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Archive for September, 2010

Twin Scourges: Abortion and Breast Cancer

As a scientist, the most frequent question I am asked is, “When are they going to find a cure for (fill in the blank)?” It’s a great question and merits serious contemplation and public discussion, because the ones responsible for finding a cure are not just the scientists, but all of us. I have begun to answer that question by asking the following:

“What are you willing to do to find that cure?”

Read the rest here.

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The Absurdity of Recall Bias


Just a brief reflection upon the concept of recall bias with which we have been contending. Several authors, including the notoriously pro-aborts, Palmer and Rosenberg, have held out the contention that women who are healthy control subjects are more prone to not tell the truth when asked in a detailed health history if they have ever had an abortion than are women with breast cancer. This is the purported fatal flaw of retrospective studies, which employ self-reports from patients.

Supposedly women with breast cancer are busily searching for any culprit to blame.

We have seen consistent evidence of an increase in BC in women who have had induced abortions, and we shall see much more to come.

We have seen in paper #7 in this series a large prospective study (declared by the pro-aborts as the only valid type), one employing national health databases, that couldn’t hide that risk even when the authors did all in their power to dilute the magnitude of the reported risk by combining into a single category, risk groups of divergent incidence rates.

And we have not even seen the worst. Beginning on the first day of Breast Cancer Awareness Month we shall turn our sights on the Queen of All the Liars, Dr. Louise Brinton, epidemiology chief for the National Cancer Institute whose repeatedly alternating scientific papers and public policy statements have had the head-turning effect of a game at Wimbledon.

It is odd that the assertion is for healthy women to lie on one question out of so many, and for BC patients to be truthful on said question, especially when the stated rationale for much of the lying is that many of the women in the studies had abortions in the years before they were legal. Yet many of the BC patients too had their abortions in the years when abortion was illegal. So what makes BC patients given to greater veracity when their traumatic illness is grounds for denial that they could have inflicted this on themselves through the killing of their own baby?

We have seen the ABC link in the Greek study, and the declaration that abortion was widely accepted and openly practiced in Greece for years before its legalization; a reality that crushes the assumption of guilty silence in the control group creating an illusion of increased incidence in the BC case group. So the Greeks have the same elevated risk without any of the alleged confounding guilt

We have seen Rookus’ and van Leeuwen’s paper that supposedly established this phenomenon (and has been extensively held out as proof) to be founded on statistics so absurd that they are beyond taking seriously.

Finally, we have the assertion by many that the same relative risks of BC in most studies constitutes proof of error, proof of recall bias. Herein is perhaps the greatest lie of them all.

The data support the model that we know from the physiology of the breast and the data that we have from animal studies as well. The gold standard in science is the ability of an experiment to be reproduced by others with the same results. It’s called reproducibility, and we see it over and over in the ABC literature. Vatten, et al. really did the scientific community a grave disservice by obviously covering up the ABC link in their disgraceful analysis of nearly 700,000 subjects in the Norwegian prospective study.

They could have ended the debate, one way or the other. But the war rages on because of a series of cover-ups on the part of those who are in a position to control the conversation, in no small measure by controlling the grant funding.

Lest any think my statement partisan, I am not vested in any way in a particular outcome in all of this. If the data, honest data, showed absolutely no ABC link I would be the first to say let’s move on. Abortion is wrong on so many other levels that we don’t need the added fuel from an ABC link to stoke the fires of opposition. Besides, we live in an age of shrinking research grant pools. Every dollar is precious. If there were no ABC link, then we could move on and use that money more productively.

But there is a link, a very real and disturbing link. And there are very committed idealogues who value the right to slaughter babies over the lives and health of the women they claim to champion.

Some sisterhood.

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Those following daily are beginning to get confortable with the jargon (I hope). For ease of newcomers following along , please consult the glossary of terms that I’ve written to make the terminology very understandable. Also, consult the post that explains the essential background.

Title: Pregnancy related protection against breast cancer depends on length of gestation

Journal: British Journal of Cancer (2002) 87: 289-290

Authors: LJ Vatten, PR Romundstad, D Trichopoulos, R Skjarven

Funding: Norwegian Cancer Society

So far we have seen research that has linked induced abortion with an increased risk of breast cancer. We have seen authors who stand behind their methods and results, but who attribute the increased link to a purported recall bias, which is claimed by the pro-abort researchers to be a function of these retrospective (self-report) studies. We have also seen one of the papers upon which these claims have been made, and have seen the appallingly sloppy and irresponsible statistics employed which simply strain credulity. Further, we have seen that spontaneous abortion (miscarriage) has no effect on breast cancer risk, as the estrogen levels in the mothers is abnormally low in these pregnancies. I have also been assailed by the usual suspects who claim that the retrospective studies are too small (a fair claim for a few, but not the majority).

Today we turn our attention to a paper employing a method touted by the pro-aborts: a prospective study. In this study National birth and cancer databases in Norway were employed to get an objective assessment of women from first birth in 1967 until the diagnosis of cancer, death from any cause, or the end of the follow-up period on December 31, 1997.

This study should please the pro-abort crowd for a couple of reasons. It’s prospective and it’s large, very large: 694,657 women.

Results: The study substantiated the data from some of the comparatively smaller studies we have thus far considered. For instance, it showed an increasing incidence of breast cancer with increasing age at first birth (95% CI):

Less than 20 years 1.0 (reference value)
20-24 years 1.10 (10% increased risk)
25-29 1.30 (30% increased risk)
30-34 1.48 (48% increased risk)
35+ 1.56 (56% increased risk)

So we see in a large prospective study the validation of the trends found in the smaller studies.

Now for the length of gestation in first pregnancy. As the length of gestation decreases, the risk of breast cancer increases (95% CI):

40 week gestation 1.0 (reference value)
37-39 weeks 1.08 (8% increased risk)
32-36 weeks 1.11 (11% increased risk)
less than 32 weeks 1.22 (22% increased risk)

So, from this short communication we see the validation of previous studies. We also see some major holes through which one could drive a truck.

In such a large data set, why didn’t the authors separate out spontaneous from induced abortions? They make an incredible claim that one study by Melbye shows no difference in breast cancer risk in women with either induced or spontaneous abortions. This, even though one of this study’s authors (Trichoupoulos from Harvard) published data to the contrary with 95% CI (We’ve already studied two of those papers here at Coming Home in the last week). So the authors lumped miscarriage in with induced abortion and still showed a 22% increased risk of breast cancer.

They could have, and should have, shown the data for induced and spontaneous abortions separately in this prospective study to put the issue of recall bias to bed, one way or the other. It would also be a good basis of comparison for those two categories’ results in the retrospective literature.

So why didn’t they?

The answer lies in the data reported. The data validate all other findings in the retrospective literature. The data also validate the proposed biological model, of placental lactogen maturing the breast cells in the last trimester.

Note even here the dishonesty built into the numbers, as week 32 (the earliest week reported) is in the middle of the third trimester. At this point, according to none other than Melbye, 90 % of the protective effect is already in place. Thus, the authors stratified the risk inherent in the remaining 10% of protective effect yet unachieved in the third trimester. They did nothing to show the loss of protective effect. In short, they lied.

A further masking of induced abortion’s effects is the lumping of miscarriage with induced abortion. As there are typically many more miscarriages than abortions, and since all earlier studies show no increased risk of BC with miscarriage, this too dilutes induced abortion’s real numbers.

Was this masking of the numbers regarding an ABC link intentional? I believe it was. The single greatest issue at stake in this paper was a refutation or validation of recall bias as an issue in the retrospective body of literature. The authors have all of the data before them and could re-crunch the numbers.

Taking the weak assumptions that underlie ‘recall bias’, the even weaker numbers (weak to the point of absurdity in an undergraduate statistics class) of the proposed evidence of recall bias by Rookus and van Leeuwen, the ham handed approach to an exquisite prospective data set of almost 700,000 women and the lack of population stratification to bolster the issue of recall bias, this scientist simply cannot believe that Vatten, et al. were so over-simplistic by any means other than intentional design.

This study validated every other trend in the body of retrospective literature. Even the 22% increased risk of BC in women whose pregnancies were interrupted in the middle of the protective effect period scream a validation of the 30-50% increased risks for induced abortions in the retrospective studies whose smaller numbers were not massaged.

Such recklessness constitutes a betrayal of women who are entitled to fully informed consent prior to a surgical procedure such as abortion. If any other surgical procedure raised women’s risk of breast cancer by 50% and the data were similarly massaged careers would end and lawsuits would abound.

When I was a graduate student we were taught that the only thing of value a Ph.D. has is his/her integrity, without which all else is naught. If these authors can’t be trusted to competently assess and report the data when millions of women’s lives hang in the balance, then what good are such people to society, to the scientific community? Is the next grant, the next paper, the next academic promotion, the adulation of pro-abort colleagues, the loss of one’s academic soul worth it?

One need only consider the epidemiologically marginal 50% increased risk of BC multiplied by the 1.8 BILLION women worldwide who have had abortions since 1960 (and the scores of millions more to come in the coming decade) to get the frightful numbers of women who have endured, and will endure the effects of such betrayal.

Scientific integrity matters.

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The ABC Literature: #6

Those following daily are beginning to get confortable with the jargon (I hope). For ease of newcomers following along , please consult the glossary of terms that I’ve written to make the terminology very understandable. Also, consult the post that explains the essential background.

A very busy weekend, so here in #6 is the article that should have been published on Sunday. I will catch up by later today, so as to keep my word about a paper/editorial per day.

Rookus and van Leeuwen respond to Brind, et al. in the matter of recall bias. Yesterday in #5 we saw part of the critique presented by Brind, et al. Today, the response from that same Journal issue:

Journal of the National Cancer Institute, April 16, 1997; Vol. 89, No. 8, 589-590.

“ Dr. Brind and colleagues argue that the small number of subjects exposed to induced abortions (12 of 225 case patients and 1 of 230 control subjects) in the southeast {Catholic} region does not justify this conclusion.

“We agree with them that subgroup analysis based on small numbers increases the probability of chance findings. However, the choice for comparing the two regions was not arbitrary Rather, it was based on a sound hypothesis: Populations with different religions and attitudes toward induced abortion may differ in their willingness to report induced abortions. Indeed we ended up with small numbers in the southeastern region, but precisely these numbers were found to have a large impact on the estimated relative risk (RR) of breast cancer after induced abortion…”

That second paragraph is stunning. First, they agree with Brind about the unreliability of the appallingly low numbers they found in the Catholic southeast region of the country, but then go on to use them anyway.

Their justification: A sound hypothesis that Catholics are morally superior and more truthful by nature.

Of course they didn’t exactly say it that way. They just hypothesized that the one Church in western Christendom that encourages a nightly examination of conscience, and has as a sacrament the process of self-confrontation and confession of sin, would produce more conscientious and truthful individuals than would those Protestants and seculars who do not have such ascetical practice.

Actually, they were probably more motivated by the cultural caricature of Catholic guilt.

What further argues against such a hypothesis is the very country where this study took place-the Netherlands. Famed for their embrace of prostitution, euthanasia, and Catholic Church attendance rates in the teens (percentagewise), it absolutely strains credulity that anyone could accept such a hypothesis. The Dutch have long ago abandoned their faith. They lead Europe in decadence and debauchery, in callous disregard for human life.

It is the Netherlands that has recently announced its interest in building a “hospital” whose sole purpose is physician assisted suicide and euthanasia, and was on that track at the time of the study. Yet the authors hypothesize behavior of Catholics more indicative of what one would expect in medieval Spain. The hypothesis was not predicated on a valid reading of Catholicism as it exists in the Netherlands, but only as it exists as a cultural caricature in the minds of the researchers.

The authors conclude their second paragraph by boldly embracing both the low numbers of subjects and the spurious data they generated. One has to admire them for their chutzpah.

The authors then go on to respond to this from Brind, et al.:

“To bolster their claim, Rokus and van Leeuwen also compared self-reports with prescribers’ records of oral contraceptive use in the two regions. They found a slight but significant tendency for southeastern control subjects, compared with western control subjects, to underreport the duration of their oral contraceptive use. However, since the authors found no evidence of reporting bias between case patients and control subjects (who had been matched for region), reporting bias could not logically be held accountable for the observed positive association between induced abortion and breast cancer.”

Rookus and van Leeuwen go on to embrace the lack of 95% confidence in those data stemming from more flawed research design. One cannot compare reporting disparities between control groups in different parts of the country and then suggest that the same holds true, or not, in case patients, and then make the leap that there is a difference (not seen or measured) between case patients and controls.

Brind, et al. have completely exposed Rookus and van Leeuwen’s work as:

1. Flawed in its hypothesis
2. Flawed in its design
3. Flawed in its results
4. Flawed in its statistics
5. Flawed in its conclusions, based upon the flaws in #’s 1-4 above.

Then, referring to a similarly flawed Swedish study, the authors state:

“The Swedish study by Lindefors-Harris, et al. is the only study so far in which reporting bias was directly evaluated. We agree with Brind et al. that it would be highly unlikely for women to report an induced abortion that never took place, which shows that the registry was not complete. Even so, however, the study does provide suggestive evidence that reporting bias was present, if we assume that the chance to be registered at the time of induced abortion was equal for women who would and would not develop breast cancer later on.”

So the guys with a terrible hypothesis and no data of their own suggest that another study with incomplete data could have been valid if one assumes conditions and numbers to have been present that support the hypothesis of recall bias. Imagining that I had the winning lotto numbers for last week makes for nice daydreams, but it doesn’t make me a real millionaire. Similarly, imagining numbers that would have/could have supported their hypothesis doesn’t make the hypothesis a validated assumption of objective reality.

This is pretty much the extent of the evidence for recall bias so often quoted by pro-abort researchers such as Palmer and Rosenberg who are desperate to explain away the implications of their research.

I’m including these letters/editorials, as they are an integral part of the scientific literature. They are opportunities for scientists to refute/defend/discuss the studies. They help us enter into the minds of the authors and see the work through their eyes, see their rationale.

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Revealing Autism

Today 9, soon to be 10 year-old Elizabeth asked us why we have taken Joseph on so many special trips. So today was the day that we told her about her 11 year-old brother’s autism, that all of those special trips have been us taking Joseph to the best specialists in the country. She accepted it well and in a spirit of reverent compassion because we presented it in just that manner.

Joseph doesn’t know because he isn’t ready to know. It’s an individual call.

Elizabeth had over an hour’s worth of questions that we answered slowly, deliberatively, and as thoroughly as we thought she could grasp. Then she asked THE question:

“So why do so many parents want to abort handicapped babies? Don’t they know what they’re missing?”

This from the little girl who awoke every school day at 6 AM for three years so that we could get Joseph to his speech therapy at 7AM and then to school. This from the little girl who sat in waiting rooms daily for a total of 8 hours per week, between all of the therapies, and never once in 7 years has uttered a complaint.

Beth grasps how much of her life, and ours, has been subordinated to Joseph’s needs. Yet she is bewildered that parents don’t understand what they are missing in aborting their handicapped children.

Love sees that which narcissism and fear obscure.

They are holy, these little ones. No doubt why Jesus says that the Kingdom of Heaven belongs to such as these.

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The ABC Literature: #5

Those following daily are beginning to get confortable with the jargon (I hope). For ease of newcomers following along , please consult the glossary of terms that I’ve written to make the terminology very understandable. Also, consult the post that explains the essential background.

A very busy weekend, so here in #5 is the article that should have been published on Saturday. I will catch up by later today, so as to keep my word about a paper/editorial per day.

The issue of recall bias stems from a paper we shall review this week by Rookus and van Leeuwen in the Netherlands. In the past week we have seen Palmer and Rosenberg refer to this study as the source of “reporting bias”, or “recall bias” as it is otherwise known. Before we delve into the Rookus and van Leeuwen study, we need to set the stage for understanding it and its assertion by considering a response to their study by Dr. Joel Brind of the City University of New York, along with fellow authors Vernon M. Chinchilli, Walter B. Severs, and Joan Summit-Long. Their response was a letter to the editor in:

Journal of the National Cancer Institute, April 16, 1997; Vol. 89, No. 8, 588-589.

Brind, et al., note that the Dutch paper reports a much greater relative risk (RR) of 14.6 {meaning 13-fold increase, which is gigantic} among women having had abortions from the Roman Catholic southeastern region of the Netherlands, compared to the more secular western region with a RR of 1.6 (30% increased risk). Clearly Roman Catholicism does not, when coupled with induced abortion, raise a woman’s risk of BC. How then to explain the whopping 13-fold increased risk in Catholic women, when the 30% increased risk in the more secular region is more in line with the similar data from around the world?

The answer resides in how the statistical analysis is performed. While a 95% CI was generated for these numbers, it is widely regarded in statistics that the actual sample size needs to be sufficiently large. For example, If I read in today’s paper that 66% of Americans are satisfied with the economic status of the country, I would become suspicious. If I then read that only three people were surveyed, my deep suspicions would be confirmed. The sample size was too small.

This is in fact what Brind et al., assert about the Dutch study. Only 13 women were included in the Catholic region of the country. In their own words, Brind, et al..:

“…this apparently huge difference was obtained by limiting the analysis to parous women only under the age of 45 years old, a subset containing only 13 subjects exposed to induced abortion in the southeast {Catholic region}. It is not prudent to make such a strong claim based on such a small sample, regardless of statistical significance.

“To bolster their claim, Rokus and van Leeuwen also compared self-reports with prescribers’ records of oral contraceptive use in the two regions. They found a slight but significant tendency for southeastern control subjects, compared with western control subjects, to underreport the duration of their oral contraceptive use However, since the authors found no evidence of reporting bias between case patients and control subjects (who had been matched for region), reporting bias could not logically be held accountable for the observed positive association between induced abortion and breast cancer.”

It is noteworthy to highlight the fact that the authors restricted the upper age limit to an age when many breast cancers are not yet detectable (45 yrs.), which serves to further skew the data.

When I was a psychology major as an undergraduate, we were made to take courses in statistics, quantitative analysis, research design, and tests and measurements. St. John’s University was rigorous in its emphasis on mastery of understanding valid vs. flawed research design and our ability to grasp the meaning of valid vs. invalid statistical analyses. The graduate program in biology was even more rigorous in this regard. It pays off abundantly when schools place such heavy emphasis in these areas, and young pro-lifers contemplating working in the pro-life field are well advised to take this coursework in college, regardless of their major, as Brind, et al. have demonstrated repeatedly that the great area of deception is here in the statistical arena.

As we go along, we shall see more of Brind’s exemplary work in exposing the shoddy research design and statistical analysis that served as the foundation for this fiction of reporting bias.

This October, please consider $upporting the following who desperately need our $upport to get the truth out*:

Breast Cancer Prevention Institute

Coalition on Abortion/Breast Cancer

*I have no institutional affiliation or membership with either group. Karen Malec and BCPI have been great resources for me, utterly generous with their time and resources.

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Those following daily are beginning to get confortable with the jargon (I hope). For ease of newcomers following along , please consult the glossary of terms that I’ve written to make the terminology very understandable. Also, consult the post that explains the essential background.

Title: Prolonged breastfeeding reduces risk of breast cancer in Sri Lankan women: A case–control study

Authors: Malintha De Silva , Upul Senarath, Mangala Gunatilake , Dilani Lokuhetty

Journal: Cancer Epidemiology 34 (2010) 267–273

Goal: To assess the association between duration of breastfeeding and the risk of breast cancer in Sri Lankan women.

The method in the author’s own words. It’s very clear and worth the read:

We conducted a case–control study in selected health care
facilities in the Western province of Sri Lanka from January to
December 2007. The cases were selected from three tertiary care
hospitals: the Cancer Institute Maharagama, the National Hospital
of Sri Lanka and the Colombo North Teaching Hospital. The Cancer
Institute Maharagama is the only referral hospital for cancer in Sri
Lanka, and provides care for the majority of cancer patients in the
country. The National Hospital of Sri Lanka and the Colombo North
Teaching Hospital also provide diagnostic facilities and initial
treatment for selected cancers, i.e., surgery for breast cancer.

A ‘case’ of breast cancer was defined as a woman who was
newly diagnosed to have invasive breast cancer either by fine
needle aspiration (cytological) or core/excision biopsy (patholo-
gical), with or without a positive mammogram (radiological),
together with clinical diagnosis. The sample was restricted to
women aged 30–64 years and admitted to the surgical units of the
above mentioned hospitals. Among the excluded were those
having more than a 3-year delay between diagnosis and admission
for surgery, secondary deposits in the breast where the primary
malignancy was at another site and critically ill patients. All the
women who satisfied the above mentioned criteria were enrolled
in the study as ‘cases’ until the required sample size was fulfilled.

The control group was selected from Well Women Clinics
conducted in five Medical Officer of Health divisions in the
Western province, namely Pitakotte, Nugegoda, Wattala, Ragama
and Ja-ela. The Well Women Clinics offer screening services
including clinical examination of breasts and PAP smear test for
cervical cytology for apparently healthy women in the community.
However, these clinics do not provide mammographic screening
facilities for breast cancer. The controls were matched to the cases
by the respondent’s age group (5-year age groups) and parity, since
these 2 variables were well recognized risk factors, which would
otherwise confound the hypothesized association between breast
cancer and breastfeeding. Once a case was identified, two controls
comparable to the index case were selected from the immediate
Well Women Clinic out of the 5 clinic centers.

The data were collected by interviewing women by the trained
interviewers using a pre-tested, structured questionnaire.
The questions were focused to collect details of
breastfeeding and other potential confounding factors for breast
cancer. The lactation history was obtained for each live birth
separately, including details regarding duration of breastfeeding,
period of amenorrhea during breastfeeding, age at first lactation
and at most recent lactation. The total duration of breastfeeding
was calculated by summing up the number of months of
breastfeeding per each child. In addition, information was
collected on level of education, employment, family history of
breast cancer, menstrual and reproductive history, exposure to
passive smoking, use of alcohol and daily activity level.

Results: Data are reported with a 95% Confidence Interval

Among women with past history of abortion, the OR is 3.42 (More than triple the risk of developing BC).

Paasive smoking raised the risk three-fold (OR=2.96)

Breastfeeding 24 months or more compared to no breastfeeding OR=0.40 (60% reduction in breast cancer among breastfeeding women)

The results validate well-known data indicating an increase in BC among women exposed to cigarette smoke.

The data validate what is known about the protective effect of a full term pregnancy and prolonged exposure to lactogen and the general maturational effects of lactation hormones on the lobule cells during breastfeeding.

And the data support all the aforementioned risk associated with breast cancer in women who have not had the protective effect of a first full term pregnancy because of abortion.

Note to those who continue to assert that I am ideologically driven in my presentation of the data and rejection of the fantasy called recall bias, or reporting bias:

Ideology is manifest when researchers claim the presence or activity of a phenomenon for which they have absolutely no data. All that these folks have is a hunch. But there needs to be a way to test for this phenomenon. In paper #3 yesterday, we saw even stronger association between abortion and breast cancer in Greece where there are no cultural constraints on abortion, and a diminished likelihood of reporting error. Thus, the Greek study tells us that if anything, the underreporting is not in the control groups, but in the experimental groups here in America.

The Sri Lankan study shows an overwhelmingly high incidence of BC associated with abortion. This is a nation that is 70% Buddhist, 15% Hindu, 7.5% Muslim, and 7.5% Christian. Thus, there doesn’t appear to be the grounds for Palmer and Rosenberg’s contention of Catholic scruples as the source of reporting bias.

I am reporting the science. The ideologues are those who invent phenomena to attenuate data that challenge their most cherished beliefs and practices.

This study was entirely funded by Sri Lankan sources.

This October, please consider $upporting the following who desperately need our $upport to get the truth out*:

Breast Cancer Prevention Institute

Coalition on Abortion/Breast Cancer

*I have no institutional affiliation or membership with either group. Karen Malec and BCPI have been great resources for me, utterly generous with their time and resources.

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