'Study of Studies' Confirms Abortion Link to Breast-cancer

by Joel Brind, Steven J. Condly, Angela Lanfranchi and Brent Rooney

A 1996 "comprehensive review and meta-analysis", coauthored by one of us (Joel Brind) on the association between induced abortion and breast cancer, stated that the extant worldwide literature had already demonstrated "a remarkably consistent, significant positive association between induced abortion and breast cancer incidence, independent of the effect an induced abortion has in delaying first full term pregnancy (FFTP)".

Importantly, if these conclusions were correct, the impact on breast cancer incidence should be clearly evident by now, over 20 years later. This is especially true, considering the worldwide expansion of legalized abortion during the late 20th century and the latency in the development of breast cancer. In fact, evidence abounds that supports this conclusion, especially as elective abortion has played its part in the "Westernization" of cultures in the developing world, such as in Asia. In regard to mainland China, for example, one study stated unequivocally in 2008: "China is on the cusp of a breast cancer epidemic."

Clear and abundant evidence notwithstanding, the reality of the abortion-breast cancer association is still widely discounted or disputed. For example, E. Linos et al., in their lengthy analysis of "an emerging epidemic of breast cancer in China", managed to avoid a single mention of the word abortion, even as they predicted that millions of Chinese women would fall victim to breast cancer in the coming decades, "where breast cancer incidence rates are approaching those in Western nations, in which breast cancer is the most commonly diagnosed female cancer".

We searched the medical literature for studies on breast cancer incidence in women in South Asia (India, Pakistan, Bangladesh, Sri Lanka, Bhutan and Nepal) published in the English language since January 1, 2000. Bibliographies of all studies identified were also searched. In all, 26 primary studies were located.

As in other parts of the developing world, breast cancer is now becoming established as the most common cause of death among middle-aged women in South Asia, catching up to the industrialized world where this has been the case for over two decades. In the West, induced abortion is the single best predictor of breast cancer incidence in at least eight European countries. Similar findings have clearly emerged in China, where the institution of the one-child policy in 1980 made induced abortion commonplace, though almost exclusively after first childbirth.

In South Asia, both breast cancer and induced abortion have been relatively rare until recent years. Since the typical traditional South Asian woman (at least among the rural population) neither drinks nor smokes, marries in her teens, begins having children immediately thereafter, has several children and breastfeeds them all, there are few prevalent risk factors for breast cancer.

To obtain a most conservative projection of future impact on the more than 800 million females now alive in South Asia, we assume a 21.5% prevalence of induced abortion and an absolute lifetime breast cancer risk increase of 3%. We thus obtain an estimated 5.16 million South Asian women now alive who will have been diagnosed with breast cancer in their lifetimes. With a current mortality rate of approximately 50% (compared to about 20% in the West), over 2.5 million South Asian females alive today can be expected to die of breast cancer attributable to induced abortion.

It has now been more than six decades since the first peer-reviewed evidence of induced abortion as a breast cancer risk factor appeared in the large nationwide study in Japan by M. Segi et al., two decades since the first review and meta-analysis of worldwide studies reported an overall significant link in worldwide studies, and one decade since P.S. Carroll's revelation of induced abortion as the single best predictor of breast cancer incidence in Europe.

Our present report documents the substantial literature of at least 20 new studies published just within the last decade in South Asia alone, summarizing a significant and moderately strong, dose-dependent association between abortion and breast cancer. This association emerges across a diverse array of study populations and designs, and it is supported by now substantial understanding of the biological mechanisms that undergird it.

Nevertheless, health ministries in the U.S. and around the world, as well as medical associations and even voluntary anticancer organizations echo messages of denial of any effect of induced abortion on breast cancer risk. For example, the current guidance of the U.S. National Cancer Institute flatly states: "Women who have had an induced abortion have the same risk of breast cancer as other women." Instead, abortion is still touted as a safe procedure, and even the World Health Organization (WHO) does not list abortion as a risk factor, even though breast cancer is now the most common cause of cancer death for women worldwide.

Continuing denial of abortion's effect on breast cancer risk can only ensure that the acknowledged worldwide breast cancer epidemic will continue to worsen, costing many millions of women their lives over the next several decades.

The study's co-authors are Joel Brind, PhD, professor of biology and endocrinology, City University of New York; Steven J. Condly, PhD, a research psychologist at West Point military academy; Angela Lanfranchi, MD, FACS, a breast surgical oncologist and clinical assistant professor of surgery at Rutgers Robert Wood Johnson Medical School in Piscataway, New Jersey; and Brent Rooney, MSc, research director of the Reduce Preterm Risk Coalition, Canada.

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