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Mammograms, Induced Abortion, and the Marlboro Man Print E-mail
By Matthew Hanley   
Thursday, 31 July 2014
 

New studies seem to come along regularly these days, which contradict what was widely – and just recently – supposed to be beneficial to health. Who can keep track any more of how much coffee, cholesterol, and exercise is ideal? This situation might be conducive to the holy indifference that St. Ignatius of Loyola counseled towards the goods of this world, such as health and wealth. But indifference towards the public health authorities usually lacks that sublimity.

A recent edition of the New England Journal of Medicine contained an article that might be classified as the latest salvo in the “mammography wars.” It essentially concluded that abolishing mammography-screening programs is preferable to the status quo because they actually do more harm than good. An independent Swiss Medical Board arrived at this recommendation after a thorough review of the evidence.

The first thing they noted was that current debates revolve around outdated trials. However, treatment itself has improved considerably in recent decades, thereby wiping out the modest gains mammography was thought to confer.

Second, there are the unintended harms of the procedure, particularly those that stem from overdiagnosis. That technical term refers to dormant cancer, or precursors to cancer, detected by mammography that actually pose no threat.

Another recently published Canadian survey, featuring twenty-five years of follow-up, found that almost 22 percent of the cancers detected by mammography were overdiagnosed, resulting in unnecessary treatment, including surgery, radiotherapy, chemotherapy, or some combinations thereof. The Canadian scholars also concluded that annual mammography does not contribute to reduced mortality.

These conclusions will likely strike some as jarring, particularly since women, by and large, tend to radically overestimate the protective benefits of mammography screening. One large survey found women overestimated – by eighty fold! – the windfalls of screening; they also supposed that death from breast cancer among those not screened was thirty-two times as high as it actually is.

The Swiss team noted that their findings have been met with a certain hostility, to which they countered that, yes, one “argument was that the report unsettled women, but we wonder how to avoid unsettling women, given the available evidence.”

Not everyone agrees; the debate rages on.  It seems fair to say, however, that if there are certain gains to be had from mammography, they presently appear marginal at best. For women of the relevant age groups and for their doctors, the dilemma is easy to appreciate. Trade offs must be considered, and in weighing the possible benefits against the possible harms, not everyone would choose the same course of action.

There is one thing that all sides agree on, because everyone explicitly couches their arguments in the following terms: women deserve the most accurate information.  An exception to this operating principle is allowed, however, when it comes to a factor that, unlike mammography, has the potential to curb incidence rates: the relationship between induced abortion and subsequent breast cancer.

What basis exists for such a claim?  The vast majority studies, dating back to 1957, have indicated an association. Every single one of the statistically significant findings indicates a positive association, whereas every one suggesting a negative association is not statistically significant. 

A highly important meta-analysis, consisting of thirty-six studies from fourteen provinces in China up to 2012, recently yielded several significant findings. Women with a history of induced abortion were at 44 percent higher risk of developing breast cancer, compared with women who had not had one. Here’s what that means: supposing that the overall risk of developing breast cancer over the course of a lifetime is, say, 10 percent. Procuring an abortion would cause the overall risk to jump to 14.4 percent.

This Chinese review corroborates a similar 1996 meta-analysis that found an overall 30 percent increased risk.  Indeed it is even more compelling; not only is the estimated risk moderately greater, but a clearly evident “dose effect” also emerged. This refers to the fact that risk rises as exposure to a hazard rises; the existence of a dose effect is regarded as lending further credence to a plausible theory. They found that risk rose to 76 percent among women with two induced abortions, and again to 89 percent among women with three abortions.

Strong as these finding are, they are not enough to constitute proof. We also need a physiological mechanism of action. But we have that too.  It essentially boils down to estrogen exposure: the more of it, the greater the risk. In the early phases of pregnancy, a woman is exposed to massive amounts of estrogen, which triggers a proliferation of the types of breast lobules most susceptible to cancer.  This is why a woman who delivers prematurely (i.e. prior to thirty-two weeks) faces twice as much risk of breast cancer. It is only in the latter weeks of a typical pregnancy that other hormones begin to help transform those vulnerable lobules into cancer-resistant lobules.  Giving birth, as no one contests, is protective.

Any epidemiologist worth his salt would see that these combinations of factors deserve to be taken seriously. Shunning intellectual honesty, however, the authorities have worked overtime to conceal the relationship. One way they have done so, incidentally, is to conflate induced abortion with spontaneous miscarriages, which are not a risk factor.

Far more profitable than disguising the truth so that women will not become “unsettled” would be to rectify this ongoing travesty. The National Cancer Institute is, in effect, misleading women, saying (according to the numbers) that abortion’s equivalent of “the Marlboro Man is not in greater danger of lung cancer than the non-smoker.”

Is there any doubt who has more clout: Big Tobacco or Big Abortion? The health authorities dare to look the other way for only one of these industries, wholly indifferent to the lives and health harmed by the other. 

 
Matthew Hanley is senior fellow with the National Catholic Bioethics Center. With Jokin de Irala, M.D., he is 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. The opinions expressed here are Mr. Hanley's and not those of the NCBC. 
 
 
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Comments (8)Add Comment
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written by Dennis Larkin, July 31, 2014
Science is not down to a science. It's largely politics and ethics. Paul Feyerabend, atheist philosopher of science, demonstrated this thirty years ago.
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written by Dana, July 31, 2014
I knew it!!! My last mammogram was ten years ago. It was so painful I knew it had to be terribly wrong to abuse such fragile tissue so I never went back. My doctor checks me over once a year and as far as I'm concerned, that is ample. I've read that cancer can be caused by a severe blow and the horrendous pressure used seemed like a blow to me. Common sense says the procedure is utterly ruinous to women's health, as are birth control pills, abortion and other inhumane and hateful procedures used in the real war on real women. The sterile cuckoos of planned empty-nesthood and the current banana republic regime forcing this reprehensible and immoral practice are nothing more than vulgar savages imposing their pagan black arts on an ill informed public!
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written by grump , July 31, 2014
Because profits come before people in the U.S. health care system, the idea is to keep you out of hospitals and from seeing physicians. This not only cuts down on costs and boosts the bottom line but also guarantees that doctors will always get good tee times.

Got colon cancer 6 years ago and although I'm still not out of the woods, the VA routinely defers colonoscopy exams for several months claiming it's not only backed up and overwhelmed but once every three years is good enough. Try telling that to a cancer cell.

Meanwhile, military veterans like me are dying daily because they can't get medical treatment while illegals are crossing the border in droves and receiving first-class, immediate care, living in nice accommodations and getting lollipops and lots of free stuff.

The unkindest cut of all is the VA threatening to sic the IRS on me for still owing them $250, which I've been paying off at the rate of 50 bucks a month. This arrangement, however, must be updated every three months due to any "new charges."

And to think, Lois Lerner calls us a--holes!
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written by Chris in Maryland, July 31, 2014
Dr. Hanley's witness shows why we should oppose giving "government" the control over their "health care."

We as Catholic people need to consolidate and preserve Catholic health care systems, with Catholic insurance, Catholic doctors and nurses, for Catholic people.

Those who oppose this (e.g., USCCB) are not only playing themselves into the hands of those who hate the Catholic view of life - they are playing all of us into their hands.
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written by jane, July 31, 2014
Actually a woman is MORE vulnerable to breast cancer than the average woman right after she gives birth. This risk declines shortly, and eventually giving birth (especially before age 30) becomes protective in the long term. Unfortunately scientific inquiry around explosive topics is susceptible to politics and numbers can be presented to make any case one wants to make.
However, I work with the National Breast Coalition, and those ladies are committed to one thing only: truth. They want to get out the facts about breast cancer as we learn them I am confident that if the abc link was verifiable, and the methodology was good enough to establish a consensus about this link, they would not hesitiate to make sure the facts were known.
The problem, as I understand it is that the methodology of the reporting has been shown to be influenced by bias.

it is complex, but the goal of scientific research is not to avoid unsettling people, but to get the facts out as we learn them. Information does change as we learn more. But it is better to be unsettled by the facts than ignorant of them when it comes to such a deadly disease.

Currently there is not scientific consensus about the abc link!
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written by Myshkin, July 31, 2014
Ah, the late Paul Feyerabend. He is almost entirely shunned by the philosophy of Big Science crowd. Although no one ever really countered any of his historical or philosophical arguments (Imre Lakatos was his severest critic), his work has been mostly neglected in the past 20 years. Why is that? Well, the past 20 years has seen the rise of the Richard Dawkins-Stephen Hawking ideology of science, which is essentially an unthinking throwback to the 19th century. Feyerabend (building on Kuhn) shook the foundations of that way of thinking about science, so in today's climate he is simply not talked about.

Nowadays, science has become an even bigger sacred cow than when Feyerabend wrote back in the 70s and 80s. Even though I am am a Thomist, I very much appreciated Feyerabend's skewering of the pretensions of hubristic scientists. I wish he were alive today.
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written by Beth, August 01, 2014
SO much money being made on scare-tactics and "guilting" the grieving in the cancer industry. It is shameful!
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written by Vince, August 07, 2014
People will always have different opinions of what is right and what is wrong. Abortion is an issue That raises a lot of flags for many people. An abortion ceases the growing process, therefore ending the future life of a human being. This little being may not start off with a heartbeat or brain activity, but cells are still dividing and allowing it to grow. ABORTION IS A CRIME WE SHOULD STOP OR ELSE BE PUNISH MAYBE NOT HERE BUT THERE,,,IN HEAVEN. Just wanna share this link here it is an amazing application it keeps a safe and secure at all times they arereally a good quick responder to any emergency we have just click the link for more information http://safekidzone.com/#!/page_home

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