By Joel Brind, Ph.D.
Editor’s note. This story, which appeared in the September 2003 issue of National Right to Life News, is Thursday’s installment in our year-long “Roe at 40” series which brings you some of the best stories from National Right to Life News going back to 1973. We have carried dozen literally scores and scores of stories about the link between an induced abortion and an increased incidence of breast cancer. This particular story is one of the few where Joel Brind could celebrate an honest assessment of what he calls the “ABC link.” Although a decade old, there is a load of useful information.
NRL News readers are familiar with accounts of how political bias distorts mainstream reports of anything to do with abortion. Thus, a baby is described as anything but a baby, and abortion is described as anything but taking the life of a baby. And of course, abortion is always described as safe, safe, safe.
How refreshing it is to find, in a mainstream medical journal, a no-punches-pulled expose of the politics that keep the lid on the abortion-breast cancer link (ABC link).
Karen Malec’s “The abortion-breast cancer link: how politics trumped science and informed consent,” appears in the September issue of the Journal of American Physicians and Surgeons.
Malec begins by making a crucial point: published evidence of the ABC link appeared as early as 1957, preceded Roe v. Wade by 16 years. Had such evidence not been suppressed, Malec notes, “The court’s opinion of abortion safety might have been different.”
From there, Malec succinctly catalogs the history of epidemiological research, including some of the breathtaking omissions, misrepresentations, and denials by many of the scientists involved. And she names names. And Malec cites her sources, with two pages of references.
Among the most glaring omissions that Malec details occur in the high profile review of cancer incidence and mortality which appeared in the “Journal of the National Cancer Institute” in 2001. Although the first two authors of that study had previously published evidence supporting the ABC link, the word abortion never appeared in the review.
That omission was shown to be doubly significant when one actually examines the data presented in the review. The data clearly show that the increase in breast cancer incidence from the mid-1980s to the end of the century occurred only among women young enough to have obtained legal abortions.
Malec points out that the magnitude of this breast cancer increase is in line with predictions my own research team made in our 1996 “Comprehensive review and meta-analysis.”
Malec includes numerous references to my own research and commentary. How refreshing it is to be quoted so liberally, and have all the quotes accurate and in context! There is, however, one phrase of mine, “outcome based science,” which warrants further explanation.
As Malec correctly points out, I employed this phrase in characterizing a 1997 study on Danish women headed by Mads Melbye. This study has been widely cited as supposedly disproving the ABC link.
Malec notes the inappropriateness of using one study to draw a conclusion, especially in light of so much evidence to the contrary. However, my descriptor was really a literal reference to a very serious violation of scientific procedure embodied in the Melbye study.
One of the most obvious and inviolable rules of epidemiological (or any other scientific research) is that the exposure must always precede the outcome.
Melbye included all cases of breast cancer diagnosed in his Danish study population since 1968. However he only included abortions performed since 1973. Since the study was purportedly looking for any effect of abortion (the exposure) on the incidence of breast cancer (the outcome), he had put the epidemiological cart before the horse, by some five years.
There is also the second implication of the term “outcome based science” by which I mean that researchers adjust their data calculations in order to obtain the outcome they desire. In the case of the ABC link, that would be to indicate that there is no such link!
Malec’s review (though only three pages long) certainly conveys the flavor of the widespread hypocrisy (and worse) that has characterized research on the ABC link. There is much more to this iceberg beneath the surface, as the pages of NRL News have documented over the last 10 years.
Malec considers the implications of ABC link research and politics on doctors and their patients. She points out that doctors have a duty to inform their patients of potential harm of any surgical procedure for which evidence has been published, “even if uncommon and not definitively proved.”
No doubt many doctors (and patients) who read Malec’s review will be skeptical that a profession dedicated to patients’ health and well-being would ever stoop so low as to knowingly deny the potential dangers of their services to their patients. Malec addresses such skepticism by concluding her review with a quotation from eminent breast surgeon Angela Lanfranchi, who recounts the famous story of Dr. Ignaz Semmelweis.
Semmelweis, a resident in Vienna during Beethoven’s time, was distressed that one in four women in the care of hospital physicians died in childbirth, of childbed fever. He noticed that midwives’ patients only died at the rate of one in fifty, and all the midwives did differently was wash their hands.
“It must have been very embarrassing for the greatest medical professors of his time to be told by a lowly resident that they were responsible for many women’s deaths,” Lanfranchi said in a speech. For proving that this simple procedure made all the difference, Semmelweis was rewarded with the destruction of his reputation and career.
More importantly, women continued to die needlessly for another 30 years “until the germ theory proved Semmelweis was correct.”
And now, with legal abortion, it is young women who suffer again.
We tend to put doctors and scientists on a pedestal, but Malec shows us they are human, and subject to be driven to denial by powerful political forces.
They should read her article on how this continues to unfold in the context of the ABC link. So should you.
Karen Malec is president of the Coalition on Abortion/Breast Cancer. Her web site is www.abortionbreastcancer.com.
Joel Brind, Ph.D., is a professor of human biology and endocrinology at Baruch College of the City University of New York.