An original article describing the research which shows the effect of abortion on breast cancer rates.
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Abortion And Cancer
An Article By Judith E. Koehler which first appeared in the Weekly Standard on January 22, 1996. Reproduced here with permission. Judy Koehler was senior legislative counsel of Americans United for Life when she wrote this article. She is currently a Judge on the Illinois Appellate Court.
Quietly and with little notice from the press, state legislatures have started requiring that women be informed of the cancer risk associated with abortion. As a result, it may soon be common knowledge that having a baby at a young age modestly reduces a woman's lifetime risk of breast cancer, while having an abortion may increase it.
In September 1995, Louisiana became the first state to require that women considering elective abortion receive information about the association between abortion and breast cancer, known as the ABC link. At least 24 hours before an abortion is scheduled, the woman must be given a booklet prepared by the state. While acknowledging that "several studies have found no overall increase in the risk of developing breast cancer after an induced abortion' and that "this issue needs further study," the booklet warns that "several studies do show an increased" long-term medical risk. The warning is even stronger for women who have a family history of breast cancer or who themselves have breast disease. Louisiana urges those women to seek medical advice before they consider an abortion.
Montana has followed Louisiana's lead, and the Pennsylvania legislature was sufficiently interested to commission a review of the scientific research. That "meta-analysis" was performed by Dr. Joel Brind, professor of biology and endocrinology at Baruch College of the City University of New York, in collaboration with specialists associated with the Hershey Medical Center, an affiliate of Pennsylvania State University. Their work is currently undergoing peer review. Its publication is expected early this year.
Conveniently for the layman, Brind--whose own research has explored the connections between reproductive hormones and human disease for over a decade--summarized the state of medical knowledge in the December 25, 1995, issue of National Review. By his count, 22 relevant studies have appeared in the peer-reviewed medical literature, of which 11 found a statistically significant link between induced abortion and increased incidence of breast cancer, and another 6 found an increased risk, though below the level of statistical significance (a measure indicating 95 percent certainty that a discerned link is real, not simply an effect of random variation). Brind stresses that the evidence for the ABC link has come not only from the United States but also from Europe, Japan and the former Soviet Union over a period of four decades.
Among the studies that found an increased risk, the magnitude of the increase varies, but Dr. Janet Darling's findings can be taken as illustrative. Her research, published in 1994 in the Journal of the National Cancer Institute, suggests that a 22-year-old woman's lifetime risk of developing breast cancer rises from at least 10 percent, the average for women in general, to 15 percent if she has an abortion. If she has a baby, by contrast, her long-term breast-cancer risk drops to 7 percent. Daling's work suggests the risk is highest-indeed, very high-for women who undergo abortions before the age of 18 and who have family histories of breast cancer; of the 1,600 women she studied, 12 fell into this category, and all 12 got breast cancer by the age of 45. The risk- lowering effect of giving birth, by the way, is universally acknowledged. It is explained by the action on the breasts of hormones released late in pregnancy.
Even if the ABC link represents only the modest cancer risk that Daling found, it must affect large numbers of women, for two reasons: The incidence of breast cancer is high and rising; and abortion is the most frequently performed elective surgery, affecting 1.5 million American women a year.
Already breast cancer is the most common cause of death among middle-aged women. Not surprisingly, its rising incidence has prompted legislation in more than a dozen states, mostly to encourage screening, to require that patients be informed of treatment alternatives, or to compel insurance companies to cover particular procedures. Requiring that women be informed of an avoidable likely risk factor for breast cancer- elective abortion-is in line with this trend.
It is also in line with contemporary standards of informed consent. Even without legislation, courts often hold doctors liable if they fail to inform patients of material risks associated with treatment. Here, it is interesting to note that consumer rights organizations and the American Civil Liberties Union-usually the first to demand that patients be scrupulously informed of all risks-actively oppose requiring informed consent for elective abortion. Even though the ABC risk appears to be highest for minor girls, who are least able to think realistically about the danger of fatal diseases later in life, these organizations suddenly lose interest in protecting vulnerable consumers.
There will always be some women who choose to undergo abortion even if it means their risk of breast cancer rises. But all women, especially the young, should be advised of current scientific knowledge, and doctors have a duty to warn them. Given the reluctance of the normal champions of patients' rights to make this case, lawmakers should step in.
Read another Article by Judge Judy Koehler
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