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An enduring debate: cancer and abortion

Most studies dispute the theory there is a link, but advocates on both sides are keeping the issue in the spotlight.

March 10, 2003|Daniel Costello | Special to The Times

Could having an abortion increase a woman's risk of breast cancer?

The politically charged question, the subject of more than 30 peer-reviewed studies over recent decades, was supposed to have been put to rest five years ago when one of the largest and most respected studies on the topic found no correlation. Largely based on this research, most epidemiologists now agree there is no link, as does the American Cancer Society, the World Health Organization and the National Breast Cancer Coalition.

But 30 years after Roe vs. Wade, the issue is gaining new currency, as evidenced by a closed-door session two weeks ago at the National Cancer Institute, a respected cancer information resource. Two states, Montana and Mississippi, now include information about a possible link between abortion and breast cancer in materials women receive at abortion clinics. Ten more states are considering similar legislation, according to the Center for Reproductive Rights, a New York-based legal advocacy group. And ad campaigns promoting the theory, sponsored by anti-abortion organizations such as Christ's Bride Ministries, are increasingly popping up on highway billboards, in baseball stadiums and on cable television.

Last year, anti-abortion groups sued abortion clinics in San Diego and North Dakota for telling patients there was no link. A judge dismissed the California lawsuit before trial, while the clinic in North Dakota won its case after a three-day trial. Anti-abortion groups say they plan to file more lawsuits soon.

That the National Cancer Institute, a government agency under the auspices of the Department of Health and Human Services, held a conference at all demonstrates the persistence of advocates on both sides of the debate. Last summer, 22 members of Congress wrote Health and Human Services Secretary Tommy Thompson to criticize the agency's long-held position that there is no link between abortion and a heightened risk of developing breast cancer. With little new research to support the move, the agency modified its position and posted on its Internet site that research on the issue was "inconsistent."

Last week, the institute posted its conclusions from the recent conference on its Web page, saying: "Induced abortion is not associated with an increase in breast cancer risk." An institute spokeswoman said the agency intends to change its Internet fact sheet on the issue.

Even so, some abortion opponents, and at least two scientists who have studied the relationship between abortion and breast cancer, insist there is a link and that the debate has only just begun. Many anti-abortion groups say they will continue their efforts in state capitols, and are confident that a few more states may soon mandate that abortion clinics disclose a warning of a possible link. Others are focusing directly on doctors, from family physicians to gynecologists, hoping to persuade them to raise the issue with their patients directly.

The public relations push is heating up too: One anti-abortion group, the Palos Heights, Ill.-based Coalition on Abortion/Breast Cancer, says it is sending 200,000 pamphlets to churches and others groups nationwide this year highlighting research showing a link.

"We should continue to look at this until everyone is convinced," says Joel Brind, a professor of biochemistry at Baruch College in New York, who has researched the subject and is an outspoken proponent of the theory linking abortion and breast cancer.

Science behind theory

Researchers don't know exactly what causes breast cancer, but reproductive factors have been associated with the disease since the 17th century, when the rate of breast cancer was found to be higher among nuns. Today, scientists believe that childbearing lowers women's breast-cancer risk.

The abortion-breast cancer theory is based on biology, specifically around the interruption of the hormonal flow that occurs in women's breast cells after an abortion. During pregnancy, a surge of estrogen, progesterone and prolactin in the breasts helps differentiate the breast cells and prepare them for lactation. During the second and third trimester, the differentiation permanently changes the breast cells.

Although many scientists dispute the rationale, abortion-breast cancer link proponents argue that when a woman artificially interrupts her pregnancy, she leaves a countless number of undifferentiated breast cells in limbo that increase her odds of developing cancer later in life. Miscarriages are thought to be less worrisome because many are associated with low levels of hormones and thus produce a lower number of vulnerable cells.

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