Q: In this task, you are given a text of many news articles seperated by special token "|||||". Your task is to summarize them.
I'm a physician who has had concerns about National Breast Cancer Awareness Month for years. They persist despite my wife's breast cancer diagnosis a decade ago (for the record, she's fine and shares my concerns).I worry that the campaign has led women to be more fearful of breast cancer than they need be: the "1 in 8" or "1 in 9" statistic, in particular, serves as a poster child for how to exaggerate risk (both because it encompasses an entire lifetime and because it's not the chance of dying but of being diagnosed). Equally troubling is the relentless promotion of screening mammography as the solution.That the campaign's principal founder is a manufacturer of breast cancer drugs doesn't make me feel any better. Nor does the appearance of pink as a fall color in the National Football League Knowing my concerns, a reporter recently asked me, "What do you think women should be aware of?" Here's my list:1. Breast cancer is an important cancer If nonsmoking women want to worry about any cancer, breast cancer is the one to worry about. The reason is simple: It's the cancer they are most likely to die from. But this risk should be kept in perspective: A woman's chance of dying from breast cancer in the next 10 years is in the range of two per 1,000 (if you are age 40) to 10 per 1,000 (if you are age 75). And always consider the flip-side of these statistics: The chances of not dying from breast cancer in the next 10 years are 990 per 1,000 — or better.If you are a woman who smokes, worry about lung cancer instead, and heart disease 2. There is a serious debate about the value of screening mammography.You know this. But what you might not know is that this debate persists despite 50 years of research involving more than 600,000 women in 10 randomized trials, each involving about 10 years of follow-up. No screening test has been more exhaustively studied.That the debate persists in the face of this wealth of data tells you something: Screening mammography must be a close call. (Note that doctors don't debate about the value of treating really high blood pressure ; that issue was settled more than 40 years ago with a trial of less than 200 men in less than two years).The reason screening mammography is a close call is simple: It produces both benefit and harm. The combination of heightened awareness and increased screening has undoubtedly led to more breast cancer diagnosis. And a very few women have benefitted by avoiding a breast cancer death. More, however, have been harmed by unneeded surgery, radiation and chemotherapy for small "cancers" that would not have been found without the mammogram and would never have caused problems. Many more have been caught in cycles of testing, abnormal results, biopsies and worry.3. Screening mammography is your decision, not your physician's.Although it's hard to know how widespread the problem is, a number of women have shared with me that they have been frightened ("Don't you want to live?") or guilted ("Don't you care about your family?") into being screened. And it gets worse. One told me that her doctor said she could no longer be a patient if she didn't accept screening. (Imagine my mechanic saying he would no longer work on my car if I wasn't willing to have him check my coolant system for leaks.)To be fair to my primary care colleagues, such coercive practices may not reflect their own beliefs but rather that they too are being coerced. Ensuring that all women are screened has become one of the most prominent metrics in healthcare "report cards." There are practical reasons for this: It is easy to measure, easy to understand and hard to argue against. So regardless of what informed women want, it gets done (remember, we doctors got into medical school because of our ability to get good grades).Screening is a choice. Those who like mammography and want to do everything possible to avoid a breast cancer death should feel good about doing it every year if they wish. Those who don't like the procedure or the prospect of being turned into a patient unnecessarily should feel equally good about not doing it or doing it less often or starting it later in life.4. Unlike screening mammography, there's no debate about diagnostic mammography.Doctors agree about what to do when a women (like my wife) notices she has a new breast lump: Get a mammogram. Diagnostic mammography is the technology we use to figure out what the lump is. That's not screening; that's diagnosis. And no one argues about it.5. There have been real improvements in breast cancer treatment.Its odd how much we hear about breast cancer detection, when the real question is how well we can treat it. All the focus on screening has overshadowed a more important story: Breast cancer treatment has improved over the last 50 years. Breast cancer surgery has gotten a whole lot more sane. Radical mastectomy is largely gone, and more women are given a choice between simple mastectomy and breast-conserving surgery.But arguably the biggest improvement involves adjuvant therapy, the chemotherapy and hormonal therapy that follows surgery. After summarizing 194 randomized trials, the international collaboration of Early Breast Cancer Trialists concluded that the addition of adjuvant therapy cuts the breast cancer death rate in half. That's huge.6. Too much disease awareness may not be good for your health.Breast Cancer Awareness Month serves as a prototype for "disease awareness" campaigns. Too often these morph into campaigns to find things wrong with healthy people. Our medical care system is extremely capable in this regard. We can detect miniscule abnormalities in the body's anatomy and its chemical milieu. And, as if that's not enough, we increasingly change the rules to narrow the definition of "normal": Lower blood pressures have become hypertension, lower blood sugars have become diabetes Many interests are served by this behavior. But that may not include yours. That's because health means more than the absence of abnormality. Health is also about how people feel; it's also a state of mind. And it's hard to feel good when things are constantly being found wrong. Pursuing health, ironically, may require that we not pay too much attention to it.H. Gilbert Welch is a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and an author of "Overdiagnosed: Making People Sick in the Pursuit of Health." ||||| Salon/iStockphoto 
  
 It's October again. There's a brisk nip in the air, leaves are starting to tumble from the trees, and half of all your usual consumer goods are now cotton candy colored. Welcome to another breast cancer awareness month. 
  
 For over 25 years now, thanks to the efforts of organizations like the Susan G. Komen Foundation and the Avon Foundation for Women, one of the most pervasive -- and deadliest -- diseases to strike women has become an important topic for research, detection and public awareness. No doubt all that advocacy has played a part in the sharp decline in breast cancer rates over the past decade, an encouraging sign for all of us who possess breasts -- and for our daughters. But as breast cancer awareness becomes an increasingly pervasive branding opportunity, perhaps it's time to consider what the glut of pink says about our attitudes about the meritocracy of disease, and the ways in which we dispense compassion. 
  
 That breast cancer is a serious health issue -- one that shows a keen favoritism for my own demographic -- is undeniable. In the past two years alone, four women in my not very large social circle have been diagnosed, one of whom died the day after her daughter finished kindergarten. So I know, in a painfully firsthand way, the dominant image of breast cancer. It's moms. Moms who generally haven't done much more to attract the disease than be female and draw a genetic short straw. It's hard to argue with the injustice of that. 
  
 Yet plenty of other deadly diseases get considerably less attention. The leading non-accident-related cause of death in America is heart disease, frequently a diet and lifestyle-related problem that only recently has gained traction as its own important cause. And how? By taking a cue from breast cancer and dressing it up as a women's issue with a fashionable color. It bears noting that the prevailing icon of heart disease isn't that of an obese male; it's a slim red dress. And as you're sipping your blush-tinted Sutter Home Wine for Hope, remember that the American Cancer Society estimates that this year lung cancer will kill triple the number of Americans that breast cancer does. The combined cancers of the genitals, including ovarian, cervical and prostate cancer, will kill about 20,000 more individuals than breast cancer. The CDC meanwhile estimates that over 1 million Americans are HIV positive, and that one in five is unaware of the infection. And alcoholism, addiction and depression will this year continue to kill not just via the overt channels of overdose and suicide, but in their brutal toll on overall health. 
  
 When we talk about disease, our capacity for goodwill seems to diminish in direct correlation to the question of personal accountability for it. It's only natural that the news of a diagnosis is often greeted with a desire to know its cause. Christopher Hitchens' revelation of his esophageal cancer spurs a litany of his hard partying exploits. Michael Douglas' throat cancer? "Largely due to drinking and smoking." We want to know how things happen so we can avoid having them happen to us. But we also, in the process, run the risk of ennobling those with certain sicknesses while stigmatizing others. For evidence, look no further than the latest episode of "Project Runway," and Mondo's admission that he has been silently living with HIV for 10 years. A decade is a very long time to live with any health-related condition, and it is unacceptably too long to live with shame. 
  
 I've had two surgical procedures because I was at risk for cervical cancer, a disease that usually manifests in the presence of the sexually transmitted HPV virus. An estimated 80 percent of sexually active women will at one time or another contract HPV. But you won't find a lot of STD-themed ribbons at the Target. And since being diagnosed with malignant melanoma, the questions I've heard most often have been, "Were you a sunbather?" and "Did you do a lot of tanning?" Well, no, but would you have cancer-blamed me if I had? 
  
 We all make choices that affect our health and our long-term quality of life prospects, and some of us certainly choose to poke sticks at the Grim Reaper more aggressively than others. But few of us make consistently perfect choices, and no one deserves disease. It's certainly pleasanter to buy a pink bucket of KFC and congratulate oneself for "promoting awareness" than it is to march for cirrhosis, hepatitis and gonorrhea, but what if we had even a measure of the same generous, unconditional support we give this month to women with breast cancer for those living with less morally unambiguous conditions? What if October wasn't just pink? Imagine how much suffering we could eliminate. Imagine how much we could cure. |||||
A:
National Breast Cancer Awareness Month has gone too far, argues H. Gilbert Welch. Even though he's a physician, and even though his own wife survived a breast cancer diagnosis a decade ago, he has serious concerns about the campaign, which “has led women to be more fearful of breast cancer than they need be,” he writes in the Los Angeles Times. He calls the much-repeated "1 in 8" or "1 in 9" statistic "a poster child for how to exaggerate risk (it's not the chance of dying but of being diagnosed)" and says the fact that a breast cancer drugs manufacturer helped found the campaign "doesn't make me feel any better." He offers a list of things women should be aware of: Yes, breast cancer is important, but it’s equally important to keep your risk in perspective—and to remember that we have made radical improvements in treating it: "The chances of not dying from breast cancer in the next 10 years are 990 per 1,000 — or better." And mammograms may not be as important as you’ve been led to believe: In fact, they’ve led to women being “harmed by unneeded surgery, radiation and chemotherapy for small ‘cancers’ that would not have been found without the mammogram and would never have caused problems.” Click here for another perspective on Breast Cancer Month.