Presumably, there is some endocrinological basis to the increased risk, so there is probably an intervention that can be given to women who have had an abortion to reduce the risk.

Also, is there any data on women who have suffered a miscarriage and breast cancer? That would be interesting, and could provide a hint as to the appropriate mitigation treatment for women who have had an abortion.

The tendency to crush any hint of harm from abortion (it's a medical procedure, so it is axiomatic that there are risks) suggests that the supporters of abortion on demand fear that support for their cause is brittle. Might I suggest that their attitude is one of the reasons why they might be right to fear for the future of their cause.

feminist prefer the right to kill their own babies above the long term welfare of health or others. Why are so many Liberal pollies so gutless these days in identifying with truth. They ignore medical evidence and deny what Islam stands for. Surely they have caved into the 'regressive' media.

A long time ago I was taught that the number of cycles/periods a woman had increased her chances of having breast cancer. Anything that increased or decreased the number of cycles/periods would thus affect breast cancer.
Thus if she began her periods at an early age or reached menopause at a late age or had few or no children she would be at an increased risk.
Conversely starting periods late, early menopause and having many children reduced the number of cycles/periods and thus reduced the risk of breast cancer.
No idea what the latest research says.

Thanks for providing this alternative perspective.

Wikipedia <. "Four years after receiving his PhD in 1981, Brind had a spiritual awakening, after which he decided to try to use science to pursue what he saw as a "noble" goal of discouraging women from killing their unborn children.[2]"

Enough said...

Peer reviewed and published in a recognised journal? Of course not.

Agree with a very commonsense Mayan. If there is a plausible endoctrinal/hormone related link, then surely it can be mediated/medicated?
And if there is a still to be established, actually establishable scientific link, then surely better contraception, would prevent these same problems arising, i.e., condoms/the pill or failing that, the morning after pill that simply delays ovulation while any sperm remains viable!
And a far less dangerous procedure, than later medical intervention, that may even still s beating human heart!
And only allowable for strictly solid evidence based medical harm reasons; like late term tissue rejection, that can only ever result in a dead mother and a dead baby, if the pregnancy is not then terminated, etc!
And then should we caution the mother, about possible abortion related links to breast cancer?
Perhaps a moralizing Senator (Pardon, Pulpit pounding Parson) Abetz would?
Or perhaps display some long overdue moderation, and simply limit himself to another sermon from the mount, replete with a very big basket of fish and bread!? (They do that well down in tiny Tassie don't they?) (Albeit, I was very sick the last time I ate Tasmanian Trout!)
Or would that merely mean, his sermonizing, would be accompanied by an obnoxious fishy smell?
Rhrosty.

Congratulations to Professor Brind for challenging the status quo of the medical establishment who appear to be more committed to protecting the status of "safe abortion" than the health or lives of the mothers, let alone their fetuses. The endocrinological explanation of why abortion increases risk is that during pregnancy under the influence of the pregnancy hormone, estradiol, the number of immature Type l and Type 2 cells increase in the mother's breast, these are vulnerable to cancer, and these do not mature into stable Type 3 and 4 cells until after 32 weeks gestation. This is why childless women have a higher risk of breast cancer than those who have children.
An early miscarriage will usually not increase risk because the hormones have not risen greatly. In fact Swiss researchers were able to identify back in 1976 with a simple blood test at 8 weeks gestation which pregnancies were likely to miscarry. However, a miscarriage caused by an accident or blow to the abdomen or in the second trimester of pregnancy will increase breast cancer risk, as will a premature birth under 32 weeks gestation.

Hey, Susieonline: Please tell me your religious affiliation, in some detail, please. I must insist on ignoring whatever you say until I can judge you and your comments on the basis of your religion. Enough said.

Isn't breast cancer also said to be more evident in women who don't have children or have them later in life?

Too easy, just marry them off as children and allow some old bugger impregnate them when they are first capable of conceiving. No contraception. No terminations.

Maybe that could become the case in the eventual Tribal Oz. One of those unexpected negative consequences of the endless diversification-we-are-required-to-have.

As interesting as the epidemiological finding is that there could be a link between abortion and breast cancer, such higher risk is likely to be very much lower than the other risks of an ordinary healthy pregnancy, particularly where the mother was not in the best situation for it.

In any event, scaring the hell out of women is not so ethical is it? There needs to be some sober weighting, balance and alternatives. Otherwise the publication of research such as it is, can be dismissed as alarmist and probably misleading.

@onthebeach:

"...publication of research such as it is, can be dismissed as alarmist and probably misleading."

Since it is an unconfirmed statistical outlier, has been rejected by the peak professional bodies, has not been published in a quality peer reviewed journal and comes from someone who has a reputation as being biased due to his religious beliefs, it's also fair to say that it is also untrustworthy, unreliable, unprofessional and not worth considering.

Oh, yes. I have no religious beliefs. No need for the professor to ask.

Next week: "Does too much sex make your eyes go funny?"

Mr. Blind, my beliefs have nothing to do with scientific data, and neither should yours.

Leave religion out of the science lab until it can be scientifically proven there are actually any gods out there.

Why not work on more effective contraception methods to lower the abortion rate?

If there is indeed a link between induced abortions and breast cancer, why? What is the trigger? If it is 'hormonal', which hormones. What about naturally occurring abortions? Considering 1 in 7 pregnancies result in a miscarriage this would be relevant.

Maybe it is not induced abortions, maybe it is linked to all abortions, induced and natural. Or linked to the oral contraceptive pill. Or delayed sexual intercourse. Or linked to the lack of orgasms. Or the components in the semen of some men. Or breast feeding. Or the lack of breastfeeding. Or indeed, bearing a son to full term instead of a daughter. Considering the study quoted came from China. Possibly the most relevant common factor.

I've worked in hospital settings for some 37 years and seen many, many women with breast cancer. Including within my own family. The only women I know who have had abortions do not have breast cancer. None of the women with breast cancer have had medically induced abortions.

For the Runners of this world. Breast cancer is NOT a punishment sent down from your God for what you may consider to be the sins of a woman.

Breast cancer and medically induced abortions are two very important issues in women's health. It is concerning there is an effort to conflate the two lately.

'Breast cancer and medically induced abortions are two very important issues in women's health. It is concerning there is an effort to conflate the two lately. '

it is more concerning Yvonne that genuine concerns by doctors and others are simply dismissed because it threatens the baby killing industry.

Suseonline there IS a very effective contraceptive. It's called "ABSTINENCE". And for those already married there is the Billings method of natural family planning. Thousands of couples use it to plan their families.

These methods are a little harder but they work very well and they are quite cheap.

@ Gadfly:
Presumably one not interested in pleasures of the flesh, our Gadfly is either oblivious of the fact that "one you miss is one you never get" or is well past his prime breeding days.

Offering 19th century remedies in the 21st century is going to produce, at best, 19th century outcomes including unplanned pregnancies and increased, not decreased demand for abortions both legal and otherwise.

Only the deluded would advocate only abstinence, by any name, in lieu of a full suite of options which a woman may consider in order to maintain her health while avoiding unwanted pregnancies. Only the very cruel would go to the extreme of attempting to deny terminations for those who, for good cause, request them.

Let's separate religion and male-centric world views from consideration of women's health issues.

Lol Gadfly, when I was working as a midwife, if I had a dollar for the number of babies born as a result of the billings method, I would be a rich woman!
You certainly need to be very good at practicing abstinence if you use that messy method.

Abstinence is something put out there by holy old boys who prize 'virginal' women, because they know it is impossible for the virginal bride to know if her supposedly virginal groom is actually telling her the truth!

Sounds like a man's world to me...

From the article: “With literally millions of women bound to get breast cancer because of abortion, one wonders what it will take to wake up the medical world to this unfolding tragedy.”

If one wants to lower abortion rates, then alleviating poverty, improving contraception and raising more awareness is the answer. Religiously driven calls for abstinence are always an abject failure (in fact, abortion rates even rise with the level of religiosity and conservatism of a given populace) and scaring the heck out of women is not only unethical, but risks more unwanted children in the event that it succeeds.

If there really is a link between abortion and breast cancer, then all that means is that we need to improve breast cancer detection and cure rates, and improve breast cancer prevention through awareness campaigns that focus on ALL factors that contribute to an increased risk of breast cancer. That way, women - who do not want to go through with a pregnancy - can feel a degree of comfort in the knowledge that their chances of early detection and cure will be maximised in the event that they do develop breast cancer, and that they still have some degree of control over this with a healthy lifestyle.

This alleged abortion-breast-cancer link does nothing for the anti-abortionists’ cause. Sorry, try again.

I would be interested to know if the same (spurious?) correlations could be found with miscarriages. But I guess that wouldn’t be in the interests of anti-abortionists to publish. I do think, however, that expecting women have the right to know whether or not the abortions that God is performing on them, without their consent (i.e. miscarriages), cause breast cancer too.

As a side note (and since it’s been raised), I’d also argue that one’s religious motives certainly are relevant as Christians have the ‘lying for Jesus’ factor that needs to be taken into account when assessing their claims; something that non-believers have the virtue of not even possessing an equivalent of.

I think the link to breast cancer is about genetics: have any of your relatives suffered it? No? Then you are most likely quite safe. Blaming abortion for the malady is like saying masturbation will give you hairy palms - an affliction I have never seen in relatives or anyone else.

Runner, what is deeply concerning is that you do not seem to want to follow this argument through and think if this is true for medically induced abortions, why would it not be true of miscarriages. There is the same abrupt hormonal change and change from a pregnant uterus to a non-pregnant uterus. If you truly cared you would wonder about this wouldn't you?

Perhaps it is just simply too dangerous for women to fall pregnant at all, because 1 in 7 pregnancies end up in miscarriage and therefore all men should keep their zippers up and not impregnate any woman.

yvonne

your arguement is a mute point. Miscarriages are not voluntary while abortions are simply a choice ( by and large a convenience choice). In other words even the simple understand one is a choice and the other is not.

Suseonline Statistically the Billings method does work even if there are failures. IN any case the odd unwanted baby is not a disaster to loving parents who can cope with the odd mishap. As for Abstinence it is becoming a popular concept in the US. They say that "True love waits". Maybe it is a bit challenging but people who practice it find true happiness in each other and their children.

Gadfly, you are a lost cause : )
At least you don't turn nasty like our resident 'fundi' Runner.

I doubt many (any?) men would seriously practice abstinence as such.
They would have to take matters in hand much more often, but I have been told by a 'holy site' that male masturbation leads to prostate cancer, so what to do?
This scenario is at least as possible as abortion causing breast cancer.

In any case, the women practicing abstinence would have to be very trusting indeed...

I thought this hoary old chestnut had been put to death in 2004 with the publication of a meta-analysis by Betal et al. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)15835-2/fulltext

Their conclusion from prospective studies was "Pregnancies that end as a spontaneous or induced abortion do not increase a woman's risk of developing breast cancer."

So why did Huang et al. get such different results?

Firstly, because the preponderance of their studies were case-control retrospective studies rather than prospective studies. Retrospective studies are subject to significant recall bias and it is known that women who have breast cancer are more likely to disclose their reproductive history in full than those who don't.

Secondly, the best studies in Huang et al. find no significant difference. It is only when the poorer quality studies are added that a difference occurs. This should have been an immediate red flag to the researchers that study quality was having a major impact on the results.

Huang et al. is seriously flawed because of the latter issue.

Whilst I do think the bias's of authors is generally relevant I won't dismiss their claims out of hand if those claims are based on underlying research that does not appear to be impacted by those same bias's.

Is it credible or are there good reasons to doubt the findings (the findings of this research from what I can find on line does appear to support the claims made in the article).

I'm trying to get a better handle on the credibility of the research. A task that might be better conducted by Foxy with her skills but as a starting place my impression is that a Huang Y shows up as an author in a lot of meta-data analysis of health impacts (especially breast cancer) on Chinese women of various factors.

No obvious link to any crusades on the causal side, but rather a wide range of factors - not sure it's all the same "Huang Y" (Foxy if you are following can you add your librarian expertise please).

A couple of links that might help others get started on a look at the research rather than how it's being used.
http://www.ncbi.nlm.nih.gov/pubmed?term=Huang%20Y[Author]&cauthor=true&cauthor_uid=24272196

For an abstract of the findings
http://www.ncbi.nlm.nih.gov/pubmed/24272196

My impressions from previous looks at the topic were that there is no credible link between induced abortion and breast cancer, this article has pointed to research that appears to challenge that claim. Happy to have the research debunked if there is a good case for that as I have some personal objections to the way anti-choice advocates use whatever they can to attack choice but want that to be based on credible evidence.

R0bert

Just what OLO needs. Another idiot like runner.
Keep your filthy hands off other peoples bodies.

Suseonline,

>> Four years after receiving his PhD in 1981, Brind had a spiritual awakening, after which he decided to try to use science to pursue what he saw as a "noble" goal of discouraging women from killing their unborn children.[2]”<<

The link you provided for this is http://www.washingtonmonthly.com/features/2004/0410.mooney.html. Judging from the formulation (and the rest of the article) it sounds more like a slander than something Brind would have written about himself. Could you please provide a link or quote, where he speaks about this “spiritual awakening” and its link to his professional research?

[Even so, there are many examples of people who have had what some psychologists call “a limit experience” (e.g. NDE, surviving a horrendous accident, a tragedy in the family, etc) that determined the direction of their future life.]

There are many scientists who spent their life finding evidence for something they a priori believed to be true. It is up to his/her fellow specialists, not us, to decide whether his/her work is of a sufficient scholarly standard (e.g. gefitting a university professor), irrespective of whether or not they like what the supporting evidence he/she offers points to.

>>Leave religion out of the science lab <<

Again, could you please give an example, or best quote Brind, where he uses his religion in his lab? I think more importantly one should leave religion out of debates about the meaning or acceptance of (claimed) scientific findings on this OLO.

Oh oh; what a confusion of mixed metaphors we have here! Mick Jagger was right after all; war is but one shot away!

Piece of cake, George.

http://www.unc.edu/courses/2005spring/epid/278/001/Krider_Politicized%20Science_Spring%202004.htm

"Take the example of Joel Brind, the primary advocate for an abortion-breast cancer link (or ABC as he calls it). His own account of this "discovery" emphasizes his conversion to Christianity rather than any hard scientific data: "With a new belief in a meaningful universe, I felt compelled to use science for its noblest, life-saving purpose," he told Physician magazine (July/August 2000). He describes how the "pieces came together": "By 1991, I realized that my understanding of life was incompatible with a pro-abortion point of view." After "making contact" with a local right-to-life group concerning RU-486 (the "morning after pill"), he began to formulate his theory."

If you want to read the original

"Dr. Brind, by the way, is featured on the cover of the July, 2000 issue of Physician's Magazine, which is published by Focus on the Family. You can obtain a complimentary copy by writing Carrie Gordon Earll at Focus on the Family, P.O. Box 35500, Colorado Springs, CO 80935-3550."

http://www.catholicculture.org/culture/library/view.cfm?recnum=2902

If it is true that breast cancer is EXPLODING in Asia, then other possible explanations could be made, such as people from Asia adopting a more western lifestyle, thereby being exposed to artificial chemicals and hormones. Not to mention dietary changes.

Well, I believe runner is simply a new-age prophet really. We live in a form of society represented by the failure of the counter culture of the sixties: an"Altamont" of frenzied drug-taking, alcoholism and violence!
Abandoned traditions for convenience of free love and moral sloth! There lies a rockery road over which society must travel in order to reimerge with an acknowledgement of failure of the flower-power revolution!
Abortion could be a catalyst for this change, with it's doubtful outcomes and possible long term side effects represented in this article!

There have been few genuinely scholastic responses against Joel Brind so can we assume that the Abortion Breast Cancer link cannot be refuted and that in fact it is time to do something to protect women from breast cancer.

The various critics have had ample time to post genuine responses that play the ball and not the man so let us assume that there are no comebacks to Dr Brind's arguments?

If one says nothing that is a political act suggesting that there is nothing to say. If the ABC link cannot be disputed then how about some action based upon this important article??

Rhosty: Or perhaps display some long overdue moderation, and simply limit himself to another sermon from the mount, replete with a very big basket of fish and bread!? (They do that well down in tiny Tassie don't they?)

They go to violent extremes in Tassie. At the end of 2013, Tassie passed a Bill that decriminalised abortion, but criminalised opposition to abortion. The Bill requires doctors with moral objections to refer women to a pro-abortion doctor – or risk de-registration. This is a profound and dangerous violation of conscience. The new legislation also included dreaded ‘bubble-zone’ laws, restricting pro-lifers from offering assistance to mothers -- and restricting free speech -- within 150 metres of an abortion mill . Tasmania is the first state to have such laws, and violators may be charged with a maximum $9,750 fine or be sentenced to 12 months in jail.

JohnBennetts: "Only the very cruel would go to the extreme of attempting to deny terminations for those who, for good cause, request them."

It is extremely cruel that each abortion results in the murder of the innocent, defenceless party.

George,

What you are effectively suggesting is that, in the case of religious beliefs at least, most should simply sit back, shrug their shoulders and think, “Meh, what would I know?’

<<I think more importantly one should leave religion out of debates about the meaning or acceptance of (claimed) scientific findings on this OLO.>>

For someone who may not have the research expertise, or the time on their hands, to trawl through the research Brind cites, identifying potential bias can be a useful tool for quickly determining the level of caution with which the claims and findings of any given research might be approached.

People are entitled to exercise scepticism, indeed they would be wise to, and there is nothing wrong with alerting others to potential bias - as I did in highlighting the ‘lying for Jesus’ factor (most frequently and overtly featuring in creationist claims). Shaming others out of making such observations, by expressing one’s disapproval in a patronising tone, could be interpreted as an attempt at silencing opinions that one is not comfortable with. Religious beliefs do not deserve a special immunity with regards to raising the possibility of bias.

It seems, however, that the majority of Brind’s peers disagree with him anyway, and the research supports them, so the pointing out of his bias is merely an afterthought now.

After reading this article, I’ve been having a browse of various breast cancer studies - those NOT based on the scientifically discredited ‘recall’ method used by Huang (and also used by those equally ludicrous studies ‘proving’ that women are as violent as men).

Scientifically endorsed ‘cohort’-based studies all show absolutely no link between breast cancer and abortion. In fact, some even show a negative correlation.

Also, China’s age-standardised breast cancer rates per 100,000 have only increased from approximately 18 in 1973 to 22 in 2012. How anyone can form a hypothesis on such a miniscule national increase is anyone’s guess.

And in the US, age-standardised breast cancer rates per 100,000 have increased from 110 in 1975 to 130 in 2012. Interestingly, breast cancer rates actually started to decrease after the year 2000, that is, 28 years after Roe versus Wade. Go figure. (The main explanation for the down-trend is the significant decrease in HRT.)

Compare this also to the increase in prostate cancer rates per 100,000 throughout the West, which have increased four-fold since 1975 – from approximately 30 in 1975 to 120 in 2012. In Australia, it has increased 2.5 times since 1998.

Obviously, there is something men are doing that is bringing on this disastrous epidemic that is irresponsibly leaving families fatherless, husband-less, brother-less and son-less. We MUST do something to protect men from themselves and the terrible pain and grief they cause their families by dying.

I have no proof of course, but I suspect it's got something to do with all the sex men are having (because sex is what is behind just about every evil in the world). We MUST pass laws that put extremely strict quotas on men's sexual activity. One day they'll thank us for this.

Agronomist,

Thanks for the link to the article written from a similar position as the one Suseonline linked to. I could find only the one piece directly from Brind that you also quoted:

"With a new belief in a meaningful universe, I felt compelled to use science for its noblest, life-saving purpose … By 1991, I realized that my understanding of life was incompatible with a pro-abortion point of view."

Well, should not every e.g. medical researcher “use science for its noblest, life-saving purpose”?

Anyhow, no mention in this quote of “spiritual awakening” or admission that Brind's world view preferences played a role in the methods - hence findings - of his research, although he clearly proclaims his world view and offers an interpretation (which we might or might not accept) of his findings that agrees with it.

Would you therefore find suspicious also findings by scientists who make known their atheist position, and even claim that their findings support this position?

I found Richard Dawkins’ “The Blind Watchmaker” full of passages where he wears his atheism on his sleeve, however it did not affect my respect for what he wrote about evolutionary biology where he is a specialist. I would only have been suspicious had he offered his belief or disbelief (about God) as a SCIENTIFIC argument.

Carl Sagan, Stephen Weinberg, Stephen Hawking would be other examples of scientists, whose contribution to physics I hold in high esteem in spite of their openly proclaimed atheism.

On the other hand, as some here already indicated, one can accept Brind’s research results on their face value (for reasons I as a non-specialist cannot judge) without agreeing with his interpretation or recommendations. After all, it is almost generally agreed that there is a link between smoking and lung cancer although the need to make smoking illegal is not a generally accepted consequence.

AJ Phillips,

Please note that I was referring to “debates about the meaning or acceptance of scientific findings” not to debates about the meaning or acceptance of terms like ‘lying for Jesus’ or ‘creationist claims’ that you mention.

It is astonishing to me how so many can make so many comments and claims re: studies they have obviously never read. So abortion rights advocates laud the Beral meta-analysis which reported no link (even though they excluded studies on the basis of such unscientific reasons like "principal investigators... could not be traced". It must be tough to locate the authors of a study published in 1957!),and they trash the meta-analysis of Huang et al., who agreed with our own 1996 meta-analysis that did find a link. (and by the way, for the commenter who was worried about studies being peer-reviewed and published, our 1996 meta-analysis --published in the British Medical Associations's Journal of Epidemiology and Community Health--and that of Huang this year had in common that we included all peer-reviewed, published studies, whereas the majority of studies included by Beral had not been published at all!

And of course, the Beral meta-analysis was published 10 years ago. Since 2007, in addition to the Huang meta-analysis, there have been published in peer-reviewed medical journals, at least 17 studies from the rest of Asia; 12 from the Indian subcontinent. All of them report increased risk (Preponderance, anyone?) As I point out in my article, these are populations in which the effect of abortion stands out prominently precisely because there are few other common risk factors for breast cancer. One of you said that Huang showed that the "best" studies showed no link. Incorrect: the worst studies, i.e., those from Shanghai, where the majority of women have had at least one abortion. As Huang pointed out in his meta-regression analysis (within the meta-analysis, for anyone who actually cares to read it), the evidence of the link disappears when the prevalence of abortion is too high, because there is no population of typical women who have not had an abortion. So, sure, you can do a study that finds no link whenever you want to; just do it in other place where abortion is at least 60% prevalent among the women, and voila! you find no risk increase, except it won't be valid.

Now to answer those who wondered about spontaneous abortions: No, everyone in the field agrees that they generally do not contribute to breast cancer risk. The reason is that they are not the same hormonal interruption as induced abortion. Rather, they are naturally terminated pregnancies (most in the first trimester) that failed in the first place for lack of the usual hormonal surge (which causes a growth spurt in the breasts). No hormonal surge; no growth spurt; no increased cancer risk. On the other hand, the same hormonal blow as a late term abortion happens even in live births that occur before 32 weeks. So very premature birth (before 32 weeks) doubles breast cancer risk, while a delivery after 32 weeks reduces risk.

Finally, suseonline, I quite agree that neither your nor my religious beliefs should impact our scientific judgement. But two can play the sarcasm game:-)

Prof. Brind do you have publicly accessable links to Huang's paper and some of the others you refer to?

It is a difficult space, so many on both sides of the broader debate on abortion show a distinct lack of interest in truth. Also to help the process for those trying to get a better understanding of the claimed link any rebuttals of those findings?

I'm on the pro-choice side of the debate but don't have the level of emotional investment in that precludes a willingness to consider evidence that does not sit well.

As George pointed out a link to an increased risk does not require outlawing an activity, although I do suspect the real issue would be legal liability. There would seem to be plenty of scope for law suits against the government in the future if funding is provided for abortions while a claimed link to cancer exists.

If you wonder about the level of scepticism from my perspective so many on the anti-choice side of the debate cry wolf so often that no claims from those opposed to abortion can be taken at face value.

Do you have any comments on the issue with recall in these studies that Killarney mentioned (I will leave aside her comments on DV, a lot of history there)? Thats a topic I've seen elsewhere in regard to this topic.

R0bert

Well, George I am not really that concerned about Joel Brind’s religion.

What I am concerned about is the fact that Joel Brind has disregarded the largest meta-analysis on the topic covering 83,000 individuals from around the world in favour of a seriously compromised meta-analysis from China.

The fact that he has chosen to prove the biological connection between having an abortion and contracting breast cancer later in life, thereby dissuading countless women from killing their unborn children, rather than assess what the data shows means that he is too biased to be reliable.

Agronomist,

That is a different cup of tea. As I said, I am not a specialist on these matters, maybe you are. But even so, you cannot expect to resolve the problem of whether or not Bird’s research methods are fair - involving a serious accusation concerning falsification and his integrity as a university professor - on this forum, where - I presume - the majority of us are also non-specialists and can have only a non-critical understanding of what he is saying.

Joel Brind's explanation around spontaneous abortions is very obviously wrong. Spontaneous abortions occur for a whole host of reasons, not because of a lack of hormonal surge.

Prof. Brind,

What do you expect to be done if a link between abortion and breast cancer could be established?

As I said earlier, your research does nothing for the anti-abortionists’ argument. A woman’s right to autonomy and control over her own uterus overrides the rights of the fetus. If a two-year-old needs a kidney transplant, and the mother is the only one who can provide it in time, should the mother then be forced to provide that child with a kidney? Of course not and therein lies the contradiction in the anti-abortionists’ stance: they endow fetuses with more rights than they would a child. If your life is contingent on someone else’s body, then they have a right to say no to that. Fetuses have a right to live, but they don’t have a right to live at somebody else’s expense. By believing that they do, you are granting them special rights that you would deny to people who have already been born.

It is for these reasons that the best you could hope for, if you are right, is that it may deter a small proportion of women. You would be far better off doing something to change attitudes towards contraception advice and services, and sex and sex education, so that they are not done in an atmosphere of embarrassment and secrecy as they are in the US; which has higher rates of abortion compared to countries with healthier attitudes towards sex such as the Netherlands, which has the lowest rates of abortion. The fact that you aren’t suggests that you are a zealot who is only interested in an outright ban on abortion - which will never happen, because most people’s thoughts are not so clouded by religious belief that they cannot understand the fundamental point that I have made above.

If you believe that what I have said is invalidated by the fact that a fetus has a soul, then great, find evidence for this belief and get back to us. But it is disingenuous to pretend that your primary concern is women’s health.

Sorry Mr. Brind, but I tend to believe organizations such as the Breast Cancer Network of Australia, and the CEO Maxine Morand has recently spoken out against this very subject in the Herald Sun (22-7-2014).

“The Cancer Australia review of evidence of breast cancer risks references all risks for breast cancer including a section specifically on pregnancy termination, and it is not a risk,” says Ms Morand.

“I go to a lot of conferences where people such as professors of epidemiology at Oxford University speak in detail about what the risks are, and what the reproductive factors are, and abortion is not one of them.”

She states that they have cited 53 references re causes of breast cancer, and abortion is not amongst them. I am sure you have chosen to ignore all these references?

She goes on to condemn the actions of 2 Liberal politicians who support this unproved link between abortion and breast cancer in order to push their pro-life barrow at some silly 'Family Conference" later this month in Australia.

http://www.heraldsun.com.au/news/opinion/why-are-we-supporting-abortion-scaremongers/story-fni0fhk1-1226996730358?nk=415cebeb4091ce27fa8739234645f413

So after about 36 hours there are still no scientific refutations of Dr Brind's article?

As Dr Johnson once said "If you have nothing to say then say nothing". That would be good advice for some of the contributors to this debate.

Nobody can refute the article or Brind's argument about the link between abortion and breast cancer. So why not accept reality and ask your representative to present legislation to deal with this problem?

Gadfly, you are just being stubborn now.
You only need to have a basic look at the subject "Debunking the theory that abortion is linked to Breast Cancer" on Google, and a plethora of evidence comes up.
I can't be bothered pasting it all in here because I know you won't read the links!

So I found the best one to post....that from the American Cancer Society....because you obviously take no notice of the Aussie breast cancer sites.

"The largest, and probably the most reliable, study on this topic was done during the 1990s in Denmark, a country with very detailed medical records on all its citizens. In this study, all Danish women born between 1935 and 1978 (a total of 1.5 million women) were linked with the National Registry of Induced Abortions and with the Danish Cancer Registry. All of the information about their abortions and their breast cancer came from registries – it was very complete and was not influenced by recall bias.

After adjusting for known breast cancer risk factors, the researchers found that induced abortion(s) had no overall effect on the risk of breast cancer. The size of this study and the manner in which it was done provide good evidence that induced abortion does not affect a woman’s risk of developing breast cancer."

http://www.cancer.org/cancer/breastcancer/moreinformation/is-abortion-linked-to-breast-cancer

So there you see, the Danes got all their data straight from medical registries and did not need to have religiously motivated scientists 'looking for the link" ....

Susieonline, you need to know a bit more about the 1997 Melbye Danish study. While claiming to be based on government health registers and therefore not subject to “recall bias”, Melbye did not record abortions performed before Danish records were computerised in 1973, even though abortion was partly legalised in Denmark in 1939 and each abortion was recorded in a government register.
So women who had abortions before 1973 and later developed breast cancer were wrongly recorded by Melbye as not having had an abortion. Moreover Melbye included young women who had had an abortion shortly before the end of the study – but were too young to have shown any sign of breast cancer, which takes at least 8-10 years to be detectable.

These serious flaws were pointed out in a letter published in a prestigious medical journal, but Melbye has not retracted his study. A recalculation of the Danish data and found a significant link between abortion and breast cancer.

Where is your proof on these studies Edmund, and how come neither the US or Australian cancer organizations still don't acknowledge this supposed link between abortion and breast cancer?

Even should there be a small possibility of a link, what difference will that make?

If the current proven links between diet and Western lifestyles and breast cancer are not taken seriously by many women, what makes you think it will make any woman think twice about it if she wants to have an abortion?

The predominantly male, Christian, pro-life people are really clutching at straws here.
It is no one else's business, other than the parents and doctor, if an abortion is being considered

This is a great article on the Melbye study in which Brind comprehensively demolishes it.

http://abortion-not.org/brindmelbye.htm

You still don't get it Gadfly, I and many others don't care what Brind thinks, because he is quite obviously biased on this subject.
When I had a look at his websites, all the so-called medical experts, board members etc were not-for-profit organizations of pro-life, far-right, conservative, religious people....who are all just as biased as Brind, no doubt.

http://discovermagazine.com/2003/feb/feathated
" The vast majority of epidemiologists say Brind's conclusions are dead wrong. They say he conducted an unsound analysis based on incomplete data and drew conclusions that meshed with his own pro-life views. They say that epidemiology, the study of diseases in populations, is an inexact science that requires practitioners to look critically at their own work, searching for factors that might corrupt the results and drawing conclusions only when they see strong and consistent evidence. "Circumspection, unfortunately, is what you have to do to practice epidemiology," says Polly Newcomb, a researcher at the Fred Hutchinson Cancer Research Center in Seattle. "That's something Brind is incapable of doing. He has such a strong prior belief in the association [between abortion and cancer] that he just can't evaluate the data critically."

Hmmmm....who to believe?
Pro-life organizations , or Cancer Research Centres?

OK Suseonline. If these people are so sure of themselves let them debate him in public? They are like Al Gore on global warming who refuses to debate opposition experts in public.

These folks are the same. They have good jobs in the public service or academia and would probably be forced to resign if they backed Brind.

Before World War II nobody wanted to side with Winston Churchill because it meant conscription, rationing, compulsory labour. Most creature comforts were limited. It was easier to live in a fantasy world in which Hitler was not such a bad guy and you could reason with him. But two years later German bombs were falling on London.

Eventually the chickens will come home to roost here. Thousands of women will be on chemotherapy or having mastectomies or even dying. The people in these cancer organizations will take early retirement to escape the retribution that they deserve.

This debate is typical of any scientific discussion with contradicting evidence regaring scientific question (i.e. almost all science) but also politicized for some reason or another.

As Suseonline points out above, epidemiology is an inexact science, and requires a critical evaluation of ones own studies to accurately account for bias and other conflicting factors. The fact that Dr. Brind admits that he first came to the "belief" that abortion increases breast cancer risk, and then performed studies to "prove" this belief, shows that Dr. Brind's studies may be flawed, and especially that as a scientist, Dr. Brind has some serious shortcomings. That said, none of this means that his is necessarily incorrect (or correct).

However, as any real scientist should know, one study does not automatically invalidate another study, and there is never any way to really "prove something" in epidemiology or even other scientific fields (other than mathematics). One must look at the entire set of data and studies as a whole and evaluate whether there is a consistent, believable association.

So lets look at other epidemiological studies that show a consistent, believable association between a specific factor and disease and compare the the odds ratio claimed in the Huang study (OD=1.44).

Smoking and lung cancer OD=44
High cumulative life-time exposure to sunlight and skin cancer OD=47.6
Obesity and cardiovascular disease OD=20-59
Human papilloma virus infection and cervical cancer OD=45-150

Continued.

So what I am trying to show here are examples of factors that are generally accepted in the scientific community of significantly increasing the risk of disease. These studies have been performed by many, many groups and have shown a consistent and obvious effect in the vast majority of studies. Now compare to the claims made by Dr. Brind, where we have many studies, each showing small positive or negative effects, the vast majority not statistically significant. What does this mean? Well I believe that it means that currently there is no compelling evidence of the abortion-breast cancer link. This is what almost every reputable cancer, medical and scientific organization is also saying. If there is a real link, it is so small that even a minor additional factor not accounted for can completely change the outcome of the study.

The fact that Dr. Brind has an admitted predetermined bias, has selectively ignored data that disagrees with him and promoted data that agrees, and is knowing politicizing and misrepresenting scientific method to the general public shows that Dr. Brind has no absolutely no scientific integrity. Others with political ideologies will continue to point to studies that support their opinions, and their opponents will point to studies that support their own. A real scientist is able to objectively review all the data and say "I don't know". This wont win any public debates, but is how science works. Time to get back to basics Dr. Brind.

P.S. I wouldn't necessarily call a journal with an impact factor of 2.9 a "prestigious international journal". Perhaps just another example of Dr. Brind the political activist rather than an objective scientist.

Stezza, thanks for that. A useful summary.

R0bert

Hey Stezza, you publish lies, ie. "The fact that Dr. Brind has ...selectively ignored data that disagrees with him" and say I have no integrity? Shame on you, for taking this sometimes rancorous but generally civil discussion down a notch!

And while we're on the subject of "selectively ignoring data" how about your conveniently ignoring all the recent data from South Asia? Almost all the ORs reported were significant, one >20. That's because breast cancer is traditionally rare there, the typical female getting married and having kids as a teenager, not smoking, not drinking. So a risk factor like abortion really stands out. (If you ever took an interest in actually reading any of these papers, you'd see that many authors matter-of-factly refer to abortion as an established risk factor. I tested the hypothesis that it was a risk factor based on the fact that I had seen enough published data to suggest so, and it turned out to be right (whatever you or I or anyone else thinks, facts are facts.)

If you actually knew anything about epidemiology, you'd know that for a disease with a lifetime incidence in the neighborhood of 10%, you could never obtain an OR of 20 or 40, because an OR of 10 would essentially mean that every woman gets the disease!

Finally, I would like to point out abortion's being a risk factor does not at all mean that all women who have abortions will get breast cancer, or that all--or even most--women who get breast cancer have had an abortion. But I often get accused of suggesting such things. All I am doing is pointing out a hazard of a procedure that is a matter of choice. Well, if its a matter of choice, everyone facing this choice is entitled to know the possible consequences of that choice, right? But somehow, I have never seen--in all the advertising with which we have been bombarded over the years about cigarette smoking causing lung cancer, the indisputable fact that 85% of long-term cigarette smokers DO NOT get lung cancer. Selective reporting, anyone?

Joel Brind, you keep on about these studies from South Asia; however, a quick search of pubmed discovered 2 small studies, one from 2010 and one from 2013. Both were case-control studies and therefore subject to recall bias. One of 100 cases http://www.sciencedirect.com/science/article/pii/S1877782110000317 showed a statistically significant increased risk, the other of 94 cases http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2013;volume=38;issue=2;spage=95;epage=99;aulast=Kamath did not.

However, what you have signally failed to do is to show how these small case-control studies invalidate large prospective studies. For example, this large study of 25,576 women from Denmark http://onlinelibrary.wiley.com/doi/10.1111/aogs.12107/abstract;jsessionid=E38357B47670D22A371BBD192A5CB29C.f01t03 that found no significant link.

It seems to me that you are just looking at what you want to see. Focussing on small case control studies and ignoring large prospective studies demonstrates a clear bias.

Perhaps because the article is called “Abortion breast cancer link explodes in Asia” and Denmark is not in Asia?

Prof Joel Brind,

Just for clarity and comparison (since you want to make one), what proportion of abortion patients "DO NOT" get breast cancer?

My suspicion is that the proportion of abortion patients that DO NOT get breast cancer differs from the control at the third significant figure. Unlike smokers.

I'm not sure what justification you find in making any comparison whatsoever with smoking. If (as many smokers say) 85% of smokers "DO NOT" get lung cancer (ignoring all other smoking-related cancers, airway and vascular diseases) and this profound risk at least an order of magnitude greater than applies to breast cancer in abortion patients, all it seems to do is undermine your use of the term "explosion" in your original title. Perhaps "goes pop!" would be more apt?

Insofar as abortion-related cancer could be used as a research tool, identifying specific mechanisms of cancer-induction (say the selective accumulation of oxidised steroids in cellular compartments) and improving our understanding of cancer, this is interesting, but I don't get the impression that this is your main thrust. It may be in your grant applications, and it is the bland position you revert to when challenged persistently, but in this opinion forum it *seems* that you are simply joining a bandwagon of abortion-bashers pushing this in the past week.

Whilst the risk that you are so eager to comprehensively warn people of might exist, greater risks reside in the fine print at the bottom of the box for a great many medical procedures and treatments and it in this fine print I suspect your warning should be. Disproportionate promotion of risks can alter priorities poorly.

If an abortion patient smokes I would suggest that this is their single biggest risk, and their doctors advice should focus there. Your concerns and many others equally real, might not be worthy of precious clinical minutes.

See you in the fine print.

Rusty

"Shame on you, for taking this sometimes rancorous but generally civil discussion down a notch!"

No Dr. Brind, you bring this discussion 'down a notch' by insinuating reputable medical and scientific organizations disagree with you because they are racist:

Brind- "Do they think all these brown and yellow people reporting such strong evidence of the ABC link in Asia must be incompetent in epidemiology?"

And outright accuse them of a "cover up"
Brind- "A primer on how to recognize a cover up of the abortion-breast cancer link (ABC link)"

Challenging an established dogma, and going against the crowd can be a valued characteristic for a scientist. I would have more respect for you if you continued to perform studies and challenge those that disagree with you using scientific method. However, you simply state "I am right" without being able to convince even a minority of those in your field. In search of people to agree with you (a similar method you seem to use in your research), you post activist blogs full of conspiracy and misinformation on pro-life websites. This, in my opinion is what really challenges your integrity as a scientist, and puts you in the same league as Andrew Wakefield with his anti-vaccination followers.

If there is a slight risk, a concerned Asian woman could have one less serving of red meat a week to compensate I would guess. Or maybe have a five minute walk somewhere a couple of days a week.

Warnings should be presented with some perspective. However that isn't the duty of researchers alone. Perhaps the real risk is the shabby tabloid 'shock, horror' journalism that seems to be all there is on offer anymore.

So, Stezza, still not interested in actually looking at any of the data? Yes, I said some provocative things in this post, and I stand by every word. So if the willful ignorance of all this data from Asia is not racist, let's hear a critique of the actual studies, shall we? Not from you, I'm afraid. At least the Agronomist is willing to check out pubmed. Sorry, but a lot of these studies are from regional medical journals and medical school journals, and they tend to appear on Asian search engines, and only on pubmed later if at all.
As far as studies that do not agree with my findings, I have published extensively on these. For example, Mr. or Ms. Agronomist, that 2013 danish study you cited (by Christina Brauner et al.) was also answered by published letters, one by me (and you can find that in the same journal in pubmed). The problem with the Brauner study was that it followed women for 12 years all right, but starting an average of 28 years after abortion. Hence, it is of limited use, merely showing no risk increase after abortion if you survive for a few decades after the abortion without getting breast cancer by then. But as to the overall risk increase--which seems maximal between 10 and 20 years out--that paper contributes nothing. So why don't you try googling me and actually reading all the stuff I have published in peer reviewed journals--especially about papers that do not show the link. See especially my letter in the British Journal of Cancer in 2004, which explains why the Shanghai studies do not show the link, or my 2005 review in the Journal of American Physicians and Surgeons, where I analyze all those prospective studies that don't show the link.

Joel Brind, it is all a bit unhelpful if the research you are using cannot be examined. My own search through pubmed for case-control studies has identified a mix of studies that find a significant effect and those that do not. This in of itself suggests that the likelihood of there being a real link is small. It is particularly so when many of the studies have 10 or less participants within each arm that have had induced abortions. Coupled with the notorious unreliability of case-control studies among cultures where abortion is frowned on, means these studies just can’t be relied on.

All the prospective studies ever conducted have found no differences. These studies are more reliable because they have larger numbers and there is no recall bias.

It is simply untenable to argue that abortions increase the risk of breast cancer. There is no good data to back such an idea (there is bad data that supports it and you unswervingly go for the bad data) and all the good data does not.

I find myself bemused reading your criticisms of the prospective studies. In the case of Brauner et al., your criticism is that a significant period elapsed between the average age of abortions and enrolment in the study. Why should this matter? Are you proposing that abortions only increase the risk of breast cancer in young women, but magically fail to have any impact as women age? If so, why have you elsewhere levelled criticism for studies not following women up for long enough? You cannot have it both ways.

Prof Brind is lying about his reason miscarriage is different to medically induced abortion, namely, because the hormones that cause breast tenderness are abruptly ceased with a medically induced abortion, this not being the case in miscarriage.

The earliest symptoms of a pregnancy are a missed period and TENDER BREASTS caused by Oestrogen. The women who are not first alerted to the fact that she may be pregnant by her sore breasts would be few and far between. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_signs_and_symptoms?open

On another note: even in the Western world childbirth is still one of the major killers of young women. No 6 I recollect. No, there's no link. I had one, but inadvertently discarded it. It's not really hard to research this yourself. In the developing world it is much higher. It is important to remember that pregnancy is not without risk.

Cancers of the breast are not all the same. Some are virulent and deadly. Some rarely cause death. If Brind wants to link medically induced abortion to breast cancer and mentions hormones that make breasts tender, which would be Oestrogen, then these cancers have a very low mortality rate.

On the other hand, what about the link that has been made by credible sources to not breastfeeding? Breastfeeding for 1 1/2 to 2 years seem to be protective against developing breast cancer. http://www.ncbi.nlm.nih.gov/pubmed/21808811

Why not focus a bit more on making it comfortable for women to breastfeed and to encourage women to do so if you people are indeed so worried and care so much about women? Think of how many more women will be saved from ever developing breast cancer than with this silly little theory being debunked left, right and center. There are many links in this thread.

yvonne - one for the USA 2010 http://www.cdc.gov/women/lcod/2010/WomenAll_2010.pdf

The two brackets covered by ages 20 - 34 the rates were the 6th highest at 2.6% and 2.8%. Note if you happen to be a black woman in the USA that's 4.1% across those age brackets. A number of references at http://www.cdc.gov/women/lcod/

Some material from WHO at http://www.who.int/gho/maternal_health/mortality/maternal/en/ and http://apps.who.int/iris/bitstream/10665/112697/1/WHO_RHR_14.13_eng.pdf

Developed regions, a lifetime risk of 1 in 3700 of maternal mortality,
developing regions 1 in 160.

R0bert

Thank you Robert for that link. I get so upset with this new push to make women who have had abortion evil and wrapping it up with 'caring about women'.

We cannot go back to making abortion illegal. The horrendous results when it was, we just cannot go back to that. In the past Pregnancy and childbirth was really 'women's business'. Abortificients have always been around. It is only when men in the medical profession started taking over obstetrics this has changed.

Childbirth has become much safer for women and the child, but now there is also a big push to take it all out of the hands of women.

Our focus should not be on women having safe legal abortions, but on why an unwanted pregnancy happened and how to limit this from happening.

Women do not become pregnant on their own. The belief in the Virgin birth notwithstanding.

I would bet that the pro fantasy 'God-will-provide' life advocates do not care for children other than their own. Do not practically help and assist in the raising of a child not their own. Do not care about all the children who are born. Not their education, not their health, not their future. I bet they've never had to deal with an abused child. Children are being abused by church leaders, by step fathers, by group leaders, and also by their mothers. Not a peep about the children already born. And the horrible part is that more often than not they profess to be Christian. Jesus Christ would be enraged by the self-righteous condemnation of others by those who should leave condemnation to the all Powerfull, all Knowing God they say they revere.

yvonne, my main issue is the continued cries of wolf, wolf. I don't like abortion but support the right to choose. I do get bothered at times that the opposition to research such as the Asian material referenced here is to much driven by defence of abortion rather than truth seeking but thankfully some have had the skills to dig a little deeper on that front than I was able and challenge the claims based on evidence.

There are some Christians who both do and give a lot to help the less fortunate, many who have been genuinely horrified at the actions of abusers operating in the name of their god. As with any group the doers and people of integrity tend to be drowned out by those who yell the loudest or who have built too much on an image to act with authenticity.

In the case of this article I think Prof Brind could do a lot better by acting presenting more as an objective researcher and less as an advocate, if there is something to these findings I'd place more trust in them in the context of an objective evaluation than in an advocacy piece.

R0bert

Well well well, Agronomist, you raise very interesting points about follow-up time and my "having it both ways". Indeed. In the standard case-control setup, one identifies a group of cancer patients and compares them to healthy women of the same age. The follow-up time issue is taken care of by making sure that abortion was available for long enough for women to develop breast cancer, testing the hypothesis that the latter was caused by the former. That's why the first US study--Pike et al in 1981 (OR = 2.4)--was restricted to women under age 33, abortion having only been legal about a decade. (Also why the Howe et al study of 1989, based on prospective data from fetal death certificates, was restricted to women under age 40. BTW, most of these prospective studies--echoed by some commenters here--deny the existence of the Howe study, since it found a signicant OR of 1.9; an inconvenient truth.) But in Brauner (2013) healthy older women (age >50) only were recruited for the prospective study and followed for an average of 12 years. Essentially, it was like following up a control group for a standard case-control study, rather than being a standard case-control study.

In contrast, the slew of prospective studies between 1997 and 2008 (Danish study of Melbye 1997, Harvard Nurses study, CA teachers study, EPIC study) all share the flaw (among many) of having as little as ZERO follow-up time. So in Melbye, for example, a 15-year-old who had an abortion on 31 Dec. 1992 (when the ascertainment period for the study ended), was in the study as having an abortion, but no breast cancer! In fact, in Melbye, fully 358,000 of the 1.5 million women (25%) were under age 25 on that date. They represented over 100,000 abortions, but only 8 cases of breast cancer!

So it is the studies that deny the link that want to have it both ways: Studies that have inadequate follow-up time and those that allow too much time to elapse (thus eliminating those afflicted with breast cancer in the interim), thus making the link conveniently disappear.

Joel Brind, you are wrong about the Howe et al. study. It was not a prospective study, but a case-control study. It did not use interviews and so doesn’t suffer the problem of recall bias that most case-control studies have, but it likely had some issues around data matching.

Leaving that aside, I see you are going for a version of the Golden Mean. An effect will only be observed if the follow up period is exactly right. Too short and no effects; start too late and no effects. When you have to create very specific circumstances like this in order to find an effect, it is likely that the effect has limited or no applicability

Imagine yourself a pregnant woman now? In the light of this debate how safe would you feel about an abortion now. The link is not definite but it is a strong possibility. Wouldn't you think that the risk is there. Wouldn't you think that it's too big a risk. The studies that go against the link have serious flaws. Of course you could take a risk on it but the consequences could be fatal.

Gadfly42,

If I was a pregnant woman and the scans showed abnormality I would immediately progress with termination.

Just to give one example to show that people are quite capable of managing risk themselves.

I would definitely put any political party at the bottom of a long preference list if they even looked like changing that and trying to make up my mind for me.

Agronomist, I like your rational thinking.
Brind you have been outplayed here, and your obvious bias is very blatant.
Why not use your scientific talent to find out the real reasons for breast cancer occurring, reasons that aren't attached to your pro-life stance?

Gadfly, you have absolutely no idea of what goes on in a woman's mind when she is considering having an abortion.
She would already know that the possible consequences of having an abortion include puncture of the uterine wall, hysterectomy, or infertility, and more.
If they are still needing to have the abortion, then do you honestly think a tiny chance of this breast cancer link will make a blind bit of difference?

The choice will always be the woman's right in this country, so you need to move on...

OK, Agronomist, you are correct in that Howe et al was not a typical prospective study, like a cohort study in which the following of subjects over time is built into the original study. Rather, it may be classified as an historical prospective study, in which the data have all been entered prior to any disease determination; hence, there is not even the possibility of recall bias. (BTW, the recall bias hypothesis has actually been disproved many times in ABC link research. The original "evidence", presented in a 1991 study by Lindefors-Harris et al, was that at interview, fewer controls admitted to abortions that were on the computerized medical record than did breast cancer patients. But the underreporting by controls only showed up relative to "overreporting" of abortions among the patients, i.e., that the abortions they reported to the interviewer had not taken place, because the computer had no record of them! Of course, this is nonsensical on its face, and the original purveyors of the "overreporting " subsequently retracted the idea in published correspondence in the Journal of Epidemiology and Community Health in 1998. There has never been any credible evidence of response bias in ABC link research, yet it still gets trotted out like fact, even by some commenters on this forum. Meanwhile, even the idea of response bias fades from credibility in the face of the magnitude of the ORs reported recently from Asia, as response bias only becomes a possibility when the association is weak.)

But I digress: The Howe 1989 study (a case-control study nested in a prospective data base) is really the gold standard type of epidemiological study, because it avoids the weaknesses of cohort studies (like lack of adequate follow-up time), while having all the strengths of a classical case-control study, where one may pair-match cases for different potential confounders: much better than statistical adjustment which has inherently much more uncertainty.

Also, Agronomist, I in no way chase a "golden mean". Brauner was--in contrast to Howe--a study which took a control group that was already over age 50 and followed them to see who would get breast cancer in the ensuing 12 years. But anyone who had gotten breast cancer before she was old enough to enter the study was excluded from the study. It was, however, a valuable study in suggesting that if you have an abortion and don't get breast cancer during the next 30 years, you are no more likely to get it thenceforth than a woman who has not had an abortion. (In my published letter re: Brauner, you can see that my objection was to the extrapolation of this limited result to the generalization of there being no ABC link.) So the data available at this point seem to indicate an outcome window of between about 5 or 10 years, and up to about 30 years following abortion. But it is important to note that we are not looking for such a "golden mean" window out of our desire that there be one; rather, this seems to be emerging as characteristic of the actual risk profile.

Joel Brind, Howe et al was not prospective in any manner. It was a retrospective study. Individuals with breast cancer were identified and then linked to foetal deaths. Prospective studies enrol individuals and then follow them into the future. You should know the difference between a prospective study and a retrospective study, so I don’t understand why you keep claiming Howe et al. was a prospective study.

One point worth making about Howe et al. is that it found a significant effect of spontaneous abortions on breast cancer risk, something you claimed in the comments above did not happen.

So who has disproved the recall bias hypothesis? Don’t tell me it is Joel Brind? I think we have already established that Joel Brind is biased and his opinions are untrustworthy. Where is the data? It is well known that recall bias is a problem with case control studies and not just those involving abortion. It is why any case control study needs to be treated with some caution.

I will leave your comments about the golden mean for others to read. I think they illustrate quite clearly the problem you have.

Well said Agronomist.
I think you can safely rest your case : )

I'm disappointed in you, Agronomist, for I did not think you were one for mincing words re: unimportant distinctions. The key element in Howe is that the data were prospective, and therefore immune to the possibility of response bias.

Meanwhile, reporting bias was ruled out of Daling 1994, who reported a significant ABC link of OR = 1.5. In her study, she tested for bias by using a study population for cervical cancer and abortion. That population, with controls selected from the same general population and on the same basis of her breast cancer study, showed an OR of 1.0. If response bias were present, the cervical cancer population should also have shown an OR >1, but it did not.

Now back to Howe 1989, which is arguably the best evidence against response bias as the reason ORs >1 are consistently observed in ABC studies. You say she obtained a statistically significant association with spontaneous abortion as well, which means you only read the abstract. The Howe abstract is in error: Read the actual study. In table 3, the results are reported separately for induced and spontaneous abortion: Induced abortion: OR = 1.9, 95% confidence interval: 1.2 - 3.0; Spontaneous abortion: OR = 1.5, 95% confidence interval: 0.7 - 3.7, ergo, not statistically significant.

Joel Brind, when I first referred to Howe et al. I noted that it was not affected by recall bias. However, it is still a retrospective study and the fact that you have continually referred to it as a prospective study until I pulled you up, suggest to me that you are want to gild the lily when it suits your bias. What Howe et al. does suffer from is failure to identify confounders; hence these are not managed for.

Moving on to Daling, her study did not rule out reporting bias. In fact the study identified reporting bias among the subjects. 21% of the cases failed to report an abortion that was listed in the national registry as did 29% of the controls. That is reporting bias for you: failure to report an important event. More worryingly, in Daling’s study 7 times as many cases reported having abortions that were not listed in the national registry compared to controls. The most likely explanation is that these were abortions conducted by unlicensed practitioners and hence were illegal (even though abortion was legal in the state at the time). These represent 20% of the cases who reported having an abortion.

Still mincing words, I see. A case-control study that is nested in a prospective data base is also referred to as an historical prospective study, since the data are prospective. period. But since we at least agree that, because of the prospective nature of the data, the study is immune to the possibility of reporting bias (aka response bias), let's just stop beating this dead horse, shall we?

Yet your confusion re: the Howe study is now compounded by your confusing Daling (1994) with the 1991 study of Lindefors-Harris (not the Daling study), in which the interview records of subjects were compared with the national registry data on abortions. (There is no national abortion registry in the US, where Daling's population was drawn from.) You throw around numbers like "21%" and "29%" of case and control subjects having underreported abortions, which gives the impression that these numbers are significant. They are not. For a statistically significant result, the authors needed to compare underreporting among controls to "overreporting" among cases (which nonsense I discussed in an earlier comment). But even then, the gigantic ratio you tout of "7 times as many cases reported having abortions that were not listed in the national registry compared to controls" was literally owing to just 7 actual patients compared to one actual control subject!

You really need to read up on your abortion-breast cancer literature and get your facts straight, Agronomist. Or maybe just stick to agronomy.

No one has given that article any credibility except the pro-lifers. The methodology has been discredited and is fatally flawed. Promoting it has no credibility and deserves none.

Happy to add to the confusion, eh Minotaur? I agree that the Lindefors-Harris article has no credibility and is fatally flawed, but why would pro-lifers give it any credibility? There is no valid evidence of any response bias in ABC link research; none.

The hostile response of those claiming there is no link between abortion and breast cancer is surprising, if not unprofessional.

If the science is as sound as they make out, such vehement reluctance to allow airing of studies that indicate otherwise, clearly suggests that their prime motive is to protect their vested interests.

Indeed!