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Aborted truth?

Public health organizations remain silent on research that links abortion to breast cancer

Every October, observances of National Breast Cancer Awareness Month seem to round up the usual symbols and activities: pink ribbons; runs and fitness walks to raise money for research; and magazine features on breast cancer prevention. But in January, when pro-lifers mourn the national legalization of abortion through the U.S. Supreme Court's 1973 Roe vs. Wade decision, some people-although not the biggest media outlets-pay attention to what appears to be the single most avoidable risk factor for breast cancer: induced abortion. Scientific evidence linking abortion and breast cancer has been available for more than 40 years. But some researchers say the very agencies whose medical and ethical responsibility it is to warn women of breast cancer risks are suppressing that data. "The mainstream organs of public health policy and the media have used their power and prestige to bury the truth," charged Dr. Joel Brind, a professor of biology and endocrinology at Baruch College at the City University of New York. Dr. Brind and colleagues analyzed 33 international studies linking abortion and breast cancer, including 14 studies of American women. The review, published in 1997 in the British Medical Association's Journal of Epidemiology and Community Health, found a positive link in 27 studies. High estrogen levels during pregnancy cause breast cells to multiply rapidly. During miscarriages hormone levels decline naturally. But researchers suspect that abruptly aborting a pregnancy leaves these developing cells vulnerable to cancer. The Brind review concluded that induced abortion increases a woman's risk of developing breast cancer by an average of 30 percent. The American Cancer Society projects that 40,800 American women will die this year from breast cancer and that another 182,000 new breast cancer cases will be diagnosed. Dr. Brind, who is also president of the Breast Cancer Prevention Institute in Poughkeepsie, N.Y., believes that as many as 5,000 to 8,000 of this year's new cases may be linked to previous abortions. He arrives at that estimate by overlaying abortion-breast cancer research data with other statistics, including the total number of post-abortive women and the number of years abortion has been legal in the United States. The FDA's recent approval of the abortion-inducing drug RU-486 may worsen the situation. "If RU-486 increases the number of abortions by making abortion easier, it's going to increase the incidence of breast cancer," said Dr. Brind. Congressman Dave Weldon (R-Fla.) agrees. In a letter he sent to his colleagues after the U.S. House of Representatives debated RU-486, Mr. Weldon called the prospect of increased abortion-linked breast cancer a "health care time bomb." As the cumulative total of aborting women continues to increase and the population ages, Dr. Brind projects the incidence of abortion-linked breast cancer could be as high as 40,000 to 50,000 additional cases annually. But when it comes to implementing health safeguards to protect the public, what's good enough for most risk factors is apparently not good enough for abortion. For example, federal agencies have required product recalls when the lifetime risk of cancer was calculated at one death per million. The American Civil Liberties Union argues that doctors should inform patients if a procedure's risk of death is one in 10,000. The Occupational Safety and Health Administration (OSHA) has issued cancer-risk warnings based on a single scientific study. But the Food and Drug Administration, Centers for Disease Control, and other public health agencies have remained silent on the abortion-breast cancer link. Gerson Weiss, president of the American Board of Obstetricians and Gynecologists (ABOG) told WORLD, "There is no evidence [the abortion-breast cancer link is] an issue. No one has put together any reasonable evidence that would be a specific issue to look at, nor is there any theoretical reason to suggest that there may be a problem." Dr. Weiss was previously chairman of the ABOG gynecologic practice committee and sits on the group's executive board. He dismissed the Brind analysis, as well as the data from more than 100 cancer researchers in 33 studies over 40 years: "It was an evaluation of many poor studies and like anything when you 'glum' data together, garbage in gives you garbage out." But other respected groups disagree with Dr. Weiss's assessment. Earlier this year, for example, Britain's Royal College of Obstetricians and Gynecologists (RCOG) called evidence for an abortion-breast cancer link "inconclusive," but admitted that Dr. Brind's review was "carefully conducted" and "could not be disregarded." Dr. Brind called the conclusion disappointing, but was encouraged because the RCOG, which represents abortion practitioners themselves, is the first professional organization to acknowledge that valid evidence does exist. No U.S. agency has done so; in fact, the National Cancer Institute brands the evidence "weak and inconsistent." Congressman Tom Coburn (R-Okla.), who is also a physician, believes groups like ABOG are more interested in protecting safe-sex ideology than the health of women. "When you start coming up with science that disputes the message of 'no consequence to any sexual freedom,' then their goal is to bury it. The liberal press, which believes strongly in the same ideology, helps them do that-including the liberal medical press." Example: The National Cancer Institute points to a Danish study published in 1997 in the New England Journal of Medicine that states "induced abortions have no overall effect on the risk of breast cancer." But in a letter to the Journal, Drs. Brind and Vernon Chinchilli criticized the findings, arguing that "serious errors of misclassification and data adjustment had likely masked a statistically significant risk increase." Last October, a Good Housekeeping article titled "The Good News about Breast Cancer" assured readers that "with exciting breakthroughs in prevention, detection, and treatment, your odds of beating [breast cancer] just got better." It advised women to eat lots of fruits and vegetables, avoid alcohol, and "keep the pounds off," and noted that two new studies and a large NCI survey "link HRT [hormone replacement therapy] to higher rates of breast cancer." But the magazine didn't mention the abortion link. Good Housekeeping assistant publisher Sean Sullivan referred WORLD's question to Holly Fussell, who works in the magazine's communications department. She offered to put WORLD in touch with the article's editor, but later claimed she "wasn't able to reach anyone," "didn't know who the editor was," and "didn't think speaking to an editor would be helpful at this time." Finally, Ms. Fussell concluded that the 40 years' worth of data on the link between abortion and breast cancer "obviously was information that was not available to the writer." Rep. Coburn figures it will require medical malpractice claims charging lack of informed consent to end the conspiracy of silence on the abortion-breast cancer link. At least one attorney is working on just such a strategy. In a 1998 Wisconsin Law Review article, Chicago-based attorney John Kindley argued that there is enough evidence to support an ethical and legal duty to disclose fully the breast cancer risk to women who are considering abortion. Mr. Kindley also has filed a false advertising lawsuit against a North Dakota abortion clinic for distributing a brochure containing false statements about abortion-breast cancer research. "Because this appears to be so political, the court may provide the best avenue for resolving this scientific controversy," said Mr. Kindley. "When a jury has the opportunity to hear both sides, it will become even more clear that women have a right to know the facts." Other options besides litigation could be pursued. Tommy Thompson, nominated to be secretary of health and human services, could push for thorough studies of the abortion-breast cancer link. Congress could schedule hearings on the subject. Best of all, well-connected medical researchers themselves could decide that this is too important a subject to be disregarded because of political correctness.

-Linda Shrewsbury is a World Journalism Institute fellow