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RFM NEWS SPECIAL REPORT
Dan [at] rfmnews.com
February 25, 2002
Possible link between abortion & breast cancer summarily dismissed by abortion supporters and media / Critics say Women's E News jumps on disinformation bandwagon
According to critics, the legal and journalistic arms of the abortion industry jumped on the disinformation bandwagon with the publication of a February 17, 2002, article in Women's E News authored by Margaret Woodbury entitled, "Judge to rule on abortion, breast cancer link." Funded by the NOW Legal Defense Fund and the Barbara Lee Family Foundation, the Internet wire service reported, "Many researchers are troubled ... because the weight of current scientific evidence does not seem to support a link between breast cancer and abortion."
California obstetrician-gynecologist, Frank Joseph, MD, said in a letter to Women's E News, "After reading (the article), one would think studies done that showed abortions increase the risk of breast cancer were equal in amount to the studies that showed no increase. Come on -- at least be honest and give all the facts to your readers. After all, we are talking about life and death, or doesn't this concern you? Would you call 13 of 15 studies done in the United States, that showed the increase risk -- even? Of course not -- 13 to 2 is NOT even close to being equal. Also, 28 of 37 studies done worldwide, according to my math, is not close to being equal."
Citing a false advertising lawsuit filed against a Fargo, North Dakota abortion clinic, Woodbury reported that the plaintiff, Amy Jo Mattson, is seeking to compel the Red River Women's Clinic to stop distributing a pamphlet which asserts that most of the medical evidence does not support a link between abortion and the disease. The case is due to go to trial on March 25, 2002.
Karen Malec, president of the Coalition on Abortion/Breast Cancer, an international women's organization, said, "Woodbury omitted a significant piece of information. When the lawsuit was filed in December 1999, the Red River Women's Clinic was distributing a pamphlet which said, 'Anti-abortion activists claim that having an abortion increases the risk of developing breast cancer and endangers future childbearing. None of these claims are supported by medical research or established medical organizations.' The clinic had provided its patients with a patently false statement and it was certainly in its financial interests to do so. By 1999, 26 out of 32 studies worldwide found elevated risk."
After the lawsuit was filed, the clinic seemed to abandon its effort to deny the existence of research implicating abortion. A revised pamphlet was printed using a 1996 fact sheet from the National Cancer Institute's (NCI) website. Its web page said, "Although it has been the subject of extensive research, there is no convincing evidence of a direct relationship between breast cancer and either induced or spontaneous abortion. Available data are inconsistent and inconclusive, with some studies indicating small elevations in risk, and others showing no risk associated with either induced or spontaneous abortions."
Mischief at the National Cancer Institute
Over the last few years, according to critics, the NCI has suffered a significant loss of credibility with respect to its evaluation of the research. In 1999, the NCI was accused by a scientist of having published "an outright lie" about the research on its website. Joel Brind, Ph.D. a professor at Baruch College who with colleagues at Penn State had authored a 1996 review and meta-analysis for the Journal of Epidemiology and Community Health, reported the website falsely claimed, "The scientific rationale for an association between abortion and breast cancer is based on limited experimental data in rats and is not consistent with human data." However, not only had more than two dozen studies been conducted on women in various parts of the world, which had associated abortion with breast cancer, but the NCI had at least partially funded most of the 13 studies conducted on American women by that year with all but one reporting risk elevation.
The agency's statement implied that the effect of miscarriage (spontaneous abortion) on breast cancer risk was much the same as that of induced abortion. The research, on the other hand, has demonstrated that most miscarriages do not increase breast cancer risk because these pregnancies do not generate enough estrogen to initiate the development of tumors. Estrogen is thought to be the culprit associated with most of the risk factors for breast cancer. Breast cancer risk is augmented by overexposure to estrogen beginning early in pregnancy without the protective hormonal milieu taking place in the third trimester. Estrogen comes from progesterone, and miscarriages occur when there is not enough progesterone required to continue the pregnancy.
Physician-Congressmen Blow the Whistle on the NCI
The NCI was under fire from several members of Congress in 1998 and 1999, including two physicians, Congressmen Dave Weldon, MD and Tom Coburn, MD. Rep. Coburn accused the agency of having misled the public about the research paid for by American taxpayers and had "selectively released data." Using particularly sharp words to describe the agency's misrepresentations, Coburn said the agency clearly had a "bias for lack of what the facts are." The NCI's web page, he declared, was "not scientifically driven, on this issue, but is more politically driven...."
Congressmen Coburn and Weldon denounced the NCI and attested that women "are still being kept in the dark -- or worse yet, knowingly given misinformation by government agencies charged with protecting their health." The physicians said that they were disturbed by the "anti-information position of the NCI with respect to this particular issue...."
Congressmen Henry Hyde (R-IL) and Chris Smith (R-NJ), on the other hand, condemned the agency for having "sabotaged" research reporting a positive association between abortion and the disease. In particular, they cited research authored by a highly regarded epidemiologist, Janet Daling and her colleagues at the Fred Hutchinson Cancer Center in Seattle. Published in the Journal of the National Cancer Institute (JNCI) in 1994, Daling, an abortion supporter, said "Among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women."
Dr. Lynn Rosenberg, an epidemiologist with the Boston University School of Medicine, penned an editorial published in that same issue of JNCI in which she disparaged the Daling study by raising the issue of possible recall bias (reporting bias), a theory unsupported by medical research which says that breast cancer patients are more likely to accurately report having had abortions than healthy women. The fact is Daling ran a separate test for recall bias and found no evidence of it at all in her study. Rosenberg opined that the study's findings were "far from conclusive, and it is difficult to see how they will be informative to the public."
National Cancer Institute Revises Web Page
The NCI amended its web page late in 1999 and removed the word "inconclusive." The high bar which had been established by the agency which demanded "convincing evidence of a direct relationship" was not included in its revised statement which said, "The relationship between abortion and breast cancer has been the subject of extensive research. However, evidence of a direct relationship between breast cancer and either induced or spontaneous abortion is inconsistent. Some studies have indicated small elevations in risk, while others have not shown any risk associated with either induced or spontaneous abortion."
The new web page was marked by the disappearance of what Dr. Brind called an "outright lie" from its web page, but now the data were described as "inconsistent." Some experts say the agency found it beneficial to continue to mislead women by treating induced and spontaneous abortions as if they had one in the same effect on breast cancer risk. It neglected to reveal the number of studies published since 1957 showing risk elevations. In an attempt to discredit its own research subsidized by American taxpayers, the NCI's statement asserted that "some studies" found "small elevations in risk." A close examination of the 1994 Daling study, however, reveals the truth. Daling found an incalculably high risk of breast cancer for teenagers with a family history of the disease who have abortions before the age of 18. Among members of this age group without a family history, Daling determined the risk more than doubled. Altogether 7 epidemiological studies have reported a more than twofold elevation in risk.
Revised Red River Clinic Pamphlet Still Misleading
While discussing the new wording which appeared in the revised pamphlet distributed to patients at the Red River Women's Clinic, John Kindley, the plaintiff's attorney, said in a May 11, 2000, statement that "the supposedly non-existent evidence of a causal relationship between induced abortion and increased breast cancer risk is neither weak nor inconsistent. The NCI statement quoted by the Red River Women's Clinic is patently and obviously false, and the clinic knows it. A business can't repeat to its customers a falsehood about its services, just because the falsehood originally happened to be made by a government agency."
Significantly, the defense attorney for the clinic, Linda Rosenthal of the Center for Reproductive Law and Policy, told Woodbury the plaintiff and her supporters "lie about the science." However, in November of 1999, the Center for Reproductive Law and Policy hired an expert witness to testify for abortion providers in a case involving Florida's parental notification law. That expert witness was Dr. Lynn Rosenberg, whom Congressmen Hyde and Smith said "sabotaged" the Daling study in the JNCI. Rosenberg said she couldn't determine how Daling's findings would be relevant to women. When asked by the attorney for the state if, "A woman who finds herself pregnant at age 15 will have a higher breast cancer risk if she chooses to abort that pregnancy than if she carries the pregnancy to term," Rosenberg reversed her position and replied, "Probably, yes."
NCI Plans New Fact Sheet
Woodbury reported that the NCI is planning yet another version of its fact sheet on the abortion-breast cancer research. Patricia Hartge, an NCI epidemiologist, told her that "An examination of the scientific evidence makes it very clear the overall picture is no increased risk of breast cancer to women who have had abortions."
Some, who believe there is a link between abortion and breast cancer, have accused Hartge of participating in the agency's campaign to disparage the medical research in spite of the fact that most NCI and NCI-funded studies have supported a link. With the publication of the 1997 Melbye study in the New England Journal of Medicine, came another NCI editorial in that same issue. Melbye's study was conducted on Danish women and funded by the Department of Defense. It was especially favored by the abortion industry, including Women's E News, because it found no overall link. The study was called "definitive" and its purpose was to discredit the Brind paper and all of the other studies reporting elevated risk.
Those who believe there is a link between abortion and breast cancer say Hartge did her job well, by pacifying American women who were nervously contemplating an abortion. She said, "In short, a woman need not worry about breast cancer when facing the difficult decision of whether to terminate a pregnancy." What wasn't revealed was that Melbye found a statistically significant 89% elevated risk among women having abortions after 18 weeks gestation. Moreover, Melbye tallied records of breast cancer cases dating back to 1968 -- five years before tallying abortions. In other words, Melbye counted the incidence of the disease reported over a 5 year period before counting the proposed cause. Because abortion was legalized in 1939, not in 1973 as Melbye had thought, Melbye misclassified 60,000 women who had abortions as not having had abortions.
Recall Bias Theory Advanced to Cover-up Link
Karin Michels, an assistant professor of epidemiology at Harvard Medical School, advanced the cause of recall bias on behalf of the abortion industry. She told Woodbury, "There is a very high chance women with breast cancer are more willing to soul search and more accurately report their abortion histories."
If there were such a phenomenon as recall bias in the abortion-breast cancer research, then the findings reported in the studies showing elevated risk would be artificial. A number of studies have been conducted to test for recall bias, but no scientists currently claim to have found convincing evidence of it. In fact, Michels was a member of one of those scientific teams which found no evidence of recall bias. The case-control study by Lipworth et al. was published in the Journal of the National Cancer Institute in 1996 and found an increased risk of 50% among Greek women. Lipworth observed that there was no social stigma associated with induced abortion among Greek women, and "even before legalization, induced abortions were practiced in Greece with widespread social acceptance." Lipworth concluded that recall bias could not, therefore, have skewed the results of the study. Lipworth said, "This can be interpreted as indicating that healthy women in Greece report reliably their history of induced abortion."
Exactly one week after submitting the article for publication on October 20, 1994, Michels told Dr. Lawrence Altman, a reporter for the New York Times, that the scientific method of interviewing women and asking about abortions "is a flaw in the design (of the studies) because women who have breast cancer are more likely to disclose an abortion than women who did not develop breast cancer."
Swedes Accused of Covering Up Link
Woodbury asserted in her article that a Swedish study had found evidence of recall bias, but the Swedish scientists, who were the first to advance the theory of recall bias, came up with unexpected results when they tested for evidence of it. Funded by a family planning group, the Swedes found seven women who reported having had abortions which the computer said they had not. Hence, the belief that a prospective study -- one based on medical records, not interviews -- is the gold standard for epidemiological research seemed to be shot down by some of its own proponents, and the Swedes have since withdrawn their claim of having found evidence of recall bias. In fact, the Brind-Penn State team of scientists had proven that the Swedish team had covered up a link in its study on Norwegian women, and made the accusation in the Journal of Epidemiology and Community Health in 1998. The Swedes have never responded.
Another study which may have drawn favor from the abortion industry and its NCI supporters was a case-control record-linkage study authored by M. J. Goldacre et al. and published in the Journal of Epidemiology and Community Health last year. Known as the Oxford study, this group used hospital medical records which had recorded information about its subjects. There was a significant difficulty with the database, however. It contained 28,616 breast cancer cases, but only 300 recorded abortions in the hospital. That represents 1% of the cases. Since most abortions performed in Great Britain have taken place in clinics, not hospitals, and since the abortion rate in that country has been approximately 2.5% of women of childbearing age each year, most of the abortions in the database were not recorded and many women were improperly classified as not having had abortions.
Included among this study's authors, was D. Yeates who in a 1982 study by Vessi et al. participated in an effort at Oxford to debunk the first American study to report a link between abortion and breast cancer. Published in 1981 by the respected M.C. Pike and colleagues, the American study found a 140% elevated risk among women procuring an abortion before first full term pregnancy. Vessi et al. responded with a study showing a 16% decreased risk for women having an abortion before term pregnancy and claimed that "The results are entirely reassuring" for women. Upon closer examination, however, it is revealed by the study's authors that "Only a handful of women stated they had a termination before their first term pregnancy...." For this reason, according to Dr. Brind, "...This study is not 'entirely reassuring' with regard to the question of induced abortion in breast cancer; the study is entirely irrelevant, but they put it up as a reassuring study, to reassure the world that this finding, that abortion may be dangerous, really isn't true."
An Amazing Acknowledgment
Kim Gandy, president of the National Organization for Women, acknowledged the importance of an early first full term pregnancy on a woman's breast cancer risk. She said, "We know that early pregnancy has a protective effect against breast cancer and this will need to be factored into future studies that compare women's risks."
When asked about Gandy's comment, Karen Malec of the Coalition on Abortion/Breast Cancer said, "If NOW recognizes the importance of early first full term pregnancy, then the logical question is: Will this organization, which claims to be 'for' women, stop promoting the postponement of childbirth among childless women through its advocacy of what it has euphemistically labeled 'reproductive rights?'"
Lancet Oncology Article Attempts to Discredit British Study
Late last year, a British study by a group of independent statisticians, the Pension and Population Research Institute, published a study which reported that the incidence of breast cancer would double by 2023 due to induced abortion. In an attempt to discredit the study, author Tim Davidson advanced recall bias theory as a difficulty with the research and claimed there was 'no consistent and conclusive' proof of an association. He concluded, however, that "...more work is needed in specific areas where a stronger association might exist, such as in late second-trimester abortions, in very young patients, and in families with a genetic predisposition...."
The data concerning the abortion/breast cancer link is persuading to some, but not to others. Yet it seems apparent no attempts are being made by organized medicine to let women in these groups know that this is an area of concern for scientists.
"It's intriguing that Women's E News and NOW want to even talk about the abortion-breast cancer link," said Malec. "The abortion industry would prefer that this issue never came up and has been, for the most part, tightlipped about the research since the first study was published in 1957. It is only in recent years that the subject has been raised in the public forum and, when it has, the industry reacted like a possessed person who just had holy water sprinkled on himself. Now that the public is beginning to learn the truth, the industry wants to respond like Joe Camel by asserting that there is 'no proof' of a link."
Malec added, "Women should have been told in 1973 when Roe v. Wade legalized abortion that two studies were on record as showing a positive link between abortion and breast cancer."
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