Talk:Abortion–breast cancer hypothesis/Archive 3

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Daling quote

Took me quite some time and some creative searching, but I found the article it its entirety here. Can I replace the Daling quote now? - RoyBoy ⁸⁰⁰ 22:05, 28 December 2007 (UTC)

And yes, I noticed he spelt it Dailing. - RoyBoy ⁸⁰⁰ 22:07, 28 December 2007 (UTC)

A couple of issues. The quote, given Daling's well-documented disavowal of pro-life political appropriation of her words and work (see Jasen) and her subsequent retraction/correction her original study's findings, is an exceptional statement. In accordance with WP policy, it needs exceptional sourcing. Some guy's editorial from an anonymous datadump (Daily News or no Daily News) that does not source the quote (not when, not where) does not strike me as a reliable, let alone exceptional, source. I thought Daling retracted in 1996. If the editorial had given a date and source of the quote, it would have helped. Phyesalis (talk) 21:57, 30 December 2007 (UTC)

The article is the source of the quote, so why is a date and source necessary? And I didn't do original research when I called Daling, it was verification. I believe I've gone above and beyond what is necessary here. You are making inferences based on your reading of Jasen:

relative risk of only 1.2, that “there was no excess risk of breast cancer associated with induced abortion among parous women”

This is hardly a retraction of their previous findings; perhaps it is a correction... but only if Daling says so. Not you, nor Jasen. It should also be noted, nulliparous women is more of a concern with the ABC hypothesis. - RoyBoy ⁸⁰⁰ 00:17, 31 December 2007 (UTC)

I am adding the overlooked nulliparous result to the article now; the final draft of which was done in April 18, 1996. I am re-adding the quote, as the Gelman article was published on 28 September 1997. - RoyBoy ⁸⁰⁰ 01:58, 31 December 2007 (UTC)

It is an exceptional quote. Considering:

• "After attempting to take other risk factors into account, they found that, among women who had been pregnant at least once, those who had had an induced (but not a spontaneous) abortion had a 50 per cent higher risk of developing breast cancer before the age of 45 (RR=1.5) than those who did not, and that the highest risk was associated with abortion in the last month of the first trimester (RR=1.9). Contrary to some previous studies, including that of Pike and his colleagues, they reported no difference in risk associated with the number of abortions or in women with completed pregnancies. Much would be made by Brind and others of the findings which concerned women who had aborted before the age of 18. For this group, the relative risk was 9.0 if the abortion took place between 9 and 24 weeks of pregnancy, and all twelve of the women with a family history of breast cancer who had aborted before the age of 18 had later been diagnosed with breast cancer. But these categories represented less than 3 per cent of the total of 845 cancer cases, and the interpretation of such figures would also be complicated by the fact that cancer patients who had never had a completed pregnancy were being compared with a control group of parous women.42 Daling herself warned against reaching “a firm conclusion at the time”.43 In fact, Daling and her team published a study two years later which found that abortion was associated with a relative risk of only 1.2, that “there was no excess risk of breast cancer associated with induced abortion among parous women”, and that there was no sub-group “in whom the relative risk associated with induced abortion is unusually high”.44 That report would go largely unnoticed. Jasen

So she goes from saying there is an increased risk of a range of 1.5 - 9.0 to saying it's "only 1.2" and that “there was no excess risk of breast cancer associated with induced abortion among parous women”, and that there was no sub-group “in whom the relative risk associated with induced abortion is unusually high”. Please, that's a huge correction.

In the next section of Jasen:

"While the study was still in progress, Daling was pursued for days by a Virginia lawyer employed by a right-to-life group trying to recruit her as a spokesperson, and she recounted how she finally told him, “I don't think you care one bit about breast cancer and women's health”.47 Once the report appeared, newspapers, magazines, and television news shows publicized the highlights, many cautiously, but some in a partisan fashion, either praising or criticizing the study. Daling herself repeatedly told the media that politics and personal views should not be allowed to cloud the issue, but it was inevitable that breast cancer would become a new weapon in the abortion wars."

Now, when I followed the citation, I got this quote from Daling given to US News "I feel scientists have to put their political and personal views aside and report the data," Daling told U.S. News. I support the inclusion of this quote as it is non-controversial and well-sourced. As for your phonr call, how do I know you called her and how do I know she said what you say she said? Got some certified transcript of the ocnversation? I don't think that satisfies WP:V. Is there some other precedent in WP to support this method of verification? Please note WP:V on this issue, "Including exceptional claims in Wikipedia requires locating the best available sources supporting such claims, but that alone is not enough: if and only if these sources are reliable should you include the material. Be sure to also adhere to other policies, such as the policy for biographies of living persons and not giving undue weight to minority opinions. The requirement to provide carefully selected qualitative sources for exceptional claims especially applies in the context of scientific or medical topics, historical events, politically charged issues, and biographies of living people."

Respectfully, I request that you either trim the Daling quote down to the US News quote, or remove the quote for the time being. Phyesalis (talk) 03:23, 31 December 2007 (UTC)

Why are you still citing Jasen? Jasen skipped the nulliparous results and focuses only on parous for editorial convenience, her continued relevance on this meme is questionable at best. Daling got positive results, period. Some of which (nulliparous) are statistically significant. Am I mistaken Phyesalis?

My phone call of course does not serve as Verification. At this point I shouldn't have brought it up, because it also has no relevance now that I have found the source.

The quote will stay. It is verified to its original source. The US News quote is older 1994 and less relevant (in relation to Daling's studies) and less informative. I got the feeling you were very prepared to reject my verified quote if it came before her latest 1996 research. You're personal preference on this quote has been wrong from the beginning (asserting libel merely because of a pro-life source), and now that it has been sourced your asking me to replace it with a Less Relevant quote (btw, very appreciated effort) that actually agrees with my quote! It's only an "exceptional claim" because of your personal inferred incredulity in the face of facts; and after you found your quote its a tenuous position.

Now I'm starting to get annoyed at you. How does Daling berating a pro-life lawyer in any way contradict my quote? Yes, Daling like any informed individual knows ABC has been used in the "abortion wars", my quote merely clarifies she's seen it used by both sides. You can't have a war without opposing sides Phyesalis. They reinforce one another They are not mutually exclusive and they are not in contradiction. It is vital to keep the quote in this article, to get people such as yourself to recognize the pro-choice side has not been the bastion of scientific objectivity we would like to think of it as.

As I think you suspect, this quote and the full Daling et. al. (more than one scientist folks) results disproves the notion that the ABC hypothesis has been rejected. I reassert based on Daling's quote(s) and a more complete summation of their scientific, modern, peer reviewed findings; we can no longer assert nor fool ourselves into thinking every "mainstream scientist" Rejects the ABC hypothesis. I'd like the lead back to "unsupported", and I'd like someone else to be bold and do it for me; because I am not in the mood for another tug of war on a clear inaccuracy in our lead. - RoyBoy ⁸⁰⁰ 04:10, 31 December 2007 (UTC)

PS: Melbye referring in a letter published in June 19, 1997 (NEJM) to Russo's ABC hypothesis as a possible explanation for their results after 18 weeks gestation can hardly be considered a "rejected" hypothesis. Brind has said Melbye et al. "corrected" that result for the NCI workshop; but without proper peer-review, those corrections are of no concern to me. - RoyBoy ⁸⁰⁰ 19:43, 31 December 2007 (UTC)

OK, let's take a deep breath here. Maybe we're getting too hung up on semantics. Perhaps not "every mainstream scientist" rejects the hypothesis, but scientific consensus is not a matter of unanimity. There are still scientists who claim that HIV does not cause AIDS, that the existence of the flagellum disproves evolution, etc. Yet a scientific consensus on those topics exists. The choice of word ("rejected" vs. "unsupported") is actually less important, accuracy-wise, than a clear statement that every reputable medical/scientific organization that has looked at the question (NCI, WHO, ACOG, etc) has found that abortion is not a risk factor for breast cancer. It does a disservice to present this as an active scientific controversy when there is apparent consensus. The existence of a small band of pro-life advocates who produce research supporting a link, or the occasional mined speculative comment from a mainstream scientist, do not a scientific controversy make. A political controversy, yes. Undoubtedly. A meta-discussion about the nature of scientific dissent and consensus is somewhat off-topic, since (per WP:WEIGHT) Wikipedia presents views in the context of their current acceptance by experts in the field. Also, I'm wary of editorial efforts to promote the idea that bias is rampant on both sides. Such assertions run the risk of implying that both sides have equally abused the science to promote their agenda, which is not the case. MastCell ^Talk 20:22, 31 December 2007 (UTC)

I'll try and make this brief but thorough:

• Semantics:
  This is about accuracy. Words matter.

• HIV:
  Any mainstream scientists think that? I doubt it, any mainstream scientists come up with results in support of HIV not causing AIDS? Not that I'm aware of. My understanding is that advocates have taken initial historic scientific uncertainty on HIV and quote mined it to the present; with no science to back them up. So why waste our time with a comparison? Have you been infected by the bad analogy bug? (;")

• Speculative comment:
  It is Daling's conclusion based on first hand experience. Right now, you are speculating.

• Clear statement:
  Is already in the lead and will remain there, "largely rejected". As far as I'm concerned it is one of the best memes added by Phyesalis to the article. Even if it is only scientifically supported by a workshop I find suspect. Doesn't stop me from integrating it in the lead.

• pro-life advocates who produce research:
  Most of the research for the ABC hypothesis is done by pro-choice or neutral parties. One meta-analysis doesn't justify that comment. You might be referring to pro-lifers bringing up older studies which support ABC, yeah so? Don't be lazy, reject those studies scientifically.

• speculative comment from a mainstream scientist, do not a scientific controversy make:
  I would agree with that, but conflicting scientific evidence does. We have some conflicting evidence, therefor we have some controversy. Controversy isn't a binary on/off concept. The extent with which response bias has effected previous research is also speculative. Yet you do not seem to have a problem with it in the least. Yeah, its the consensus view... but consensus does not validate (NPOV) a concept, science does.

• WP:Weight:
  Clarify what your are thinking, as this sentence seems most relevant, "Views that are held by a tiny minority should not be represented except in articles devoted to those views." This article is precisely here for these views in context.

• Rampant:
  No one says it's rampant, not even Daling. She's saying it exists on both sides. Do not attach and invalid idea to a valid quote to make it appear invalid. That's a bad MastCell!

• Consensus:
  "Apparent" consensus is the key term. There is objective, verifiable, notable differences on what exactly the consensus should be per (WHO, NCI, Daling, Melbye, Michaels) and high risk sub-groups they identify with "sound methodologies" that the scientific consensus simply does not touch on, and has not rejected. I'm not even sure how you maintain the rejected position after Melbye referred to the Russo hypothesis which remains plausible.

Happy New Year everyone! ... and afterward, then what? - RoyBoy ⁸⁰⁰ 01:31, 1 January 2008 (UTC)

I'm going to respond to just a few points right now, in the interest of brevity. AIDS-denialism could point to a number of mainstream scientists (including the famous "2 Nobel Laureates") who supported it. My point was not that these are directly analagous, but that a scientific consensus can exist despite a handful of highly vocal dissidents. By "rampant", I meant that you're implying that bias and political advocacy are equivalent factors on both sides. That's not the case, demonstrably. I get the sense that you want to argue the science. I don't really want to do that in this venue - for Wikipedia's purposes, it's far more relevant how the NCI, WHO, ACOG, etc have parsed the available data than what we individually think about it. I'm not going to attempt to scientifically refute anything - I'm just suggesting that where clear expressions of consensus exist, as they do here, it's not our role in this venue to highlight what we perceive to be the flaws in that consensus. Doing so is WP:OR. MastCell ^Talk 20:25, 3 January 2008 (UTC)

Hmmmm, I think I understand now!!! Whew for a second I thought you were attempting an analogy like Phyesalis, I am very very relieved that was not the case. Instead you merely made okay mundane (but misdirected) points, expressed poorly; which is much better than what I was initially thinking. Seriously, I'm not kidding; I'm immensely pleased with the turn of events. For a while there I thought you had severed your corpus callosum by some freakish shaving accident. *happy face*

Anyhow, an uninvolved "sympathetic" Nobel Laureate; and "those with scientific credentials that have never worked with HIV" isn't a meaningful comparison to mainstream (in this context meaning active) ABC researchers finding positive results who are not dissidents; and are more than a handful. Yes, an ABC consensus does exists, but within the context of ambiguous mainstream recent scientific evidence; as expressed by WHO and peer-reviewed mainstream studies. Alternative theories on HIV/AIDS do not have that, or do they?

All this "roles" and "venues" isn't enlightening; "rejected" is verifiably inaccurate. If you disagree, man up and tell me directly why without having to resort to vague and ultimately misdirected truisms. Goddam, next you'll be telling me it isn't in our "role" to have "death" in the Abortion lead. MastCell it is our role, in good faith, to figure out how to accurately (NPOV) communicate the sum total of human knowledge. We cannot effectively do that with what you just tried to sell me. If you think the consensus has "rejected" the ABC hypothesis, I agree... and its already in the lead. Do not confuse that with the hypothesis itself being rejected. Scientists and studies with conflicting evidence and gaps in knowledge, reflected in WHO, know better (yup, it is their role). It is Wikipedia's responsibility to reflect that reality first and foremost, because it corresponds to the scientifically oriented NPOV policy. (which I'm confident favors WHO over NCI, as WHO transparently tells us the evidence they considered; doesn't Wikipedia prefer transparency?)

On a side note, Sarah Silverman is pretty funny... even at an abortion clinic. I never saw that coincidence coming as my TV tuner self started!"D So, ummmm, am I really being unreasonable... or am I just pushing for what's correct? - RoyBoy ⁸⁰⁰ 04:30, 4 January 2008 (UTC)

Conspiracy of silence

Another significant issue that now exists in the article is the "conspiracy of silence" note from Jasen. While it is a notable theme for Brind, we first need a live link to look at (Jasen ref is dead). Then in keeping with Wikipedia policy we need to provide evidence Brind brings to the table, not only that we require it to be in his words; not Jasen's, as its certainly possible Brind communicates his distrust of mainstream ABC interpretation in more nuanced and sophisticated terms. (instead of "conspiracy", he merely sees "bias" and/or "wishful thinking") Some supporting evidence for this (AIM on Howe study, and pro-choice Family Health International funding, which really should be returned to the article since Patrick Carroll's funding is front and center) has been removed from the article.

Anyway those matters aside, you can't potshot (even with good sources) Brind's views without making an effort to support and clarify his views and evidence in his own words. Though, I suspect there will be a significant spectrum of different ways he has put this issue, dependent on the audience he is writing to; which means we should try to find something he has written for a general audience. As I think this is what Wikipedia articles are geared towards. If you cannot do that, then Jasen's note should be removed. - RoyBoy ⁸⁰⁰ 07:22, 3 January 2008 (UTC)

...this paragraph is a recap, and more of a reminder for me than to start a new discussion right now... Daling has been returned but the independent allegations of the AIM reporter on Howe's difficulty getting published have not returned. Now MastCell has in the past has shrugged at the importance of that meme, since in his estimation it is commonplace for American studies to be in British journals. This is part of the reason why I was so easy going on removing it as a "unreliable" source per Phyesalis. I'm unsure about both of those now and may have to revisit this issue given recent poor rationales provided against the Daling quote. Though, the AIM source was taken down by its author (or moved?)... so ergo it does become a less reliable link/source from the get go. So may not come back at all in the end, research will be needed, I suppose by me. - RoyBoy ⁸⁰⁰ 07:22, 3 January 2008 (UTC)

It is not at all uncommon for American studies to be published in British journals, and vice versa. I'm in the U.S., but I've submitted papers to British journals. If that's OR, then take a look at recent issues of some of the British journals, or at the New England Journal of Medicine or Blood, where at least half of the studies published are from non-American groups. Implying that this reflects on the quality of the study or supposed difficulties in getting it published is ill-informed. If I recall correctly, I objected on grounds that AIM has no claim to being even remotely independent; it's a partisan outfit. Our article on Accuracy in Media hits the high points here - it was founded by people who believed that Walter Cronkite was a Soviet agent. It criticized Fox News (!) for being too far "left" on global warming. And of course there's the "Quit Gay Sex" campaign. My point being that this is not a particularly reliable source for anything other than a doctrinaire hard-right line on the topic.

The fundamental point with Brind is WP:WEIGHT. He's one researcher, whose opinion represents a distinct and well-documented extreme minority of the scientific community. It is notable - no one is arguing otherwise - and it should be described accurately. But I disagree that this article needs to become even more of a platform for his minoritarian views. That said, it would reasonable to reproduce Brind's own words about "conspiracy" vs. "wishful thinking" - though we should also note that Jasen describes his allegations as being a "conspiracy of silence". MastCell ^Talk 20:06, 3 January 2008 (UTC)

Glad you agree.

Don't get all silly on me "platform for his minoritarian views". Policy is clear, you bring up a POV, you give it context and evidence that goes with it. By definition, anything Brind says is minoritarian... I gotta say I like the word. Weight is much less clear, as he is notable voice on a minority issue article; frankly the entire Advocate section has grown significantly and some could be moved to Brind's article. There is the Gelman article which claims a concerted effort by pro-choice organizations to suppress ABC evidence; judging by the speed, size and funding of the LH cohort of "49,000" women, that certainly seems possible.

I hope y'all get out of your collective dissonance soon, its revealing I need to bring up policy to you guys to do the obvious. Though I guess only one of ya is actively editing the article; but the others are encouraging incomplete (Brind) and inaccurate (rejected, no evidence in Russo) edits.

I'm also unsure how a peer-reviewed study can be allowed to remain outside the science section. Maybe you can work some magic and get that moved; but if you think it isn't science, then I guess you have expanded Wikipedia's role. Every study has criticisms, every study could be subject to bias of its researchers and/or funding. Brind's meta-analysis isn't special in those regards; certainly is special in having an advocate participate, doesn't change what it is. It certainly can change how its received. - RoyBoy ⁸⁰⁰ 05:07, 4 January 2008 (UTC)

URL date

The date might need to be updated after all, as the link changed; so that would mean someone would need to assess it to verify there is a new URL. If the content is the same, then I guess the old date is best... but I'm unsure if the content was changed/updated at all. - RoyBoy ⁸⁰⁰ 08:53, 16 February 2008 (UTC)

Disputed status

I have made several significant changes to the article today and in the previous week(s). I am satisfied with the article currently, and I no longer dispute it. However, others may... so before I remove the Disputed template are there any issues still in Dispute? - RoyBoy ⁸⁰⁰ 00:38, 20 March 2008 (UTC)

You'll have to convince me a Lead Editor of the LA Times taking apart a notable ABC article isn't relevant here. Is your argument that letter's purpose/focus is on LA Times bias? So what, bias about what topic??? Yeah, quite specific and not tangential. - RoyBoy ⁸⁰⁰ 03:48, 20 March 2008 (UTC)

Your timeline is off. The Carroll letter appeared before Mooney wrote his article, and should thus be mentioned before the Mooney article in our summary. Mooney was refuting Carroll, not the other way around which is how it seems as it is written currently. In essence, your purpose for including this letter to the editor in this way seems to be to discredit the Mooney article - but Carroll doesn't mention Mooney. On a different note, any potential flaw in the LA Times article doesn't ultimately detract from the Mooney article because Mooney doesn't rely on the LA Times for his conclusions about the ABC link. You can see Mooney came to the same conclusions about the ABC link in his article "Research and Destroy" in which he doesn't mention the LA Times article at all. We don't even reference the LA Times story in this article with regards to the ABC link, which leaves the reader supremely confused. Ultimately what's happening here is Original Research. If you want to indict the LA Times for not presenting the "full story" on ABC, then do so on the LA Times wikipedia page. It's not relevant here since we don't reference the L.A Times article. --IronAngelAlice (talk) 04:27, 20 March 2008 (UTC)

I'll fully agree it can be confusing to the reader given the timeline, but both articles refer to Gold's article on the ABC issue. It is pertinent to the Mooney article because his notable assessment can be directly contrasted to Carroll's. It is curious you'd find a Chief Editor's quote unnecessary. Without Carroll's quote we do not have a direct contrast of opinions. It's as if you think Mooney's opinion has more weight. Don't give me the excuse that Mooney is on topic, while Carroll isn't... they are both criticizing media coverage. Carroll is precise and specific, Mooney is editorializing and is speaking in broad terms while providing his non-expert opinion on the state of peer-review science on the ABC issue.

In case you are thinking otherwise, I'll attempt to clarify. Regardless of timeline, Carroll trumps Mooney, easily. In notability, credentials, interest in Gold and most importantly specificity. You don't even want to hear what Carroll is saying, I know this, based on your poor prose on his analysis and ridiculously lengthy reiteration of the questionable NCI.

Gold's article has problems, you should recognize that and edit appropriately. "the one scientist who supports the ABC hypothesis", give me a Fucking Break. I'm not in the mood to assume good faith anymore. You just inferred Brind is the only scientist that considers the ABC hypothesis plausible. - RoyBoy ⁸⁰⁰ 00:14, 21 March 2008 (UTC)

Oh and Carroll rebukes Gold, Mooney merely disagrees with Carroll's position... mostly based on Gold's "intelligent design" article. Has it occurred to you that Gold listened to Carroll for good reason(s)? - RoyBoy ⁸⁰⁰ 01:00, 21 March 2008 (UTC)

Also, I have no problem with removing the banner now. The Mooney/Carroll issue can be resolved without a "dispute" tag ;)--IronAngelAlice (talk) 05:41, 20 March 2008 (UTC)

Well I have to admit, I didn't see that coming. Thanks, but no thanks until the political hack job you created is cleaned up. - RoyBoy ⁸⁰⁰ 00:14, 21 March 2008 (UTC)

"Political hack job"? What? Can we put back on our "rational" caps now, and just assume good faith? I agree with your edits for the most part - they make the section much more readable than what I had written. However, I did remove the last sentence since is was original research (your observation). In truth, I don't see the Mooney's criticism of the media much of an addition to the article overall. His article "Research and Destroy" is far more pertinent. Just out of curiosity, do you have a personal problem with Mooney?--IronAngelAlice (talk) 23:41, 21 March 2008 (UTC)

I suppose so, look at ya taking the high road and stuff. That pleases me, one tweak I just did... move Brind out of the quote and into the preceding intro; merely for flow. Needless to say I was displeased with how you situated Carroll being "rebuked" by Mooney; though thanks for inspiring me to use the word for Gold's article. Absolutely agree on the last sentence, I shoved it in there for our benefit as a "think out loud" exercise; to give you a taste of what I've seen others do to this article. You want "rational"? Sure thing. I can do rational better than most, but it means a lot of reading for you; and plenty of typing for me:

That is an excellent question about Mooney. Generically speaking, no, he seems to be a perceptive and bright individual. But his assessment of ABC is curiously non-existent, and appears to me, to be based on the NCI workshops authority rather than the "peer reviewed" science he mentions as a linchpin of his criticism of Carroll and praise of Gold. That does bother me, in much the same way the Planned Parenthood website will criticize positive ABC studies for being "extremely small", but then hold neutral/negative ABC studies with similar or even smaller datasets as reliable and gospel... and then good faith people let it slide as if all is well. Hey, Gold's article on intelligent design may have been a rosey colored poor article; that certainly does not change the fact his ABC article was very poor for different reasons, and he was thankfully taken to the woodshed by someone who cares about journalistic integrity.

Its aggravating after you see it dozens of times. Mooney is somehow being especially insightful as he paints truisms with a broad brush? Not this time! Mooney associates "intelligent design", cloning hoax with the ABC hypothesis as equally "fringe" science. On what planet is that not Flagrantly Irresponsible Journalism? Last time I checked, the cloning hoax had several news releases over a matter of months; "intelligent design" had precisely zero bonafide scientific studies published over its run of 20 years; whereas the ABC hypothesis has dozens of studies spanning decades, various continents, with a spectrum of results, criticisms, politics and even sub-articles (response bias, editorials, meta-analysis), Congressional interference, state laws, shifting scientific "Fact Sheets", and judges determining the issue is in a "state of flux".

You tell me how Mooney should be in anyone's good books after that? Mooney took the low road, it's guilt (or in this case) "fringe by association". It is piss poor rationale (we have our caps on still?) and I've seen better rhetoric in Star Trek vs. Star Wars forums. LOL... seriously, Mooney argument is inexcusable despite his good faith truism on journalism; and I don't think I'm done with Mooney's mention here. It feels distinctly wrong to give Mooney the last word over a Head Editor who generates Pulitzer's where he works. Mooney is at best a middle-weight compared to Carroll on journalism, and a light-weight compared to Brind on the ABC issue.

Mooney's article is flawed and contains assumptions on ABC, Carroll's criticism is beyond reproach and damning. That's why Gold changed his tune for "intelligent design", was it an appropriate change, I don't know, I'd have to read the article... since I'm not willing to take Mooney's assessment at face value. How Carroll would need to "defend" himself in any way seems to be a matter of the political momentum created by the NCI conclusion; not on the substance/science of the matter, which Carroll reiterates is what is ultimately important. “You have an obligation to find a scientist, and if the scientist has something to say, then you can subject the scientist’s views to rigorous examination.” That looks like a good candidate to follow up Mooney.

See how long that was!?! It's much easier to say "political hack job" and leave it there. - RoyBoy ⁸⁰⁰ 07:46, 22 March 2008 (UTC)

I do. The article starts out with the manifestly false statement that the abortion-breast cancer hypothesis "is an unsupported hypothesis that posits a causal relationship between induced abortion and an increased risk of developing breast cancer."

Unsupported?? Actually, it is supported by numerous studies.

There is dispute over whether an abortion after first full-term pregnancy increases breast cancer risk, but there is no scientific dispute of the fact that delaying first full-term pregnancy (whether by aborting or by delaying a first pregnancy) increases breast cancer risk.

Additionally, quite a few studies have found a correlation between abortion and breast cancer which is too high to be fully explained by delay of first full-term pregnancy. That is controversial, but even that is not "unsupported."

The article, as written, is factually incorrect, and POV-biased in the extreme. NCdave (talk) 14:01, 20 March 2008 (UTC)

No, it's actually not. The ABC hypothesis posits that having an abortion puts one at higher risk than never being pregnant in the first place, so your third paragraph is irrelevant to this topic. "Rejected" is actually a better word than "unsupported" - there was some preclinical evidence supporting the hypothesis, but the weight of epidemiological evidence has led to the rejection of a link by the scientific community. There was a lengthy discussion about "rejected" vs. "unsupported" - I guess "unsupported" won, but "rejected" is probably the more accurate term. Calling this "controversial" without acknowledging that it's been rejected by every major medical and scientific organization to look into it - now that would be factually incorrect and POV-biased in the extreme. MastCell ^Talk 15:48, 20 March 2008 (UTC)

While I understand your sentiment, the consensus interpretation of those studies by the scientific community cannot be ignored. Even if we disagree with it. - RoyBoy ⁸⁰⁰ 00:14, 21 March 2008 (UTC)

"Unproven" is a term that has been offered as an alternative to unsupported, while I consider that more accurate on the actual status of the primary science, that does not reflect the "not associated" determinations of the NCI and WHO. - RoyBoy ⁸⁰⁰ 01:59, 21 March 2008 (UTC)

MastCell, you are mistaken about the ABC link. The argument is not over whether someone who has an abortion is at higher risk of BC than someone who never got pregnant. It is over whether a pregnant woman increases her risk of BC if she chooses to have an abortion rather than complete her pregnancy. At the time she makes her choice, having never gotten pregnant is not an option.

There are (at least) two components to that increased risk. One is not controversial: the fact that delaying first full-term pregnancy increases risk of eventual BC, for those women who have an abortion before ever having a full-term pregnancy. It is believed that a woman's risk of eventual BC increases by about 3.5% per year of delay in first full-term pregnancy.

The controversy is only over the other component, which according to some but not all studies, increases BC risk over and above that which can be accounted for by delay in first full-term pregnancy.

Actually you are mistaken. ABC studies specifically account for parity (childrearing) in their analysis. When parity isn't properly accounted for, I go out of my way to mention it. We are concerned with the ABC issue, not parity, just as the ABC studies are. This distinction is also mentioned prominently at the beginning of Abortion-breast_cancer_hypothesis#Proposed_mechanism; you aren't telling us anything new.

However, do you find the current mention(s) insufficient, confusing or not visible enough? Are you pushing to make this distinction in the lead? I do want your feedback, because I do not want others to have the same misunderstanding and/or miss this distinction when they read the ABC article. The ABC hypothesis is about Abortion and Breast Cancer NOT delayed childrearing and Breast Cancer. - RoyBoy ⁸⁰⁰ 21:10, 21 March 2008 (UTC)

I forgot to mention it is also talked about in the "Confounding factors" section of the article; because Childbearing is one of the most prominent factors scientists try to eliminate from their results. - RoyBoy ⁸⁰⁰ 23:19, 21 March 2008 (UTC)

Here's Brind, reporting on the combined effect of both factors:

"The odds ratio for nulliparous women was 1.3 (1.0,1.6), that for abortion before the first term pregnancy in parous women was 1.5 (1.2,1.8), and that for abortion after the first term pregnancy was 1.3 (1.1,1.5)"[1]

The difference between 1.3 and 1.5 is the effect due to delay of first full-term pregnancy, which is not controversial. The difference between 1.0 and 1.3 is the other (controversial) effect. NCdave (talk) 05:00, 21 March 2008 (UTC)

Incorrect, the control groups for each result have matching childrearing (parous women are matched to parous women of similar child bearing). Making childrearing not a factor in the results; and what you are seeing is (ideally) differences for abortion. To explain:

Younger breasts are more sensitive to hormones, hence an Abortion can have a higher potential impact. Meaning a 17 yr/old and 21 yr/old have abortions and they both have a child at 25; the 17 yr/old could have sustained a higher BC risk because of her higher sensitivity at 17 AND because she had a 8 year gap versus a 4 year gap for the 21 yr/old. Which is more time for partially mature cells (from the abortion) to be damaged.

To put simply, scientists remove childrearing automatically; they design their study to focus on Abortion exclusively (they don't always succeed, but that is the goal). This is what their study is examining, hence this is what we focus on. - RoyBoy ⁸⁰⁰ 21:10, 21 March 2008 (UTC)

RoyBoy, "Unproven" is an appropriate term for the disputed component of the connection between abortion and breast cancer that does not result from delay of first full-term pregnancy. However, it is not an appropriate term for the uncontroversial connection between BC and an abortion which delays first full-term pregnancy. That connection is modest in magnitude (~3.5%/year delay), but it is very widely acknowledged.

I agree with unproven, but that doesn't matter. We just went through a lengthy mediation on the lead, where I got "rejected" (which is POV and incorrect) replaced with "unsupported"; I do not feel the need belabor that word further. Understand? - RoyBoy ⁸⁰⁰ 21:34, 21 March 2008 (UTC)

For this article to be accurate and NPOV, it needs to discuss both: the very widely acknowledged increase in BC risk which results from an abortion before first full-term pregnancy, by delaying first full-term pregnancy; and the controversial additional risk which is claimed to result from abortion independent of whether it is before or after first full-term pregnancy. NCdave (talk) 05:11, 21 March 2008 (UTC)

No. We separate them on purpose, in order to avoid confusion; and clarify to the reader what the studies results are actually examining. Scientists remove parity from the equation, so do we. - RoyBoy ⁸⁰⁰ 21:10, 21 March 2008 (UTC)

Parity explained

Mastcell, this looks like a weakness we need to address for the ABC article. So much so perhaps making the distinction in the lead is necessary, to ensure the reader does not confuse delayed child rearing with the ABC hypothesis, and ABC study results. I think I have seen some lay articles/essays that incorrectly list these two components as part of the ABC hypothesis. While they are certainly both part of the ABC "issue", delayed child rearing (again ideally) has nothing to do with the ABC "hypothesis". Your thoughts? - RoyBoy ⁸⁰⁰ 21:49, 21 March 2008 (UTC)

The relationship between parity and breast cancer risk is covered in detail (I hope) at breast cancer epidemiology and etiology of breast cancer. The specific notability of this sub-topic stems from the claim that abortion is particularly risky - that is, riskier than being nulliparous - because of the initial surge in hormones and breast development followed by the premature withdrawal of those hormones, etc etc etc. Perhaps a simple clause in the lead, that the ABC hypothesis posits that abortion is linked to an increase in breast cancer risk over that of a nulliparous woman, would be appropriate. MastCell ^Talk 21:55, 21 March 2008 (UTC)

Interesting, but we need to ensure nulliparous AND delayed child rearing are clarified in a straightforward way. I think where we might have dropped the ball is "delayed child rearing" specifically; not taking into consideration the effect moving Confounding factors around would have on the article. - RoyBoy ⁸⁰⁰ 22:04, 21 March 2008 (UTC)

CWA

The article currently says,

Dr. Karen Malec, a pro-life activist, started the Coalition on Abortion-Breast (CAB) in 1999 with help from Concerned Women of America (CWA), a conservative right-wing Christian group. According to historian Patricia Jasen, CWA defines itself as "anti-gay, anti-choice, anti-feminism and anti-sex education (as well as anti-Harry Potter)." Malec's organization is openly devoted to anti-abortion rhetoric.

The POV bias in that paragraph is intense.

It is true that the CWA is conservative, but "right-wing" is pejorative, and "conservative right-wing" is redundant.

But much of the rest of the paragraph is not merely biased, it is also inaccurate.

The statement that the CWA defines itself as "anti-gay, anti-choice, anti-feminism and anti-sex education (as well as anti-Harry Potter)" is obviously false. I say "obvious" because it is written in the language of the Left. Conservatives don't describe themselves as "anti-gay" or "anti-choice." They say "pro-life." So that description is obviously not CWA defines or describes itself, it is a leftist's caricature.

This is how the CWA actually describes itself:

CWA is built on prayer and action.

We are the nation's largest public policy women's organization with a rich 29-year history of helping our members across the country bring Biblical principles into all levels of public policy.

We help people focus on six core issues, which we have determined need Biblical principles most and where we can have the greatest impact...

Mission Statement

The mission of CWA is to protect and promote Biblical values among all citizens - first through prayer, then education, and finally by influencing our society - thereby reversing the decline in moral values in our nation.[2]

BTW, Harry Potter is not one of those six core issues. Here's what the CWA says about Harry Potter:

"CWA takes the position that parents know what is best for their children. ... Scripture speaks strongly about the occult, so parents should explore the Harry Potter books themselves to decide whether they’re appropriate for their children."[3]

That certainly doesn't sound like the CWA "defines itself" as being anti-Harry Potter. The reason for mentioning Harry Potter would appear to be simply to ridicule the CWA, by mischaracterizing their position.

What's more, the source (Patricia Jasen) cited to justify this stuff is simply dishonest. For instance, her article says, "The evangelical leaders Pat Robertson and Jerry Falwell gave their support to the violent strategies of such groups as Operation Rescue." In fact, Operation Rescue has never employed violence, and neither Robertson nor Falwell have ever supported violence.[4] Operation Rescue protesters have often been assaulted themselves,[5] but Operation Rescue is a nonviolent organization.

Also, I wonder what organization other than Toastmasters is openly devoted to "rhetoric?" Pro-life organizations are devoted to defending and protecting the most vulnerable members of society: the unborn, the disabled, and the elderly. They are not devoted to "rhetoric." I don't know where the bit about "rhetoric" came from. NCdave (talk) 15:40, 20 March 2008 (UTC)

I'm not going to argue about Operation Rescue's tactics with you, since it's utterly off-topic. That's bait I can pass up. I also agree that the last sentence, about being "openly devoted to anti-abortion rhetoric", is silly and should be removed. "Conservative right-wing" can also be shortened to just plain "conservative". Otherwise, Jasen's article is a reasonable source, though obviously not a self-description. Her full sentence reads: "In fact, the coalition was founded with the support of Concerned Women for America, a national right-wing Christian organization which defines itself as anti-gay, anti-choice, anti-feminism and anti-sex education (as well as anti-Harry Potter) and actively lobbies for legislation recognizing the abortion-breast cancer link." One could streamline this (and point out the actually relevant bit) into something like "... Concerned Women of America, a pro-life conservative Christian group which lobbies for legislation recognizing an abortion-breast cancer link." Would that be better? After all, CWA's stance on homosexuality, feminism, or Harry Potter are not directly relevant here, however we might characterize them. MastCell ^Talk 16:03, 20 March 2008 (UTC)

I applied MastCell's suggestion; and will link to the groups wiki-article to provide the context. - RoyBoy ⁸⁰⁰ 01:47, 21 March 2008 (UTC)

What Jason said about O.R. is irrelevant to this article, but not irrelevant to the reliability of Jason as a source. Falsus in uno, falsus in omnibus.

What Prof. Jason claimed was a self-description of CWfA is obviously nothing of the kind, and has no place in the article. MastCell's proposed wording for the description of CWfA is a vast improvement over Jasen's, but still imperfect. Prof. Jason's term "national organization" is better than "group" to describe CWfA because "group" sounds small, and we're talking about the largest women's public policy organization in the USA.

Also, the phrase, "which lobbies for legislation recognizing an abortion-breast cancer link" could easily be misread as a description of the organization's main purpose or primary activity, which it certainly is not. In fact, I don't think we should even say that CWfA lobbies for such legislation unless we can find a reliable source for the claim. The Jasen sentence, which also falsely claims that CWfA defines itself as anti-Harry Potter, certainly is not a reliable source for any information about CWfA.

It might be that Jasen's claim that CWfA lobbies for such legislation is really a reference to CWfA's support for "Women's Right to Know" laws. One of the many misleading statements in Prof. Jasen's article is this one:

"Within a year of the publication of Daling's report, legislation had been passed in two states and proposed in several others, either directing authorities to investigate the cancer link or taking the form of “Women's Right to Know” acts requiring that women be advised of a possible cancer risk."

That makes it sound like the ABC link is the motivation for "Women's Right to Know" ("Informed Consent") laws, but that isn't so. The ABC link is of very minor importance in such laws. These laws and bills always require that a wide variety of information be given to women by abortion clinics prior to an abortion, including information about fetal development, her legal rights, alternatives to abortion, available social services, and the medical risks of both abortion and childbirth. Information about the evidence for an ABC link is a very small part of all that, and these laws and bills always require that all information supplied by the abortion clinic be unbiased and accurate.

I believe that CWfA does support "Women's Right to Know" bills, though whether or not they actually lobby for such bills I don't know. But even if they do lobby for Right to Know bills, I very much doubt that they lobby specifically for provisions relating to the ABC link. I might be wrong, but I suspect that Jasen just made up that bit about CWfA lobbying "for legislation recognizing an abortion-breast cancer link," like she made up the bit about CWfA defining itself as being anti-Harry Potter.

Anyhow, I don't really think that there's a need for this article to describe the CWfA. Let's just name them and Wikilink to their article. Okay? NCdave (talk) 05:46, 21 March 2008 (UTC)

"National organization" (vs. "group") is fine. Discarding Jasen's article entirely as a source, based on what you consider to be an error in description, is not. Nor is speculation that she "just made up" something she published in the peer-reviewed literature. If you're concerned about the text leaving the impression that lobbying in favor of recognition of an abortion-breast cancer link is CWA's sole or main activity, we can alter the text to read: "which, among other activities, lobbies for legislation recognizing an abortion-breast cancer link." The fact that CWA lobbies in favor of recognition of an ABC link is, indeed relevant enough to this article to warrant a 9-word clause. MastCell ^Talk 19:29, 21 March 2008 (UTC)

I changed it to organization, I'm unsure about national only because couldn't they be considered international in scope? I think they influence outside the U.S. don't they? Just thinking out loud here... I'll put in national for now. - RoyBoy ⁸⁰⁰ 21:17, 21 March 2008 (UTC)

Just as a general FYI, NCdave has raised the issue of Jasen's article on the reliable sources noticeboard. MastCell ^Talk 06:38, 24 March 2008 (UTC)

Thx. - RoyBoy 21:20, 24 March 2008 (UTC)

The hypothesis is "controversial" not "unsupported"

I just made a change no one should have a problem with. Prior to my change, the article read that the hypothesis was "unsupported." Using any English dictionary, the prior statement is simply not accurate. Scientific studies have shown a link. Others have found fault with these studies and that is why the controversy exists. For Wikipedia to say the hypothesis is "unsupported" is to take sides in the controversy, an act that is strictly forbidden by Wikipedia policy. The article must remain WP:NPOV. Is everyone clear on this point? RonCram (talk) 01:39, 30 March 2008 (UTC)

While I largely agree with the edit, try not to presume to tell people what they "should" be thinking. Also, Wikipedia technically is not taking sides; the reliable references we have used for the first sentence do. Don't misconstrue the substance of the article and then quote policy.

Indeed studies have indicated a link, "shown" is your POV. Clear?

If by "others" you mean the scientific community and even many of the study authors themselves have found fault with them (and certainly wouldn't characterize their results as "shown" a link), and that generally speaking there is a current agreement the small risks indicated may have been the result of error(s). As far as I can tell, there isn't (much) of a scientific controversy in that regard. The fact there is a political controversy is irrelevant to accurately describing the current status of the ABC hypothesis.

Lastly, policy needs correct context. The NPOV determination of the ABC hypothesis is that it is largely unsupported by the scientific community and the evidence they hold to be most relevant; not the evidence you/we consider relevant. If you can show otherwise with relevant and reliable sources, and I believe it is possible though difficult given persistent pro-life overreaching, then that would be something interesting to look at.

What is uninteresting is someone quoting policy. NPOV requires us to take the scientific view. It's been easily established the scientific view of the ABC hypothesis is generally unsupportive. Demonstrate otherwise please, do not dictate. I'm aware some pro-life medical associations recognize an ABC link; I'd consider this a starting point of discussion... but it needs more than that, and I believe more than what is in the article. Hence the current word "unsupported". - RoyBoy 04:33, 30 March 2008 (UTC)

Forgot to say, please do continue questioning and challenging this article. I want this hashed out now while we have interested parties paying attention, and prior to the GA review. I do appreciate the effort(s) to improve the article, even if I disagree with the rationale initially provided. - RoyBoy 04:39, 30 March 2008 (UTC)

I came up with an alternative that doesn't require such rigorous research and removes the inaccurate perception ABC is completely unsupported:

See below now. - RoyBoy 03:50, 1 April 2008 (UTC)

I rewrote the defining sentence to be short and easier to understand and shortened supporter brackets. I moved determinations on the ABC hypothesis to the next sentence, which allows us to expand it a bit for accuracy, separate NCI from WHO, and unclutter the definition. - RoyBoy 15:51, 30 March 2008 (UTC)

RoyBoy, certain studies have concluded a link exists. This is not my POV. You only need to read the abstracts to verify my statement. I have provided a series of peer-reviewed articles below for you and other editors to see. The fact a controversy exists cannot be hidden from Wikipedia readers. Neither do I want to pretend the hypothesis is the majority opinion among medical researchers. The article needs some serious reworking to be made NPOV. RonCram (talk) 08:08, 6 April 2008 (UTC)

Okay, but this isn't my first time around the block. Meaning everyone sees different problems from differing perspectives, and there usually are problems but when they go to fix them they create new problems unintentionally. (look at Phyesalis edits to see) For example, there certainly is controversy; and I mean to include that as you can see in my new version below... but it does have to be placed in the broader context of scientific consensus; in order to not confuse and/or give too much weight to the "controversial" meme. It's a balancing act that is by no means easy; spotting a weakeness is great, fixing it may not be quick and it can involve more references than you have at hand. - RoyBoy 01:05, 7 April 2008 (UTC)

NCI tweak

In researching for the lead I found the following note by the editor in Malec's article: "Although the issue was subject to a vote of “over 100 of the world's leading experts,” the NCI website does not state the result of the vote itself." I am going to incorporate this into the lead now. - RoyBoy 17:36, 30 March 2008 (UTC)

I don't think that's a good idea. It's extremely leading - in that it clearly implies that the NCI is covering up the actual number of dissenters - and it gives prominent weight to a source (JPandS) which is poor and substandard. I would suggest indicating that the NCI issued a consensus statement with one dissenting opinion, that of Brind. This is accurate and non-leading. MastCell ^Talk 02:33, 31 March 2008 (UTC)

While these are pertinent points, I really do feel this point is essential to actually providing an accurate and non-leading description of the NCI workshop. During all our back-and-forth, mediation, all this time it has been assumed (even by me) that Brind was the only dissenter. As I've correct for in the ABC article in the past, Brind is the only one to formally dissent. To say Brind was the only voice of dissent is presumptive and frames the NCI consensus incorrectly. I'd like to get it from another source, but for this I think the JPandS is okay; because it is the best pro-life source I can think of right now. (any source which points this out would likely be pro-life) Sure its not a great source, but it is a pertinent point. - RoyBoy 03:49, 31 March 2008 (UTC)

Pro-choice editors have made it a point to say, repeatedly, that there was 100 experts at this workshop. We need to answer a fundamental question, how many of those experts truly supported the conclusions that were published? Did they have alternatives to choose from and vote on, was there even a vote? These are basic questions. - RoyBoy 04:05, 31 March 2008 (UTC)

It was a workshop. They produced a report. The report was signed off by all members except for Brind, who went to the trouble to file a dissenting opinion. It doesn't matter to me if we say there were "over 100" experts or not. However, I'm not comfortable with framing partisan sources to shoot holes in the NCI report in the lead (if at all). Maybe dozens of the participants dissented but they were sworn in a blood oath to hide the link or lose their funding. That's speculation. I'd prefer we stick to what is verifiable - that the NCI workshop produced a report rejecting/finding no support for an abortion-breast cancer link, and that Joel Brind, a pro-life advocate and the leading proponent of such a link, filed a dissenting opinion. MastCell ^Talk 19:57, 31 March 2008 (UTC)

Alright, the problem is you are asserting "they produced a report", if you want to keep things verifiable you need to verify how the workshop actually operated; not how you think it did. It doesn't make sense 100 experts put they're two cents in a whirlwind round table of discussion. Indeed as I said above, we don't even know if there was a vote, but that makes a heck more sense then your statement; which implies everyone had a say and they all concurred with the conclusion. At this point it seems clear the JPandS knows how a science workshop/conference actually operates, better than you or I.

Also, could you please look at my draft of the lead above. If RonCram likes it, I do intend to implement it. Relegating the unverifiable NCI to the second paragraph. Actually reading the Lead over, I really don't like how we repeat the NCI and cohort study info/conclusion twice in the 2nd and 3rd paragraphs. It should be merged to provide a coherent narrative... man this isn't going to be easy. I'll work on further tonight... hopefully. - RoyBoy 21:05, 31 March 2008 (UTC)

With all due respect, this is a very idiosyncratic definition of verifiability. To verify that the NCI held a workshop and produced a report, we simply need to demonstrate that... well... the NCI held a workshop and produced a report. Done. Speculation about how the workshop operated may have a place somewhere in the article, so long as it is properly attributed to a partisan source in the text, but it doesn't belong in the lead. I suppose I might know a bit more about how these sort of things operate than does Karen Malec, a pro-life advocate without scientific or medical training making a partisan point in a questionably fact-checked journal, but that would be speculation as well and largely irrelevant. MastCell ^Talk 23:21, 31 March 2008 (UTC)

I'm not explaining well... Yes, "NCI held a workshop and produced a report"... however, your previous statement was more ambiguous. "They produced a report." Implying all the experts actively participated, then boldly stating they "signed off". To my knowledge that isn't verifiable. Was there a vote? We honestly don't know, do we? Your addition to Association of American Physicians and Surgeons should have been fact-checked a bit more. (tweaking ACS mention now)

Further, Malec didn't make the point... the editor did, Lawrence R. Huntoon. Fact-check that prior to asserting knowledge on something that is truly beyond us. Until we can clarify the unknowns, I am equally uncomfortable with the inference every expert "signed off" with the exception of Brind. Think about this MastCell... could all these experts truly agree with the NCI workshop report/conclusions, while WHO came to a notably different assessment? We don't have the luxury of knowing the opinions of the workshop experts; I realize that now, and that's what is behind my JPandS inclusion.

You amusingly hit the nail on the head when you speculated on the "blood oath", however we have been speculating all along that the experts "signed off" on the report. I want to put an end to that, here and now. - RoyBoy 02:43, 1 April 2008 (UTC)

Er, OK. Let's focus on the verifiable, then, to save ourselves a lot of grief. Surely we can agree that the group of experts convened by the NCI analyzed the evidence and produced a summary report, with one dissenting opinion? MastCell ^Talk 05:22, 1 April 2008 (UTC)

Yup. Where we may disagree is if Lawrence R. Huntoon is a RS for commentary on the NCI workshop. Verifiability has been met, even though JPandS is suspect, I have seen nothing to contradict the NCI vote meme. As of now I think he is a RS, since this is my opinion I haven't forced the meme back into the lead immediately. But if there is no reason beyond the source to doubt the meme, I find that insufficient, given the NCI is Verifiably nontransparent. - RoyBoy 18:47, 1 April 2008 (UTC)

The visibility of this source (JPandS) is not sufficient to support such a leading statement in the article lede. Part of reliability is fact-checking and reputation (JPandS fails on both counts); another part is independence and lack of partisanship (again, JPandS fails). JPandS is a suitable source for a partisan, pro-life perspective on the issue, but not for undermining a National Cancer Institute expert workshop in the lede. I feel pretty strongly about this. MastCell ^Talk 20:57, 1 April 2008 (UTC)

Alright, you're right. But I'm keeping my eye open for corroborating evidence; I'll put it in the NCI sub-section, likely right after "target for pro-life groups". That provides good context. - RoyBoy 02:51, 2 April 2008 (UTC)

That looks fine to me. MastCell ^Talk 03:50, 2 April 2008 (UTC)

ACS tweak

I'm reworking the ACS mention in the ABC lead now; and removing cancer organization assertion as the reference doesn't actually say that, and even if it did PlannedParenthood is an silly source for such a broad scientific statement. - RoyBoy 02:53, 1 April 2008 (UTC)

Lead rework

The abortion-breast cancer (ABC) hypothesis (supporters call it the abortion-breast cancer link) posits induced abortion increases the risk of developing breast cancer; it is a controversial subject and the current scientific consensus has concluded there is no significant association between abortion and breast cancer risk. In early pregnancy, levels of estrogen increase, leading to breast growth in preparation for lactation. The hypothesis proposes that if this process is interrupted by an abortion – before full maturity in the third trimester – then more relatively vulnerable immature cells could be left than there were prior to the pregnancy, resulting in a greater potential risk of breast cancer. The hypothesis mechanism was first proposed and explored in rat studies conducted in the 1980s.

The American Cancer Society concludes that presently the evidence does not support a causal abortion-breast cancer association, yet a causal link continues to be championed by pro-life activists like Dr. Joel Brind, Dr. Angela Lanfranchi and Karen Malec. In the past, pro-life advocates have sought legal action regarding disclosure of the abortion-breast cancer issue. This brought short-term legal and political intervention culminating with the Bush Administration changing the National Cancer Institute (NCI) fact sheet from concluding no link to a more ambiguous assessment. In February 2003, the NCI responded by conducting a workshop with over 100 experts on the issue, which determined from selected evidence that it was well-established "abortion is not associated with an increase in breast cancer risk."

Though the scientific community is largely skeptical of the hypothesis and has been rejected by some; the ongoing promotion of an abortion-breast cancer link by pro-life advocates and medical associations is seen by others as merely a part of the current pro-life "women-centered" strategy against abortion. Pro-life groups maintain they are providing legally necessary informed consent; a concern shared by conservative Congressman Dr. Dave Weldon. While early research indicated a correlation between breast cancer and abortion; the current scientific consensus has solidified with the publication of large prospective cohort studies which find no significant association between first-trimester abortion and breast cancer. These studies along with all relevant research strive to remove from their results the many confounding factors, such as delayed child bearing (parity), which effect breast cancer risk apart from abortion. The abortion-breast cancer hypothesis continues to ferment mostly political and some scientific debate.

In 2004, Beral et al. published a collaborative reanalysis of 53 epidemiological studies and concluded that abortion does "not increase a woman's risk of developing breast cancer." A large epidemiological study by Mads Melbye et al. in 1997, with data from two national registries in Denmark, reported the correlation to be negligible to non-existent after statistical adjustment.

Comments

Please place discussion on the rework here. - RoyBoy 20:25, 1 April 2008 (UTC)

Karen Malec is not a doctor. According to the cited source, she is a former teacher who is now an advocate. MastCell ^Talk 21:11, 1 April 2008 (UTC)

Okay. I don't understand what you want done, remove her from the Advocate list Phyesalis inserted? - RoyBoy 22:10, 1 April 2008 (UTC)

Oh! Remove the Dr., my bad for relying on Phyesalis. - RoyBoy 22:14, 1 April 2008 (UTC)

Otherwise, my major concern is that this lead does not accurately and proportionately represent the views of experts in the field. There should be a clear, concise, and direct sentence indicating that the National Cancer Institute, American Cancer Society, and World Health Organization have all found no evidence of such a link. Right now, it's spread out all over and the reader could well be left with the impression that there is less unanimity than actually exists. MastCell ^Talk 21:19, 1 April 2008 (UTC)

Thanks for honest feedback. However, "no evidence" is not in keeping with reality and does not accurately communicate the actual positions of the ACS and WHO. I am actually disappointed in myself for not correcting the gross errors in the current lead much sooner. The positions of the NCI, ACS, and WHO are now clearly reproduced, and are in keeping with the references.

I find you almost have no basis for your position. Your "not recognized" bit in Association of American Physicians and Surgeons is pretty good and brief, but does not provide the caveats WHO and to a lesser degree ACS have built into their conclusions. Point of fact there is less unanimity than the previous Lead asserts with POV and OR synthesis of sources. I have spelled that out using the sources in an exacting manner.

I do have a suggestion(s), if you can find a RS source has that actually checked all the major health/cancer organizations positions on ABC (maybe the Discover article, I'll scan it shortly); I'd gladly incorporate a line akin to: "Abortion is not considered/recognized a breast cancer risk by any major cancer organization" back into the lead. Perhaps even put it in the first sentence; removing the current "first-trimester" redundancy.

But make no mistake, after being forced to go through a mediation for a ridiculous "rejected" POV, I'm done being politically correct here. Daling finding statistically significant results that are not explained away by response bias makes it clear to me there isn't unanimity. We haven't even adequately explored NCI workshop vote meme, and you are asserting there is actual "unanimity" against the ABC hypothesis!? I am not humoring you on that point, and the science outright rejects the notion of "no evidence". - RoyBoy 22:10, 1 April 2008 (UTC)

I don't want to have a circular argument about our personal readings of the various studies. The ACS, WHO, and NCI have found that the evidence does not support a link between abortion and breast cancer. They have used slightly different langauge in doing so, but their conclusions are quite consistent and relatively easy to summarize. Yes, the WHO specifies first-trimester abortion (which is 90+% of abortions), so we can make that clear, but I don't see why it should be so difficult for the reader to learn the positions of these major medical organizations. MastCell ^Talk 03:49, 2 April 2008 (UTC)

Because accuracy gets lost in translation, using superficial consistency and a good faith desire to summarize. The NCI workshop (not the NCI) rejects ABC entirely, the ACS rejects a causal relationship, and WHO rejects it in first trimester abortion. This isn't politics where several sayings are equivalent; these are differing precise scientific determinations. They are consistent in believing the link is insignificant for most women; but they are certainly not the same. Understanding these differences and why they exist is difficult. Why should ABC suddenly become easy? - RoyBoy 23:55, 2 April 2008 (UTC)

I don't accept that this issue is too complex to produce a readable, concise, and easily comprehensible summary. I think we're making it too complex. The 3 positions you mention are virtually identical and highly consistent, with the 1st-trimester caveat for the WHO, which is a minor point since >90% of abortions are first-trimester. MastCell ^Talk 00:01, 3 April 2008 (UTC)

(undent) I'm glad we are having this discussion again. Would you care to explain how that is a minor point? Let me save us the trouble. Is isn't minor at all; as it makes your assertion of "no evidence" factually incorrect. Pregnancy hormones do not switch on at 12 weeks gestation. No one is in a position to stipulate ABC risk starts at 12 weeks, that includes you, NCI workshop, WHO, ACS, PP, RCOG, ACOG etc. and so forth. So because most women "probably" need to not worry, we should therefor summarize things to be consistent with what precisely? No ABC association?

Real science indicates real risks. There isn't a need for further "circular argument" on study results, as the "ACS, WHO, and NCI" clearly and consciously do not comprise the whole of ABC science, who's abstracts we should not ignore... but even within the narrow evidence range they (ACS, WHO, NCI) do consider/examine, their conclusions prove ABC is not easily summarized. If it were, they would all say "no association" and we can all go home... or to cookie ice cream and other articles. Fortunately, some organizations are more conservative with the actual science than others.

I'm intrigued by what you have in mind, but I probably won't like it based on Association of American Physicians and Surgeons. Which is good (not great) for a summary on a sub-article, but not so hot here. Actually there is no restriction on saying what the sources stipulate in the sub-article; so I might have to expand that Again, to reassert their position isn't actually unanimously/equally rejected by science... which is what you had there before... and it was wrong; I proved it wrong in mediation, yet it stayed until I began correcting it. What's up with that? Lapse in judgment... or literacy? Yeahhh, I'm still not happy bout' that. - RoyBoy 01:54, 3 April 2008 (UTC)

I am simply arguing that the interpretation of the evidence by major medical bodies such as the WHO and NCI be given appropriate weight. It won't be productive to address your personal concerns about the validity of their conclusions in this venue. Here are the actual positions:

• American Cancer Society: "The public is not well-served by false alarms and at the present time, the scientific evidence does not support a causal association between induced abortion and breast cancer." ([6])
• American College of Obstetricians and Gynecologists: "There is no evidence supporting a causal link between induced abortion and subsequent development of breast cancer, according to a committee opinion issued today by The American College of Obstetricians and Gynecologists (ACOG). ACOG's opinion is in agreement with the conclusion reached at the National Cancer Institute's Early Reproductive Events and Breast Cancer Workshop, which met in March 2003." ([7])
• World Health Organization: Entitled "Induced abortion does not increase breast cancer risk", states that "results from epidemiological studies are reassuring in that they show no consistent effect of first trimester induced abortion upon a woman’s risk of breast cancer later in life." ([8])
• National Cancer Institute: "They [the NCI workshop] concluded that having an abortion or miscarriage does not increase a woman’s subsequent risk of developing breast cancer." ([9])

There is a remarkable degree of consistency and unanimity among these expert bodies. There is 99% overlap and perhaps 1% difference, but you're focusing on the 1% and obscuring the 99%. That's my problem. The sole caveat is that the WHO opinion specifies 1st-trimester abortion since 90+% of the studied patients had first-trimester abortions. A brief, accurate summary might read: "Review of available evidence by major medical bodies, including the U.S National Cancer Institute, the American College of Obstetricians and Gynecologists, and the American Cancer Society, has found that induced abortion does not increase the risk of breast cancer. The World Health Organization has also found that abortion in the first trimester of pregnancy does not affect the risk of breast cancer." MastCell ^Talk 18:29, 3 April 2008 (UTC)

Ah, I understand. You are stating no evidence in relation to a "causal link". Well, that's not so bad I suppose. The issue is this caveat exists based on Melbye, one of the largest ABC studies done. This isn't WHO standing alone, with a novel/questionable position or as you incorrectly put it their "opinion". Poor wordplay MastCell, do not deem things you disagree with as opinions, WHO isn't some kind of editorial blog.

Further, 1st-trimester is not the sole caveat of ACS, NCI and WHO; focusing on a causal link exclusively is also a caveat in itself (you should know better). Then when we expand our scope beyond those sources, your percentage break down goes from incorrect to ridiculous. I will think about your suggestion, and if it's appropriate given the ACS does not deny an ABC correlation; additionally WHO says no association, the term "not affect" is not appropriate as its absolute and does not concur with the Melbye and Michel study findings (which WHO uses).

You can't rearrange words of these bodies and expect me to allow you to disassociate the lead with the actual data. - RoyBoy 22:23, 3 April 2008 (UTC)

Poor wordplay indeed. These are all "opinions"; it's just that the opinions of the NCI, WHO, ACOG, etc are notable while yours and mine are not. I think that the wording of these sources is quite clear; they are obviously extremely similar positions; four of the largest medical bodies in the world find that abortion does not increase the risk of breast cancer while none support such a link. I don't see coherent objections to this above and I'm still not clear on why it's hard to simply and effectively communicate the state of expert opinion on this topic. MastCell ^Talk 22:51, 3 April 2008 (UTC)

Your opinion that "no association" (NCI) and "no causal association" (ACS) are equivalent is incorrect and misleading. The "sole" first-trimester caveat is additional insurance from further discrepancies from reality. I concur none support a causal link; which says to me no support to a direct relationship; but an indirect relationship is still on the table for ACS and WHO. As I clarified in the Russo ref expansion, their hypothesis is not directly causal, merely one part of the lengthy process of normal carcinogenesis. (as Kahlenborn stipulates, one of the causes)

I reiterate, there is no requirement the lead's ABC determination is restricted to ACS, WHO and NCI. Currently I wouldn't add the nulliparous caveat from Daling in the lead as it's unconfirmed, but it is an additional caveat you haven't bothered to include in your opinion(s). This isn't my opinion versus notable opinions. I have verifiably good reason for low confidence in others ability to interpret notable opinions. - RoyBoy 16:37, 4 April 2008 (UTC)

What do you mean by "an indirect link"? It either increases the risk of breast cancer, or it doesn't. Things that are "one part of the lengthy process of carcinogenesis" increase the risk of breast cancer. I don't understand the distinction you're making, and it appears to be hairsplitting as a result. I'm not sure what bearing your low opinion of others has on what should appear in Wikipedia, but this it is mandatory per WP:WEIGHT that we represent expert opinion appropriately, and expert opinion could not be much clearer. MastCell ^Talk 20:09, 4 April 2008 (UTC)

Figure it out, "potential" is the key word. My opinion is pertinent if mistakes are repeated; I'm not saying that is happening now, as this "hairsplitting" is a different issue, but it was a generalization that I don't trust others to get it right. You will have to clarify WEIGHT for me in this instance, as it does not automatically follow a Review of evidence has more weight than the Primary evidence. For example, I'd maintain Melbye has more weight than any Review, including the NCI workshop. - RoyBoy 23:11, 4 April 2008 (UTC)

The latest edit and revert summary to the article (I agreed with your revert of my band-aid caveat, but not your summary) focused my attention on this subject again. I believe I have accurately summarized/synthesized the scientific consensus with "no significant association between abortion and breast cancer risk" which removes the misleading (regarding evidence) "unsupported"; and gets rid of the first-trimester redundancy. My lead draft also mentions "reject", but in a significantly improved context. I plan to implement this lead in a few days. - RoyBoy 17:08, 19 April 2008 (UTC)

Recently I also added "ambiguous assessment" review of the NCI fact sheet incident in an attempt to render a very tight summary of what happened. Is that sufficient/accurate, or should it be tweaked/expanded? I might expand mention of pro-life Congressional interest specifically in relation to informed consent; a key concept inserted into the lead, as its a possible legacy of the ABC issue regardless of future scientific determinations. - RoyBoy 17:20, 19 April 2008 (UTC)

The hypothesis is "controversial" not "unsupported"

I have corrected this in the past but I see POV wording is being used again in the lead sentence. This must stop. The article currently reads

The abortion-breast cancer (ABC) hypothesis (also referred to by supporters as the abortion-breast cancer link) is an unsupported hypothesis that posits a causal relationship between induced abortion and an increased risk of developing breast cancer.

The hypothesis is "controversial" not "unsupported." Any editor who does not understand this needs to learn how to use a dictionary. You cannot have an article discussing the controversy around the science and have a lead sentence saying there is no scientific support for the hypothesis. A number of medical organizations that have supported the hypothesis. [10] RonCram (talk) 06:05, 6 April 2008 (UTC)

Pro-life organizations, this isn't compelling evidence. Don't assert POV wording with references like this. I am working on a Lead rewrite as a result of your previous comments, learn that controversial subjects (like ABC) may not bend to your will on your timetable. I/we are working on it, I encourage your continued participation in the process. - RoyBoy 01:30, 7 April 2008 (UTC)

That list of supporting medical groups is actually a pretty good source for the fact that an ABC link is currently championed only by partisan pro-life organizations, though... MastCell ^Talk 20:01, 7 April 2008 (UTC)

LOL, nice one. Where would it go? Would these be considered advocates? I don't think so. If its not notable enough for the lead, then under Politicization? My gut reaction is that it is lead worthy. - RoyBoy 23:34, 7 April 2008 (UTC)

... as it provides an opportunity to inform/warn and give broad context. - RoyBoy 23:40, 7 April 2008 (UTC)

Waco Billboard

Is there anything in [11] that will help this article? (Quote)"One such study used by groups that want to downplay the ABC link is the 2004 Lancet study that has been criticized for its errors in at least five medical journals"(end quote).

It is an interesting synopsis, all of the researchers referred to are pro-life. But the points they make on the 2004 (Beral) study are interesting. We refer to the major point already here when noting "selection bias". However, I might use the part about "28 never-published, never-peer-reviewed studies", that is something I think should be added. Thanks. - RoyBoy 03:59, 31 March 2008 (UTC)

Actually this information was in the existing Brind reference, so I grabbed it from there. - RoyBoy 19:55, 1 April 2008 (UTC)

I'd be interested to find out what those "medical journals" are. If they are all conservative, and not registered under Medline (PubMed) then it isn't a compelling point. But maybe cumulatively it would be notable to mention. - RoyBoy 19:55, 1 April 2008 (UTC)

Why is this article still on Wikipedia?

Upon reading the introduction alone, the relevancy and existence of this article are questionable. (quote)"the current scientific consensus has concluded there is no significant association between abortion and breast cancer risk."(end quote)...(quote)"Though the scientific community is largely skeptical of the hypothesis and has been rejected by some;[9][10] the ongoing promotion of an abortion-breast cancer link by pro-life advocates"(end qoute). Surely it's flawed and should either be made to show that - ie: "this is a page that will set the record straight regarding this almost-propaganda campaign" or it should be abandoned entirely. User:AnnabelAnnabel 12:31, 26 April 2008

Just because it is seen as purely propaganda by some does not make it so. The positive results contained in scientific studies make that abundantly clear. The introduction also specifies, that first-trimester abortion is not associated with breast cancer, according to the World Health Organization. This means, if you choose to read carefully, that 2nd-trimester abortion can and does have some positive results. As yet, the ABC hypothesis is not flawed, and remains plausible despite pro-life advocacy and propaganda. As this article elaborates, in detail. - RoyBoy 07:15, 26 April 2008 (UTC)

Future links

Just external links we may use in the future:

• http://www.investigatemagazine.com/mar3abrt.htm New Zealand article
• http://goliath.ecnext.com/coms2/gi_0199-5388402/The-abortion-breast-cancer-link.html Brind and Australia research

- RoyBoy 17:24, 18 May 2008 (UTC)

Hyphenation

Is this the correct way to hyphenate the name of this hypothesis? My first though on coming across the page name was "What is an abortion-breast?" --EncycloPetey (talk) 20:05, 20 June 2008 (UTC)

Heh, well I can't say for sure; but several articles do hyphenate it that way. It can be changed if I'm satisfied the grammar is indeed imprecise. - RoyBoy 19:21, 22 June 2008 (UTC)

Proponents section

Just a warning, I know next to nothing about this particular topic, though I'm no stranger to medical research in general.

• Dr. Brind's "C.V." in the article rather poisons the well since it's basically a list of conflicts of interest. What medical or scientific background does he have? I can't even tell if he is a PhD or an MD from the description. I don't doubt that his positions on this topic are dubious (to put it generously), but is he a "single purpose account" (as it were) or does he also produce reasonable research? The article as stated reads "this guy is obviously biased and he's a total nutcase". He probably is, but the article is so heavy-handed about it that the conclusion I draw is that the person writing the article thinks he's totally off his rocker and I can't make my own judgment.

• Who are Drs. Weed and Kramer? Are they respectable scientists or do they also have conflicts of interest? I'd almost suggest not mentioning them by name if they are only representing "mainstream thought" and their own positions on the subject are otherwise unremarkable. An avalanche of names may confuse a reader.

Just some thoughts. As a side point, there are a couple of statements that could use cites, such as the "thousands and thousands" claim. Somedumbyankee (talk) 04:02, 27 June 2008 (UTC)

Indeed, the section on Dr. Brind was written by an editor who was hostile to Brind and his position. I tweaked the section, but clearly not enough. I will redo the section shortly, moving things to his sub-article and bringing pertinent details (endocronologist) in Proponents.

Drs. Weed and Kramer were named as it is an editorial. It could be fair to say it is the mainstream view, however it remains an editorial. If further independent notable sources could be found that reiterate those points, I'd be more than comfortable to remove the names. - RoyBoy 22:07, 28 June 2008 (UTC)

I have updated the proponents section, trimming as much as possible and placing it in Joel Brind, and I removed "Drs. Weed and Kramer" for the sake of brevity. Of note, I repeated the RCOG assessment from the Brind section below. Feedback would be appreciated, thanks. - RoyBoy 15:01, 29 June 2008 (UTC)

GA Review

This review is transcluded from Talk:Abortion-breast cancer hypothesis/GA1. The edit link for this section can be used to add comments to the review.

The article is, for the most part, very well-written and thorough researched.

N Prose. Mostly good, I made a few minor copyediting changes, but it reads very well. A few sentences need to be fixed, mainly because I cannot understand exactly what's attempted to be said here in order to fix them myself:

• This sentence is incomplete and needs to be finished: "The results indicated a increased 1.9 (1.2 - 3.0) RR for induced abortion and 1.5 (0.7 - 3.7)"

• This sentence doesn't make much sense as written: "The study was funded by Family Health International, a pro-choice NGO and although the study started with 49,000 "after 11 years she had fewer than 5,000" who stayed in the study."

• "The first section of Table 1 in the Melbye study:" -- needs a source.

• "The following are induced abortion results from Table 4 of the Michels study, with parity distinguished between nulliparous (no children) and parous (had children):" -- needs a source.

Y Factually accurate. Most everything that is required to be cited, or that could be challenged, is cited. The sources appear to meet WP:RS guidelines.

Y Broad in coverage. This article is very thorough, and covers both the pro & con aspects of the issue very well. At 81 Kb, the article is getting a bit long. Going forward, perhaps some of the descriptions on studies could be moved to linked articles, and descriptions here could be paraphrased? But I don't think this would hold the article from GA at this time.

N WP:NPOV. Quite surprisingly, I do not see any major NPOV issues with the article. Like I said, it covers the pro & con aspects quite well.

I still think that the pro & con is covered pretty well (good enough for GA, but another user has raised some other NPOV concerns, so see below. Dr. Cash (talk) 02:03, 28 June 2008 (UTC)

Y Stability. The vast majority of edits in the edit history are by a single user, RoyBoy (talk · contribs). So no, there are no major stability issues.

Y Images. Article's a little light on images, and could use an eye-catching image for the top-right corner (though this is not a requirement for GA). The images that are present are appropriate tagged with image copyright tags and fair use rationales.

So, the article mostly meets the GA criteria, and can be listed once the issues with the aforementioned sentences are cleared up. I will put it on hold until that is done.

Cheers! Dr. Cash (talk) 22:41, 27 June 2008 (UTC)

I don't really agree with the NPOV assessment (specifically the Proponents section, as I've already commented). Some concerns:

• The proponents section. Some ideas on what to add:

1. any conflicts of interest on the part of prominent opponents should also be listed.

2. The qualifications, related research, etc... of the proponents are notable (why would anyone believe them?).

3. Some characterization of what support (if any) the proponents have from other notable scientists or other nominally neutral parties would be nice.

Hopefully my tweaks have addressed these concerns. - RoyBoy 17:04, 29 June 2008 (UTC)

Made one other edit to discussion of Dr. Brind's background, just language concerns, not so much content. Somedumbyankee (talk) 19:34, 29 June 2008 (UTC)

Good call again, very RS with pertinent info. - RoyBoy 01:07, 4 July 2008 (UTC)

• The Howe study could use a bit more discussion about why the possible RR values are so broad (0.7-3.7 particularly) and why it was thought to be inconclusive.

The "With more data the confidence interval becomes smaller" in Abortion-breast_cancer_hypothesis#Epidemiological_studies addresses this issue. Does it need to be reiterated so quickly? The specific patient pair numbers for this is 65/35 case/control for induced and 17/11 case/control for spontaneous. - RoyBoy 17:04, 29 June 2008 (UTC)

Hmm. I'd just put a few words on it like "this is an example of the problem of small study size blah blah" No Great American Novel, clearly. Somedumbyankee (talk) 19:34, 29 June 2008 (UTC)

My goodness, found a significant mistake on my part. I have 1451 case patients for Howe, but in actuality they are 100 case patients WITH abortions and 63 controls. Damnit! All this time misrepresented the statistical significance of the Howe study. Fixed, and explained CI in relation to dataset. - RoyBoy 01:55, 4 July 2008 (UTC)

• "Highly regarded study" (Melbye) is kind of weaselish, especially since rejecting that study is the cornerstone of Dr. Brind's arguments.

Not a precise characterization. Brind does consider the analysis flawed, but that does not change the quality of their dataset which is widely acknowledged (Brind included) as being one of the most complete in the world. Moreover, as referenced by the now fixed PP link, it was received by notable publications and organizations as authoritative. Even if we take Brind's criticism as valid, that doesn't change the broad and positive coverage the Melbye study received. Should one, two or several news references be added? - RoyBoy 17:04, 29 June 2008 (UTC)

One is plenty. Somedumbyankee (talk) 19:34, 29 June 2008 (UTC)

Added detailed NYTimes article. - RoyBoy 01:37, 4 July 2008 (UTC)

• For clarity, the two Lindefors-Harris studies should be identified by something other than date since they're about two different things (actual study 1989 vs. analysis of response rates 1991), unless they are the same study and I'm very confused (probably also a problem).

Good call, transitioned to Lindefors-Harris "response bias study". - RoyBoy 17:04, 29 June 2008 (UTC)

• One of the cites used is Planned Parenthood (currently #45, used 3 times). I would avoid using this organization whenever possible when talking about the science since they have a clear position in the overarching abortion debate and listing then with neutral sources may distract readers from the presentation.

Seems like an excellent precaution. Replaced one with "WEED", and removed the other as it reiterates Sanderson's position. Leaving the Melbye ref since Planned Parenthood is named and it seems important to clarify what science pro-choice organizations focus on. - RoyBoy 17:04, 29 June 2008 (UTC)

The article has some language which sounds like it wants to disprove the link, (for example one that I changed). It's minor, but it has a certain sense of "gotcha!" which I don't care for. Somedumbyankee (talk) 23:44, 27 June 2008 (UTC)

LOL, indeed. There has been some contentious editing in months past, not all of which I have been able to spot and remove. - RoyBoy 17:04, 29 June 2008 (UTC)

These issues seem valid as well, and should be addressed prior to GA. The planned parenthood reference definitely needs fixing; when I click on it I get a 404 not found error, so I cannot even verify the content. Dr. Cash (talk) 02:02, 28 June 2008 (UTC)

Excellent and invaluable analysis, both of you. I'll be working on it this weekend. The PP link is curious as I fixed that recently from a previous move. Will look into it. - RoyBoy 22:10, 28 June 2008 (UTC)

• This sentence is incomplete and needs to be finished: "The results indicated a increased 1.9 (1.2 - 3.0) RR for induced abortion and 1.5 (0.7 - 3.7)"

Fixed. - RoyBoy 16:14, 29 June 2008 (UTC)

• This sentence doesn't make much sense as written: "The study was funded by Family Health International, a pro-choice NGO and although the study started with 49,000 "after 11 years she had fewer than 5,000" who stayed in the study."

Tweaked. - RoyBoy 16:14, 29 June 2008 (UTC)

• "The first section of Table 1 in the Melbye study:" -- needs a source.

Added. I sourced it originally, but removed it as redundant. - RoyBoy 16:14, 29 June 2008 (UTC)

• "The following are induced abortion results from Table 4 of the Michels study, with parity distinguished between nulliparous (no children) and parous (had children):" -- needs a source.

Added. - RoyBoy 16:14, 29 June 2008 (UTC)

---

Are there any outstanding issues? - RoyBoy 02:45, 4 July 2008 (UTC)

There are some language things that I think could be better, like "posits" (correct, but unusual and distracting word choice). There are some extra commas here and there that I'm seeing and some awkward wordings (q.v. "In early pregnancy, levels of estrogen increase, leading to breast growth in preparation for lactation.") I'd definitely work on the copy editing before considering it for FA, but I know the "needs copy editing" thing is incredibly annoying because it sunk my last GA submission. I don't see it as a game-ender, and I'd defer to the primary reviewer as to whether that's enough of a problem to keep it on hold. SDY (talk) 03:44, 4 July 2008 (UTC)

I think that the issues raised by both of us are largely addressed, and that the article meets the Good Article criteria and can be listed. I still recommend a good copyedit; while I've made a few minor copyediting changes, there could still be some minor issues and the reviewers at FAC are very thorough -- they're going to go through this with a fine-toothed comb, so make sure all the commas are in the right place, and all other punctuation is in place. But overall, I think that the prose is very "good", and there are no major glaring issues that a non-English major is going to catch,... So I think the article is therefore a "good article". Cheers! Dr. Cash (talk) 16:27, 24 July 2008 (UTC)

Woot! Your collective feedback made this possible, thank you Derek, SDY, Mastcell and in small part OrangeMarlin as the controversial past tense tweak was necessary in retrospect. - RoyBoy 22:30, 24 July 2008 (UTC)

Only in the United States!

As far as I know, this hypothesis is only controversial in the United States. I have never heard of it in any other context (I am in Europe) and I do not think that anyone outside the US seriously supports this hypothesis.

If I am correct, this should be mentioned prominently in the introduction. I would write "it is a controversial subject in the United States" and also in the third paragraph "pro-life activists in the United States". (In fact, I believe that the whole term pro-life is only used inside the United States.) However, I first wanted to hear what other people thought, since I can imagine there are many discussions about the contents of this article. --KarlFrei (talk) 11:50, 17 July 2008 (UTC)

That would be fine with me, and, I think, a useful clarification. MastCell ^Talk 22:29, 17 July 2008 (UTC)

The only warning I'd throw in that is that two of the major studies on the topic are both European, which is odd if it's solely a domestic US concern. SDY (talk) 23:17, 17 July 2008 (UTC)

I think perhaps the issue's persistence in the face of those two major, negative studies is an American phenomenon. MastCell ^Talk 23:35, 17 July 2008 (UTC)

Persistence in the U.S. sounds okay, negative outcomes doesn't. The RCOG source partially relies on the NCI strength assessment of their selected studies, which you have inaccurately re-contextualized to lend further credence to the majority interpretation/conclusion. I believe that has inappropriately shifted the weight of the references, and I do not think rejects the hypothesis. They do stipulate "argue against" a causal relationship. I am reverting/tweaking some of your changes; as outright rejection remains clearly premature given the WHO assessment, and the very insistence on it is all the evidence required to acknowledge this as a controversial subject.

As to its lack of prominence in Europe, that could simply be a function of acceptance of abortion; and not necessarily reflective of the ABC issue itself. But that's speculation on my part. I would hasten to add ABC does not need to be a hot topic in Switzerland for it to be a controversial subject. - RoyBoy 00:32, 18 July 2008 (UTC)

I am particularly taken aback with your impromptu Views of medical organizations. Is there room to add pro-life organizations, or are those not "major" enough for the list. What has me "aback" is you essentially created your own version of the Conclusion section with a preamble that was unacceptable; and then proceeded to take the quotes that were most consistent with the preamble, rather than most relevant. I find the list relevant, yet redundant and bloat, with its purpose to persuade rather than inform the reader prior to reading the rest of the article.

But I'll defer to other opinions on the matter. - RoyBoy 00:54, 18 July 2008 (UTC)

Added back "it is a controversial subject". When you have things like this cropping up:

The cohort analysis of the 2000 IowaWomen’s Health Study by Lazovich et al. represents a sizable cohort (more than 37,000 women) with ample follow-up time (subjects were 65-74 years of age at time of data analysis). Nevertheless, it is statistically a very small study, as the women in the study were at least 55 years of age at baseline in 1986, and almost all of the 653 reported abortions took place before their legalization in 1973. Consequently, the statistical confidence intervals (95% CI) are very wide, with the overallRR= 1.1, (95% CI: 0.8-1.6).

Interestingly, higher RRs are reported for subgroups previously reported to be at higher risk, specifically women with abortions under age 20 (RR = 1.5) or at age 30 or more (RR = 1.7), and women who remained nulliparous (RR = 1.7). Since the small numbers precluded statistical significance for any of the findings, Lazovich et al. claimed to have “observed no excess risk among women who reported having an induced abortion,” and further emphasized that their “data do not provide support for” a causal link between abortion and breast cancer. However, it is also clear that their data are in no way inconsistent with such a link.

Pretending this is straightforward and settled because some segments of the world simply aren't concerned is a difficult position to maintain. Their lack of concern is a null factor in WEIGHT as they have no opinion one way or the other. It can be mentioned in the article with reliable sources of course to give a worldwide view. But what is there to mention exactly? Apathy?

BTW, Lazovich (2000) is used by RCOG for their expedient assessment. - RoyBoy 01:11, 18 July 2008 (UTC)

The reader needs to be informed that every major medical and scientific organization that has examined the evidence has concluded that there is no link. If that is not directly apparent to the reader, then the article is not accurate and not neutral. The article as currently written goes to great lengths to obscure that basic, vitally important fact in a blizzard of confidence intervals from various primary studies and unsupported insinuations of bias on the part of the NCI.

If there are medical organizations with the credibility, impartiality, and reputation for rigor as the NCI, WHO, ACS, RCOG, etc, then please propose them for inclusion. I will consider them "major".

I chose the quotes because they directly and unequivocally answer the question: "Does induced abortion increase the risk of breast cancer?" If you'd like to substitute others, then do so, but don't bury clear, unarguable conclusions in secondary detail. That's what the rest of the article does, and on re-reading it I was struck by how opaque the article is, when the actual reliable sources are remarkably clear, direct, and unambiguous. MastCell ^Talk 03:58, 18 July 2008 (UTC)

The current "Views of Major Medical Organizations" sounds like an appeal to authority. Calmly stating that no link has been found after an exhaustive search is much more neutral, and far more convincing. Yes, the summary should be included, but the reader doesn't have to be bludgeoned with it six times when all of the views are exactly the same and the synthesis of the conclusions is just above it in the lead.

Frankly, it makes the article look desperate to prove a point and weakens the rejection of the ABC link because it compromises neutrality.

Portraying the majority point of view with proper weight does not mean the article should be turned into a quote farm, however notable the sources. SDY (talk) 09:01, 18 July 2008 (UTC)

I take your point about the quote-farm aspect. I also agree the tone could be changed or improved. I'm not as keen on the appeal-to-authority bit; while it's a fallacy in logic and can be taken to an extreme, WP:WEIGHT is essentially a codification of appeal to authority: it mandates that we rely on recognized experts in a field to weigh and synthesize data for us. Anyhow, I think we agree: I would also like the article to calmly and clearly state that no link has been found after an exhaustive search. I feel the article has in the past not done so, and perhaps overreacted in the "desperate-sounding" direction. MastCell ^Talk 22:06, 18 July 2008 (UTC)

BTW, this looks fine to me. Maybe it could even be combined with another section rather than having a small standalone section. MastCell ^Talk 22:54, 18 July 2008 (UTC)

Australian case?

An Australian case

I can't find any reference to it outside of aggressively pro-life sites. It was settled out of court, so it's not particularly binding. The concept of a legal requirement to inform is probably solely US, so the language as it stands is fine.

I'm not sure if this should go in the article, since there isn't a whole lot of information out there about it. As the link above points out, privacy laws prevent distribution of some details. SDY (talk) 21:22, 19 July 2008 (UTC)

As apparently the first case involving informed consent it might be included at some point. I find the "paternalistic" meme interesting and have found it mentioned elsewhere by more neutral sources. I'll be putting that in the article once I can confirm it in a journal editorial. MastCell, if I remember correctly, do you have access to online journals? - RoyBoy 00:19, 20 August 2008 (UTC)

My reversion

I've made this reversion to several edits by RoyBoy (talk · contribs). My concerns with those edits are:

1. "Controversial" is POV. There is no controversy in the medical and scientific community, it is a political controversy, if at all. The statement is about scientific consensus.
2. "from selected evidence" implies that the editor is trying to force a POV. All evidence is that there is no link.
3. "many of these focus their attention on recent larger studies that have insignificant positive results and alleged flaws." This implies there's smaller studies that support the hypothesis. Non have verifiability or reliable sourcing, key hallmarks of NPOV.

We cannot have an article that pushes a minority POV that has no standing in the medical or scientific field. OrangeMarlin ^{Talk• Contributions} 02:18, 18 July 2008 (UTC)

That's wrong, plain and simple.

1. Controversial is not POV. Dr. Daling is not "political". To proclaim this as DONE scientifically, because of the current consensus against "causation", isn't accurate nor is it inclusive/sympathetic to the minority; more importantly it does not acknowledge the scientific evidence to the contrary.
2. "All evidence is that there is no link." Really? That happens to be wrong, there is even positive results in studies lauded for their accuracy, so I am reverting you.
3. Yes, it does imply smaller studies; some of which are quite verifiable and reliable. If you wish to contend they are not reliable, that's your POV that you'd need to justify.

"No standing in the medical or scientific field" is your POV, and it's ill-informed. - RoyBoy 01:53, 20 July 2008 (UTC)

I do agree in one respect, controversial by itself implies any/all kinds of controversy. As that is (as of now) not the case scientifically, I have made it the past tense. - RoyBoy 02:01, 20 July 2008 (UTC)

If you guys keep inserting "rejected" I'm going to be very disappointed. Not finding evidence of sufficient strength for a causative conclusion, has absolutely no baring on the validity of the hypothesis. Nobody, I repeat no one at all, has come out to say the mechanism is wrong. The closest I've seen is Michaels et al. theorizing hCG mitigates hormonal effects in early pregnancy. This is the only thing that speaks to the hypothesis possibly being incorrect or in this case incomplete. - RoyBoy 02:06, 20 July 2008 (UTC)

"This implies there's smaller studies that support the hypothesis." There is one, the Howe study (which had data quality problems as well). "From selected evidence" deals with the problem of meta-analysis: the raw data has problems because asking people questions about sensitive subjects doesn't always lead to honest answers.

A lot of the results of the larger studies come from meta-analysis and look into problems like response bias, which is not a trivial issue. Comprehensive (i.e. Beral) analysis and newer studies (one on PubMed as recent as 2007) do seem to put a couple more nails in the coffin, which agrees pretty strongly with the second sentence of the article-as-it-was: "and the current scientific consensus has concluded that there is no significant link between first-trimester abortion and breast cancer risk." I don't know that "concluded that there is not" and "rejected" really mean different things in the end, but...

The article does not push a minority POV. It goes into great detail on doing science in the real world, where there are no absolute answers, just rigorous peer-reviewed analysis of available data that agree on a conclusion.

Science does not deal in absolutes. SDY (talk) 03:17, 18 July 2008 (UTC)

I think that to the extent this article fails, it is not because it's blatantly biased. It does make clear that there's a scientific consensus. The problem is that it then goes on to a lengthy, largely impenetrable thicket of primary data that makes this issue appear more "controversial" than it actually is. The article uses reliable sources, but fails WP:NPOV in its selection and presentation of those sources in a manner which obscures the clarity and unanimity of medical opinion on this topic.

For this to be a good, informative, useful, neutral article, it needs to be readily apparent to the reader exactly what various expert bodies have concluded. Fortunately, we have a plethora of excellent sources from scientific bodies of the highest order, including the WHO, NCI, and RCOG. The reader should know who has looked at the evidence and what they concluded, upfront. Then if they want to spend 30 minutes going through the hazard ratios and confidence intervals and sifting through the insinuations of bias, they can - it's all there. But the article fails the reader through its opaqueness, and I noticed this again when I came back to re-read it just now. Hence the edits. MastCell ^Talk 04:03, 18 July 2008 (UTC)

I should add that I'm not married to the wording in my edits. These were just the first things I came up with to address the concerns I'm listing here, but there's certainly a lot of room for improvement. I think the underlying issue - the need to clearly inform the reader - is more important than the specifics. MastCell ^Talk 04:07, 18 July 2008 (UTC)

The way I read (and read, hate that past and present are written the same) the opening, that was what it said: the consensus is that there is no ABC link. How else would you interpret that? That's the technical way to say exactly the same thing as "the hypothesis was rejected."

The article does have accessibility issues, but the argument that was initially presented is "this article pushes a fringe POV." It doesn't. It's just written at a very technical level. Could it benefit from plainer language? Certainly. Choosing more direct quotes where appropriate is definitely a good way to do that. I mostly just object to people coming in with comments like "implies that the editor is trying to force a POV" when it's really just that the article is not written for a general audience. SDY (talk) 04:24, 18 July 2008 (UTC)

You might have misinterpreted my statement. The article now does not push a fringe POV. However, if the edits that were done were allowed to stand, there might have been a change of POV. Sorry that I wasn't so clear. OrangeMarlin ^{Talk• Contributions} 06:08, 18 July 2008 (UTC)

I apologize for the personal tone and imputation of motive in my earlier posts. I think SDY is correct in characterizing the problem as an overly detailed description of individual trees without a satisfactory description of the forest. I don't know that my edit was the best way to address this, so I'm interested to hear other suggestions, assuming other folks agree that this is an area where the article could be improved. MastCell ^Talk 08:58, 18 July 2008 (UTC)

Question about the lead

"The abortion-breast cancer (ABC) hypothesis (supporters call it the abortion-breast cancer link) posits that induced abortion increases the risk of developing breast cancer;[1] Current scientific consensus has rejected the hypothesis and concluded that there is no significant link between first-trimester abortion and breast cancer risk."

This talks about first-trimester abortion, but I don't see anything else in the article that does. Is there a distinction here, or can we just strike first trimester? SDY (talk) 09:17, 18 July 2008 (UTC)

Since 90+% (95+%?) of abortions are first-trimester, the great bulk of published data deals with first-trimester abortions. A couple of secondary sources (e.g. the WHO, I think) are very careful to say that the evidence shows no link between first-trimester abortion and breast cancer, since the number of late abortions in the cohorts is too small to draw standalone conclusions. Other sources simply take the cohorts as a whole, as representative of people who actually have abortions, and conclude there is no increased risk, period. A fine point and one I'm not sure we need to delve into in the lead, but that's probably the basis for the distinction - is that correct, Roy? MastCell ^Talk 09:39, 18 July 2008 (UTC)

The "Opinions of major medical" section can probably take that into account. I agree that it isn't particularly significant, but it should be explained. Looking at that section in general and some of the conversations raised, that section could really be used to provide a history of the hypothesis. Reading through the article, it sounds as if the "book was closed" on the topic as early as 1999, which doesn't quite line up with the later (ongoing?) studies.

Whether meaningful research is ongoing on the topic is something the article could be clearer about (obviously the proponents know there is a link, and will keep looking until they find the truth, but for the rest of the world...). I thought I saw a 2007 Nurses' Health Study II-related study on PubMed while looking at some of the refs. SDY (talk) 17:02, 18 July 2008 (UTC)

PMID 17452545. I think their angle was that previous registry-based studies lacked info on some breast-cancer risk factors (age at menarche, obesity, etc). As well, their study didn't assess abortion once at baseline, but was updated to account for women who had abortions over the course of follow-up. Potentially, there were a couple of loopholes that their data closed. MastCell ^Talk 22:18, 18 July 2008 (UTC)

"first trimester" may seem like an unnecessary distinction, but it is absolutely crucial to make prominently. I have spent a lot of time on this article, and I dislike coming back here every 3-4 months with science enthusiast(s) telling me there is "no evidence of an ABC link".

From the very beginning I took care to show everything notable from scientific studies. The 3% increase every week in the Melbye cohort study is notable, but it only becomes significant at 11 weeks+ (assuming 30% increase is your line in the sand, take the diff between 0.81 and 1.12 = 31% increase). It becomes statistically significant 18 weeks+.

There are multiple ways to communicate that information. I've found WHO did it best. Stipulate first trimester abortions and people needn't worry unnecessarily, while you accurately communicate positive results and/or warn the minority who had late term abortion(s) of a possible impact to their health. It is a NPOV win-win, having it removed isn't good, especially now that we have "uniform" opinions being said with WHO unfortunately included (as they are the only ones NPOV enough to make that distinction). While I can agree to "uniform", you all some of you have it wrong as to what is being actually being communicated by the science community. "No causative link" does not equate to "there is no evidence of a link" *self censored expletives*. Whoever among you is incapable of being careful, please stop editing articles beyond your expertise. I am consciously getting thin skinned; hopefully stable articles can mitigate this ongoing issue.

SDY, the Abortion-breast_cancer_hypothesis#Melbye study does discuss the first-trimester distinction. - RoyBoy 02:29, 20 July 2008 (UTC)

MastCell, indeed since most abortion are covered by the first-trimester it is strong reason not to be overly concerned with the ABC hypothesis. This is partly why WHO pointed it out, as to why other sources did not make the distinction... well taking the cohorts as a whole is something a layman/journalist would do, however for a scientific organization to do that is disappointing and probably problematic. They know better than to entirely ignore contrary evidence, but that's likely a matter of political expediency, not scientific rigor. So I can understand when people come here with a "no ABC evidence" perspective, doesn't make me feel much better though. *kicks a stuffed animal* - RoyBoy 02:41, 20 July 2008 (UTC)

Hmm. That's an important distinction on "what we're sure about and what's still unresolved" and it should probably be discussed in the section on the opinions of medical groups.

What they don't say is in some ways at least as important as what they do say, though much harder to cite. I condensed the opinions down to uniform because they were rather repetitive, but if there's a difference then what they are not unanimous about that should be brought out. The Melbye study is suggestive of a late-term risk: is there any more recent research on this topic that explicitly addresses it, or at this point is it just one of those "no answers, apply precautionary principle" situations?

It appears that "No causative link" is WP:JARGON and should be excised or explained. There is a real demand to have this article, or at least the lead and the non-analytic sections, be intelligible to a nonspecialist. I think the "major medical" section is a good place to address this. SDY (talk) 02:54, 20 July 2008 (UTC)

Indeed the unsaid is of great interest and frustration, though the 3% increment is in the Melbye abstract, so it might bare repeating in the article. There is no recent research I'm aware of, and I'm doubtful there is even a better dataset on late-term abortions available. The precautionary principle seems to apply; in agreement with Melbye's interpretation. - RoyBoy 03:45, 20 July 2008 (UTC)

I forgot to mention, good call on selecting the American Cancer Society to quote from. Their specifying "present time" and "causal association" is one of the better assessments. - RoyBoy 14:51, 20 July 2008 (UTC)

Elaborating on "what is left unsaid" by reliable expert bodies is a reasonably good definiton of original research, and it's not a productive direction to take a Wikipedia article, in my opinion. Agreed that we can do a better job of summarizing what they do say, but it seems reasonable to focus on the 99% overlap in what the sources say, rather than the 1% largely inconsequential difference in how they say it. MastCell ^Talk 04:05, 21 July 2008 (UTC)

It might be worth poking around to find a reference that explains their thought process. The NCI meeting may very well have transcripts that have been made public.

That they didn't specify and just said "no link in any case" may very well have been a conscious choice. If the WHO makes a distinction, are they the only medical group that does? Having the WHO be a fringe opinion would be a shocker, but hey, it could happen. SDY (talk) 04:55, 21 July 2008 (UTC)

Heh, yes it certainly would given they most accurately summarize Melbye. It's the middle of the night here so I'm not conscious enough to do research, but if I remember correctly Brind's account addresses the issue of what was and was not on the public record. Yes, searching for public brings up some points.

To clarify SDY in case you are unaware, the NCI workshop did not mention Melbye's late-abortion findings because Melbye brought in new unpublished data/analysis during the workshop which made it go away. Unconventional delivery and one of Brind's criticisms. - RoyBoy 07:34, 22 July 2008 (UTC)

Perhaps ending the workshop early, prior to the public forum should be added to the article? What the heck am I still typing for, bedtime. - RoyBoy 07:37, 22 July 2008 (UTC)

Should pro-life medical associations be mentioned in the Views section? It would be about 2-3 sentences mentioning their position, why they hold it (preponderance of interview-based studies) and why the scientific consensus is otherwise (response bias concerns). I am beginning to think again the Views section should be incorporated into the lead; which already mentions the ACS position. - RoyBoy 07:47, 22 July 2008 (UTC)

I'm fine with describing the views of major pro-life medical organizations as you suggest, so long as they are properly characterized as pro-life medical organizations. MastCell ^Talk 18:34, 22 July 2008 (UTC)

Tweak on "NCI tweak" shown far above

There are serious problems with the above. They boil down to, essentially, whether NCI itself is bias. While, of course, I can't prove this, but in 2006 I talked on the phone with Dr. Brind about how NCI considers the matter of an ABC link. Essentially, the reply from this man who was on the NCI committee now mentioned was: 1) An NCI committee meets, and a possible link is discussed. 2) The committee votes. 3) Anyone who votes that there is an ABC link is A) permanently removed from the committee, thus readjusting the percentage of link-believers for following meetings, B) the link supporters and their employers, if they get funding from NCI, have their funding removed, and thus C) the link supporters are fired and likely are unable to even continue their careers.

In other words, the NCI's findings are political, not scientific or medical. This leads to the great possibility of NCI planning the workshop of the 100 experts such that the only conclusion the experts could make is that there is no ABC link. These are some of the possible ways: 1) Noting that this is a workshop, the NCI would have chosen which material was to be reviewed. There is nothing wrong with that, but if the above paragraph is even half true, the material selected would exclude material showing a link. 2) NCI would, of course, determine which "experts" would be invited. Perhaps just to claim non-bias, they invited Dr. Brind, but can Wiki show that the other 99 weren't chosen because of a known pre-disposed bias that there is no link? —Preceding unsigned comment added by 69.42.7.158 (talk) 02:12, 18 August 2008 (UTC)

Well not precisely, that could be true to some extent, but Dr. Daling was also at the workshop; and her findings on ABC are in disagreement with the NCI workshop. To analyze the politics of the NCI workshop isn't helpful, as the only person in attendance putting forward an alternative story is Brind. That goes only so far given his ABC advocacy. The best that can be done is note what others have noted of a factual nature.

Even if we were to find a source on bias in the workshop selection of experts/evidence, it would likely be the guesswork/heresay of a pro-life editorial. That also has limited verifiability and wouldn't be appropriate for inclusion in the article; demonstrating bias of individual scientists is even more problematic. - RoyBoy 03:23, 18 August 2008 (UTC)

I am genuinely curious: who do you think was responsible for convening the NCI panel and choosing its participants? Is this a decision that might be made and/or ratified by the Director of the NCI? MastCell ^Talk 07:05, 18 August 2008 (UTC)

I cannot remember specifics, I need to find the Brind article that alleges the organizer(s) having excessive control over the workshop, and inviting a few scientists with known ABC positions. Haven't found it yet but did find the videos of the workshop. Watched the opening speech and it looks like the director called for it. - RoyBoy 01:56, 19 August 2008 (UTC)

OK. My understanding is that the workshop was convened at the direction of Andrew von Eschenbach, the NCI Director at the time and a perennial favorite appointee of the notoriously pro-choice and science-friendly Bush Administration. I believe that von Eschenbach also ratified the selection of experts, though I'm not entirely sure of this - hence the curiosity. Since the selection of experts is derided in the pro-life literature as "biased" or manipulative, I'm curious on what level, and by whom, the decision was actually made and approved. MastCell ^Talk 06:27, 19 August 2008 (UTC)

(undent) This link touches on the "pro-abortion" scientists invited, which is half of what I'm looking for. It also clarifies Brind's frustration with the workshop:

The workshop provided "no discussion, really, of the merits of any preceding data. I asked a couple of questions, but that was it. Nobody else was interested in discussing the merits or demerits of previous research. The answer I got when I asked, 'How can you do this (deny an association between abortion and breast cancer) despite all the data going the other way?' was, 'There's widespread agreement that (it) is true, that previous research is flawed.'

"So you ask a scientific question, you get a political answer. It's a very interesting state of play. The only thing that really surprised me was the sheer bluntness of this political assault. It was very clear they were going to do whatever it took to stamp out the abortion/breast cancer link once and for all from the public's mind. ... It was all just a very big fix."

Still looking for another version of Brind's NCI criticism... ahhh, here it is. "Workshop Chairperson Louise Brinton, a senior NCI epidemiologist, exercised major control over which scientists were to be invited." Now this is speculation on my part, but if someone could select group leaders at the workshop, one could extensively control the findings. - RoyBoy 23:53, 19 August 2008 (UTC)

But we know Brind was unhappy with the panel - he's never stopped talking about it. And sources which describe over 100 experts convened by the NCI as "pro-abortion doctors" aren't much use for an encyclopedia. OK, so Brind claims (key caveat) that Louise Brinton exercised "major control" over the makeup of the panel. Is this independently confirmable? And what about Louise Brinton - Brind implies that she has some sort of "pro-abortion" agenda and that she's a modern-day Margaret Sanger or something. She appears to be Chief of the Reproductive Epidemiology Branch. She's studied the effects of other surgical procedures on breast cancer risk (e.g. tubal ligation, breast augmentation). In other words, she's exactly the person one would expect to be in charge of such a panel. I'm not seeing where the "fix" comes in. MastCell ^Talk 00:00, 20 August 2008 (UTC)

The source isn't asserting 100 experts were pro-abortion. No Brinton's influence is not confirmable to my knowledge. I sought to satisfy your curiosity. No one is contending she is ill Qualified to lead the panel; however I'm sure you can see a potential for a fix. I assume by "not seeing" you mean it is not verifiable with a reliable source. Of course not, as specified earlier such issues are problematic, and by that I meant impossible, as people typically do not out their motivations to others... and sometimes not even themselves.

While her influence isn't and will not be confirmed in my estimation, that should not make you incapable of appreciating that selection bias of experts by someone familiar with the who's who of epidemiological personalities could setup a politically hostile workshop; especially if she represents an institution with significant purse strings.

Besides, if such alleged behavior were verifiable that would make the ABC article slightly but significantly different as we would have entered a new chapter in the ABC story / scientific consensus. We won't be holding our breath, but that doesn't mean Brind is wrong on this point. Ultimately I cannot discount anything Brind's says about the NCI workshop given more accurate and nuanced interpretations of the same studies by other organizations make the level 1 finding by the workshop seem at odds with reality; yes who's to blame is a curiosity suitable for editorials / tell-alls... but it isn't what matters. - RoyBoy 01:32, 20 August 2008 (UTC)

I do appreciate your answers to my questions - I learned something from your response, and wanted to take it a step further. About Brind: look, let's say you sat down with 100-some of your colleagues and hashed out a document that satisfied all but 1 person. Then that 1 person claimed that he didn't get his way because of censorship, manipulation, political intrigue, dirty tricks, and questionable ethics on the part of the other 99 participants. You'd take that as convenient self-justification, with a grain of salt, pending independent confirmation, right? A more plausible explanation might be that his arguments were simply unconvincing to the other panelists. I'm not asking for proof of the unprovable, just wondering where the grain of salt is. Even if there were some circumstantial evidence that Louise Brinton, or anyone, had some hidden "pro-abortion" agenda, that might be a start toward accepting the conspiracy theory, but I'm not seeing that. In fact, the only person whose agenda seems circumstantially quite clear is Brind. MastCell ^Talk 06:57, 20 August 2008 (UTC)

That's coo, brain testing is good. Why its not a grain of salt for me, and shouldn't be for others, I've explained several ways in the past... Just as with the nature vs. nuture debate and the long standing incorrect consensus nurture was dominant (meaning everyone is born equal), there was/is no conspiracy. In the face of weak/contradictory evidence scientists choose the option they prefer and/or which is most politically expedient. I'm convinced this is happening for the ABC issue based on lopsided criticism, coverage and selective responsiveness of scientific studies by scientists and media. So even if the ABC hypothesis proves to be much ado about nothing, there is something quite amiss regardless.

This round I'll start from your point, Brind's arguments were "simply unconvincing". That was indeed the case. Why? Response bias? But the studies used to support that aren't very good and do not even directly apply to the ABC studies criticized. Then they'll bring up the large record studies show no link. However they have flaws of their own and evidence of correlations. Indeed no link, but that isn't the point if one is actually concerned with being accurate, rather than using flawed rationale, bioethics and distinct lack of scientific rigor in finding Brind's points/concerns unconvincing. These experts are required to offer more than verbal assurances and a level 1 finding with zero referencing.

When that happens, why aren't you taking their conclusions with a grain of salt? - RoyBoy 04:47, 21 August 2008 (UTC)

It comes back to Carroll: "You have an obligation to find a scientist, and if the scientist has something to say, then you can subject the scientist’s views to rigorous examination." I've seen nothing in the workshop videos to indicate Brind was even given the benefit of a rigorous review. Are you missing the fact saying something apart from the consensus without solid evidence has consequences? Daling avoids the ABC subject for a reason; research for yourself. Phyesalis' reaction and abject disbelief on Daling's quote is telling, it along with other less verified quotes goes to the very core on the lack of honest scientific ABC dialogue. This lack of dialogue would have been repeated at the NCI workshop. I'm unsure how your emphasis of 99 other participants changes this, lol, I mean they aren't a dataset Mastcell;'D nor a Wikipedia article, more does not equate to better. In instances of group think, it can actually make things worse by reinforcing weak ideas.

On a related note, do you have access to this journal editorial? I asked for it far above, but its buried in an old thread so I guess you missed it. - RoyBoy 04:32, 21 August 2008 (UTC)

It appears to be freely available: try this link [12]. If that doesn't work, maybe I'm just getting it free through institutional access. If that's the case, send me an email. MastCell ^Talk 22:53, 21 August 2008 (UTC)

LMAO! Yeah the big free button went unnoticed by me. Thanks. - RoyBoy 23:44, 21 August 2008 (UTC)

I am the one who wrote the first two paragraphs in this section. I offer the readers to see what www.conservapedia.org has to say about this topic. I won't try to tell you to believe them, but I will tell you not to automatically disbelieve them. The topic is on their abortion page.

In the meantime, since I know Dr. Brind I will see if he has time to look at this page and make comments. Note, though, that he is very busy. —Preceding unsigned comment added by 69.42.7.158 (talk) 17:50, 28 August 2008 (UTC)

Suffice to say that Conservapedia's content policies differ dramatically from Wikipedia's, and if the two articles are similar then that is cause for concern. MastCell ^Talk 18:52, 28 August 2008 (UTC)

LOL! Well said. I have been to Conservapedia's article; it was okay relatively speaking... certainly better than their Evolution article. When I pointed out they were ignoring large studies that concluded no link, I was told they were flawed and pro-abortion, and somehow these editorial assessments by editors with no references at hand for verification, believed they could ignore studies they didn't like entirely. Incredibly frustrating... among other things. - RoyBoy 03:22, 29 August 2008 (UTC)

Wait a sec here, "scientifically-rejected point of view" in Conservapedia... ABC hypothesis. Really, scientifically rejected eh? No quite. - RoyBoy 03:36, 29 August 2008 (UTC)

Undue weight

I've reverted this edit. I believe it gives undue weight to the allegations of Joel Brind, a partisan figure in the debate, vs. those of the 100+ expert panel of the National Cancer Institute. The suggestion that the NCI used only "selected evidence" - sourced to Brind's conspiracy allegations - gives way too much prominence to this individual and inappropriately attempts to undermine the conclusions of the NCI expert panel. The footnote is even worse - it includes an editorial rebuttal to the NCI's conclusions (!) in clear violation of WP:SYN. MastCell ^Talk 04:54, 1 September 2008 (UTC)

Discussion that gets off point.
The following discussion has been closed. Please do not modify it.
I agree with your concerns, however I included the text merely to show the ref text pertinent to "selected evidence", I did not intend it as a rebuttal. The removal of "selected evidence" was appropriate this time given the current reference does not stipulate it. I do not understand the relevance of conspiracy allegations in relation to what the ref was being used for. When it comes down to it the NCI workshop could not possibly review all the evidence; to remove "selected evidence" from the lead gives the impression their conclusion was based on broad overview. I've seen no reliable reference indicating the evidence that was actually considered at the workshop. It is reasonable to conclude -- like a meta-analysis -- the workshop had a inclusion/exclusion criteria for evidence. Brind is the only source I've come across thusfar that speaks of the evidence considered. I can likely find a better Brind article on the subject, but would that too be rejected? - RoyBoy 23:52, 1 September 2008 (UTC) Their conclusions were based on a "broad overview". They were also based on "selected evidence", to the extent that they assigned quality ratings to the evidence and down-weighted studies they considered of poorer quality. The phrase "selected evidence" is prejudicial, and doubly so when the footnote points to Brind's conspiracy allegations. Brind is obviously a partisan source when it comes to this subject - if the New York Times or Nature described the panel's methodology, that would of course be acceptable to me, but relying on Brind to describe it is not far removed from relying on the American Life League. Allegations from Brind have a place in the article (and they are given more than enough airtime), but they need to be properly contextualized and not presented as if he's simply an uninvolved, neutral third party. That would produce an incorrect impression. MastCell Talk 03:56, 2 September 2008 (UTC) I concur, incorrect impressions is indeed what is pertinent, such as the NCI workshop being a scientifically verified broad overview, with weighting corroborated to actual scientific evidence? Rather than assertions by scientists? I want to see it! Not hope for the best based on a short NCI summary! I (we I hope) would like to know if the workshop was cut short, leaving out the "general session", and why that occurred. Along with other straightforward questions of fact Brind brings up, that have nothing to do with personal allegations. - RoyBoy 00:44, 3 September 2008 (UTC) I doubt that repeating this is going to convince you, but I feel quite strongly about it. The fact that you don't think the NCI panel was "scientific" enough is absolutely irrelevant. The fact that Joel Brind disagreed with their conclusions is marginally relevant, per WP:WEIGHT. We reflect what reliable sources say, and we reflect views in proportion to their representation among experts in the field. This isn't the venue to argue our personal beliefs about various panels or studies. MastCell Talk 05:38, 3 September 2008 (UTC) While I agree to your objections of the reference I do have, that doesn't permit you to assert a popular view of the workshop as fact to support a contrary position. I've slapped down enough pro-choice misconceptions to choke a gaggle of eager reporters. Yes: "I convened the Workshop to provide a comprehensive and integrated scientific assessment of the important association between reproductive events and the devastating problem of breast cancer," said the Director of the National Cancer Institute, Andrew von Eschenbach, M.D. But did that happen? Scientists allegedly saying to Brind, well we mostly agree early positive results are unreliable. That isn't comprehensive, it's dismissive. We require specifics that say otherwise to ignore that. Looking to Jasen's refs on the NCI workshop, I came across this excellent article on the subject. What makes it excellent is that it clarifies Dr. Susan Love's opinion on how she personally weighs the evidence, that somehow a large dataset by Melbye with a manually adjusted overall conclusion is all that is really required to decide the ABC issue. Never mind the creeping positive results mentioned in its abstract, many misclassified women prior to legalization who used abortion very differently than it is used today, and the short time span of legalized abortion. Oh "everybody in the field felt this question had been answered." Really? Is that a fact, or simply the people she knows personally? Does this help validate your position? Personal beliefs??? Hey! At least I'm slapping together something from someone who was there, I'd like to see more on your plate. I don't know of another assessment clarifying what evidence the NCI workshop considered, how they weighted it, and why. You currently have no ref to compliment your POV of a broad, comprehensive review of the ABC evidence and their assessment(s) of it. I fail to understand how the NCI assessment would be any different than the history of rationales / criticisms already detailed in the Wiki article. If it resembles the "response bias" / record based studies mantra, well then that's a problem. Isn't it? That would mean their assessment is based on assertions of interview study weakness and record study strength / no association whatsoever. Can you clarify otherwise? - RoyBoy 00:36, 4 September 2008 (UTC)

No, I'm really not playing another round of the game where we debate our personal opinions of the various studies and groups. You are not a published authority or expert on the matter, and neither am I. I'm talking about the National Cancer Institue, the American Cancer Society, the World Health Organization, and the American College of Obstetricians and Gynecologists, among other internationally prominent expert bodies. They've all reached virtually the same conclusion after reviewing the evidence. I'm just asking that we don't assert our own opinions, or those of individual pro-life advocates, in a manner which violates WP:SYN or WP:WEIGHT. MastCell ^Talk 05:20, 4 September 2008 (UTC)

(undent) Clearly, I believe I've allowed us off topic. The ACS, WHO, ACOG, not even the NCI speak to the evidence assessment of the NCI workshop. They are not pertinent to "selected evidence", unless you can find otherwise. Your assertion of Weight consequently has no merit, as to Syn... you'll have to clarify that for me. I would think Brind pointing to positive results shows the workshop was selective on the evidence they considered valid. Since Brind was actually there, I'd think his editorial is pertinent; though I'm not as confident about my usage. - RoyBoy 02:40, 5 September 2008 (UTC)

Do you have any other source apart from Brind that speaks to the evidence assessment (inclusion / exclusion) of the NCI workshop? I acknowledge your concern of undue weight of Brind, but he was at the NCI workshop, and his explanation fits the workshop's strong conclusion. Positive findings were excluded/minimized – for whatever reasons (avoiding sidetrack) – what's pertinent is that occurred, and it should be reflected in the lead. Not buried in the sub-section to provide an initial impression the NCI workshop was more comprehensive than it actually was. WHO is more inclusive with their evidence/assessment, "selected evidence" clarifies why the workshop assessment differs.

If I put the ref back, I can remove the quoted text, which I intended not to rebut, but just to point to the pertinent text of the ref. As to Synth, I would need clarification on that. Brind does not say selected evidence, but he does point to evidence the NCI workshop weighted differently. Instead of expanding on that with a long explanation of response bias/weight in the lead, I use "selected evidence" as a shorthand. How about another shorthand? "emphasis on record based studies", "emphasis on recent studies"? - RoyBoy 04:20, 3 October 2008 (UTC)

When you say that "positive conclusions were excluded/minimized", you're clearly implying that this was somehow nefarious or at least politically motivated. A more neutral (and accurate) phrase would be that studies reporting an association were found to have methodological flaws which limited their validity, and that the overall weight of evidence strongly indicates that there is no link. Again, Brind is one person. Over 100 experts agreed and signed off; one (who happens to have a dominating political agenda) did not. It is undue weight to pretend this is anything else, or to mention it in the lead. MastCell ^Talk 18:32, 3 October 2008 (UTC)

But you're saying "studies reporting an association were found to have methodological flaws which limited their validity." We need a source for that in the lead, then a source clarifying flaws were NOT found, they are asserted through poor science. Now I think they did something wrong, you concur with the NCI workshop and/or quite rightly point out its the conclusion / consensus position. That's fine. Pretending nothing happened (by not mentioning it in the lead) is not fine in my estimation. To do so makes you imply a comprehensive scientific review occurred. All the sources you have quoted previously do not tell us the level of review the evidence actually received.

You are also implying things, through omission, which can be better than my commission.... :"D ... but are less obvious and hence more problematic. When you take stock, if a study is considered flawed... well then what happens??? It is minimized / excluded from consideration, I'm focused on the result and you're focused on the rationale, which we still need a reliable reference for. The Ms. Magazine article frames it as the "strongest evidence" shows no ABC association. (Well you can interpret it that way, but only if Melbye re-analyzes their 18+ week group, which is allegedly what happened at the NCI workshop) Was my way incorrect/inaccurate, possibly, that's why I removed it from the Abortion article as well until this is resolved.

"strongest evidence" is a positive way of putting it, and we can put that for now as a stopgap in the Lead... but it is subjective and without scientific validation; as editorials tend to be. I am steadfast against the NCI workshop being left to its own self-image as comprehensive and being scientific. - RoyBoy 23:33, 3 October 2008 (UTC)

I don't know how much headway we're going to make here, as I feel we've had this conversation several times before. For the record, my perspective is that we have clear statements from the most reputable medical bodies in the world, including the NCI. Whether you or I consider their science "flawed" is immaterial, for Wikipedia's purposes. Whether Joel Brind considers it flawed may be notable, but it hardly warrants coverage in the lead. From my perspective, it is a very simple and fundamental matter of undue weight that the clear conclusions of every major medical body to have studied the issue should not be presented in some sort of false equality with the views of a single, highly politicized individual. The lead is for summary and general statements; the NCI, the WHO, ACOG, RCOG, the NIH, and the American Cancer Society belong there. Joel Brind's personal opinion does not. MastCell ^Talk 07:01, 4 October 2008 (UTC)

You've won on that count, but I'm trying something different, aren't you missing something? Ms. Magazine (among others if I look) points out the evidence used in the conclusion was the "strongest". This clearly shows evidence was assessed and weighted; what they considered the strongest was used for their conclusion. To leave the NCI workshop as it is would be to equate it to other, more careful and scientifically cautious, assessments. That isn't accurate.

You're likely right about weight and Brind, but I'm right about the NCI workshop minimizing evidence. Ms. Magazine infers it. It and hopefully other articles can expand on that. Sure it would be great if we had details, but all that is really required is the notion some evidence was considered invalid. (note: considered; rather than proven) - RoyBoy 01:38, 5 October 2008 (UTC)

Again with the "minimizing". Expert panels synthesize evidence. To do that, they evaluate the strength of individual studies and weight them accordingly. Ms. simply states that the NCI found some studies more convincing than other studies, and that the strongest data argued against an ABC link. I categorically object to spinning that straightforward issue into a criticism of the NCI panel. I see absolutely no source to support your conclusion that the NCI panel was less "scientifically cautious" than other expert bodies, other than perhaps Joel Brind, whom we've discussed above. MastCell ^Talk 07:07, 5 October 2008 (UTC)

(undent) I'm dropping the idea of turning it into a criticism for now (given I don't have a good enough reference), but there should be an acknowledgment something occurred. What that "something" clearly isn't straightforward given your wording above. You say "synthesize", I say "selected"; mine is plainly more pertinent than yours. Of course they synthesized, that's what they were brought together to do. :"D

If they had simply synthesized the evidence they would have come up with something similar to WHO. In good faith you conflate them, you shouldn't be doing that. Do I have a reliable reference that clarifies what occurred, no, fortunately you've been a great check on that. But I do have Ms. and others stating the strongest evidence was selected prior to synthesis. I know this occurred, not just because of Brind, he just happens to corroborate it.

In rewriting the Lead, it was important for me to get "confounding factors" and the "delayed child bearing" memes addressed right off the bat. The "selection bias" meme is of top importance to the ABC issue as both sides have accused each other of selecting the evidence that suits them; it is Lead worthy as that is where the discussion ultimately ends/stalls. Using it for the NCI workshop is accurate, but I acknowledge not sufficiently referenced, so I'm willing to use "strongest evidence" positive spin to at least have what occurred noted.

If you agree or remain steadfast on the NCI workshop tie in, either way "selection bias" itself needs to be in the Lead. Otherwise I wouldn't consider it FA worthy. - RoyBoy 19:56, 5 October 2008 (UTC)

removed "clear" from lead

I removed the word "clear" from this sentence:

The current scientific consensus has solidified with the publication of large prospective cohort studies which find no clear association between abortion and breast cancer.

The conclucions of the references cited do not mention any reservations or cavaets. They are unqualified assertions that no casual link exists:

Conclusions Induced abortions have no overall effect on the risk of breast cancer.

Conclusion Among this predominantly premenopausal population, neither induced nor spontaneous abortion was associated with the incidence of breast cancer.

— Preceding unsigned comment added by 12.3.123.65 (talk) 11:02, 14 October 2008

Sounds good to me. No sense in using weasel words, when the citations support what we've written.OrangeMarlin ^{Talk• Contributions} 18:21, 14 October 2008 (UTC)

"no overall effect" is not an "unqualified assertion that no casual link exists". "Overall" is a caveat, a rather important one, given the positive result they mention in their abstract. Reinserting. - RoyBoy 20:50, 14 October 2008 (UTC)

Further, the context of the sentence is "association", not "causal link". - RoyBoy 20:55, 14 October 2008 (UTC)

At this point, I don't know what else to call this other than an ongoing campaign to water down the clearly expressed findings of an expert panel of the National Cancer Institute. I disagree in the strongest possible terms with the constant, creeping bloat of weasel words obscuring a very clear conclusion, but I don't feel the equanimity necessary to debate it further at this point. MastCell ^Talk 21:21, 14 October 2008 (UTC)

Oh really? You could call it an ongoing creeping campaign to "clearly express" inaccurate positions on the ABC evidence. How does the NCI have bearing here? The Melbye study contains some association. I respect your semi-restraint, however I will type without my emotions in check. This at times leads to unnecessarily long discussions, anywhooooo...

Does Melbye contain an association? Yes.

Do they mention it in their abstract? Yes.

Is Melbye a reliable source? Yes (pro-choice), kind of (Brind), no (pro-life).

Is it difficult to interpret the association? Sort of. It is difficult to know what it means for individual women, and for overall risk, but not difficult to understand risk goes up as gestational age increases. If the NCI workshop has something to say about the Melbye study, provide a reference prior to prodding me with a weasel. Thanks. - RoyBoy 01:38, 15 October 2008 (UTC)

Frustration does go both ways. - RoyBoy 02:35, 15 October 2008 (UTC)

Serious POV issues with this article

I admit that I do not know a great deal about this controversy, but the editors here have not been making a good faith effort to deal with the controversy in an even-handed way. Readers of this article would come away with the mistaken perception the ABC hypothesis was the work of one researcher - Dr. Brind. Not true. In a very short period of time, I was able to locate a number of peer-reviewed articles that support the hypothesis and believe I could find many more if time allowed. I am not saying all of the researchers below definitely believe the link has been established but they all conclude the link is possible. Studies supporting a possible link between abortion and breast cancer:

• MC Pike, et al “Oral contraceptive use and early abortion as risk factors for breast cancer in young women” 1981 [13]

• Helen Ownby et al “Interrupted pregnancy as an indicator of poor prognosis in T1, 2, N0, M0 primary breast cancer” 1983 [14]

• Holly Howe, et al “Early Abortion and Breast Cancer Risk among Women under Age 40” 1989 [15]

• Janet Daling, et al “Risk of Breast Cancer among White Women following Induced Abortion” 1994 [16]

• Polly Newcomb et al “Lactation and a Reduced Risk of Premenopausal Breast Cancer” 1994 [17]

• Polly Newcomb et al “Lactation in Relation to Postmenopausal Breast Cancer” 1999 [18]

I suggest editors make a greater effort to research and write NPOV. If you are only reading one side of the argument, you are doing yourselves and Wikipedia readers a disservice. RonCram (talk) 07:52, 6 April 2008 (UTC)

I am very glad you stipulated you don't know much about ABC, because that is indeed the case; I'm not saying this out of arrogance, but from extensive research and experience with this issue and this article in particular. The research you've done is tremendous, but it is not telling me/us anything new as its preliminary stuff. What do those researchers think about ABC now, and how much weight do their results have? These studies do not exist in a vacuum.

You have pointed out the "controversial" issue and I'm working on it constructively and methodically, so that a correction will stand the test of time. (the references I have do clarify ABC is controversial) I'd suggest you don't redo what has already been looked at (and already referenced in the ABC article, such as Howe and Daling), but see what else you don't like in the article and bring it up here in talk. Thanks. - RoyBoy 01:30, 7 April 2008 (UTC)

Also please take the time to recognize things are occurring, you don't need to reiterate "controversial" because your edit was changed back. As you can see on the talk page I am working on a new Lead, which I hope will be stable. - RoyBoy 01:32, 7 April 2008 (UTC)

Further, it's important to remember these studies do not "support the hypothesis", they have results which do support it; however, for the studies to be truly in support of the hypothesis their conclusions would have to supportive. I do not see that. Howe for example, the largest and most compelling of the studies, they believe their results were "inconclusive" for a variety of issues. So we cannot take their results as supportive of the hypothesis, despite their statistical significance. - RoyBoy 03:00, 7 April 2008 (UTC)

Note, I am posting this in the discussion and not interfering with the article itself. Please therefore give regard and not treat it as an intrusion.

REFUTE THIS if you can:

http://www.lifeissues.org/AbortionBreastcancer/brochuretext.html

The Link Between Abortion and Breast Cancer

"There is an ominous relationship between the abortion of your first pregnancy and later development of breast cancer."

A first pregnancy permanently changes the structure of a woman’s breasts. Before she is pregnant, her breasts cannot produce milk, as the gland cells are immature and underdeveloped. When she becomes pregnant, estrogen and other hormones flood her system. This results in rapid growth in size, while the internal structure undergoes dramatic change.

Cells, previously dormant, rapidly grow into a system of branching ducts and gland cells capable of producing milk. Once this growth, change and maturing is complete, there is no further significant change the rest of her life. Once mature, the chance of developing cancer is much less. When these cells are changing and transitional, they are less stable and have much greater potential of becoming cancerous. If she completes her first pregnancy, this unstable period passes and her gland cells mature and stabilize.

When these cells are changing and transitional, they are less stable and have much greater potential of becoming cancerous. If she completes her first pregnancy, this unstable period passes and her gland cells mature and stabilize.

But – if she interrupts her pregnancy, in its early phase – 90% of abortions are done in the first trimester – she in effect stops the development of the cells at this unstable, transitional phase. It seems apparent that cancerous changes can and do occur more frequently among these transitional cells of a woman who has terminated her pregnancy. If she aborts more than once before completing a pregnancy, her chance for cancer increases even more. A subsequent full term pregnancy helps, but sadly never removes the sharply increases threat of cancer.

This sounds fairly soundly based to me. Breast tissues not being mature until the massive estrogen generated at the beginning of her first pregnancy, thus stimulating the development. Unstable cells (changing, transitional) being at risk of MUTATING into cancer cells.

I don't assume Wikipedia is a debating society, but I would hope you agree it is intended to disseminate information for people to read and consider. Please incorporate this information into the article so that people can read it, do their own research if they wish, consider it, and reject one view and accept the other, or choose a middle course.

Please? For the sake of the women who will use Wikipedia? For the sake of the women who are involved in running Wikipedia? Please do it for them? GBC (talk) 14:29, 15 April 2009 (UTC)

The only problem with disseminating that information is that it's incorrect. As every medical and scientific body has found, abortion does not cause breast cancer. Women (people) reading this article aren't well-served when the breast-cancer card is cynically played as a scare tactic to try to "win" the abortion debate. The article does a fairly good job of explaining that there is no link between abortion and breast cancer, and that various pro-life groups continue to push the issue against the clear scientific consensus as a political/ideological tool. MastCell ^Talk 15:55, 15 April 2009 (UTC)

And women reading this article aren't well-served when the available alternate information - that could save their lives - is suppressed. Let them both be given equal consideration. Let people think for themselves. Stop being such spoon-feeding liberals that decide what people should think - let people do their own thinking by letting them have all the information. GBC (talk) 00:40, 16 April 2009 (UTC)

Can we agree that spoon-feeding people outright errors is even worse than spoon-feeding them correct answers?

The problem with giving "equal consideration" to every possible view, regardless of its actual merits, is (in addition to being banned by the relevant Wikipedia policy) that the various experts -- not just pro-abortion people -- have looked at the actual experience of real women and concluded that first-trimester abortions (natural or induced) simply do not result in an increased risk of breast cancer compared to a woman that never got pregnant in the first place. So this "information" cannot "save their lives", because their lives aren't at risk in the first place (and in the case of a miscarriage, there's nothing the women could do about it anyway).

Among the currently believed reasons for this idea not connecting with reality is the fact that most pregnancy-related breast changes happen during the last half of the pregnancy, not the first few weeks. Another relevant point is that a large number of abortions happen in mature women who have already had one or more children, while this line of argument really only applies to a first-time pregnancy. So what you have above is a nice story (speculation like this is where most science starts), and it was worth investigating, but it simply didn't prove to be true (an outcome that is also typical of many scientific investigations: things that sound interesting when you're blue-skying at the research committee don't always turn out the way you think they will. If they did, then we wouldn't call them experiments; we'd call them a waste of time and money spent reinventing the wheel). WhatamIdoing (talk) 02:49, 16 April 2009 (UTC)

I'm busy in real life, and I got a new computer! So I've taken a break from this article. Again as I tend to do, I agree mostly with the above, especially mature vs. first time; however, even though most breast changes do happen later on, there is no question tenderness and growth do occur in the first trimester. *folds arms* You may have to clarify for me, but I take exception with inferring/associating ABC with blue-skying speculation. Hormones impact cancer risk, period. - RoyBoy 04:41, 16 April 2009 (UTC)

When you start with an idea of a possible mechanism, and you develop a study to evaluate your idea, you're in blue sky territory. You go to your research committee and you tell them a big, long story about what you think might be the case, what you've considered, what you don't know yet, and how you think you'll learn what you want to know. Your initial idea may be no more solid than a stray wisp of a cloud in an otherwise clear blue sky, but sometimes chasing those phantasms pays off. The term is not an insult; it's just the nature of theoretical biology.

(The opposite approach [trial and error] is also used by science, e.g., in non-rational drug discovery: grind up ______ organism, separate all the molecules, test them for bioactivity against a standard panel of cells, and hope that one of the few active molecules does something useful. The ABC question could have appeared from either approach; it just happens that this particular piece is bluesky work instead of data-driven.) WhatamIdoing (talk) 18:03, 16 April 2009 (UTC)

GBC, Wikipedia correctly gives weight to scientific consensus. While there are dissenting views and some evidence to Suggest an association, both of which are in the article. We present relevant opinions/conclusions by noted experts and studies on the subject, with a focus on the consensus of that information. Further, an abortion can save a woman's life; so its not immediately clear what option is best. If people actually do want "all" the information, including bad information... the Internet is just a click away.

Avoiding a very long explanation, while transitional cells are more likely to be cancerous; one would have to demonstrate they are more of a problem (because there are more of them) than the pre-existing immature breast stem cells. As noted in the article "human chorionic gonadotropin" plays a role in cellular differentiation; and that may help "clean the slate" during early pregnancy breast development... mitigating any ABC effect early on, what WhatamIdoing alluded to above. It's not as easy as saying "transitional cells are unstable", which this article does say several times already. - RoyBoy 04:41, 16 April 2009 (UTC)

Selection bias in the Lead

Hopefully in the next while we can figure out a way of including "selection bias" in the lead that mentions the accusations by all sides, and perhaps notes the debate/discussion ultimately ends up there with everyone convinced their selected evidence best represents the current status of the ABC issue. Dr. Jasen might be a solid start? - RoyBoy 05:44, 17 November 2008 (UTC)