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Saturday, December 28, 2002The National Cancer Institute, which used to say on its Web site that the best studies showed "no association between abortion and breast cancer," now says the evidence is inconclusive. A Web page of the Centers for Disease Control and Prevention used to say studies showed that education about condom use did not lead to earlier or increased sexual activity. That statement, which contradicts the view of "abstinence only" advocates, is omitted from a revised version of the page. Among the critics is the president of Planned Parenthood: Gloria Feldt, president of the Planned Parenthood Federation of America, said the new statement on abortion and breast cancer "simply doesn't track the best available science." Now, there's an impartial voice. Here’s what the website used to say about abortion and cancer, according to the Times: The earlier statement, which the National Cancer Institute removed from the Web in June after anti-abortion congressmen objected to it, noted that many studies had reached varying conclusions about a relation between abortion and breast cancer, but said "recent large studies" showed no connection. In particular, it approvingly cited a study of 1.5 million Danish women that was published in The New England Journal of Medicine in 1997. That study, the cancer institute said, found that "induced abortions have no overall effect on the risk of breast cancer." The Danish research, praised by the American Cancer Society as "the largest, and probably the most reliable, study of this topic," is not mentioned in the government's recent posting, which says the cancer institute will hold a conference next year to plan further research. The Danish study (You can access the entire paper for free if you register, otherwise you just get the abstract.) compared Danish cancer registry information from 1973 to 1993 to abortion registry information from the same time period and found an incidence of breast cancer of 0.7% in women with no history of abortion, and of 0.4% in women who had one or more abortions. The study has its problems. It didn’t control for age, which is an important variable for breast cancer. The incidence of breast cancer is much higher in older women. Yet, by looking at data only after 1973, it effectively overlooked any abortions that the older women in the registries might have had as young women. And, as the editorial that accompanied its publication pointed out, there was an unexpected increase in breast cancer in women who had late stage abortions: Among the women with late terminations, there were 14 cancers - almost twice as many as expected. Slightly fewer cancers than expected were diagnosed in women whose abortions took place before seven weeks of gestation. ....For the scientist trying to elucidate how pregnancy sometimes impedes and sometimes enhances one or more steps in breast carcinogenesis, puzzles remain, and this large study highlights some of them. The possibility of an increased risk with very late abortion, a decreased risk with very early abortion, or both must be seen as one of those puzzles. Neither the clear central finding that there is no overall risk nor the unresolved peripheral issues ought to influence the continuing public debate about abortion itself — a debate that is ethical and political in its essence. (emphasis mine) In other words, the evidence is inconclusive, which is what the new National Cancer Institute post says: The relationship between the varying levels of hormonal exposures over the course of a woman's lifetime and her risk of developing breast cancer has been the subject of extensive research. Certain reproductive events have been demonstrated to have protective effects (such as a full-term pregnancy), or in some cases can increase the risk of developing breast cancer (for example, early age at first menstrual period). For other events, the data have been inconsistent. Specifically, the possible relationship between abortion and breast cancer has been examined in over thirty published studies since 1957. Some studies have reported statistically significant evidence of an increased risk of breast cancer in women who have had abortions, while others have merely suggested an increased risk. Other studies have found no increase in risk among women who had an interrupted pregnancy. NCI is currently supporting mechanistic and population studies to gain a better understanding of the hormonal changes that occur during pregnancy and interrupted pregnancies and how they relate to breast cancer risk. (again, emphasis mine) That’s an accurate summation of the state of affairs. What is there to object to? Nothing on the merits of science. Everything if you are operating under the assumption that the Bush Administration and all of its branches is single-mindedly devoted to the goal of thwarting a woman’s right to choose. (Although Pravda (!?) says our biased media is plotting to keep the truth from us.) As for condoms, well, the Times says that the emphasis has changed: As for the disease control centers' fact sheet on condoms, the old version focused on the advantages of using them, while the new version puts more emphasis on the risk that such use may not prevent sexually transmitted diseases, and on the advantages of abstinence. Here’s what the website says now: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse, or to be in a long-term mutually monogamous relationship with a partner who has been tested and you know is uninfected. For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of the male latex condom can reduce the risk of STD transmission. However, no protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD. This is unequivocally true. In fact, this is the standard advice regarding condoms when discussing them as a birth control method. Yet, you can bet that none of the critics of the condom as STD prevention information would criticize that advice when applied to preventing pregnancy, least of all Planned Parenthood. To be fair, the Planned Parenthood people didn’t provide a quote about the condom issue. In fact, the paper couldn’t find any condom boosters to provide inflammatory quotes about the change. Instead we just get snippets of the website that aren’t very convincing examples of anti-condom bias: "The studies found that even with repeated sexual contact, 98-100 percent of those people who used latex condoms correctly and consistently did not become infected." But the recently revised page warns that evidence on condom use and other sexually transmitted diseases is inconclusive, though it says the uncertainty demonstrates that "more research is needed — not that latex condoms do not work." It comes down to much ado about nothing. The breast cancer/abortion link, if there is one, is miniscule. The research is conflicted and uncertain (a good clue that there really isn’t a substantial link), and the website conveys an accurate description of that state of affairs. Condoms, while effective, aren’t 100% effective. Nothing is 100% effective. The advice on the website reflects that basic truth, and in no way disparages condom use. It’s human nature to impute to others our own motives and failings. When someone does something that raises our ire, we suspect they’ve done it for the same reasons we would have done it - out of spite, or laziness, etc., even if the true circumstances are much more innocent. That’s what’s going on here. Those who are accusing the Administration of malice for changing websites are doing so only because they are the types who would change information solely to promote their agenda. And, of course, they hate everything the Bush Administration does. posted by Sydney on 12/28/2002 08:39:00 AM 0 comments 0 Comments: |
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