News on Chinese Study re the Abortion-Breast Cancer Link Goes Mainstream

It is not only pro-lifers now who are writing about the increased risk of breast cancer caused by induced abortion. Patrick Goodenough reporting for CNS writes that the Chinese study puts the Abortion-Breast Cancer Link back in the spotlight and may breathe new life into a debate over a long-contentious issue which both sides [of the abortion debate] have accused the other of exploiting to promote its cause.

The meta-analysis by Chinese researchers, published in the peerreviewed journal Cancer Causes and Control, found a 44 percent increased breast cancer risk after an abortion. It also found that the risk grew significantly with subsequent abortions - a 76 percent increase after two abortions, 89 percent after three.

In summary, the most important implication of this study is that "IA [induced abortion] was significantly associated with an increased risk of breast cancer among Chinese females, and the risk of breast cancer increases as the number of IA increases," said the authors, from the Tianjin Medical University Cancer Hospital's epidemiology and biostatistics department.

Just a month ago, Chinese media were reporting on a global breast cancer study which noted a 20-30 percent increase in breast cancer incidence among middle-aged urban Chinese women over the past decade. Among younger women, the study released by GE Healthcare found relatively low incidence, but said that would likely change.

"[O]ne may expect that the fundamental changes in reproductive patterns in China brought about by the implementation in the 1970s of the one-child policy, as well as current lifestyle changes in China caused by rapid economic growth, will potentially lead to dramatically increased rates of breast cancer in Chinese women", it said.

The researchers at the Tianjin hospital, China's leading cancer research and treatment institute, noted that an "alarming" increase in the incidence of breast cancer in China has coincided with implementation of the one-child policy.That government program has restricted most Chinese couples to one child, with some exceptions for rural and ethnic minority couples. Tweaks have been made along the way, but abortion continues to be a central feature in a policy that entails prohibitive fines, loss of jobs or other punishments for those who contravene their birth quota.

Cases of forced abortion and sterilization as well as infanticide have also been recorded under the policy, while sex-selective abortions favoring boys have resulted in an increasingly lopsided gender ratio, with major sociological implications."

Women's Rights Without Frontiers president Reggie Littlejohn, who campaigns against China's birth-limitation policies, said the new study revealed yet another abuse. "The strong association of abortion and breast cancer established by this study brings the women's rights violations under the one child policy to a new level: a woman pregnant in China without a birth permit is subjected to both government imposed forced abortion, and also breast cancer as a result of it," she said in a statement. "Where abortion is forced, the subsequent development of breast cancer becomes a violation of women's rights in itself."

The Chinese study was welcomed by Joel Brind, professor of endocrinology at Baruch College, City University of New York and a science advisor to the Coalition on Abortion/Breast Cancer. In an analysis, Brind called it "a real game changer" after years of attempts by various interests to discredit earlier findings, including his own, regarding an "abortion-breast cancer" (ABC) link. In a meta-analysis published in 1996, Brind reported that women had a 30 percent greater chance of developing breast cancer after an abortion. Since then, said Brind, abortion advocates, charities and government agencies had "relentlessly targeted the ABC link with fraudulent studies and other attacks."

Bias?
In 2003, the U.S. National Cancer Institute (NCI) held an expert workshop that concluded that induced abortion is not linked to an increase in breast cancer risk. The NCI's 2003 finding is widely cited, by groups like the Guttmacher Institute, which notes that despite the NCI declaration, "medically inaccurate claims" on an ABC link can still be found in the abortion counseling materials required in some U.S. states.

The Center for Reproductive Rights similarly complained this year that despite the NCI finding, newly-enacted legislation in Kansas forces doctors "to affirm scientifically inaccurate information, such as a nonexistent link between abortion and the risk of breast cancer."

The American Cancer Society also cites the 2003 NCI workshop findings, but is a little more cautious in its language: "At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer or any other type of cancer."

In 2009, an American College of Obstetricians and Gynecologists committee argued that earlier findings of an ABC link were "methodologically flawed,"since there was likely "reporting bias" present. The committee said that when retrospective studies rely on asking women about their abortion history, "the sensitive nature of abortion" could affect the accuracy of the responses.

In China, however, there is little stigma attached to abortion, a procedure often euphemistically labeled "artificial miscarriage." Figures released in September by China's National Health and Family Planning Commission showed that more than 13 million abortions take place in the country's hospitals each year, confirming figures first made public in 2009.

In fact, the new study's Chinese authors make the observation that, "The lack of a social stigma associated with induced abortion in China may limit the amount of underreporting." And that is one of the reasons Brind calls the new study a "game changer."

"Putative underreporting of abortions by healthy women has been routinely invoked to discredit the ABC link - the lack of credible evidence notwithstanding," Brind said. "This line of attack - variously called the "response bias" or "recall bias" or "reporting bias" argument, has now been neutralized."

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