POSITION STATEMENT

­­­­­­­­­­­­­­­­

The Abortion – Breast Cancer Connection

 

Issued May 11, 2001                                                                                                               PRESS CONTACT:

National Physicians Center for Family Resources (NPC)                                               Evelyn Johnson, 205-870-0234

_____________________________________________________________________________________________

 

One of the main goals of epidemiological medical research is to identify risk factors that contribute to disease. Once risk factors have been identified, the public can then be educated to decrease their exposure to those risks that are preventable.

 

For many years, scientific research has examined the link between induced abortion and breast cancer (the ABC link). Although individuals may differ on the issue of abortion, the existence of strong scientific evidence linking abortion to an increased risk of breast cancer confirms that the nation must be educated regarding this data.

 

Background Medical Information:

 

Breast cancer is the leading form of cancer among middle-aged American women.

 

• Breast cancer accounts for over 40,000 deaths annually.[i]
• There are approximately 180,000 new cases of invasive breast cancer diagnosed each year.[ii]
• Breast cancer accounts for more than 30 percent of all cancer in women.[iii]        

 

A woman’s first full-term pregnancy provides a natural lifetime reduction in her risk of breast cancer.

 

• During the first trimester of a normal pregnancy, a woman’s body produces high levels of estrogen.
• Estrogen promotes the growth of cells in the breast. These cells multiply rapidly and later in pregnancy will differentiate or specialize so that they can produce milk.
• Once cells have been differentiated or specialized, they are less likely to become cancerous.
• It has been recognized for over 30 years that a full-term pregnancy early in a woman’s reproductive years will confer a measure of protection against breast cancer.

 

There is a sound, logical medical explanation for the abortion – breast cancer link.

 

• Induced abortion ends the hormonal cycle of breast growth and differentiation during pregnancy, leaving more undifferentiated (and therefore cancer vulnerable) cells in the breasts than were there before the pregnancy began. Thus cancer is more likely to arise in subsequent years.
• Miscarriages or spontaneous abortions do not generally result in increased risk for breast cancer because many miscarriages are associated with insufficient levels of hormones. As a result, the number of cancer vulnerable cells in the breasts is not increased enough to produce a measurable increase in breast cancer risk.

 

Research Studies:

 

Well-documented research spanning over 40 years shows that induced abortion may be the single most avoidable risk factor for breast cancer. 

 

• Of the 15 American studies investigating the ABC link conducted to date, 13 show an increased risk of an average 30-50 percent.
• American studies have demonstrated the ABC link in Caucasian, African-American and Asian-American women.
• Twenty-seven of 35 epidemiological studies worldwide indicate a link between induced abortion and breast cancer.

 

Even more alarming, a 1994 study specifically commissioned by the National Cancer Institute (one of the National Institutes of Health) to investigate the ABC link reported:[iv]

 

• A 50 percent overall increased risk of breast cancer by age 45 for all women who had an induced abortion;
• A more than 100 percent risk increase for any woman who had an induced abortion before age 18 or after age 30;
• An 80 percent increased risk in women with a positive family history of breast cancer who had an induced abortion at any age;
• A 270 percent increased risk in women with a positive family history of breast cancer who had an induced abortion after age 30;
• An infinitely increased risk for women with a positive history of breast cancer who had an induced abortion before age 18 (all twelve women participating in the study who fit this profile developed breast cancer by age 45).

 

 In what is regarded as the most comprehensive research to date on the ABC link, Dr. Joel Brind, et al. compared the results of 23 worldwide studies conducted since 1957 to produce a meta-analysis.

 

• Published by the British Medical Association’s Journal of Epidemiology and Community Health, the 1996 study found, “a remarkably consistent, significant positive association between induced abortion and breast cancer incidence,” with an average 30 percent increased risk attributed to an induced abortion, independent of the presence of other factors.[v]          
• Experts in the field of epidemiology have called Brind’s analysis, “carefully conducted,”[vi] and “very objective and statistically beyond reproach.”[vii]

 

 

 

 

ABC Controversy:

 

Despite consistent research findings documenting that induced abortion is a risk factor for breast cancer, proponents of abortion continue to label studies investigating the ABC Link with terms such as inconclusive, not definitive, inconsistent, or unduly alarming.

 

These apparent attempts to assure women and girls that induced abortion poses no real breast cancer risk are based largely on a 1997 study completed in Denmark. The Danish Study included an impressively large population. However, serious methodological flaws make the study’s conclusions questionable.[viii]

     

• The study claimed that elective abortion was legalized in Denmark in 1973—when in fact, it had been legalized in 1939.
• Consequently, 60,000 of the oldest post-abortive women in the study were misclassified as not having had an abortion.
• Although abortions in the Danish population were included only since 1973, breast cancer diagnoses recorded as far back as 1968 were included. This means the measurement of the outcome (breast cancer) preceded the measurement of the exposure (abortion) for many women in the study. This is a fundamental violation of proper scientific procedure (and guaranteed to lower the calculated relative risk).
• In addition, approximately one-fourth of the women in the study were under age 25 at the end of the study. These women—all born between 1968 and 1978—had some 40,000 abortions, but only accounted for 8 cases of breast cancer. They should not have been included in the study at all since breast cancer generally does not develop until later in life.

 

Regardless of these facts, a New England Journal of Medicine editorial remarking on the Danish study concluded that, “a woman need not worry about the risk of breast cancer when facing the difficult decision of whether to terminate a pregnancy.”[ix]   

 

State Legislation:

 

• Many state legislators believe a woman’s right to know should include all risks.
• Legislation requiring ABC warnings is already on the books in five states and is currently being considered in eleven others.
• Leading ABC researcher Dr. Joel Brind, an outspoken advocate of informing women of the ABC link says, “Such an overwhelming preponderance of evidence is usually more than enough to convict any risk factor in the eyes of the medical establishment, particularly when the connection makes biological sense.”[x]         

 

Conclusion:

 

Breast cancer is a deadly disease affecting over 180,000 American women every year. Not all of the factors contributing to the increasing numbers of affected women are known. However, a careful analysis of the scientific evidence does demonstrate that induced abortion, especially occurring before a woman has had a full-term pregnancy, increases that woman’s likelihood of developing breast cancer.

 

Many medical experts are convinced that induced abortion is the single most avoidable risk factor associated with breast cancer. Therefore, the medical community should be obligated to inform women and girls of all the evidence of this risk when they are considering abortion (especially since this is the most commonly performed elective surgery in the U.S.). 

 

As Dr. Stuart Donnan, editor-in-chief of the Journal of Epidemiology and Community Health remarked, “I believe that if you take a view (as I do), which is often called “pro-choice”—you need at the same time to have a view which might be called “pro-information,” without excessive paternalistic censorship (or interpretation) of the data.”[xi] 

 

Clearly, additional research into the abortion – breast cancer link is needed in order to establish more precise risk levels for different groups of women. However, the overall significant connection is already established by an overwhelming preponderance of the data, and any further delay in alerting the public will only result in more women suffering unnecessarily from breast cancer. 

 

Issued by: The National Physicians Center for Family Resources (NPC)

 

John Whiffen, MD, NPC Board Chair                          Kent Jones, MD

Jane Anderson, MD                                                     Bob Mullins, MD

Reed Bell, MD                                                             David Pate, MD

Don Carmichael, MD                                                   Donna Parker, President, Priority II

Harold Cox, MD                                                          Brenda Taylor, MD

Karen Effrem, MD                                                       Dianna Lightfoot, NPC President

Jonathan Green, Esq.