Each year, hundreds of thousands of people come together to participate in breast cancer walks and runs in cities across the U.S. Since the first breast cancer walks began in the 1980s, they have become one of the most common ways for people to try to do something about breast cancer.

Some of these walks have become huge affairs that are hosted by multi-million dollar charities and sponsored by multi-billion dollar corporations that raise millions to “end breast cancer.” And yet each year, 250,000 women still get diagnosed with breast cancer and 40,000 women still die of this disease.

As far back as the 1990s, Breast Cancer Action members and other women affected by breast cancer have been asking how much of an impact these walks actually have in supporting women and saving their lives. As these walks have become larger and more closely tied to corporations, these questions are more pressing than ever.

If you want to be sure your time and money are truly making a difference, here are four easy questions to ask before participating in or donating to a breast cancer walk:

1. How much money raised from the walk will go to breast cancer programs?

Organizations promote their walks by suggesting that the money raised by walk participants goes straight to supporting breast cancer programs.

But the reality is a big chunk of the money raised is often unaccounted for. Financial records of the event aren’t always publicly available or aren’t available in a clear, understandable format. This makes finding out how much money goes to breast cancer programs, how much goes to putting on the walk itself, and how much goes elsewhere an often impossible task—or one that requires a lot of time and resources. This information should be easy to find, especially as some walks require people to raise a large amount of money to participate.

For example, The AVON 39 Walk to End Breast Cancer requires participants to raise $1,800 and states on its website that this money is given “to local, regional and national breast cancer organizations.” In 2015, it lists that about $18 million total was given to such organizations in grants. Yet, about $34 million was raised from these events (a number we could only find by locating the press release from each of the walks Avon held in 2015 and adding up the numbers). This means 47% (or $16 million) of the money raised from the 2015 walks isn’t publicly accounted for.

2. What breast cancer programs will the walk fund?

Organizations promote their walks by suggesting that the money raised by walk participants goes to breast cancer programs that save women’s lives.

But the reality is organizations that put on walks sometimes mislead participants by using the money raised to fund ineffective efforts like empty awareness or early detection programs, which haven’t reduced breast cancer death rates. Meanwhile, research programs that remain severely underfunded include those looking into the environmental links to breast cancer that could prevent women from getting breast cancer in the first place and those that look into metastatic breast cancer so fewer women die of the disease.

For example, the very name of the Susan G. Komen Race for the Cure® Series suggests that the money raised from these walks will go to research. But Komen’s website states that only 25% of the money raised goes to their “research and training grants program,” a category that doesn’t even reveal how much money is going to research. Komen has long been criticized for their small percentage of investment in research funding. A large portion of Komen’s budget goes to “raising awareness” and early detection programs.

3. Do the walk’s sponsors increase women’s risk of breast cancer?

Organizations promote their corporate sponsors as genuinely caring about women with breast cancer.

But the reality is some corporations and organizations involved in breast cancer walks put their own profit before women’s health by pinkwashing. Pinkwashing is a term we coined in 2002 to describe a company or organization that claims to care about breast cancer, but at the same time makes or promotes products linked to the disease.

For example, each year, the Avon Foundation puts on multi-day breast cancer walks in cities nationwide. But Avon Products, the multi-billion dollar cosmetics corporation behind the foundation, uses chemicals in its makeup that are linked to an increased risk of breast cancer. Avon has long been targeted by activists to remove from its cosmetics cancer-linked ingredients like methylparaben, a chemical that has been found to increase breast cancer risk and interfere with breast cancer treatment.’

4. Does the walk present a one-sided picture of breast cancer that leaves some women out?

Organizations promote their walks by suggesting that overcoming a breast cancer diagnosis is as simple as fighting hard, getting an annual mammogram, and thinking positively.

But the reality is breast cancer is a complex, devastating disease. No amount of individual willpower, screening or positive thinking can protect women from developing metastatic breast cancer, an incurable diagnosis that kills 40,000 women each year. And for patients who don’t develop metastatic breast cancer, the disease can still leave life-long physical, mental, emotional and financial burdens. Yet, from the women they use in their marketing materials to the women they celebrate at the walk itself, organizations that put on walks too often highlight healthy-looking women and stories of triumphant survivorship through “fighting like a girl” and “beating” cancer.

For example, many women, especially those living with metastatic breast cancer, have felt alienated by the big breast cancer walks for many years. In the documentary Pink Ribbons, Inc., the late Sandy Kugelman explains how the portrayal of breast cancer as a disease that can be defeated is hurtful because it ignores the fact that women die of the disease through no fault of their own: “You can’t have that message and then not see people who die as somehow not having lost … their battle. Because why? Maybe they didn’t try hard enough. … That kind of painful messaging—it’s just wrong.”

Alternatives to breast cancer walks:

There are many meaningful ways to take an active role in addressing and ending the breast cancer epidemic. If you can’t answer the above questions to your satisfaction, you may want to consider these alternative ways to take action:

1. Contact organizations and corporations that put on breast cancer walks to get answers to the questions above and then demand changes you want to see.

2. Volunteer for or give directly to a breast cancer organization that is doing work you think is important and that doesn’t take money from pinkwashing companies that profit from the disease at the expense of our health.

3. Learn more and educate others about the history and politics of the breast cancer movement by hosting a film screening of the documentary Pink Ribbons, Inc.

4. Share your story to help others think critically about these fundraising events.