by Joel Brind, Ph.D.
Since 1994, the National Cancer Institute (NCI) has maintained an “Abortion and Breast Cancer” fact sheet on its web site, prompted by the results of a high-profile study which the Institute had funded specifically to investigate any connection. That study, by Dr. Janet Daling of the Fred Hutchinson Cancer Research Institute in Seattle, Washington, reported a significant overall increase in risk of fifty percent for women who had reported having had an abortion. Buried in the text of the full paper were even more ominous results of much greater risk increases — more than one hundred percent greater — for women who had had an abortion when under age eighteen, over age thirty, and even greater for such women who had a family history of breast cancer.
In 1996, I and three colleagues from the Pennsylvania State Medical College in Hershey published our comprehensive review and meta-analysis in the British Medical Association's epidemiology journal, in which we reviewed, qualitatively and quantitatively, all of the published abortion-breast cancer (ABC) studies then extant. Eighteen of twenty-three showed increased breast cancer risk, nine out of ten in the United States. (The table is reprinted in Ethics & Medics 28.1 [January 2003]: 4.) We also discussed how the great surge of the hormone estrogen during a normal pregnancy could indeed be responsible for increased risk if the pregnancy is aborted. (Moreover, the subnormal estrogen level of most pregnancies which miscarry explains why miscarriages generally do not increase breast cancer risk.)
NCI's Change of Position
The NCI's fact sheet on abortion and breast cancer has undergone some changes since 1996, but none so drastic as this past March, when the fact sheet shifted to the position: “It appears that there is no overall association” between abortion and breast cancer. It relied heavily on a 1997 study on Danish women, which study (whose methodological flaws were egregious) reported “no overall effect on the risk of breast cancer.” In June 2002, twenty-eight members of Congress, armed with an analysis published by the National Physicians Center for Family Resources that called into question the fact sheet's statements, objected to this change and petitioned the Secretary of Health and Human Services (HHS) to “remove” and “reevaluate” the fact sheet, believing it “scientifically inaccurate and misleading to the public.”
Within a month, the Congressmen's request was granted, an action which prompted predictable outrage from “safe abortion” advocates. In late November, the removed fact sheet was replaced with a statement on “Early reproductive events and breast cancer risk.” The new statement called the ABC link “inconclusive,” and announced an NCI workshop to be conducted in late February of this year to help determine the current state of knowledge and the direction of future research.
As of this writing, the NCI “workshop” has been concluded. Exactly what will become of the final NCI policy statement posted on its website is not yet known. However, the NCI has posted the workshop's finding, i.e., that it is “well-established” that “[i]nduced abortion is not associated with an increase in breast cancer risk.” The website also notes — as do editorials in the New York Times and elsewhere — that two NCI advisory panels have approved the findings.
Behind the Posturing
But what really happened? Sad to say, the “open, complete and vigorous scientific review” of which the NCI Director, Dr. Andrew von Eschenbach, had spoken, did not take place. The workshop — to which I was an invited participant — was nothing more than a heavy-handed political power play designed to erase any credence for the ABC link. Securing my own participation was a drama in itself, and I was formally invited only in mid-January. Yet more importantly, the workshop was set up in such a way as to guarantee the conclusion that the ABC link was not real.
There was, for example, no debate, in which advocates of both points of view could present their findings and subject them to open discussion, with the data having been made available to workshop participants well in advance of the meeting to allow proper scrutiny. Instead, there were only presentations by those scientists who had long been on record as having concluded that there was no ABC link. Janet Daling was invited to speak, but on the unrelated issue of genetic markers of breast tumors. When I explicitly asked the workshop chairperson if I would have the opportunity to make a presentation, I was turned down.
As for the opportunity to study the data, the three scientists presenting ABC data hardly mentioned what had previously been published. Instead, all concentrated on brand new, unpublished data which we had no opportunity to study. Not only was there not adequate time for such study, but an explicit request which I made on record at the meeting was turned down. The new data, I was told, would not be made available until after its publication.
Conversations with other participants revealed that there were dissenting voices at the breakout sessions that were held after the main talks. But no matter. By the time the group reassembled for the final general, on the record, session, the assembled group leaders had filtered out any dissent from the draft report. There was time and a microphone at the final general session for anyone to express any dissenting views. I expressed my dissent, but then again, I do not depend on the NCI for my funding. Most of those in the group, including the few who might be expected to agree with me, do depend on the NCI. And it was obvious that the NCI leadership had reiterated its adherence to a denial of the ABC link. Hence common sense surely dictated to NCI grantees who might have had dissenting views that expressing them would likely mean professional suicide.
Minority Report
Meanwhile, I have written an extensive minority report, and posted it on the Breast Cancer Prevention Institute website. Of course, for any properly conducted review of a controversial issue, such an opinion of an official participant should have been solicited, and at least posted on the NCI's website.
Perhaps my minority report — and maybe even others — will find their way onto the NCI's website. Hope springs eternal. Perhaps something can be salvaged of the latest battle. After all, it is a matter of settled science, which the workshop report reiterated, that full-term pregnancies lower a woman's long-term risk of breast cancer. Hence, a statement that warns pregnant women that choosing abortion will increase their long-term risk would be in order. Yet even the admission of that obvious established fact is certain to invite the wrath of the “safe abortion” crowd.
It would seem that President Bush's HHS officials have tried to do the right thing, but have underestimated just how dedicated the establishment scientists are to the legal status of abortion.
And obviously, to them, that means defending the reputation of abortion as safe for women, no matter what.
(This article courtesy of Steven Ertelt and the Pro-Life Infonet email newsletter. For more information or to subscribe go to www.prolifeinfo.org or email infonet@prolifeinfo.org.)
