Tuesday, April 24, 2007

The "ABC" Disconnection

My mother-in-law and father-in-law are wonderful people. They really are quite generous and loving. But they belong to the ultra-conservative Christian Right. As such they provide me with the perfect "sounding board" for any of my political, scientific or social arguments. If I have a viewpoint that I want to test out against the views of the Christian Right, all I have to do is let a "trial balloon" loose in one of our many conversations and I immediately get smacked in the face with the same arguments that Jerry Falwell, Pat Robertson, James Dobson, Tim and Beverly LaHaye and other right-oriented Christians.

Abortion is one of those issues that we disagree on. While I am a Christian and hold personal convictions against abortion, I also belief that God gave us choices and the freedom to be in charge of making those choices, and responsible for the same. As human beings we are inherently imperfect in our decision-making process. Throughout our history we have relied on a lot of false and inaccurate information when making many of our choices. Historically, the Christian Church, in all its manifestations, has led people to believe certain things as being "truth" that were not so. In fact, many Christians who developed contrasting or competing views, based on observation and experimentation, were persecuted, punished, ostracized or put to death.

But somewhere along the way human beings discovered science. Science began opening our eyes to some truths. However, even the best science is conducted by human beings and suffers the same inherent potential for flaws in the reasoning, including bias, prejudice and errors. But science, unlike religion or faith, if done in a conscientious manner offers us a forum and a methodology for our work to be tested, proven and critiqued. Still, not everyone approaches science in such a conscientious manner. Further, we sometimes design our experimentation based on theoretical assumptions that are later proven to be either inaccurate or incomplete. In such a case, science provides us with a forum and methodology for revamping our assumptions, our theories and re-work our experiments.

But, like my in-laws, man within the Christian Right are so convinced about the teachings of their pastors (rather than independently studying Scripture, Church history, linguistic origins of the Bible, etc.) that they refuse to listen or hear any criticism or conflicting information, especially if that information comes from science. A good example of this is the debate on evolution. There are very few scientists that do not acknowledge evolution as a sound theory and foundation for biological science. There is a tremendous amount of research, observation, experimentation and information that supports evolution as a sound theory.

In the case of abortion, many within the ranks of the Christian Right are so entrenched in their world view, which is often fed to them as doctrine, that any opportunity to criticize and discredit those that believe in abortion rights or provide science-based information on abortion. Some within the Christian Right have even gone so far as to interfere with the civil liberties of others. Some have even advocated, or actually committed, murder of those that perform abortions.

Many within the Christian Right have made claims, based on some reports coming from the United Kingdom and a few studies done on rats (which I think are inherently unethical), that there is a link between abortions and breast cancer. In the last couple of days a science-based report that followed stringent rules regarding the conduct of the observation, experimentation and statistical/epidemiological analyses has been released that clearly indicates that there is no link between abortion and breast cancer.

I have conducted a literature review on this issue, looking for flaws in the science claims and arguments offered from both sides of this debate and disagreement. What I discovered was that those studies done in the UK were funded and conducted by folks that were committed to finding ways to discredit abortion on the basis of their beliefs. The study with the rats was conducted in a manner that does not hold up to scrutiny by peers in the scientific community. There are flaws in the methods, the theoretical assumptions, and the bias being brought into the process.

But, as I stated above, science provides us with a method of testing the findings of any given study. The method requires that any study reporting findings be submitted to the scrutiny of other scientists. In fact, what is required as the "gold standard" in this regard is a repeat of the entire set of observations, experiments and analyses, resulting in an identical, or almost identical, result. Statistical and epidemiological analysis requires scrutiny of the mathematics, the statistical test chosen for the analysis, and a review of the data and its collection methods.

But abortion has become a major political football and religious views, ideologies and emotional arguments have been brought into the process. Since politics is often based on the will, whims and emotions of a majority, or at least those in control (cultural relativism), our laws do not always adhere to standards and principles derived from science or reputable information. Such is the case in at least five states that have passed laws that require family planning clinics and gynecology health care centers to provide women with information that links abortion with breast cancer. But, as this recent, very valid study reveals, such a link does not exist and the basis promoted by the majority or powerful is significantly flawed and erroneous.

The claim that there is a higher risk of breast cancer among women that have undergone an abortion is false and does not hold up under stringent scientific and medical practice scrutiny. The evidence for the so-called ABC Connection (Abotion-Breast Cancer Connection) is bogus and utterly false. The laws that require distribution of information claiming the link is real is an injustice in both a moral and legal sense.

But the Religious Right, especially the Christian Right, has a history of deliberately skewing the information it promotes and distributes in favor of their world view, indoctrination and teachings of their pastoral leaders (very few of whom have a background in science and/or medicine).

A case-in-point is the effort to force a school district in Dover, Pennsylvania, to include instruction and information regarding "intelligent design" as an acceptable and alternative theory of biological science, in direct contrast and contradiction of evolution. The claim by the Christian Right was that this was not "Creation Theory" (creationism) or biblical doctrine, but a genuine and valid scientific theory. However, as was delineated in the court's decision, the Christian Right proponents in this case misrepresented the information, including an outright lie about the origins of literature espousing "intelligent design" as being different from the Christian version of creationism.

The information provided by the Coalition on Abortion and Breast Cancer, and touted by its president, Karen Malec, at every corner of the nation and at every opportunity possible is skewed and biased. The proof of this claim of bias and skewed information is present on the Coaltions own web site:

1. Karen Malec, who has been the president of the coalition since 1999, has no legitimate credentials in science or medicine. Her bona fides comes strinctly from her work as an advocate against abortion and pro-choice policies and laws. Her wiring has always been for anti-abortion outlets and media and none of her work has ever been submitted to stringent review by peers in the science community.

2. The Board of the Coalition do not have a lot of credibility in terms of science credentials either. While one member does have a Ph.D and another has an M.D., both of these folks have been long-term members of the Religious Right and have brought their bias and advocacy views (ideology) to the forefront of their claims and reports.

In the case of Dr. Brind, most of the work he has done regarding the link between abortion and breast cancer were published or released by pro-life organizations like the National Right to Life News, as indicated on his Baruch College web page listing of his publications. While he is a recognized professor in life sciences, none of his work on the ABC Connection has withstood scrutiny by peers in the scientific community.

In the case of Dr. Chris Kahlenborn, he is a doctor of internal medicine, not a gynecologist, a pharmacologist, endocrinologist or oncologist. His reviews and writings on the ABC Connection have been predominantly published or released on pro-life sites like Life Issues, which is operated by the Catholic Missionary Oblates of Mary Immaculate.

There is an inherent conflict in the approach used by both of these people.

John Kindley is a lawyer that has a record of pushing pro-life law suits, legislation and causes. Babette Francis works for the Endeavour Forum, a group that defines its purpose as "Endeavour Forum was set up to counter feminism, defend the unborn and the traditional family." Penny Pullen is a former member of the Illinois House, and a representative of the Life Advocacy Project, a pro-life, Religious Right advocacy group. While I did not bother to research the background of the other board members, it is clear that all of the board members have a specific bias in the way they conduct their "research" into these matters.

In contrast to the advocacy approach espoused by the folks named above, I believe in researching both sides of an issue. Even when I engage in advocacy, I endeavor to remain honest in my research efforts. In pursuit of that honesty, I subscribe to organizations and media outlets that offer contrasting and opposing views. I have even worked with anti-abortion advocates in researching these issues. As I have stated, I believe abortion is morally, spiritually and religiously wrong. But I am a Catholic and I base that belief on my reading of Scriptures, the teachings of my Church (not just one preacher) and my own experience in medicine, nursing, science, ethics and history. But I am also a civil libertarian that believes the principles embedded and embodied in our Constitution are essential for our society and are God-given, one hundred percent in congruence with the principles given to us by Christ.

So, we now have reliable data and study of the ABC Connection, and there is no such link, according to a study that will withstand the scrutiny of peers and provide similar results in future studies that use the same methods and standards.

Study Doesn't Back Abortion-Cancer Link
Neither induced abortion nor miscarriage appears to influence breast cancer risk in premenopausal women, a new U.S. study concludes.

"In this cohort study of young women, we found no association between induced abortion and breast cancer incidence and a suggestion of an inverse association between spontaneous abortion (miscarriage) and breast cancer incidence during 10 years of follow-up," says a team from Brigham and Women's Hospital, Harvard Medical School and the Harvard School of Public Health, Boston.

They reported their findings in the April 23 issue of the Archives of Internal Medicine.

The researchers examined data on almost 106,000 women who took part in the Nurses' Health Study II, which began in 1993. The women were ages 29 to 46 at the start of the study.

Among the women, more than 16,000 reported having had an induced abortion at some point in their lives and almost 22,000 reported having had a miscarriage. Between 1993 and 2003, there were 1,458 new cases of breast cancer diagnosed among the women.

They found no link between abortion, miscarriage and breast cancer generally. However, "we observed associations in two subgroups, an association between induced abortion and progesterone receptor-negative breast cancer (cancer that does not respond to the hormone progesterone) and an inverse association between spontaneous abortion before the age of 20 years and breast cancer incidence."

The researchers noted that these secondary analyses were based on small numbers of women, however. "No obvious mechanisms can be provided for these subgroup findings; thus, chance has to be considered as a possible explanation," they wrote.


Study Doesn't Back Abortion-Cancer Link
A Harvard study released Monday supports earlier findings by a panel of experts that having an abortion doesn't increase a woman's risk of getting breast cancer.

However, this latest analysis isn't likely to convince all those opposed to abortion. Three states _ Texas, Minnesota and Mississippi _ require doctors to warn women seeking abortions of the purported link to breast cancer "when medically accurate," letting doctors make that determination based on current scientific evidence.

In 2003, a group of scientists convened by the National Cancer Institute concluded abortion did not raise the risk of breast cancer.

What evidence shows is that childbearing before the age of 35 reduces a woman's breast cancer risk and breast-feeding also helps, said the new study's lead author Karin Michels of Harvard Medical School. Scientists believe breast cells that have gone through a full-term pregnancy gain protection against cancer, she said.

Studies that found a link between abortion and breast cancer have relied on reports from women with cancer and healthy women about whether they'd had abortions in the past. The women with cancer may have been more likely than healthy women to report abortions as they searched for reasons why they got sick, Michels said.

The new study, appearing in Monday's Archives of Internal Medicine, looked at data from 105,716 women participating in the Nurses' Health Study, which was established in 1976 to study a wide range of health issues affecting women.

The women, ages 29 to 46 at the start of the study, were followed for 10 years. Every two years, they were asked about abortions, miscarriages and new breast cancer diagnoses. The researchers looked at medical records to confirm the diagnoses.

The researchers found no greater rate of breast cancer among the women who reported having abortions, compared to the other women. They saw no greater risk associated with multiple abortions and no greater risk linked with miscarriages.

Joel Brind, a biochemist with City University of New York's Baruch College, was the sole dissenter to the 2003 NCI report on abortion and breast cancer. He said the new study is flawed because it included very recent abortions _ too recent for them to contribute to the development of cancer. Including those abortions in the analysis may have diluted the cancer rates, he said.

Michels said more than 90 percent of the abortions in the study occurred before 1993.


Anger Over Abortion Cancer Study - December 2001
A study claiming women who have an abortion could double their chance of developing breast cancer has been attacked by experts.

The study was funded by the pro-life charity LIFE, and indicated that over the next 26 years, up to 50% of breast cancer cases in England and Wales could be "attributable to abortion".

But the Royal College of Obstetricians and Gynaecologists (RCOG) said there was no new evidence of a link, and accused LIFE of "mischief-making".

Scientists behind the study, carried out by independent statisticians from the Populations and Pensions Research Institution, say the connection could be due to oestrogen levels rising significantly during the first three months of pregnancy.

Professor Allan Templeton of the RCOG said he knew of no new evidence proving a causal link between abortion and breast cancer.

"LIFE are mischief making and we do not support the sensational reporting of this study which serves no other function than causing anxiety amongst women.

"We reiterate our advice to women that no causal link between abortion and breast cancer has been proven and that this report should not influence women in making decisions about abortion at difficult times in their life."

Oestrogen Connection

The research, led by Patrick Carroll, looked at breast cancer and abortion rates in Britain, Finland, Sweden and the Czech Republic.

It made a direct statistical link between rising cases of breast cancer and an increase in abortion rates since it was legalised.

It said the total number of breast cancer cases was expected to more than double from 35,110 in 1997 to 77,000 in 2023, "largely" because of abortions carried out on women who have not yet had a baby.

He said: "Breast cancer incidence has risen ... in parallel with rising abortion rates. There is no doubt there is a causal relationship."

He estimated up to 50% of cases could be attributable to abortion."

Launching the research, Professor Joel Brind, director of the Breast Cancer Prevention Institute in New York, said the increase in oestrogen levels of around 2000% during the first three months of a pregnancy was the most likely way risk was increased in women who had an abortion.

He added: "Women are at risk and they do not really know about it. They certainly don't seem to be finding out about it from the NHS.

LIFE estimates that by the end of 2001, at least 22,000 women in England and Wales could have developed breast cancer as a direct result of having had abortions carried out under the 1967 Act.

They say this means around about 5,500 women could have died or will die as a direct result.

"Unless there is a major advance in the near future in prevention we predict that by 2003 over 360,000 women may have developed breast cancer directly attributable to abortion. Most of their abortions have already taken place," said Professor Jack Scarisbrick of LIFE.


Abortion, Miscarriage, and Breast Cancer Risk
Introduction

A woman’s hormone levels normally change throughout her life for a variety of reasons, and these hormonal changes can lead to changes in her breasts. Many such hormonal changes occur during pregnancy, changes that may influence a woman’s chances of developing breast cancer later in life. As a result, over several decades a considerable amount of research has been and continues to be conducted to determine whether having an induced abortion, or a miscarriage (also known as spontaneous abortion), influences a woman’s chances of developing breast cancer later in life.

Current Knowledge

In February 2003, the National Cancer Institute (NCI) convened a workshop of over 100 of the world’s leading experts who study pregnancy and breast cancer risk. Workshop participants reviewed existing population-based, clinical, and animal studies on the relationship between pregnancy and breast cancer risk, including studies of induced and spontaneous abortions. They concluded that having an abortion or miscarriage does not increase a woman’s subsequent risk of developing breast cancer. A summary of their findings, titled Summary Report: Early Reproductive Events and Breast Cancer Workshop.


Wikipedia: Abortion-Breast Cancer Hypothesis

This Wikipedia entry on the ABC Connection is a great outline of the debate, the research, the biases, the politics and other issues tied into the social and cultural beliefs on these matters.

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