As we consider Dr. Louise Brinton’s role in the official dismissal without cause of the scientific evidence concerning the ABC link, it should be noted that Dr. Kathleen Malone who is in on that denial was a co-author with Brinton on the last paper (#10), as well as coauthor on this paper which shows evidence refuting the recall bias assertion. Malone this past January supported the 2003 NCI “Fact Sheet” that denies the ABC link in no small measure because of the panel’s embrace of the recall bias myth that Malone’s own study, under review in this post, refuted.
Title: Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion
Authors: Janet R. Daling, Kathleen E. Malone, Lynda F. Voight, Emily White, Noel S. Weiss
Journal: Journal of the National Cancer Institute. Vol 86. No. 21. Nov. 2, 1994
This is a Case-Control study of 845 women in three counties of western Washington State diagnosed with breast cancer between January 1983 and April 1990 (the Cases) and who were born after 1944, and 961 control subjects from the same three counties dentified through random digit dialing.
One of the parameters investigated by the researchers was the debate over recall bias and the assertion that women who had their abortions before the legalization of abortion would be more apt to conceal that information if they were healthy. Therefore, the subjects in this study were selected on the basis of age, ensuring that most of the subjects had most, if not all, of their reproductive years at a time when abortion was legal.
{Bear in mind that many states had legalized abortion for years prior to the 1973 Roe v. Wade decision}
Results:
“Among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women (95% CI)”
Other Results (Risk of in situ and invasive breast cancer in gravid women associated with prior induced abortion).
Remember that relative risk (RR) of 1.5 means 50% increased risk, 1.8 means 80% increased risk, 2.0 means doubling of risk, etc. All data have 95% CI
Age at first abortion:
30 RR=2.1
Gestational length of first aborted pregnancy
1-8 weeks RR=1.4
9-12 weeks RR=1.9
>13 weeks RR=1.4
Timing of first induced abortion
Before first birth RR=1.4
After first birth RR=1.5
Never gave birth RR=1.7
Interval between first abortion and reference date (years)
0-9 RR=1.4
10-14 RR=1.7
>15 RR=1.4
Family history of BC
None RR=1.4
Family history (sister, mother, aunt, grandmother) RR=1.8
Family history and abortion before age 18 RR=Infinitly High (All 12 cases, no controls)
Family history and abortion over age 30 RR=3.7
In a comparison of women who never had a pregnancy with women whose only pregnancy ended in abortion (63 case patients, 53 controls) RR=1.4
No increased risk of BC in miscarriage.
To assess the issue of recall bias, the authors looked at cases of invasive cervical cancer among women who reported induced abortion (214 cases) and 321 controls. The relative risk in relation to an induced abortion in the case of invasive cervical cancer was 1.0, meaning absolutely no difference, no recall bias.
This is a very important finding, as it suggests that the tight RR’s of 1.5-1.9 in the literature are indeed an indication of a valid physiological phenomenon at work in regard to induced abortion and breast cancer risk.
We now know that virtually all cervical cancers are caused by human papilloma virus (HPV). Thus, the known mechanism for cervical cancer would not be influenced by induced abortion. Conversely, the estrogen-driven proliferation of cancer-prone Type 1&2 cells early in pregnancy, and the denial of placental lactogen’s maturational influence in third trimester would deny the transformation of these immature cells into Type 4 cells.
The fact that there was no recall bias as regards an equally devastating and deadly cancer supports the validity of the studies indicating an ABC link, including this study. Final commentary on this article tomorrow.
Coming Home 
I don’t understand why miscarriages wouldn’t increase the BC risk at all, since in some miscarriages, hormone levels are normal right up until the abrupt end of the pregnancy (though most are not, so I would predict a smaller risk).
I am also very interested in what you have to say about cervical cancer and the Gardasil vaccination.
L,
Good day to you from a crisp autumn day in New York. My understanding of the literature, and from my discussions with OB/GYN’s is that most miscarriages are characterized by very low hormone levels, so much so that the few where levels are normal would simply be masked by all the others in a study.
As regards Gardasil, any level of immunity is better than none in the abstract. In reality, the vaccine does not cover all strains of HPV, and nay lead people into a false sense of security as regards engaging in sex and ultimately increasing their cumulative exposure. We are always faced with the difference between what the vaccine actually does and what people perceive it to be.
my opposition to Gardasil is that it is yet another vaccine and that it is largely untested
There have been thousands of adverse effects reported as well.
instead of altering behaviour, we simply promote a bandaid solution which encourages people to continue behaviours which make them and others sick
most cervical cancers arise from promiscuity and sex outside of marriage.
of course, far be it from any health professional to tell a person to have one partner and to save oneself for marriage.
That would be pushing an ideology on another person. *gasp*
On the bright side, this year only 4 girls in my daughter’s class were vaccinated. 🙂
The public health nurse was very upset.
Gardisil is safe, in contrast to Mercola and other antivax cosnspiracy theorists. The VAERS is self-reported and unreliable, but is a broad radar for true, causative events that stand apart from the noise.
It is a cancer vaccine. Hep B is an STD and that is a common vaccine which doesn’t raise the same ire that Gardisil does, it is given to day old newborns, and the Hep B vaccine doesn’t get accused of giving false security. 12k women get cervical cancer in the US yearly, 4-5K die yearly. 23 million doses have been given out. And while the incidence of the 4 HPV strains involved will go down, in terms of public health, it is not a very important vaccine and costs too much right now to be promoted en masse. Gardisil vs. chastity is a false opposition. We ideally try to teach kids to be chaste so they can love. Teaching fear of STD’s as the reason to avoid premarital sex is a stuffy deontology, and minimally effective.
“….most cervical cancers arise from promiscuity and sex outside of marriage.”
Yes, but not necessarily the victim’s promiscuity. My aunt caught HPV from her cheating spouse, and she developed anal cancer, which was likely related — not something I would wish upon my daughter, or anyone’s.
Instead of providing protection, should we simply offer a moral solution which allows people to make other people sick?
I am a great believer in vaccines in general, but my opposition to Gardasil was that it was new and untested. (Oh, wow, look at that — MC and I actually agreed on something!)
I wanted to see if there were any side effects, so my daughter hasn’t had the Gardasil vaccine yet, and at 13 1/2, she’s almost out of the age window. I don’t think we can get it in Japan, anyway.
But then I remember my late aunt, and I think maybe I should pay one of the foreign clinics to ship over a dose for her.
L, the solution always is a bandaid one.
Gardasil would likely NOT have helped your aunt.
There may have been other factors which you aren’t aware of.
We also do not know the effect of this vaccine on the disease itself.
It may be that other strains will become more virulent thus actually increasing the risk to women.
Or women who think they are protected getting it anyway because the shot didn’t work.
Many vaccines really don’t work all that well.
When my oldest was vaccinated against measles only one shot was given. Now, children routinely receive two shots and sometimes even those dont’ work.
For some diseases, vaccines have been a God-send. Polio, small pox, whooping cough, rabies.
For others, I think it’s likely better to simply get sick and develop the immunity naturally.
And for diseases that are the result of immoral behavior I’m more in favor of changing mores than forcing the vaccine down everyone’s throat.
This latter method HAS been the approach at our local elementary school for several of the vaccines – pushy threatening public health nurses that required a BIG push back on my part.
My child. My decision. My CHOICE. Go away.
“Gardasil would likely NOT have helped your aunt.
There may have been other factors which you aren’t aware of.”
Wow, you are very emphatic about a situation involving a person you don’t know. Why would it likely NOT have helped my aunt? Are you implying she somehow brought her infection upon herself?
To be sure, the failure of her marriage led to spate of other problems for her (she abused alcohol after her divorce, remarriage to an abusive spouse, and another divorce, and we believe she died of complications of her addiction, not of her cancer). I agree that Garasil would have been unlikely to SAVE her from all of her problems, but I can’t help but think that her life would have been easier at the end without the HPV/anal cancer on top of everything else. So I would have to say, it most certainly would have helped her.
“I think it’s likely better to simply get sick and develop the immunity naturally.” —> I partly agree with this. I vaccinated my kids against chicken pox (one caught it, anyway), but likely would have made a different decision today. But an HPV infection is different — it doesn’t make one immune in the future, as far as I know.
I generally don’t think there’s anything wrong with parents refusing to vaccinate children based on strongly-held convictions. But I also don’t think it’s wrong to decide to protect one’s daughter against exposure to the immoral behavior of others, such as the possibility of a cheating spouse, or one who had sexual relations prior to marriage.
Gentles All,
Regarding HPV, it is NOT better to get sick and develop natural immunity. The DNA from the virus inserts itself in the DNA of cervical cells setting up dramatically increased odds of cervical cancer down the road. Subsequent immunity does not impact this risk, but only deals with future development of warts and viral shedding.
Prevention through traditional moral norms, abstinence before and fidelity in marriage, is the only sure way of prevention. The vaccine can help, but not entirely ameliorate the risks inherent in sexual conduct outside of the tradition framework. As with all other freedoms, the sexual freedom today involves substantial trade-offs.
Gerard,
I was making a general statement re: vaccinations.
It IS IMO, better to get sick and develop a natural immunity for many of the less serious childhood diseases. I had measles(both types), mumps, chicken pox and also Hong Kong flu. I was sick but not deathly ill. My brother was deathly ill with measles and indeed almost died. I know people who have had whooping cough and yes, a baby too. 😦
Still I remain of mixed mind regarding vaccinations.
I do not believe that it is better to contract HPV. I believe it’s better to remain chaste prior to marriage and then to be faithful within marriage. Such behaviour drastically reduces the risk of contracting HPV.
My point is that the vaccine is promoted with the idea that one CAN be sexually promiscuous and this vaccine will prevent illness.
However, vaccines have their limits too. We also do not know how the infection will evolve over time. Less virulent strains may become more prevalent. This vaccine was not rigorously tested and it seems that pharma companies have much money to made from the sale of such vaccines.
L, I’m not getting into a discussion about your aunt. Your tone has already precluded the futility of such.
Have a nice day.
You have a nice day, too, Mary Catherine. Thank you for not speaking ill of my dead relative.
(And I think it’s funny that MC and I both decided to forego the Gardasil vaccine for our daughters.)
The main reason to get the chicken pox vaccine is to protect unborn children, as they have a high fatality rate if the mom contracts chicken pox.
Measles, mumps, pertussis can kill, cause lifelong defects (orchitis, deafness, etc.) This is why we get the vaccines. The “natural immunity” talk has been discredited except on antivaccine sites. Nor will other strains develop increased virulence, but prevalence may change. Fior example, we have more prostate cancer prevalence now than in 1885 because people live longer. But antibiotics didn’t increase the malignant behavior of prostate cancer , only increased life expectancy, and therefore increased the incidence and prevalence of prostate cancer.
If Gardisil, which has been safely tested like every other vaccine in standard FDA methodology, is promoted as a means to promote promiscuity, that is wrong, however it can still prevent disease. Blaming big pharma or big public health nurses doesn’t discredit the fact that a woman who is raped, or has a cheating spouse, or marries someone who carries HPV into marriage, can reap some benefit from the vaccine. But I agree no one should be able to force parents to get vaccines if they do not want them.
Snaul, there’s been a lot of controversy about the chicken pox vaccine over the years:
http://www.all.org/article.php?id=10203
I wouldn’t touch the chickenpox vaccine with a 10 foot pole. I had the disease and survived. 3 of my 4 children had it and my eldest girl who was 12 at the time had a very serious case of it.
She has scars all over her body including her face and suffered terribly. (The vaccine was not available at this time.)
I just don’t believe it’s safe and I don’t think the vaccines are tested enough.
Besides which, I wonder just how many of these “shots” we are going to give our children? 15? 25? 150?
I see this morning that Australia announced it is banning the flu shot for children under the age of 5.
There are more antigens on my mouse and keyboard than all my prior vaccines combined. They do not overwhelm, or underwhelm, or disrupt the immune system or any other crackpot antivax theory. Vaccines are safer than getting the diseases they protect us from.
Those who are best at fighting the anti-vaccine crowd are, in general, atheist skeptics. The sad truth is, they are correct, have the data to prove it, and are good at defending vaccines. I don’t know why, but there is a contigent of religious people who are anti-vax. I wonder if it comes from the collapse of christian universities and subsequent distrust. As a result, training in science has been suspect, and has diminished an ability to deal with scientific issues in the U.S. In JPII’s Fides et Ratio, science and religion are not opposed, but complementary. God gave us the gift of reason. It is perhaps one of His best gifts. To misuse it, to follow conspiracies, is a threat to faith. When some children grow up thinking vaccines are some government/big pharma scam, then take a microbiology class at college, and reason themselves to the opposite view, then their own faith will be perhaps distrusted, harmed, made more difficult.
Some skeptics pigeon-hole the ABC link in the same category as the anti-vaccine movement. I disagree with them (based on the science), but I sometimes cannot blame them.