As ABC Link Evidence Continues to Mount, Worldwide Cover-up Sinks to New Lows
Joel Brind Ph.D.
It has been famously noted that facts-like the fact that abortion increases a woman's risk of getting breast cancer - are stubborn things. One hopes that means that eventually, the truth always comes out. But along the way, we also see that necessity - like the political necessity to cover up the truth of the ABC link - is the mother of increasingly inventive ways to do just that.
The Abortion-Breast Cancer link was first documented in the peer-reviewed medical literature in 1957. By 1996, about two dozen studies from around the world made the link unequivocal in my view. I and several colleagues published a comprehensive review and meta-analysis (in the British Medical Association's epidemiology journal) which documented a significant, overall breast cancer risk increase of about 30%.
But peer-reviewed papers from the most prominent sources of public health information, most notably Oxford University and the US National Cancer Institute (NCI, an agency of the US Federal Government), published flawed study after flawed study claiming to show no risk. So by 2008, the very idea that abortion could increase a woman's risk of breast cancer was viewed as heresy worldwide.
The main argument used by ABC-link deniers is variously called "reporting bias" or "response bias" or "recall bias". It goes like this: When you construct a standard, retrospective "case-control" epidemiological study, you identify a group of women with breast cancer (the "cases") and a similar sized group of similar women who do not have breast cancer (the "controls"). Then, via questionnaires and/or interviews, you find out-among other relevant data pertaining to medical and reproductive history-who had any abortions and who did not. If more of the cases have had abortions compared to controls, this translates to the association of increased risk with abortion; numerically, a "relative risk" greater than 1. Moreover, if standard statistical modeling determines that one can be more than 95% certain that the association is not due to chance, the result is said to be statistically significant.
Honest and sincere public health professionals would surely never dismiss a significant relative risk of 1.3 (as we reported in 1996 in the aggregate of extant worldwide data), especially for a life-threatening disease like breast cancer and a common elective surgical procedure like abortion, would they?
Enter response bias. Suppose, in the study outlined above, there really is no difference in the frequency of abortion among the cases v controls, but the healthy controls are more likely than the women with breast cancer (cases) to deny their abortion history. Then it would falsely appear that abortion was associated with breast cancer, due to response bias: a bias, or difference in the accuracy of reporting between the case and control groups.
As plausible as this response bias may seem, credible evievidence of its existence in ABC link research has never been demonstrated. In fact, it has been repeatedly proven not to exist in ABC link studies. That stubborn fact, however, has not deterred the ABC link deniers from repeatedly citing the same discredited hypothesis-as if it were fact-to accomplish their political objective of erasing the ABC link from the public mind.
Of course, if the ABC link were real, we would expect that by now-with abortion rates exploding around the world in recent decades, especially in Asia-we would be witnessing a growing worldwide breast cancer epidemic. We are. In late 2013, Dr. Yubei Huang and colleagues published a systematic review and meta-analysis of 36 studies in mainland China. They reported an overall 44% increase in breast cancer risk among women with one or more abortions; up to an 89% risk increase among women with three or more abortions.
Moreover, by 2014, no fewer than 13 studies on women from South Asia (India, Pakistan, Bangladesh, Sri Lanka) had been published. Every one of them showed increased risk, with relative risks as high as 10 and 20! These join other recent studies (from the past 10 years) from elsewhere in Asia (Iran, Kazakhstan), the Mideast (Egypt, Palestine, Iraq) and elsewhere (Turkey, Armenia, Mexico) confirming the ABC link.
Sorry, epidemiologists, response bias does not explain relative risks of 10 or 20, even if it had any validity at all. And in the most recent study-yet another one from India, making the total number of Indian studies 11, all since 2008-is the strangest yet. The authors of this 2016 study by Nagrani et al. actually acknowledge that they have observed increased breast cancer risk with induced abortions, and even that: "most previous case-control studies have observed a positive association between induced abortion and breast cancer". But they are quick to explain, on the basis of severely flawed studies based on medical records instead of retrospective interviews or questionnaire, that these results are "likely to be due to recall bias."
The reason this typical invocation of recall bias is so egregious in the Nagrani study, is the clear finding of what is called a "dose effect." This means that the risk increase found among women with two or more abortions was clearly greater than that observed among women who had a history of only one abortion (as had been also documented in 36 Chinese studies). So we are therefore supposed to think that healthy women who have had one abortion will report it accurately in a study, but once they have had their second abortion, they will start lying about their abortions to the epidemiologists doing the study? In other words, the minimal, non-significant risk increase (10%) Nagrani et al. reported to be associated with one abortion is supposed to be pretty accurate, but the significant, (58-108%) risk increase associated with two or more abortions can be dismissed as an artifact caused by recall bias?
So just who are these wizards of smart who believe that you, dear readers of their study are so stupid and/or so ill informed as to believe such nonsense? Well let's see: You would be reading the 15th published, peer-reviewed South Asian study since 2008 alone that reported data on the ABC link, all of which previously having reported positive evidence of the link, and you would not have noticed that not one of those previous studies was ever mentioned or cited as a reference!
As I have been studying the ABC link and its cover-up for over 23 years, I go straight to the by-line. There I see that one of the co-authors, Preetha Rajamaran, works for the NCI, the US government agency that has been lying about the ABC link for over 20 years. That explains everything.