When ideology drives science – intellectual dishonesty in the ‘abortion/breast cancer’ and ‘change therapy' debates

In July 1949, the New England Journal of Medicine printed an article by Dr Leo Alexander titled 'Medical Science under Dictatorship'.

In it, he explains what happens to science when it 'becomes subordinated to the guiding philosophy' of a political ideology.

'Irrespective of other ideologic trappings', he argues, the 'guiding philosophic principle of recent dictatorships' is to replace 'moral, ethical and religious values' with 'rational utility'.

Alexander eloquently demonstrates how 'medical science in Nazi Germany collaborated with this Hegelian trend' and became the source of 'propaganda' which was 'highly effective in perverting public opinion and public conscience, in a remarkably short time'.

This expressed itself in a rapid decline in standards of professional ethics and led ultimately to the German medical profession's active participation in 'the mass extermination of the chronically sick' and of 'those considered socially disturbing or racially and ideologically unwanted'.

Britain is not Nazi Germany and is a democracy rather than a dictatorship. However, all democracies are also susceptible to influence by well organised minorities and it is very clear, in this post-Christian society, that the corridors of power are increasingly filled by those who do not subscribe to a Christian worldview and values.

In fact, many of those who occupy positions of influence in our 'mountains of culture' – universities, schools, media, judiciary, parliament institutions and entertainment industry – are actively hostile to Christianity and supportive of public policy directions consistent with a secular humanist agenda – eg. pro-choice on abortion, supportive of 'assisted dying', embryo research and same sex marriage.

These issues are of course highly political. But is there any evidence that the 'medical science' marshalled to support them is in any way being influenced or shaped by secular humanist ideology?

Two articles in the latest edition of Triple Helix would say 'yes'. They make the case that financial or ideological vested interests can be used to stifle the truth when medical issues become highly politicised. Both articles question the way that British Royal Colleges have handled scientific evidence in their support for a certain public policy direction.

Donna Harrison, Executive Director and Director of Research and Public Policy at the American Association of Pro-life Obstetricians and Gynaecologists (AAPLOG), argues that the Royal College of Obstetricians and Gynaecologists (RCOG) has misrepresented available scientific evidence to support its view that there is no link between abortion and breast cancer.

She explains why a link between abortion and breast cancer is entirely biologically plausible and points out how oft-quoted studies which deny such a link 'often resort to errant methodology which obscures the actual scientific question they were purported to answer'. She singles out for particular criticism a frequently cited meta-analysis by Beral et al on which the RCOG leans heavily in formulating its abortion guidance. She then cites a 2014 meta-analysis of 36 studies by Huang et al which looked specifically at the relationship between induced abortion (IA) and breast cancer. It found that IA is significantly associated with an increased risk of breast cancer among Chinese females, and that the risk of breast cancer increases as the number of IAs increases.

Peter May, retired GP from Southampton, takes issue with the Royal College of Psychiatrists (RCPsych) over their opposition to 'change therapies' for unwanted same sex attraction. He accuses the College of locking itself into a 'born gay' ideology by ignoring the evidence to the contrary. The College's argument that causation is 'biological' has led to the widespread belief that LGB people are being 'true to their nature' in homosexual behaviour. Yet twin studies do not support this view and in 2006, a major Danish study reported, 'population-based, prospective evidence that childhood family experiences are important determinants of heterosexual and homosexual marriage decisions in adulthood.'

The position of the RCOG on the abortion breast cancer link, and the RCPsych on the causation of homosexual orientation, have both been profoundly influential on public policy. In fact the latter has even helped shape policy within the Church of England.

These College positions will remain crucially influential this year with the Department of Health about to issue guidelines on abortion and Parliament about to consider legislation seeking to ban 'change therapies'.

It is part of the role of Triple Helix to highlight issues like this so that our readers can participate in these debates in a fully informed way. They have profound implications, not just for public policy, but also for fully informed consent.

As Peter May concludes, 'We have a mandate to be passionate and honest about truth and to strive to teach it accurately. All truth belongs to God, and all untruths deny him. We must insist that love and truth are essential values in public discourse.'

This editorial initially appeared in the Spring 2014 edition of Triple Helix

New study adds further fuel to debate about link between induced abortion and breast cancer

Is there a link between induced abortion and breast cancer?

Any such link has been hotly denied by official bodies but a new study has added further fuel to this ongoing controversy.

The Bangladesh study published in the Journal of Dhaka Medical College on risk factors for breast cancer, led by Dr Suraiya Jabeen, found a statistically significant 20.62-fold increased risk among women with abortion histories.

This is by far the highest risk elevation reported among 73 publishedabortion-breast cancer studies.

Professor Joel Brind, a professor at Baruch College, City University of New York who is an expert on the abortion-breast cancer link, has observed that women in Bangladesh have very traditional childbearing patterns that reduce breast cancer risk. He first explains why abortion might increase the risk of breast cancer:

‘First, it is universally accepted that having a child decreases a woman’s risk of breast cancer, because the maturation of the cells in the breast into milk-producing cells renders them less susceptible to becoming cancerous. Second, pregnancy hugely increases the number of breast cells vulnerable to cancer. A live birth provides enough time for these “progenitor cells” to differentiate into more mature, more cancer-resistant cells. Therefore, abortion leaves a woman’s breasts with more places for cancer to start than were there before the pregnancy began.’

He then goes on to explain why the relative risk in Bangladesh might be so high:

‘Why such a high relative risk? That’s because almost all women in Bengladesh get married and start having children before they are 21, and breast-feed all their children as well. Consequently, breast cancer has been almost unheard of in Bengladesh, until recently.’

Of 73 worldwide studies since 1957 (including this latest) on the association of induced abortion and subsequent development of breast cancer: 53 studies show an association, and 15 studies show no association. See specifics here.

And yet many official bodies continue to deny categorically any link between abortion and breast cancer.

The Royal College of Obstetricians and Gynaecologists in their 2011 review ‘The Care of Women requesting induced abortion’ (see full report and summary) stated with a heady degree of certainty:

‘5.10 Women should be informed that induced abortion is not associated with an increase in breast cancer risk.’

Their lengthier summary concludes as follows:

‘WHO has concluded that induced abortion does not increase breast cancer risk. Similarly, in a recent review of the evidence, ACOG concluded that ‘The relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.’

There is an overview of existing studies on the American Association of American Prolife Obstetricians and Gynaecologists (see AAPLOG website). It summarises as follows:

‘The possibility of this association has been persistently and vigorously attacked and denied by the major medical groups in the country since l994. The ACOG and the NCI have been particularly strong in opposing any suggestion that there is an association. In so doing, they have taken certain liberties with their interpretation of the scientific literature. AAPLOG feels that these liberties lack basic fairness and balance in reaching their “no association” conclusion.’

It goes on to discuss why such a link might be biologically plausible:

‘There are two pregnancy related independent risk factors for breast cancer established in the medical literature:

The first is the protective effect of an early first full term pregnancy. The landmark study establishing this protective effect [MacMahon, et al, (1970) Bull WHO 43:209-221] is widely accepted in the medical world. Obviously, aborting a first pregnancy eliminates the protective effect against breast cancer for that woman.

The second independent risk factor for breast cancer is induced abortion. As of 2004, 41 studies had been published in the worldwide medical literature (including 16 American studies) reporting data on the risk of breast cancer among women with a history of induced abortion. 29 (70%) of these studies report increased risk. Thirteen of the 16 (81%) American studies report increased risk, 8 with statistical significance (at least 95% probability that the result is not due to chance) irrespective of age at first full-term pregnancy. The relative risk increase of the 41 studies combined is 30%. (Note: this means that among aborted women there would be a 30% increase in breast cancer cases over what would normally be expected).’

In a 2007 CMF File we summarised the available evidence as follows (see source for references):

‘Breast cancer rates have been rising in Europe and North America for several decades and are projected to rise further. There is evidence suggesting that having an abortion may increase a woman's risk of breast cancer in later life. A 1997 review that pooled 23 studies found that the risk increased by 30% but authors of a 2001 review have denied a link. There are clearly powerful vested interests on both sides of this debate and space precludes the necessary in-depth review. However, it is undisputed that a full term pregnancy protects against subsequent breast cancer, and that significantly preterm deliveries make it more likely. The link is therefore biologically plausible.

While it may be prudent to acknowledge that “the jury is out” with regard to a possible link between abortion and risk of subsequent breast cancer, further research is needed to conclude the debate. In the meantime, and in the interests of informed consent, every woman considering abortion should be offered as much information about the possible risks as she wishes.’

The issue has also been previously covered in the CMF Journal Triple Helix but not since 2003.

This is clearly a debate that will run and run and in which huge vested interests are involved.

In the meantime women should not be fobbed off with the unjustified absolutism of the summary sentence from the RCOG, as most presently are.

Rather they should be made aware that a link between abortion and breast cancer is biologically plausible but that the evidence is still hotly disputed by researchers, obstetricians and gynaecologists.