The Catholic Thing
Selective Science and Breast Cancer Print E-mail
By Matthew Hanley   
Wednesday, 27 February 2013

Last month, my local paper ran a front-page article highlighting the abnormally high rates of breast cancer in the San Francisco Bay Area. For obvious reasons, interest runs high in getting to the bottom of this medical mystery. Since breast cancer has multiple predisposing factors, any ultimate explanation would necessarily be complex.

The article therefore could provide no firm explanation for why rates are higher here, only a sketch of the main threads of ongoing research. Genetic and environmental factors, some of which are clear triggers for breast cancer, are mentioned in broad terms. The pesticide DDT, however, is suggested as a possible culprit: don’t get me started.

It was careful to specify only certain lifestyle factors so that the reader would be excused for assuming they are limited to diet, exercise, and alcohol use.  Aside from a brief reference to delayed and total lack of childbearing, a concerned reader would have no inkling how pertinent this and other reproductive factors can be, as I have previously discussed in these pages and elsewhere.

There is also no reference to birth control pills, an officially recognized but deeply downplayed risk factor, or to induced abortion. The authorities have deemed it fit to ignore the strong evidence about these contested factors.

Instead, readers come away assuming diligent scientists are on the case, leaving no stone unturned: who would dare stymie legitimate avenues of inquiry or conceal plausible risk factors from public view?

A new California law, which will go into effect in April 2013, might bolster the impression that our medical and political leaders are doing everything they possibly can. The law will make it mandatory for doctors to explain to patients, should their mammograms indicate high breast density, that breast density is associated with an elevated risk of breast cancer. 

Informing women and the public about legitimate risk factors seems essential, although whether or not this particular mechanism is ideal is another question. Improvements in cancer treatment – a real marvel of medical science – have not eliminated one of the present limitations of mammography as a diagnostic tool: it generates an awful lot of false positives. Translation: diagnoses of breast cancer when in reality none exists.  

According to a recent report in the British Medical Journal, more than 70,000 American women were erroneously diagnosed in 2008.  That is almost a third of all legitimate breast cancer cases among women over 40, and about half of all cases overall. By some estimates, the harm women endure from the unnecessary, ensuing procedures outweighs the benefits stemming from accurate detection.

This story in the L.A. Times makes a germane observation: the relationship between breast density and cancer had been suspected for decades, before gaining widespread acceptance by the medical community. It was not routinely conveyed to women in part because it was supposed it would “serve little purpose… since it’s largely determined by factors outside of their control (such as heredity, age and ethnicity).”

But apparently it is perfectly acceptable to deny and downplay physiologically credible reproductive risk factors falling under one’s control. This is hard to reconcile with the zealous and otherwise well-intentioned search for cures and answers.

It is also deeply at odds with the Left’s own self-understanding as unwavering champions of science. “Science,” writes Yuval Levin, “is constantly on the lips of Democratic politicians” – and as the popular narrative goes, something the Left heroically defends like a “vulnerable and precious inheritance being pillaged by Neanderthals.”

My own local State Senator, Joe Simitian (D), advanced this breast density legislation, but given the status of, say, Planned Parenthood within his party and district, I can’t quite imagine him summoning the bravery to propose that, by law, anyone considering an abortion be informed that it is associated with subsequent development of breast cancer. I guess science qua science isn’t really always to be extolled. 

Granted, he may not be adequately apprised of the relevant evidence; not everyone is. But a critical mass of the prevailing power structure is comprised of politicians who ignore the science and scientists who bow to the politics.

The most important quality any scientist must possess, as this ongoing travesty should make plain, is not intelligence – indispensible as that it is – but honesty. Without the honesty to abide by science’s own framework, you only look the part of the scientist while really playing the role of manipulator.  It takes great chutzpah to do this while maligning political opponents as enemies of science.

At the end of the day, authorities who choose to look the other way on abortion as a risk factor are not so different from, say, doctors all those years ago who failed to acknowledge that hand-washing could be protective, even well after sufficient evidence had been accumulated.  

In drawing this parallel, bioethicist Fr. Tad Pacholczyk recounts what happened in the 1840s. A pioneering doctor in Vienna began requiring hand-washing between visits to women and prior to delivering their babies; consequently the mortality rate from childbed fever plummeted dramatically.  Nonetheless, this man of science faced severe resistance, endured professional ridicule, and eventually got fired.

The achievements of science are too numerous to count. So too, it sometimes seems, are its promises and politicized claims.  The Catholic Church makes a distinctive yet rather bold claim of its own: to be the servant of “mankind, of every condition, in every weakness and need,” as Paul VI put it to close Vatican II.

I’m not sure what non-Catholics make of this grand claim. But theology aside, when it comes to grappling with this medical affliction with the clues science has provided, a question emerges: is tolerance or intolerance of neglecting certain risk factors, in all honesty, more indicative of an abiding love for humanity?

Matthew Hanley is, with Jokin de Irala, M.D., the author of Affirming Love, Avoiding AIDS: What Africa Can Teach the West, which recently won a best-book award from the Catholic Press Association. His latest report, The Catholic Church & The Global AIDS Crisis is now available from the Catholic Truth Society, publisher to the Holy See in the U.K.

The Catholic Thing is a forum for intelligent Catholic commentary. Opinions expressed by writers are solely their own.

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Comments (6)Add Comment
written by Deacon Ed Peitler, February 27, 2013
The first mistake is making the assumption that what you read in your local newspaper (or anywhere in the MSM for that matter) reflects and is guided by a search for the truth. How else could Obama have been elected if not without the complicity of the media which seeks power over truth. No, the media is guided, instead, by their sacraments of sodomy, abortion, fornication and contraception. The media will never allow truth to get in the way of these - even if it were to cost women their lives. Those truly interested in locating the truth will be forced to find it elsewhere.
written by Jacob, February 27, 2013
Brilliant article.

Birth control factories also poison rivers but you won't hear the left warning us of that environmental danger..

More women die from botched abortions than ever did from pregnancies where the baby might otherwise have been aborted.

But, as we all know well, the leftists don't care about women.
They care about women like Sauron cared about the orcs..
written by Tony Esolen, February 27, 2013
Yes, if the feminists and their servile male fellow-travelers actually cared about women, they would:

1. Apprise them of the class-one carcinogen, artificial estrogen;

2. Apprise them of the cancer-invitation that induced abortion makes;

3. Apprise them of the fact that married women, never divorced and living with their husbands, are the safest people in the nation, least likely to be the victims of a felony;

4. Keep women away from places where they have no business being, like combat.

They would also tell teenagers about the many diseases to which SSA men are prone, besides the obvious one, AIDS.

But they won't do this....
written by Grimm, February 27, 2013
"Nonetheless, this man of science faced severe resistance, endured professional ridicule, and eventually got fired. "

Dr. Semmelweis did not just "get fired," he was ostracized and marginalized and eventually died in a mental institution ... driven mad in his then-futile quest to save women's lives ... sound familiar in a metaphorical kind of way?
written by cathy, March 02, 2013
The 'high rates of breast cancer' in SF Bay area is known as a 'cancer cluster.' These cancer clusters are public health disasters, not because there is a common source (there almost never is unless everyone was exposed to an identifiable nuclear disaster or very high levels of a carcinogenic chemical at the same time/place) but because they create a media zoo with a lot of hype and sensationalism.

The reason 'scientists'--i.e. epidemiologists trained in public health--are investigating is not because they think necessarily there is an identifiable common environmental cause. Most cancer clusters do not have a single identifiable environmental cause, and the investigations are done primarily to calm public fears and to try to shut down the misleading media frenzy. The 'scientists' are also not looking for individual-level exposures like birth control pills or abortions, because that is not a shared exposure from the environment that somebody (i.e. the local government or business) can be sued for. Rather they are looking for possible sources that are shared because you all live in the same environment and are sharing a common environment, like a toxic waste dump in your community's park.

Cancer clusters are usually composed of many different kinds of cancer (or in this case different kinds of breast cancer) which have a myriad of different causes-both environmental and genetic. Most of the environmental exposures occur at a young age, and cancer takes many years to develop, and people migrate and move around a lot. Thus, when a group of people in a single region all realize they have cancer, i.e., a cancer cluster forms, this phenomenon is usually due to mere coincidence. There is usually no common exposure linking their different cancers. Even more rare is a common environmental exposure in the water/earth/air/building/community where they currently live/work (which is what the people in a cancer cluster tend to believe and is what the media would try to scare you into thinking is the case).

One would need a level of exposure from 'something in the water' or common environment to be extremely concentrated for there to be any real link between that exposure and cancer. Thus, the only cancer clusters that have an identifiable common cause are from nuclear accidents, or high chronic exposure to a particular environmental toxic chemical by a bunch of people located in the same place at the same time (i.e. asbestos from working in the same shipyard in one's youth).

Public health officials only suspect real cancer clusters with an identifiable common environmental cause when there is one of two things: 1) extremely rapid cancer development following a known exposure, and/or 2) extremely high rates of one rare kind of cancer (like mesothelioma that developed because of asbestos). These rates are usually orders of magnitude beyond what would otherwise be expected. In contrast, the rates of breast cancer in northern california are not really that different from baseline rates-only 10-20% higher. This SF breast cancer cluster is likely coincidence, and not causally linked to any common environmental exposure.

Even though it may seem morally compelling as a catholic to start blaming either abortion or the birth control pill for these marginally higher rates of breast cancer in northern California, it is difficult to make a strong case. How can we argue that more women in northern California than NY City or Boston or LA are on the birth control pill or have more abortions? And more importantly, it is nearly impossible to argue that the women getting breast cancer today in SF are the women who used more birth control pills/had more abortions twenty-thirty years ago when they were being exposed to whatever environmental factors that began the genetic mutations that ultimately lead to cancer many years down the road. You would have to trace all those women to their home twenty-thirty years ago and find out their exposures at that time--many of them probably migrated to SF from other parts of the country. Finally, scientists aren't investigating whether individual environmental exposures due to individual choices like birth control pills or abortions may be causing a cancer cluster. Rather, they are looking for shared community-level exposures (like toxic waste dumps, asbestos, etc..). The pill may be involved, or it may not. Either way, cancer cluster investigations are not about individual-level exposures. And moreover, this very low-rate breast cancer cluster we have in SF is probably arising coincidentally.

I suspect that 'detection' may be playing a bigger role than anything else at this point. When we detect more breast cancer sooner through screening, breast cancer rates can appear to be higher when really there is no change in the actual incidence rate of breast cancer. This is a type of detection bias called ' lead-time bias'. San Francisco is unusual in that it has essentially free health care (and hence free breast cancer screening) for the uninsured through Healthy San Francisco. It is quite plausible that detection bias may have a larger hand in the current breast cancer cluster than anything else, if there is anything other than coincidence leading to this cluster.

written by Berta, March 03, 2013
Even though you (and I) may like to tell people that there is a link between induced abortion and breast cancer risk, indeed there is no such link. We only hurt our credibility by stating such false claims. The National Cancer Institute convened in 2003 with 100 leading experts in the field and analyzed all the studies and research on this topic. They found that there was no evidence of an association between induced abortion and subsequent breast cancer. The British journal Lancet also published a very large study more recently, which also debunked this association as a myth. We should take this conclusion at face value, otherwise we come across as anti-science.

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