[Congressional Record Volume 148, Number 150 (Tuesday, November 19, 2002)]
[Extensions of Remarks]
[Pages E2112-E2113]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                       ABORTION AND BREAST CANCER

                                 ______
                                 

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                       Tuesday, November 19, 2002

  Mr. SMITH of New Jersey. Mr. Speaker, I rise to submit a letter from 
28 Members of Congress, and an enclosure from the National Physicians 
Center for Family Resources, requesting that the National Cancer 
Institute correct scientific inaccuracies in their Fact Sheet on the 
link between abortion and breast cancer. I commend the National Cancer 
Institute for the steps they have already taken to revisit their fact 
sheet and I look forward to a scientifically accurate fact sheet in the 
near future.


[[Page E2113]]




                                Congress of the United States,

                                     Washington, DC, June 7, 2002.
     Hon. Tommy Thompson,
     Secretary of Health and Human Services, Department of Health 
         and Human Services, Hubert Humphrey Building, Washington, 
         DC
       Dear Secretary Thompson: We write to request a review of 
     the National Cancer Institute (NCI) fact sheet FS #35.3, 
     labeled ``Abortion and Breast Cancer.'' As we work together 
     to make sure the American public has the most accurate and up 
     to date information on health risks, especially related to 
     the serious disease of breast cancer, we wanted to 
     specifically ask for a review of the official NCI information 
     on the link between abortion and breast cancer. Even though 
     this fact sheet was updated March 6th of this year, we 
     believe it is scientifically inaccurate and misleading to the 
     public.
       Even though, to date, 28 out of 37 scientific studies 
     worldwide, and 13 out of 15 in the United States show a 
     positive association between abortion and breast cancer risk, 
     the NCI fact sheet on this topic emphatically states ``The 
     current body of scientific evidence suggests that women who 
     have had either induced or spontaneous abortions have the 
     same risk as other women for developing breast cancer.'' This 
     glossing over of the weight of published scientific evidence 
     does not provide the public with the information they 
     deserve.
       Furthermore, it seems inappropriate for the NCI to rely so 
     heavily on one study to support its claims regarding abortion 
     and breast cancer. The NCI fact sheet relies on Melbye et 
     al., 1997, although that study contains many significant 
     flaws. In particular the Melbye study: misclassified 60,000 
     women as not having abortions when, in fact, the women did 
     undergo an abortion; included medical records that did not 
     consistently record a history of abortion; and, included over 
     350,000 women who were generally too young to be diagnosed 
     with breast cancer because their ages were twenty five years 
     of age and younger. We believe NCI has given this flawed 
     study too much weight and that the entire body of evidence 
     needs to revisited as soon as possible.
       We respectfully request that the fact sheet be reevaluated 
     for accuracy and bias and that it be removed from the 
     Department website until that review is completed. We thank 
     you for your attention to this important health issue and to 
     our concerns about the NCI fact sheet on the link between 
     abortion and breast cancer.
           Sincerely,
         Christopher Smith; Joseph R. Pitts; John Shadegg; W. Todd 
           Akin; Joe Wilson; Robert B. Aderholt; Walter B. Jones; 
           Sue Myrick; Milissa A. Hart; Sam Johnson; Roscoe G. 
           Bartlett; Todd Tiahrt; Pete Hoekstra; Bob Schaffer; 
           Mike Pence; Gil Gutknecht; Van Hilleary; Henry E. 
           Brown, Jr.; Jim Ryun; Barbara Cubin; Dave Weldon; Jim 
           DeMint; John Sullivan; Mark Souder; John N. Hostettler; 
           JoAnn Davis; Ernest Istook; Cliff Stearns.
                                  ____



  National Cancer Institute Fact Sheet Analysis, The Abortion--Breast 
  Cancer Connection (ABC Link), National Physicians Center for Family 
                      Resources (NPC), April, 2002

       Overall tone of denial of abc link: ``. . . it appears that 
     there is no overall association between spontaneous or 
     induced abortion and breast cancer risk, . . .'', even 
     though, to date, 28 out of 37 studies worldwide and 13 out of 
     15 in the U.S. report a positive association.
       Confusion of induced and spontaneous abortion: These two 
     terms appear together repeatedly, as if they are equivalent. 
     Never is the proper equation of spontaneous abortion and 
     miscarriage made; in fact, the word miscarriage never 
     appears. Yet paradoxically, the ``inability to separate 
     induced from spontaneous abortions'' is offered as a 
     criticism of earlier studies on the abc link.
       Misrepresentation of the published medical literature on 
     the abc link:
       (a) A key study on American women which relied on 
     prospective medical records (Howe et al., 1989), and which 
     found a significant abc link (overall RR = 1.9), is not cited 
     at all, even though much more weight is given to data ``from 
     studies that collected data on abortion history before the 
     breast cancers occurred'', and even though it is presented as 
     a weakness that ``Most of the early studies relied on self-
     reports of induced abortion''.
       (b) The study specifically funded by the NCI to examine the 
     abc link (Daling et al., 1994), which study reported a 
     significant overall link (RR = 1.5) and much higher risks for 
     teenagers (RR = 2.5) and actually reported ``RR = [squ]'' for 
     teenagers with any family history of breast cancer, is not 
     cited at all.
       (c) The only comprehensive review and meta-analysis on the 
     abc link (Brind et al., 1996), which reported a positive 
     association in 18 out of 23 studies worldwide (9 out of 10 in 
     the US), is not cited at all.
       Reliance on flawed studies which do not show an abc link, 
     merely because they are based on prospective data, namely:
       (a) the study by Melbye et al., 1997, even though it 
     misclassified 60,000 abortion-positive women as abortion 
     negative, used breast cancer records which antedated abortion 
     records, and included over 350,000 women under age 25, among 
     other flaws;
       (b) the study by Goldacre et al., 2001, even though it 
     misclassified over 90 percent of the abortion-positive women 
     in the study as abortion-negative;
       (c) the null studies by Newcomb and Mandelson (2000) and 
     Lazovich (2000), even though both are so small (23 and 26 
     patients with induced abortion, respectively) and of such low 
     statistical power that neither could even detect a RR as low 
     as 1.5 with statistical significance.
       Inclusion of inaccurate statements, i.e.:
       (a) ``In three of the (four) studies, information was based 
     on medical records than on the woman's self-report;''. In 
     fact, this is true of only two (i.e., Goldacre and Newcomb & 
     Mandelson) of the four studies referred to.
       (b) ``The strength of this study (Melbye 1997) include . . 
     . the ability to account for breast cancer risk factors that 
     may differ between those women who have had abortions and 
     those who have not,''. In fact, the lack of such data on 
     potential confounders was a weakness of the Melbye study, 
     which only adjusted for age and age at first term pregnancy. 
     Most studies also adjust for age at menarche, age at 
     menopause, etc.
       (c) ``Most of the early studies necessarily relied on self-
     reports of induced abortion, which have been shown to differ 
     between breast cancer patients and other women.'' In fact, 
     the opposite is true. Even the only study cited on the fact 
     sheet which examined this question reported: ``The authors' 
     data do not suggest that controls are more reluctant to 
     report a history of induced abortion than are women with 
     breast cancer.''
       Disguising the established breast cancer risk factor that 
     is directly affected by abortion in a substantial proportion 
     of abortion patients, i.e.: ``Well established breast cancer 
     risk factors include . . . a late age at the time of the 
     first birth of a full-term baby''. Abortion, which, in 
     childless girls and women, necessarily delays the first full-
     term pregnancy, is not mentioned at all in this context.

     

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