Another ABC Controversy

Babette Francis - ONLINE Opinion, 9 December 2013

No, this is not about the Australian Broadcasting Corporation though possibly it will figure in the discussion at some stage because the ABC's views on controversial issues such as abortion are biased: commitment to pro-choice policies and no ABC staffer keen to present a pro-life perspective. However the ABC in the title of this Opinion piece relates to another controversy, the increased risk of breast cancer caused by induced abortion - this is known as the Abortion Breast Cancer (ABC) link.

A stunning new meta-analysis on the ABC link has just been published in a peer-reviewed cancer journal. Described as "Chinese Abortion-Breast Cancer bombshell" the meta-analysis of 36 Chinese studies from 14 provinces in China shows abortion increases breast cancer risk by 44%. This meta-analysis is particularly relevant to abortion legislation in Victoria where doctors are coerced, against their better scientific judgement, to refer women for abortions.

Dr. Joel Brind, Ph.D., professor of biology and endocrinology at Baruch College, City University of New York and cofounder of the Breast Cancer Prevention Institute, USA, reports that the new systematic review and meta-analysis of abortion and breast cancer in China, published in November in the prestigious, peer-reviewed international cancer journal, "Cancer Causes and Control," showed that the overall risk of developing breast cancer among women who had at least one induced abortion was significantly increased by 44%. In this meta-analysis (a review of studies in which results from many studies are pooled), Dr. Yubei Huang et al combined all 36 studies that have been published through 2012 on the ABC link in China.

These results, said the authors, "were consistent with a previously published systematic review" referring to the 1996 review and meta-analysis that Dr. Brind compiled with colleagues from Penn State Medical Center, published in the British Medical Association's epidemiology journal. His study reported an overall significant 30% increased risk of breast cancer in worldwide studies. The new Chinese meta-analysis is a real game changer, not only does it validate the earlier findings from 1996, its findings are even stronger, i.e. shows a 44% increased risk versus the 30% increased risk in Dr. Brind's meta-analysis of 1996.

Dr. Brind comments: "Noteworthy is that the Huang study follows right on the heels of two new studies this year from India and Bangladesh, studies which reported breast cancer risk increases of unprecedented magnitude: over 600% and over 2,000%, respectively, among women who had any induced abortions."

Huang's meta-analysis also shows what is called a "dose effect", i.e., two abortions increase the risk more than one abortion (76% risk increase with two or more abortions), and three abortions increase the risk even more (89% risk increase with three or more abortions). Risk factors that show such a dose effect have more credibility. Although previous studies of the ABC link were a bit more heterogeneous and the dose effect less clear, it has been shown that the risk increase is greater the longer the pregnancy continues before abortion. Hence, an 18-week abortion increases the risk more than a 12-week abortion, and a 12-week abortion increases the risk more than an 8-week abortion.

In this new meta-analysis Huang et al. put to rest the main argument used to discredit the ABC link, variously called the "response bias" or "recall bias" or "reporting bias" argument. The argument goes like this: due to social stigma that is attached to having an abortion, healthy women are more likely to deny prior abortions in their medical history questionnaire than are women who've developed breast cancer. Hence, the argument goes, it would erroneously appear that breast cancer is more frequent among women who've had an abortion. (Feminists gullibly accept the argument that women routinely lie on medical questionnaires!)

Huang et al. dispatch this canard. They explain, "The lack of a social stigma associated with abortion in China may limit the amount of underreporting and present a more accurate picture of this (abortion-breast cancer) association."

Huang et al. then proceed to explain why two earlier high-profile studies in Shanghai did not find the link. They do so essentially by citing and pursuing the argument Dr. Brind articulated in the "British Journal of Cancer" in 2004, and more importantly, proving the point by performing a "meta-regression" of all the Chinese data.

In Dr. Brind's 2004 published letter, he explained that the Shanghai population was unsuitable for studying the ABC link in the usual manner, because the prevalence of abortion was too high in the general population.

In essence, the value of epidemiology is to identify exposures-like abortion-which may increase the risk of a given disease-like breast cancer-by comparing those exposed to the typical, unexposed population.

But when the prevalence of the exposure becomes the rule rather than the exception-as in the Shanghai studies where the majority of women had had at least one abortion-the unexposed women are not typical.

Instead they are women who have had no or fewer children and/or started having children at a later age, all of which put them at higher breast cancer risk.

Hence, comparing women who've had an abortion to women who are at elevated risk for other reasons makes the risk due to abortion tend to disappear. Huang et al.'s meta-regression analysis showed a clear tendency for the risk due to abortion to seem to decline as the prevalence of abortion among the healthy population increases, among all the studies in China.

Dr. Brind comments: "As I have shown in previous stories for (US) National Right to Life News and and National Right to Life News Today, objective research like this has been relentlessly targeted by abortion advocates entrenched in universities, medical societies, medical journals, breast cancer charities, and especially, government agencies such as the (US) National Cancer Institute.

"This assault culminated in a 2003 international phony 'workshop' by the NCI, which officially declared the ABC link non-existent. Since 2003, armed with this new official 'truth,' the National Abortion & Reproductive Rights Action League (NARAL) and their ilk have unapologetically and publicly attacked pro-life pregnancy resource centers for 'lying' to women by telling them about the ABC link. In places like Maryland, San Francisco, Austin and New York City, they even went so far as to enact laws to muzzle these women-helping- centers. Thankfully, most courts have struck down such laws as violations of free speech rights–so far.

"It is really frightening when you start doing the math on the impact of abortion on a population of over a billion women-in India and China alone: Just a 2% lifetime risk of breast cancer due to abortion-a very conservative estimate-means upwards of 10 million women getting breast cancer, and millions dying from it. Hopefully, the day is near when the official purveyors of public health information-like the NCI-will no longer be able to deny the ABC link. The new Chinese meta-analysis should hasten that day considerably."

Reggie Littlejohn, President of "Women's Rights Without Frontiers", said the research reveals "yet another human rights violation in connection with China's One Child Policy. So, the women of China have to endure the tremendous trauma of late term forced abortion, taking their babies from them, and then years later, breast cancer, taking their health and even their lives from them."

Mary L Davenport, MD, FACOG, Medical Director, Magnificat Maternal Health Program and immediate past president of the American Association of Pro-Life Obstetricians and Gynecologists wrote in The American Thinker that the Huang meta-analysis is another example of the recent excellent scholarship on abortion in peer-reviewed journals coming out of the People's Republic. There is no bigger data base than China, where there are an average of 8.2 million pregnancy terminations every year, and 40 abortions for every 100 live births. Chinese researchers and physicians are unencumbered by abortion politics, and do not cover up data showing long term effects of induced abortion, as do their US counterparts in governmental, professional and consumer organizations.....

" Professor Brind, is not unique in having experienced censorship of his findings for the past two decades, including at the notorious National Cancer Institute (NCI) workshop on 'Early reproductive events and breast cancer' in 2003. This important workshop was manipulated by its chairperson NCI epidemiologist Louise Brinton to suppress critical information on the abortion-breast cancer link. The main speaker on abortion and breast cancer, Leslie Bernstein, who had never published on this topic, openly said 'I would never be a proponent of going around and telling women that having babies is the way to reduce your risk,' even though it has been an established fact, conceded by abortion proponents, that this is true.

"The NCI workshop was designed to influence subsequent governmental policy, academic scholarship, physicians, and popular perception of the topic, and succeeded in doing so. It also influenced the individual life trajectories of many women who were led to believe, falsely, that an abortion decision would not have an impact on their future breast cancer risk. Because there is a lag time between abortion and the appearance of breast cancer, the effect of an abortion is not immediate for an individual. And abortion is only one of a number of factors influencing breast cancer risk, such as family history, use of hormones, and age at first childbirth.

"The majority of women who have breast cancer have never had an abortion. Nonetheless, there will be some women who develop breast cancer and die from it, impacted by the failure to inform them of the ABC link, and its dismissal by establishment medical and consumer groups such as the American College of Obstetricians and Gynecologists and the Susan Komen Foundation. This is an ethical breach of huge proportions.

"The new Chinese meta-analysis not only concerns the ABC link on an individual level, but also confirms the observation of statistician Patrick Carroll, who predicted the rise in breast cancer in several European countries following legalization of abortion. Again, because of the lag time between abortion and the appearance of breast cancer, the link is not immediately apparent. Carroll's work is important because he finds that not only is induced abortion an independent risk factor for breast cancer (separate from such factors as late child-bearing) but that it is the best predictive factor for forecasting a nation's future breast cancer rates. Nations such as China, with traditionally low breast cancer rates, are now seeing an increase, many years following their legalization of abortion."

Interesting, Dr. Louise Brinton, chairperson of the NCI workshop which concluded there was no ABC link, has been caught out because in 2010 she co-signed a study by Jessica Dolle et al. of the Fred Hutchinson Cancer Research Center which found that "a statistically significant 40% increased risk of breast cancer exists for women who have abortions." Dr. Brinton has since refused media requests for interviews or comments.

The Cancer Council of Victoria has also refused to meet with me and a doctor who has written on the ABC link. Cancer Councils in Australia encourage women to dress in pink outfits and jump and run to raise money for research, but do not tell women of research already available. It would be interesting to have their staff salaries and "administrative" costs published as has happened with the salaries of the Australian Broadcasting Corporation.