The Power of Pink: Cause-Related Marketing and the Impact on Breast Cancer
Jennifer A. Harvey, MDa, Michal A. Strahilevitz, PhDb
The pink ribbon is one of the most widely recognized symbols in the United States. It can symbolize strength, hope, responsibility, empathy, and permission to discuss breast cancer, though not all associations are uniformly positive. Cause-related marketing is an agreement between nonprot and for-prot organizations to promote a product that provides benet for the cause through increasing awareness and nancial contributions from sales. For-prot organizations benet through the association of the positive ideology of the pink ribbon. The relationship between the organizations should be mutually benecial; the percentage of funds donated should be reasonable, and the organizations that benet should be respected institutions. Many breast cancer organizations have obtained signicant benet from corporate partnerships in cause-related marketing. Certainly, breast cancer awareness is much stronger now than 15 years ago. However, not all products are appropriate for promotion, particularly products that may increase the risk for breast cancer, such as alcohol. No corporation is licensed to have exclusive use of the pink ribbon symbol, leaving it open to potential abuse. Backlash by consumers has raised awareness of the misuse of the pink ribbon and cause-related marketing. As marketing becomes more global, the impact of the pink ribbon in the third world may spur open dialogue and reduce the taboo associated with breast cancer observed in some cultures. Key Words: Marketing, consumerism, breast cancer, research funding J Am Coll Radiol 2009;6:26-32. Copyright 2009 American College of Radiology
October is easy to recognize. October is Breast Cancer Awareness Month, and all things become pink and adorned with ribbons. Grocery stores are awash in pink: on the packaging of soup cans, breath mints, wine bottles, diet meals, candy, deodorant, and even yogurt. Pink apparel ranges from pink athletic shoes to nely tailored suits adorned with pink ribbons. There are pink kitchen appliances, tweezers, cosmetics, and ofce products. A Ford Mustang can be special ordered with a pink ribbon motif. Even commercial airlines have planes adorned with pink ribbons. The pink season has become a standard part of fall marketing, between the back-to-school season and Halloween. A BRIEF HISTORY OF THE PINK RIBBON Breast cancer is not the rst cause to embrace the use of ribbons as symbols. Ribbons have been used in support
Department of Radiology, University of Virginia Medical Center, Charlottesville, Virginia. b Department of Marketing, Golden Gate University, San Francisco, California. Corresponding author and reprints: Jennifer A. Harvey, MD, University of Virginia Medical Center, Department of Radiology, PO Box 800170, Charlottesville, VA 22908-0170; e-mail: jah7w@virginia.edu.
of a cause as early as the Crusades and later in the temperance movement [1]. Ribbon workers encouraged men to sign pledges that they would give up alcohol and then wear white ribbons as a sign of their pledges [1]. In more recent times, yellow ribbons were used to promote a cause from 1979 to 1981, when Americans were held hostage in Iran. Throughout the country, yellow ribbons were tied around trees to symbolize support for freeing the hostages. Later, red ribbons were used to promote awareness of the AIDS epidemic. In 1990, Charlotte Haley, who had multiple relatives with breast cancer, glued peach-colored ribbons to cards that gave information stating that only 5% of the National Institutes of Health budget was apportioned to breast cancer research [2]. She sent the cards to prominent women and also sold them at local markets. Evelyn Lauder, then-senior vice president of Este Lauder, and Alexandra Penney, then-editor of Self magazine, worked on a special insert for Breast Cancer Awareness Month in October 1991 [2]. A ribbon was included as a symbol, but the color of the ribbon was changed from peach to the most universally recognized female color of all, pink. Lauder arranged for pink ribbons to be distributed at cosmetics counters throughout New York that same year.
2009 American College of Radiology 0091-2182/09/$36.00 DOI 10.1016/j.jacr.2008.07.010
Harvey, Strahilevitz/The Power of Pink 27
To date, the Este Lauder Companies and their retail partners have distributed more than 70 million pink ribbons and informational brochures around the world. They have also raised more than $25 million for the Breast Cancer Research Foundation [2]. Many companies, both for prot and nonprot, have since embraced the pink ribbon and the ght against breast cancer that it symbolizes. Today, the pink ribbon is one of the most widely recognized symbols in the world. Like the World Wildlife Funds logo, the pink ribbon logo carries great meaning to many consumers. That fact makes it valuable to marketers who are willing to share prots with breast cancer-related nonprots in exchange for a chance to link their brands to this well-known and highly valued cause. The ribbon now symbolizes more than breast cancer awareness. There are few data on what the pink ribbon symbolizes to women or men. It likely symbolizes different things to different people. The pink ribbon may symbolize strength, hope, responsibility, empathy, and permission to discuss the disease. Not all reections on the pink ribbon are positive, however. Some have voiced concern that the pink ribbon and some of the associated products, such as teddy bears, are infantilizing [3]. The use of pink ribbons may give the public a method of identifying with cancer without having to visualize objectionable images of tumors, pain, or the side effects of treatment [4]. The use of a ribbon symbol for breast cancer has also drawn parallels to that of a crusade [1]. The language used to describe breast cancer reects a war state. We ght breast cancer. Those who succumb have lost the battle. Those who live are survivors. Indeed, the philanthropic arm of the Avon Company is the Avon Foundation Breast Cancer Crusade [5]. In her essay Welcome to Cancerland, Ehrenreich [3] suggested that breast cancer-related products serve as amulets or talismans serving to comfort sufferers and provide outwardly visible evidence of faith of others. She added that the numerous personal narratives available in print and online serve as testimonials, while gatherings such as Race for the Cure events serve as pilgrimages. Clearly, a culture has developed around breast cancer that is complex and not well studied. WHY BREAST CANCER? The breast is an external symbol of femininity. Although occurring in similar age populations as breast cancer, ovarian and endometrial cancer are far less common, and there is far less awareness of either disease. Women may identify with others who have suffered from breast cancer because the breast is an external organ. The ovaries and uterus are internal organs that may engender less personal identication. In her essay Pink Ribbons and Public Private Parts: On Not Imagining Ovarian Cancer, Holmes [4] suggested that there has been an uneven

development of visual culture regarding breast and ovarian cancer because people are less able to visualize and thus identify with internal organs. The association of cervical cancer with human papilloma virus, which is a sexually transmitted disease, may also contribute to its status as a more private illness. In addition, there have been strong public gures willing to discuss their diagnoses of breast cancer. Beginning in the 1970s, the public announcement of Betty Fords diagnosis of breast cancer opened up public discussion of this disease. Since then, a wide range of celebrities, including Gloria Steinem, Suzanne Somers, Sheryl Crow, and Melissa Etheridge, have openly discussed their breast cancer diagnoses. In contrast, there has been a paucity of gures who have discussed their experiences with ovarian or cervical cancer. With the possible exception of Gilda Radner, many people would not be able to name a public gure with either ovarian or cervical cancer. The current awareness campaign of the National Ovarian Cancer Coalition is called Break the Silence [6]. This is a strong contrast to the crusade symbolism of breast cancer campaigns. The population that is aficted with breast cancer may also inuence the popularity of the cause. Breast cancer is most common in women aged 40 years and older, who are frequently identied as wives, mothers, aunts, and grandmothers. This group of women signies home and family. Thus, there may be a unique emotional response to breast cancer because of the potential threat to home and family. This may partially explain why, although breast cancer is predominantly a female disease, both genders are emotionally affected by breast cancer mortality. In contrast, cervical cancer is more common in younger women, who are less likely identied as wives and mothers. That said, the largest support for ghting breast cancer has come from women. This includes women of all ages, backgrounds, and walks of life. In her book Marketing to Women, Barletta [7] stated that marketing to women is largely about relationships. Women may join the breast cancer cause in part to become part of a community or sisterhood of women supporting other women. Participation in breast cancer events may signify supportive relationships with other women, even though the nature of those relationships may be more symbolic than concrete. CAUSE-RELATED MARKETING: WHEN BUSINESSES TAP THE POWER OF THE PINK RIBBON Cause-related marketing has been dened by marketing scholars Varadarajan and Menon [8] as

The process of formulating and implementing marketing activities that are characterized by an offer from the rm to contribute a spec-
28 Journal of the American College of Radiology/ Vol. 6 No. 1 January 2009 ied amount to a designated cause when customers engage in revenueproviding exchanges that satisfy organizational and individual objectives.
Central to its denition is the idea of a marketing partnership between a business and a nonprot entity for mutual benet. Cause-related marketing must be distinguished from nonprot marketing, which is purely designed to support a nonprot organization or cause by using marketing tools. In the nonprot marketing world, marketing can be used to increase awareness (eg, awareness of the number of women who are diagnosed with breast cancer each year), raise funds (eg, funds for breast cancer research), encourage healthy or prosocial behavior (eg, getting regular mammograms and encouraging others to do so), or promote a fund-raising event (eg, Race for the Cure). Marketing tools that can be used to market a cause or nonprot organization include advertising, public relations, special events, offering incentives to donors and volunteers, building relationships with foundations, and so on. Running an advertising campaign to increase breast cancer awareness, soliciting donations via direct mail, sending out press releases to the media promoting an upcoming charity banquet, and contacting employers to encourage participation in fund-raising walkathons are all examples of using marketing techniques to promote either a cause or a nonprot organization. However, none of these marketing activities would be examples of cause-related marketing, because there is no linkage in any of these cases between the sales of a for-prot product or service and the goal of the marketing campaign. Cause-related marketing is also not the same as corporate philanthropy, which involves the giving (without expectation of direct corporate gain) of charitable nancial and in-kind grants by companies or their corporate foundations to nonprots. Although scholars from a variety of disciplines have argued whether pure altruism even exists [9], corporate philanthropy is closer to pure altruism than is cause-related marketing. Indeed, causerelated marketing is by denition an explicit form of impure altruism. Unlike contributions that fall under corporate philanthropy, cause-related marketing involves businesses linking donations to sales, with the clearly stated goal of mutual benet. When a business participates in a cause-related marketing campaign, it links the sales of its products or services with nancial support for a cause or charity. The business actively promotes the linkage between sales and donations to its target customers. The goals for the marketers include an increase in sales as well as an improvement to their brand image. The donation to the cause serves as a purchase incentive to customers. The consumer psychology behind this is that the warm glow of supporting a worthy cause will make the brands linked to donations more

appealing both in the short run and in the long run [10,11]. Although cause-related marketing offers many great opportunities for worthy causes, nonprots that get involved need to keep in mind that marketers see causerelated marketing as both a commercial joint venture and a strategic marketing tool for their businesses. The goal for the businesses involved in cause-related marketing is not just to support a worthy cause but also to increase prots. Because cause-related marketing is intended to be a win-win situation for both parties, nonprots need to be aware that such partnerships are not viewed as pure donations. Marketers do not just look for worthy charities their management cares about; they also look for causes that will appeal to the customer base or target audience they hope to attract with the campaign. It is important for nonprots to understand that although mutual benet is part of the denition of cause-related marketing, not all cause-related marketing campaigns are equally benecial to the causes they support. Nonprots and businesses both need to be careful in choosing whom they partner with, as well as what terms they agree to. Cause-related marketing has soared in scope more than 10-fold since the 1990s. According to the latest report in Cause Marketing Forum [12], the total funds raised for nonprots as a result of cause-related marketing campaigns in 2007 were in the neighborhood of $1.44 billion. In 2006, the Susan G. Komen Foundation raised $267 million through personal giving and partnerships with 129 corporations [13]. The growth in causerelated marketing is based largely on the fact that corporate partners see it as both a way to increase short-term sales and a method of improving their brands and corporate images for long-term benet. With the increase in breast cancer awareness, there has also come an increase in businesses, particularly those targeting women, that wish to partner with nonprots that fund projects to ght breast cancer. NOT ALL CAUSE-RELATED MARKETING OPPORTUNITIES ARE WORTH PURSUING So how does a nonprot know which business partnerships are worth pursuing? Nonprot partners considering cause-related marketing campaigns with corporate partners should be guaranteed to receive some minimum level of funds for participation. They should also look for evidence that the campaigns will be done tastefully and will offer potential increases in awareness of their causes. Nonprots need to be aware that the amount of money contributed relative to sales [14], the image of the products or services being promoted [11], and the amount of marketing expenditure that goes into promoting a cam-

Harvey, Strahilevitz/The Power of Pink 29
paign [15] all vary tremendously from campaign to campaign. In addition to asking for a signicant amount of nancial support in exchange for participating in the campaign, nonprots also need to be careful to choose businesses that will not in any way jeopardize their own images [15]. Nonprots have both their need for funding and their reputations to consider [15]. These considerations mean that nonprots should weigh the decision to get involved in each cause-related marketing campaign carefully before signing on. Furthermore, if the terms are not right, they should be prepared to negotiate for better terms. Some questions to ask and factors that should be taken into account by nonprots considering cause-related marketing campaign opportunities are described below. How Much Will Be Donated? How much money is guaranteed to be donated by the company? Will the donation be a percentage of prots, a percentage of revenues, or a set amount? If there is a minimum contribution guaranteed by the company, what is the amount? If there is a maximum donation that will be made by the company, what is the amount? There is huge variance in the magnitude of donations, as well as whether they are linked to sales, linked to prots, or capped or guaranteed at some maximum or minimum amount. Obviously, a nonprot will want to have the largest magnitude of sales going to charity, as well as an acceptable minimum guaranteed donation in exchange for its participation. From the perspective of marketers, the optimal donation magnitude may depend on the target audience, as well as the nature of the product being promoted and the products price [5]. In some cases, offering as little as 1% of prots to the nonprot may be enough to increase sales. However, from the perspective of the nonprot, larger shares of prots are obviously preferred. What Marketing Efforts Will Be Undertaken? What are the nature and scope of the marketing efforts that will be undertaken by the business to promote the cause-related marketing campaign? What is the nature of the customer base being targeted with the cause-related marketing campaign? A nonprot corporation will want to know who will be exposed to each campaign. If the target market includes consumers who are not part of the nonprots current donor base, the increase in awareness may actually benet the charity beyond the funds raised. If the target audience of a cause-related marketing campaign includes the nonprots current donor base, future contributions may be affected if donors feel that buying the cause-related product is a substitute for making a donation. This in turn could affect the marginal benet of participating in the cause-related marketing campaign [15]. The timing of a cause-related marketing campaign is also a potentially relevant issue. Recent research has

shown that nonprot corporations may benet from introducing potential donors to volunteer opportunities before asking them for funds [16]. In fact, Aaker and Liu [16] found that asking potential donors to volunteer before asking them to think about monetary contributions can lead to larger monetary donations overall. This is likely due to thoughts about volunteering leading to a mind-set that links volunteering to greater happiness, which in turn generates a more altruistic response [16]. This research suggests that in scheduling a nonprots activities, campaigns to encourage volunteerism should precede both cause-related marketing campaigns and other fund-raising efforts. How Will the Nonprots Image Be Affected? Will being aligned with this particular business partner have an effect on the image of the nonprot involved in the cause-related marketing campaign? If so, will it be a positive or negative effect? Brand personality and brand image are concepts marketers in the for-prot arena know well. The image associated with a brand affects market share, customer loyalty and prots [17]. Recent research has shown that nonprots also have brand images and brand personalities and that those in turn inuence donation behavior as well as donor loyalty [18]. Prior research has demonstrated that the initial perceived ethics of a company inuence how much that business will benet from a cause-related marketing campaign [11]. It follows that the initial perceived ethics of a forprot company could inuence the image of the nonprot that partners with it [15]. To illustrate, it is intuitive that a nonprot such as the Susan G. Komen Foundation should never partner with Altria to sell Virginia Slims cigarettes, which are known to increase a womans risk for all sorts of cancer. Yet beyond such obvious cases, not all businesses have the same reputations and images. Nonprots need to be aware that the images of the organizations they choose to partner with could easily affect their own images [19]. They should also consider conducting research with their donor bases to make sure that the cause-marketing campaigns they get involved with do not reduce future direct contributions. WHY THE PINK RIBBON HAS BECOME A HOT MARKETING TOOL, PARTICULARLY FOR BUSINESSES TARGETING WOMEN The public display of the breast cancer pink ribbon suggests different things to different people. Some see it as a sign of strength (breast cancer survival). Others associate it with being responsible (a reminder to get mammograms regularly). Still others see it as a symbol of empathy (caring about those who suffer from breast cancer). The

30 Journal of the American College of Radiology/ Vol. 6 No. 1 January 2009
high awareness among consumers of the pink ribbon logo, combined with the female strength and courage it has come to symbolize to so many consumers, has made the logo more than just a powerful tool for nonprot organizations focused on ghting breast cancer. Indeed, the logo has also become a powerful tool used by forprot businesses to attract new customers as well as increase brand loyalty among existing customers. Yet not all for-prot companies are equally attracted to the pink ribbon logo. As mentioned earlier, generally, cause-related marketing campaigns that link sales to supporting the ght against breast cancer have been most popular with companies focused on marketing products and services to women. Jewelry, cosmetics, and clothing have been particularly popular. Generally, with causerelated marketing, products that are consumed publicly, such as T-shirts or bracelets, are likely to be more of a hit with consumers than items that are consumed privately, such as deodorant or tampons. The reason is that part of the benet to consumers of purchasing products linked to charity is getting to communicate their allegiance to the cause to others who see them proudly displaying the logo [20]. That said, most consumers do not want to display that logo every day. For example, Ford came out with a special edition of the Ford Mustang that is elaborately decorated with two enormous pink ribbons. That will be far less appealing to women than a scarf or necklace adorned with that famous pink ribbon. After all, those giant ribbons could get old long before it is time to replace the vehicle. There is also the issue of resale value. Just because most people care about ghting breast cancer does not mean they want that logo screaming at them and everyone else who sees it. Even for survivors who are extremely committed to the cause, there is still usually a desire to have aspects of their life that do not include a focus on breast cancer. As one survivor put it,
I will always be a cancer survivor and everyone close to me will always know that. Still, I dont want to be wearing that logo everywhere I go each and every day. Sometimes I just want to introduce myself without adding, Oh and I had cancer.
symbolize responsibility; they and others take responsibility by undergoing mammography, despite discomfort, to improve their odds at successfully beating breast cancer. The grassroots efforts supporting breast cancer research have been highly successful. This has resulted in a large amount of funds raised by nonprot organizations as well as an increase in the allocation of funds by the federal government. The Susan G. Komen Foundation, an organization that is particularly active in raising money via cause-related marketing, awarded $66 million in research grants in 2006, and in 2007, the Breast Cancer Research Foundation awarded $32 million to 151 researchers. In 1992, a large grassroots effort resulted in the US Department of Defense Breast Cancer Research Program. The program came about when women demanded that residual Department of Defense funds be spent on breast cancer research. The budget windfall would otherwise have been returned to the national budget as required. Between 1992 and 2007, the Department of Defense spent $2.07 billion on breast cancer research. In 2007, the National Institutes of Health funded 2,023 studies related to breast cancer, but only 1,092 studies related to prostate cancer and 905 studies related to lung cancer [22]. POSSIBLE NEGATIVE IMPACT OF THE MASS MARKETING OF THE PINK RIBBON: OVERUSE, MISUSE, AND BACKLASH During the month of October, the number and variety of items adorned with pink ribbons can be overwhelming. The ubiquitous appearance of pink ribbons could potentially cause them to become less meaningful and therefore less effective. The proportion of women undergoing screening mammography may have declined slightly over the past few years. In 2005, 66.5% of women reported having had mammograms within the past 2 years, compared with 69.7% in 2003 [23,24]. This reported decline in utilization is controversial; Medicare reimbursement information indicates an increase in the use of screening mammography in that population between 2000 and 2005 [25]. Although this potential decline in the utilization of screening mammography could be due to a number of factors, it is possible that consumers are becoming overly saturated with breast cancer awareness campaigns. Overuse of the pink ribbon could potentially lead to visual saturation, with a decline or loss of the emotional and intellectual response that it engenders. Most marketing symbols are protected by trademark laws. However, no corporation is licensed to have exclusive use of the pink ribbon symbol. The Susan G. Komen Foundation comes the closest; it has trademark rights on its particular pink ribbon logo. Because there is no regu-

POSITIVE IMPACT OF THE PINK RIBBON AND OTHER MARKETING EFFORTS: INCREASED UTILIZATION AND RESEARCH FUNDING Screening utilization of mammography has increased markedly since the 1970s. According to the American Cancer Society, the percentage of women aged 40 years and older who reported having had mammograms within the past 2 years increased from 29% in 1987 to 70% in 2000 [21]. Increased exposure to the pink ribbon symbol likely had an impact on this increase in utilization because of the role the ribbon has in reminding women of breast cancer. To some women, the pink ribbon may
Harvey, Strahilevitz/The Power of Pink 31
lation of who may use a pink ribbon symbol, it is open to misuse. Consumers assume that products displaying the pink ribbon are donating reasonable proportions of profits to either breast cancer care or research. However, some products, such as a recent deodorant product, display pink ribbons on their packaging without any comment about any sort of contribution to any organization linked to ghting breast cancer. Other products, such as a recent tweezer product, display pink ribbons with vague promises to donate a portion of the funds to breast cancer research. Neither the amount nor the organization that will benet is specied. Generally, if a for-prot company is vague about how much will be contributed, it is likely that the company will not be contributing very much. Although consumers may still benet from marketing of the cause through increased awareness of breast cancer, the value of the pink ribbon is jeopardized without regulation in place to prevent misuse or even abuse. A particularly sobering thought is that any corporation is free to use the pink ribbon symbol, including those selling products that may increase womens risk for developing breast cancer. In October 2007, Fat Bastard Wines donated 25 cents from the sale of every bottle of wine to breast cancer research, up to a limit of $75,000. Although the intake of small amounts of alcohol may have some health benet regarding cardiovascular disease, the use of alcohol also increases the risk for developing breast cancer in a dose-dependent fashion, with an increase in risk of 9% for each 10 g consumed per day [26]. Other wineries and wine-related products also display pink ribbons, illustrating a troubling example of a poor association of the actual cause and the related product. Consumers themselves have voiced concerns about the association of questionable products bearing pink ribbons and their potential to increase the risk for breast cancer, including yogurt with possibly dangerous hormones, cosmetics with possible carcinogens, and automobiles, which produce unhealthy exhaust [27]. Although most consumers retain a positive attitude about the pink ribbon, some backlash toward the misuse of this symbol has occurred. The Think Before You Pink campaign of the Breast Cancer Action organization publicizes perceived abuse of the pink ribbon symbol [27]. In 2002, this group ran an ad in the New York Times about a pink Eureka vacuum cleaner, for which only $1 of the roughly $200 purchase price was donated to a breast cancer organization The ad urged consumers to consider whether the purchase of that or other pink ribbon products would make a difference, or if the companies were using breast cancer marketing to boost their prots. A direct donation to a reputable breast cancer organization would obviously be far more effective for raising funds related to the cause. However, when consumers will be making a purchase anyway, they often see

no reason not to buy the product that makes even a small donation if the price and quality are similar. It is unlikely that most consumers bother to read the ne print of how much is being donated and to what organization. If consumers become more savvy with regard to reading the ne print, corporations would be even more likely to maintain integrity in their partnerships with consumers and breast cancer organizations. Examples of the range of generosity exist even within product categories. Avon has a Breast Cancer Crusade lip balm that comes in a pink container with a ribbon logo. One hundred percent of the proceeds from the sales of this lip balm go to the Avon Breast Cancer Crusade. In contrast, Dial had a campaign in which 10 cents per sale were donated on selected products, with a maximum total donation of only $150,000. This obviously represents a huge difference in how much is given to the cause. Nonprot organizations should play a role in ensuring the integrity of their cause-related marketing relationships. The Susan G. Komen Foundation, for example, requires a minimum contribution of 10% of the retail price of a product or service from its corporate partners. The product endorsed must also display the foundations Web site and helpline information so that consumers can obtain information about breast health. The foundation also declines proposals from certain product lines, such as alcohol, rearms, and automobiles. By setting boundaries such as these, cause-related marketing can be more meaningful to consumers, as well as the causes they choose to support. THE FUTURE OF THE PINK RIBBON The pink ribbon is one of the most widely recognized symbols in the United States. Hopefully, the pink ribbon will continue to inspire consumers and corporations to partner in responsible relationships that will both remind women of the importance of breast cancer screening and support ongoing research efforts to ght this disease. In many parts of the third world, discussion of breast cancer is still considered taboo [22]. The thought of undergoing mastectomy is unfathomable in some cultures, even if death is the consequence of choosing to not undergo surgical treatment. One may wonder what the outcome of a pink ribbon campaign in some of these cultures might accomplish. Would ghting and surviving breast cancer become a symbol of the strength of its survivors, as it has become in our culture? Would a sisterhood of support develop that would overcome cultural taboos, as it has in our country over the past 30 years? WomenAid International, an organization based in the United Kingdom, has developed the Pink Ribbon Project, whose goal is to raise awareness and funding of breast cancer screening and treatment programs in third

32 Journal of the American College of Radiology/ Vol. 6 No. 1 January 2009
world countries [28]. As more international corporations take up cause-related marketing as a brand-building tool, the appearance and power of pink ribbons may become more geographically widespread. It may prove both interesting and potentially inspiring to observe the response to this symbol in other societies. REFERENCES
1. Lander DA. The ribbon workers as popular educators: (re)-presenting the colours of the crusades. Stud Educ Adults 2005;37:47-62. 2. King S. Pink Ribbons, Inc. Minneapolis: University of Minnesota Press; 2006. 3. Ehrenreich B. Welcome to cancerland. Harpers 2001;303:43-53. 4. Holmes MS. Pink ribbons and public private parts: on not imagining ovarian cancer. Lit Med 2007;25:475-501. 5. Avon Foundation. Breast Cancer Crusade. Available at: http://www. avoncompany.com/women/avoncrusade/. Accessed November 18, 2008. 6. National Ovarian Cancer Coalition. Home page. Available at: http:// www.ovarian.org. 7. Barletta M. Marketing to women. 2nd ed. Chicago, Ill: Dearborn Trade; 2006. 8. Varadarajan P, Menon A. Cause-related marketing: a coalignment of marketing strategy and corporate philanthropy. J Marketing 1998;53:5874. 9. Cialdini RB. Altruism or egoism? That is (still) the question Psychol Inq 1991;2:124-6. 10. Strahilevitz M, Meyers J. Using donations to charity as purchase incentives: how well they work may depend on what you are trying to sell. J Consum Res 1998;24:434-46. 11. Strahilevitz M. The effects of prior impressions of a rms ethics on the success of a cause-related marketing campaign: do the good look better while the bad look worse? J Nonprot Publ Sector Marketing 2003;11: 77-92. 12. Cause Marketing Forum. The growth of cause marketing. Available at: http://www.causemarketingforum.com/page.asp?ID188. 13. Ernst & Young. Consolidated nancial statements: the Susan G. Komen Breast Cancer Foundation, Inc. New York: Ernst & Young; 2006.
14. Strahilevitz M. The effects of product type and donation magnitude on willingness to pay more for a charity-linked brand. J Consumer Psychol 1999;8:215-41. 15. Sharpe J. Factors nonprots should consider when considering participation in a cause-related marketing campaign. Unpublished working paper. 16. Aaker J, Liu W. The happiness of giving: the time ask effect. J Consumer Res. In press. 17. Aaker J. Dimensions of brand personality. J Marketing Res 1997;34:34756. 18. Venable BT, Rose G, Bush V, Gilbert F. The role of brand personality in charitable giving: An assessment and validation. Acad Marketing Sci J 2005;33:295-312. 19. Simonin BL, Ruth JA. Is a company known by the company it keeps? Assessing the spillover effects of brand alliances on consumer brand attitudes J Marketing Res 1998;35:30-42. 20. Strahilevitz M. Corporate social responsibility: what they dont know cant help you or them. PR News: Guide to Best Practices in Corporate Social Responsibility. In press. 21. Cokkinides V, Bandi P, Siegel R, Ward EM, Thun MJ. Cancer prevention & early detection facts & gures 2008. Atlanta, Ga: American Cancer Society; 2008. 22. National Institutes of Health. Computer Retrieval of Information on Scientic Projects. Available at: http://crisp.cit.nih.gov. Accessed November 18, 2008. 23. Cokkinides V, Bandi P, Siegel R, Ward EM, Thun MJ. Cancer prevention & early detection facts & gures 2006. Atlanta, Ga: American Cancer Society; 2006. 24. Cokkinides V, Samuels A, Ward EM, Thun MJ. Cancer prevention & early detection facts & gures 2004. Atlanta, Ga: American Cancer Society; 2004. 25. Rao VM, Levin DC, Parker L, Frangos AJ. Recent trends in mammography utilization in the Medicare population: is there a cause for concern? J Am Coll Radiol 2008;5:652-6. 26. Smith-Warner SA, Spiegelman D, Yuan SS, et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA 1998;279: 535-40. 27. Breast Cancer Action. Think Before You Pink. Available at: http://www. thinkbeforeyoupink.org. Accessed November 18, 2008. 28. WomenAid International. The Pink Ribbon Project. Available at: http:// www.womenaid.org/press/info/pinkribbon/pinkribbon1.html. Accessed November 18, 2008.