National Cancer Institute Revises Web Page on 
Abortion-Breast Cancer Link Under Congressional Pressure. (click here)

Physician-Congressman warns colleagues: ABC a "health-care time bomb."  (click here)

ABC Suit filed in North Dakota (click here) 

Congressman Tom Coburn, M.D. Accuses the National Cancer Institute of Misleading the Public and Selectively Releasing Data. (click here)

U.S. House of Representatives Debates the Abortion-Breast Cancer Link and the Federal Funding of Abortifacients, like RU 486. (click here)

Congressman Dave Weldon, M.D. Writes Members of Congress About Abortion-Breast Cancer Link August 24, 1999. (click here)

Illinois Senate Resolution Calls For Task Force

• Illinois Senator Patrick O'Malley calls for Hearings in the Senate on the Abortion-Breast Cancer Link. (click here)

• Illinois Senate Committee Passes Resolution to Investigate Abortion-Breast Cancer Link

• Information on Illinois Senate Resolution 8 and 214 (click here)

Please Note: RFM News has graciously agreed to allow the coalition to publish this Special Report on its website.

RFM NEWS  SPECIAL REPORT

Chicago, Illinois

Dan@rfmnews.com

www.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.

Oxford Study     

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."

*   *   *   *   *   *   *   *

Copyright 2002 RFM NEWS www.RFMNEWS.com <A HREF="http://www.rfmnews.com/">RFM NEWS New Page 2</A> Permission to reprint granted with acknowledgment

The Abortion-Breast Cancer Research: What it Means for Lisa Madigan and Company

by Karen Malec, President of the Coalition on Abortion/Breast Cancer Published in Illinois Leader, September 20, 2002 

Two or three decades ago, it might have been difficult to imagine a situation in which radical feminist legislators would fight bitterly to oppose a women’s health care issue. After all, the American public has been constantly reminded for the last 30 years that such politicians are the champions of women’s health care. Breast cancer and legalized abortion are issues which belonged to them alone, and any male legislator who didn’t go along with the program was represented as an individual lacking in compassion and as a violator of women’s rights. These are the mantras that have been repeated to us: abortion is “health care”; women are autonomous decision makers; radical feminists care about women’s health; abortion is a woman’s choice; and abortion is safe. 

A new chapter on women’s health, however, was opened in the Illinois legislature two years ago which illustrated that radical feminists didn’t really believe any of their mantras. A resolution was introduced in the Senate (SR 214 and SR 8) calling for a task force to review strong biological and epidemiological evidence which has been amassed over nearly a half century and implicated abortion as a risk factor for breast cancer. 

At the Coalition on Abortion/Breast Cancer, we witnessed a sorry spectacle when a vote came up for this measure in May 2001. Lieutenant Governor Corinne Wood, an abortion supporter, breast cancer survivor and spokesperson, testified in opposition to it. Outrageously, her testimony meant that other women would not be spared her own suffering. She argued that women should be kept in the dark about the research because those who’ve had abortions would only be made to feel more “guilt.” We wonder: what does she think women should feel guilty about? Certainly, this was never an issue when the tobacco-cancer link was debated. 

Wood’s testimony meant that women who’ve had abortions will continue to be denied life saving health care information. Millions of post-abortive women don’t know they’re at increased risk for the disease and aren’t seeking early detection. Abortion-bound teenagers and their parents have been left in the dark. They aren’t being informed about a National Cancer Institute commissioned study finding that women under age 18 who procure abortions more than double their risk and those with a family history of the disease just about guarantee themselves breast cancer if they obtain abortions. [1] 

Women aren’t being told about staggering evidence independently linking abortion with the disease, including: 1) 28 out of 37 peer reviewed epidemiological studies, 17 of which are statistically significant; 2) An animal study showing more aborted rats can be reliably induced to develop breast cancer when exposed to a carcinogen than virgin rats and rats having full term pregnancies; and 3) A sound biological explanation pointing to estrogen overexposure as the culprit which makes such good sense to scientists that they don’t bother to challenge it. [Reference www.AbortionBreastCancer.com] 

Not surprisingly, the same organizations which profit from abortion were also on record as opponents of the measure - Planned Parenthood, the American Civil Liberties Union and the National Organization for Women (NOW). Shockingly (but not surprisingly), a lobbyist for the Illinois State Medical Society who was also present did absolutely nothing to defend women’s health, but rather sat with lobbyists from Planned Parenthood and company. Other legislators calling themselves “pro-choice” fought bitterly against this measure as well, including Senators Christine Radogno, Debbie Halvorson and Kathleen Parker. 

This bizarre spectacle was replayed during a press conference on Sunday when Lisa Madigan berated her opponent in the race for Illinois attorney general, Joe Birkett, for having supported the formation of a state task force. Dipping into the feminists’ arsenal of stock political slogans, she lobbed the accusations that he was “exploiting breast cancer for political purposes” and “playing politics with women’s health.” (How many times have we heard that nonsense in the last thirty years?) 

Most egregiously, Madigan falsely reassured women of the safety of abortion by asserting that “there is no proof” of a link. Did you notice the high bar she set for women’s health - proof of a link between an optional surgical procedure (a choice) and a deadly disease? Isn’t that the same impossible standard tobacco executives once demanded? Proof can only be obtained by doing unethical experiments on women. New Jersey breast cancer surgeon Angela Lanfranchi, M.D., F.A.C.S. illustrated the absurdity of Madigan’s high standard. Claiming that “the abortion-breast cancer studies show a causal relationship,” Lanfranchi explained, “The only proof would be if you took 100 closely matched women and impregnated them, aborted 50 of them and then followed them to see who got more breast cancer. Since that is an unethical thing to do to a human, we have been able to do that in rats.” [2] 

Madigan’s attack on Birkett was so intense that a person has to wonder: What is Lisa Madigan so afraid of? After all, we’re only asking for an examination of the research which has been amassed over nearly a half century. Is it possible for women to have too much health care information? Could that be what Madigan really fears? As a “pro-choice” politician who has the support of the abortion profiteers, is she capable of being impartial about the research? Let’s be honest. Pro-life women don’t get abortions. Only abortion supporters do. Is their welfare really a matter of concern for her? 

Just this week, the National Physicians Center for Family Resources released a CD citing breast cancer as a long-term complication of abortion. The CD is intended for parents and health educators in educating children about sexual health. This medical organization joins other medical organizations who’ve recognized the significance of the abortion-breast cancer research, including: the American Association of Physicians and Surgeons, the Catholic Medical Association and the American Association of Pro Life Obstetricians and Gynecologists. After publishing this information in a press release, we called upon Madigan to retract her irresponsible statement that there is “no proof” of a link. What was Madigan’s response? Complete silence. 

What will be the political consequences for Lisa Madigan, Corinne Wood, et al. when the public finally learns the truth that abortion raises breast cancer risk? Women and their families will be “spitting nails.” They will speak of their betrayal for political and financial gain. They will liken Madigan’s and Wood’s behavior to that of tobacco state politicians when the tobacco-cancer link was being debated in the mid-20th Century. Taxpayers will ask hard questions too, such as: how much have we spent to finance Planned Parenthood over the years, and how much will we have to pay for the increased cost of health care as a result? 

Since the 17th Century, scientists have observed that childbearing patterns strongly influence breast cancer risk. They observed that nuns had a high incidence of breast cancer and hypothesized that childbearing must offer some increased protection. Modern-day scientists have long accepted that childlessness, late first full term pregnancy and lack of or short lifetime duration of breastfeeding increase risk. 

Conversely, medical experts have universally agreed since 1970 that the earlier a married woman has a first full term pregnancy, the lower her risk is. Population controllers at Planned Parenthood and NOW know that the longer a woman postpones her first full term pregnancy, the smaller her family is likely to be. 

Significantly, a large meta-analysis of 47 studies in 30 countries was published in the British journal Lancet in July which confirmed what scientists have long believed to be true, but nevertheless it was touted in the media as a revelation. Women who have larger families and who breastfeed more over the course of their lifetimes have a much reduced risk for the disease - 4.3% for every 12 months of breastfeeding and 7.0% for each birth. The author of the meta-analysis, Professor Valerie Beral, a long time denier of the abortion-breast cancer link, said breast cancer rates in the developed nations could be cut by more than one half if only women would bear more children and breastfeed longer. [3] Is it logical for Madigan and her pals to say that abortion doesn’t cause breast cancer at least in this way? Should they be promoting abortion sales? 

We know that abortion isn’t the only risk factor for the disease and that not all women who’ve had breast cancer have had abortions. We also know that it was once considered a grandmother’s disease, but in only a few short decades it’s become a young woman’s disease. Many of the teenagers procuring abortions today will have to fight breast cancer in 15 or 20 years at the same time that they’re also raising young children. A large number of them will lose this battle, and their children will be left motherless. 

The incidence of breast cancer in the U.S. has risen sharply since abortion was legalized in 1973 - more than 40%, according to a report last year in the Journal of the National Cancer Institute. [4] Clearly, only a radical change in American society could have brought about this tragic situation. One in 8 women is now expected to be diagnosed with breast cancer in her lifetime. 

Given these circumstances, why are abortion and abortifacient drugs being heavily marketed to American women and falsely labeled by Madigan and radical women’s groups as “health care”? Why haven’t anti-cancer organizations, whose funding is derived in part from an ever-increasing pool of cancer patients and survivors, blown the whistle on this mammoth enterprise? Why haven’t they embarked on a public health awareness effort to considerably reduce breast cancer rates through the most effective means known: increased childbearing and breastfeeding? Two Japanese studies had already reported increased risk by 1973 when abortion was legalized. [5] Why didn’t anti-cancer organizations tell women about the existence of these studies and subsequent research spanning almost five decades? Were women ever supposed to know the truth? 

References: 1. Daling et al. (1994) J Natl Cancer Inst 86:1584-92. 2. Russo & Russo (1980) Am J Pathol 100(2):497-512. 3. Beral V (July 20, 2002) The Lancet 360:187-95. 4. Howe H et al. “Annual Report to the Nation on the Status of Cancer (1973 through 1998), Featuring Cancers With Recent Increasing Trends;” J Natl Cancer Inst (June 6, 2001) 93:824-842. 5. Segi et al. (1957) GANN 48 (Suppl.):1-63; and Watanabe & Hirayama (1968) Nippon Rinsho 26:1853-9.

Commentary on National Cancer Institute’s March 6, 2002 Fact Sheet

by Scott Moon, M.D.,

Mississippi Radiation Oncologist,

March 2002

When I used to hear the name "National Cancer Institute" or "NCI" words and phrases I would naturally associate with this institution included "serious science, cutting-edge cancer research, quality health care service and information".  I routinely and confidently referred patients of mine to the NCI PDQ web-site without hesitation as I was sure that they would find the most up-to-date, scientifically sound information available.  I am intentionally using the past tense because I have just read the most recent Cancer “Facts” updated 3/6/02 regarding the Abortion Breast Cancer (ABC) link on the NCI web site.  One word that describes my impression of the information on this issue is “outraged”.

The ABC link was unfortunately completely ignored during my training years in Radiation Oncology from 1993-1997 so I will admit that I am by no means an expert on this topic.  However, anyone with even a mild interest in this controversial issue will have little trouble unearthing a very statistically sound meta-analysis done by Dr. Joel Brind titled:

“Induced Abortion as an Independent Risk Factor for Breast Cancer: A Comprehensive Review and Meta-Analysis” In the Journal of Epidemiology and Community Health 481 (1996).

This analysis provides strong, scientifically valid evidence demonstrating a significant link from elective abortions to breast cancer comparable to other recognized factors such as early menarche, late menopause, and nulliparity.

In addition, Dr. Brind and others have provided well-reasoned critiques about the many weaknesses of the Melbye study.  Even though the Melbye study is the primary evidence relied upon by the NCI review piece to assert that there is no link, they choose to gloss over the known weaknesses rather than dispassionately addressing them.  I was left with the impression that the Melbye data is viewed by the NCI in an almost reverential manner.  It is as if this study provided unimpeachable data nearly equal to a landmark randomized trial that we could all look to when making day-to-day clinical decisions when in fact nothing could be further from the truth.

Given the fact that there is a wealth of data to support an ABC link, and given the fact that the NCI statement addressing this issue completely ignores the information rather than challenging it in a well balanced serious manner, two conclusions emerge as likely explanations:

The author has either not done adequate research prior to posting such a sweeping statement dismissing the ABC link with such certainty, or there is a deliberate attempt to ignore the opposing view point because the author’s own point of view would not hold up to the challenge.  Neither choice reflects favorably upon the NCI as a respected health care leader.

To summarize why this outrages me, by completely ignoring the known scientific evidence in support of the ABC link, the NCI is exposing women to significant harm in two different ways.

Number 1:  Women who are considering an elective abortion and who are denied this critical information are being denied their right to an informed consent. They are, in effect, blindly submitting to an elective procedure that could result in the development of a cancer and potentially death.

Even if one is not convinced that there is a definite link between ABC, shouldn’t we err on the side of caution?  Are we doing more harm by providing a woman with too much information or by censoring out information about a potentially life-threatening side effect from her decision making process?

Number 2:  The Gail risk assessment model is used to help determine which high-risk women should be considered for prophylactic Tamoxifen therapy to prevent breast cancer.  It incorporates factors with RR values <2 including early menarche and nulliparity.

How many women are being denied the opportunity to be considered for this potentially life-saving prophylactic therapy by those who for whatever reason have chosen to ignore the significant RR associated with ABC link?

There is simply no justification for NOT addressing the weighty arguments and evidence regarding the ABC link head on and factoring in this very real risk factor into mainstream medical practice if and when it holds up under the intense scrutiny that any scientific position deserves.  Until the NCI directly addresses the evidence submitted by Dr. Brind and others, statements contained in the NCI “fact” statement like:

“…The current body of scientific evidence suggests that women who have had either induced or spontaneous abortions have the same risk as other women for developing breast cancer…” should be clearly labeled as “opinion” rather than fact.

Since such undeniable controversy continues to revolve around this issue, and since the stakes are so high regarding the potential impact on the health and lives of the millions of women in this country, I have a suggestion.  Wouldn’t it be reasonable and morally responsible to have an open debate between the most knowledgeable scientists and physicians on either side of the argument followed by an updated and scientifically valid “fact” statement?

Scott D.M. Moon,

M.D. Radiation Oncologist

McComb, Mississippi