy women that are unlikely to benefit, or without being transparent about the limitations, runs the risk of causing more harm than good. this includes inappropriate medicalisation, overdiagnosis and overtreatment.in our analysis published today in the bmj, we examine this phenomenon in two current examples: the anti-mullerian hormone (amh) test and breast density notification.the amh testthe amh test is a blood test associated with the number of eggs in a woman’s ovaries and is sometimes referred to as the “egg timer” test.although often used in fertility treatment, the amh test cannot reliably predict the likelihood of pregnancy, timing to pregnancy or specific age of menopause. the american college of obstetricians and gynaecologists therefore strongly discourages testing for women not seeking fertility treatment.despite this, several fertility clinics and online companies market the amh test to women not even trying to get pregnant. some use feminist rhetoric promising empowerment, selling the test as a way to gain personalised insights into your fertility. for example, “you deserve to know your reproductive potential”, “be proactive about your fertility” and “knowing your numbers will empower you to make the best decisions when family planning”.the use of feminist marketing makes these companies appear socially progressive and champions of female health. but they are selling a test that has no proven benefit outside of ivf and cannot inform women about their current or future fertility.our recent study found around 30% of women having an amh test in australia may be having it for these reasons.misleading women to believe that the test can reliably predict fertility can create a false sense of security about delaying pregnancy. it can also create unnecessary anxiety, pressure to freeze eggs, conceive earlier than desired, or start fertility treatment when it may not be needed.while some companies mention the test’s limitations if you read on, they are glossed over and contradicted by the calls to be proactive and messages of empowerment.breast density notificationbreast density is one of several independent risk factors for breast cancer. it’s also harder to see cancer on a mammogram image of breasts with high amounts of dense tissue than breasts with a greater proportion of fatty tissue.while estimates vary, approximately 25–50% of women in the breast screening population have dense breasts.stemming from valid concerns about the increased risk of cancer, advocacy efforts have used feminist language around women’s right to know such as “women need to know the truth” and “women can handle the truth” to argue for widespread breast density notification.however, this simplistic messaging overlooks that this is a complex issue and that more data is still needed on whether the benefits of notifying and providing additional screening or tests to women with dense breasts outweigh the harms.additional tests (ultrasound or mri) are now being recommended for women with dense breasts as they have the ability to detect more cancer. yet, there is no or little mention of the lack of robust evidence showing that it prevents breast cancer deaths. these extra tests also have out-of-pocket costs and high rates of false-positive results.large international advocacy groups are also sponsored by companies that will financially benefit from women being notified.while stronger patient autonomy is vital, campaigning for breast density notification without stating the limitations or unclear evidence of benefit may go against the empowerment being sought.ensuring feminism isn’t hijackedincreased awareness and advocacy in women’s health are key to overcoming sex inequalities in health care.but we need to ensure the goals of feminist health advocacy aren’t undermined through commercially driven use of feminist language pushing care that isn’t based on evidence. this includes more transparency about the risks and uncertainties of health technologies, tests and treatments and greater scrutiny of conflicts of interests.health professionals and governments must also ensure that easily understood, balanced information based on high quality scientific evidence is available. this will enable women to make more informed decisions about their health.this article was original published on the conversation as: feminist narratives are being hijacked to market medical tests not backed by evidence. it was written by dr brooke nickel and dr tessa copp from the university of sydney school of public health, university of sydney. .
