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I'm thinking of modifying the Views section to the following:
And make it the last paragraph of the Lead. I dislike how it repeats things in the lead, and is simply placed at the top of the article to push back against a perceived imbalance in the Lead.
If we did this, then the "The American Cancer Society concludes that presently the evidence does not support a causal abortion-breast cancer association,[9] yet some pro-life activists continue to champion a causal link" in the lead would have to be moved, deleted, tweaked. Indeed its partly due to this very repetition I want to merge the Views section with the lead. - Roy Boy 21:09, 18 January 2009 (UTC)
NCI
was invoked but never defined (see the
help page).WHO
was invoked but never defined (see the
help page).rcog_2000
was invoked but never defined (see the
help page).ACS_ABC
was invoked but never defined (see the
help page).ABC link needs to be in the lead because that is actually the primary title of the concept. ABC hypothesis isn't as widely used. So its of significant importance it is in the lead. I added pro-life into the brackets, and move restrict abortion to the next paragraph for improved flow. - Roy Boy 17:31, 8 March 2009 (UTC)
Yes, the WHO was somewhat more conservative in its interpretation than NCI and ACS, limiting themselves to 1st trimester abortion. As I'm sure you know, 90-95% of all abortions are performed in the first trimester. Hence this is best characterized as a minor difference in the interpretation of a gray area, rather than a major dispute, ongoing controversy, or evidence of carelessness on the NCI's part. If the two groups are in 90-95% agreement and 5% disagreement, then WP:WEIGHT and common sense indicate pretty clearly what we as Wikipedians should be doing. MastCell聽 Talk 03:09, 16 March 2009 (UTC)
(undent) RoyBoy, I think you need to pay more attention to what MastCell is telling you about scientific evidence. Reviews of previous high-quality studies are stronger than the individual studies: 95% confidence interval means that any individual study has a 5% chance of being wrong, after all. The NCI panel report counts as the opinion of medical authorities. Perhaps more pointfully, there are no widely respected medical authorities that support causality (as opposed to increased risk due to losing the protective effect that early childbearing confers). WhatamIdoing ( talk) 20:47, 16 March 2009 (UTC)
(undent) I replaced "retracted" from the Lindefors-Harris section. We indeed do not want to risk inferring the conclusion was "officially" retracted. I did not see that danger, I do now. - Roy Boy 16:44, 29 March 2009 (UTC)
I'm not much happier with its replacement, though. It claims that Lindefors-Harris "conceded" that their conclusions "might be incorrect". The source absolutely does not support this still rather remarkable assertion. All I see is an elaboration on various aspects of their methodology (not, incidentally, authored by Lindefors-Harris, so not evidence of them conceding anything). No concessions. I then see Joel Brind, widely regarded as a partisan advocate on the topic, making a bunch of assertions about Lindefors-Harris' data. Accusations from Joel Brind do not equal "concessions" by Lindefors-Harris.
I will reiterate that I am deeply unhappy with the liberties taken by this article. We are being way too cavalier in substituting editorial narratives for honest presentations of the actual content of sources. There are real WP:BLP issues here - the worst of them is probably the incorrect "retraction" claim, but the replacement text - again incorrectly claiming that a respected researcher "conceded" their "error" to Joel Brind - is equally inappropriate. MastCell聽 Talk 17:58, 29 March 2009 (UTC)
Legally induced abortion in the first trimester became more easily accessible from the late 1960s, although accessibility varied between hospitals. Some women therefore had induced abortions abroad6 or unrecorded terminations of pregnancy. We are not surprised to find some Swedish women confidentially reporting having had induced abortions during the period 1966鈥1974 that are not recorded as legally induced abortions. It is plausible that such induced abortions are more susceptible to recall bias than induced abortions performed within the legal context in Sweden.
If you want to see what it actually looks like when a subset of a paper's authors retract its conclusions, see PMID聽 9500320 (by Andrew Wakefield) and then see PMID聽 15016483. I'm asking you as one editor to another to take seriously the objections that you're hearing from us, and not to keep reinserting this material which raises questions not only of verifiability and original research, but of WP:BLP. MastCell聽 Talk 06:08, 31 March 2009 (UTC)
Hopefully this is agreeable. - Roy Boy 19:57, 26 April 2009 (UTC)
I think the statement in the lead that "the current scientific consensus is that there is no significant association between first-trimester abortion and breast cancer risk" is potentially misleading. "Significant" is used in its statistical sense here, but is there not a danger that it will be misinterpreted to mean that there is some association but only a small one? This layman's misreading of "significant" turns it (IMHO) into a weasel word that should be deleted. The consensus is not that there is a small association, but that there is none. I suggest saying either "no association" or (if people feel that's too abrupt) "no statistically significant association." Opinions? SNALWIBMA ( talk - contribs ) 22:16, 16 March 2009 (UTC)
Eldereft was bold and changed it to "does not cause". Hmmm... very interesting, that deftly threads the consensus more accurately than "does not increase the risk". The problem is it permits the opposite "layman's misreading", that there is no risk/association whatsoever. That isn't accurate and so I don't believe its encyclopedic... something I'll continue to contemplate. I am satisfied though that "does not cause" (parsed correctly by an informed reader) and in good faith, strikes the correct tone for the ABC consensus; and that further down in the lead caveats are mentioned for those interested in actual data/results on "association". Mastcell, WhatamIdoing, Snalwibma? - Roy Boy 23:41, 18 March 2009 (UTC)
WhatamIdoing makes a decent point when removing "pro life" from the lead sentence, the problem as I see it is pro-choice supporters of the ABC link tend to use much better language, such as ABC association, ABC risk, ABC hypothesis rather than link. Can anyone substantiate WhatamIdoing's: "I believe that all current and past supporters, regardless of political label, called it a "link" when they believed it"? - Roy Boy 03:42, 24 March 2009 (UTC)
I think Mastcell and I clashed on the Discovery article classification previously. While I love Discover, I think my perspective was that Barry Yeoman had published another article for MotherJones and made me cautious on the author. Ummm, scanning the article I think I remember my primary objection:
Brind dismisses response bias as an unproven hypothesis, but others have found ample evidence for it. In Sweden, epidemiologist Britt-Marie Lindefors-Harris of the Karolinska Institute took advantage of her country's nationwide registry of legal abortions. In a project documented in the American Journal of Epidemiology, Lindefors-Harris conducted a case-control study of abortion and breast cancer, but with a twist: She checked government records to see if the participants were telling the truth about their reproductive histories. Many of them, it turns out, were not. Out of 829 women, 29 appeared to misrepresent their abortion history, with the vast majority of underreporting coming from healthy women in the control group. Based on those numbers, Lindefors-Harris calculated that "an observed increase in risk of up to 50 percent may be caused by response bias."
Five years later, in 1996, Matti Rookus and Flora van Leeuwen of the Netherlands Cancer Institute came up with even more dramatic evidence of bias. The epidemiologists surveyed women in two regions of their country. In the liberal west, Rookus and van Leeuwen found a statistically insignificant relative risk of 1.3鈥攂ut in the predominantly Roman Catholic southeast, relative risk shot up to an astounding 14.6. The only plausible explanation: Because of the conservative religious values in the southeast, healthy women there lied about their abortions. "Reporting bias is a real problem," the Dutch team concluded.
Mr. Yeoman quotes ludicrously thin (Rookus) and incorrect (Lindefors-Harris) science to back up response bias, and makes it appear solid and authoritative. Consequently its really hard for me to accept it as a reliable scientific article, despite the magazine it was published in. I might lose an RfC on this, but I feel it's a pertinent point. When I'm done playing with my new toys, I'll write another draft for the Lindefors-Harris section, clarifying significant limitations to their 50% conclusion. - Roy Boy 01:21, 17 April 2009 (UTC)
In this case, you (personally) feel that Yeoman's article was sloppy (I have yet to see any reliable, independent sources backing your personal conclusions on that score, though perhaps they exist). That does not, however, make Discover a "pro-choice" source. MastCell聽 Talk 17:17, 20 April 2009 (UTC)
(undent) Big LOL, well he's made it a crusade to be sure. Clouds his judgment, but also makes him an expert regardless of being in the tiny-minority; I'd remind all his interpretation of weak data (his meta-analysis) can be valid (of marginal impact, but I emphasize not zero) if response bias turned out to be statistically insignificant.
The weight response bias deserves should be my focus, so apologies again on focusing on Yeoman above.
Bias' blanket effect on verdicts should be given the weight it scientifically (NPOV) deserves, as a statistically insignificant factor Hypothesized by the majority to account for (or create) barely significant positive ABC results. To give it more is charity. It has a liberal/conservative regional comparison in Rookus (bias Within each region would have been more informative and closer to ABC study best practices); an incorrect analysis and possibly bad dataset from Lindefors-Harris. The fact it's used by the majority doesn't change the NPOV assessment from Daling and Brind. Bear in mind the majority do not defend these response bias studies when they are finally scrutinized. Daling/Brind having the last word should indicate to us the weight Rookus and Lindefors-Harris deserve; and consequently how careful we should be on drinking the response bias kool-aid.
In the end, yes again we come full circle. That's okay though, it appears to me established articles go through it. Besides, I might actually be expressing the right ideas more clearly here. If one takes response bias at face (Yeoman asserted) value, then ABC associations nearly evaporate. If one gives bias proper NPOV weight, not based on political majority/minority but on balanced verifiable statements of fact (otherwise known as science), associations remain as the jungle of ABC studies indicate (Michel's drank the kool-aid BTW). One is left with the grey reality of the ABC hypothesis. No link, but not something to ignore either. The fringes are fun, n'est pas? - Roy Boy 04:50, 23 April 2009 (UTC)
Is the table under #Michels taken directly from the paper? WhatamIdoing ( talk) 06:02, 17 April 2009 (UTC)
After thinking it over, I decided to just kill the whole thing. It is probably a (legal) copyright violation and almost certainly violations Wikipedia's copyright rules. It doesn't really add to the readers' understanding of the conclusions, it's not an encyclopedic style, and it gives inappropriate weight (and tends in the direction of providing our own analysis of the paper) to what is basically a detail. Finally, the few people that really want that level of detail should read the entire study anyway. WhatamIdoing ( talk) 18:33, 20 April 2009 (UTC)
RoyBoy, are you familiar with WP:WTA#Synonyms_for_say? Perhaps you're just trying to avoid a boring vocabulary, but factive substitutes for "said" are unacceptable. WhatamIdoing ( talk) 05:02, 27 April 2009 (UTC)
The following two statements were recently added to the article. I have moved them here, as, at a glance, they seem to conflict with much of the evidence in the rest of the article.
-- Whatever404 ( talk) 17:26, 22 June 2009 (UTC)
The second paper is published in a relatively obscure, low-impact publication - PubMed/MEDLINE indexing is probably necessary, though certainly not sufficient, to define a reliable source for a statement of medical fact. More to the point, the findings are at odds with a number of larger, better-conducted studies as well as with unanimous expert synthesis of the literature as a whole. Specifically, the finding that hormone replacement therapy and oral contraceptives decrease the risk of breast cancer is entirely contrary to existing data, and raises some questions (for example, in another cohort of women from Istanbul, oral contraception and hormone replacement raised the risk of breast cancer, as it they commonly understood to do [ PMID聽 17371428]). If this one study causes a revolution or a re-evaluation of current scientific consensus on the issue, then it may be worthwhile discussing at length. As it is, it's probably undue weight to a single primary source which is at odds with numerous stronger studies as well as unanimous expert opinion. MastCell聽 Talk 17:43, 22 June 2009 (UTC)
"better-conducted" is presumptuous bias MastCell, and studies are expected to be at odds with each other and consensus! It isn't always a case of bad research, it can also be progress. Thisglad, new studies have minimal impact on a consensus unless they contain something new and are recognized as such.
On the flip side, despite the ironclad obscurity of the low-impact publication, the dataset is substantial on induced abortion 930 controls and 742 cases. This would appear to warrant inclusion in the Interviews section, perhaps a new "Further interview studies" section so we can mention ongoing findings. Adding one or two other studies of mixed (nil results) would be nice, assuming their datasets are almost as juicy. - Roy Boy 00:10, 24 June 2009 (UTC)
I guess you've summed up the problem: you see me "ignoring" study results, while I see myself as respecting secondary sources rather than lining up primary sources to advance my viewpoint. As to your final point, I couldn't agree more. So far the Turkish study has had no demonstrable significance - it doesn't seem to have prompted any expert or expert body to revise its opinion. Therefore, we should not assign the study substantial weight until/unless experts in the field do so. You're the one "guessing how experts will react". I'm saying that they haven't reacted, yet, so neither should we. MastCell聽 Talk 22:38, 24 June 2009 (UTC)
Have we established which ABC hypothesis papers we should include in this article? For example, there is a new paper (April 8, 2009; " Breast cancer risk factors in Turkish women 鈥 a University Hospital based nested case control study") that is not currently in the article. Should we mention it? 鈥擯receding unsigned comment added by Geremia ( talk 鈥 contribs) 09:27, 30 July 2009 (UTC)
A study (742/930 ABC cases/controls) of outpatients from clinics of the Istanbul University Medical Faculty published in 2009 by Ozmen et al. found a 1.31 (1.13 - 1.53) increased ABC risk. The authors point out various potential biases such as selection, information and even hospital admission bias may have impacted their results. They believe the large pool of patients available to them and the resulting large size of the study "provided reasonably stable risk estimates." [3]
Some pro-life supporters prefer the term abortion-breast cancer link. citation needed The subject is controversial. citation needed
Whatever404 reworked things a bit trying to clarify things, in good faith. KillerChihuahua removed the brand-new parsed unsourced statements in good faith. They were quite an eye sore once chucked out context. I'll make this brief, there are 112 sources in this article... and no one could be bothered to add a ref to them, or to undo the ugly disconnect created by Whatever404.
"some" pro-life supporters, no actually all of them do. That's is what its called. Do not add weasel words that aren't even necessary. Look it up!
This subject has never been controversial? Do you guys recall the NCI vs. the Bush administration. And that's the no brain required example you all know. There are plenty of historical back and forth from Daling and the fallout from the Howe study. - Roy Boy 04:24, 5 August 2009 (UTC)
Well that confirms to me that I can't rely on as many people around here as I would like. "risk increase" is substantially different from "cause", the inability to differentiate this is unfortunate. I'd ask that those involved do not modify the Lead any further unless they check it with someone who knows what they are doing. The WHO's determination of:
"Historical cohort studies, on the other hand, are more methodologically sound. Two major studies have been carried out using this methodology, and neither found an increased risk of breast cancer associated with first trimester abortion."
does not match recent original research by Wikipedia that there is "no risk" associated with "abortion". -
Roy
Boy
04:37, 5 August 2009 (UTC)
From my understanding, the hypothesis says abortion increases the risk of developing breast cancer. The second sentence says that scientific consensus is that abortion does not cause breast cancer. I don't think the hypothesis says abortion causes breast cancer, but it can increase the risk. I propose changing the second sentence to reflect this. However, since the first paragraph is important for the article, I wanted to bring it up in the discussion here first.-- Minimidgy ( talk) 14:39, 19 August 2009 (UTC)
I'm sure this is likely to anger those who support the views, but is this a manner of Pseudoscience? -- 74.232.40.140 ( talk) 03:53, 20 October 2009 (UTC)
I was surprised to walk into a wall of POV in the lead to this article. I was previously unaware of the issue, the only thing that crosses my mind on the content side is hearing that pregnancy protects against cancer in a number of ways. I am removing italics, "quibble" marks and infelicitous appositions.
Separately I have refactored the lead since it seemed to be structured in a "they believe this - but look at this research!" way. II am still not convinced that it is NPOV because I know little about the subject, but I hope that it is an improvement.
Rich聽 Farmbrough, 11:29, 19 November 2009 (UTC).
About this: Either the early research in question showed a correlation, or it didn't. Once you've already crunched the numbers, it's silly to talk about a "possible" correlation: Either you found one, or you didn't. "Possible" correlations only exist in proposals to conduct research, not in data. Have we perhaps confused correlation with causation in this sentence? WhatamIdoing ( talk) 21:43, 15 December 2009 (UTC)
Looking at it further there is a redundancy with the following:
and
These are saying the same thing a sentence apart. It bothered me before now, and I need to do something about it. Hopefully I didn`t muddle it too badly. - Roy Boy 05:16, 18 December 2009 (UTC)
In 2003, the NCI convened a workshop with over 100 experts on the issue. Although early abortion-breast cancer research had reported a correlation between breast cancer and abortion,[11] the "strongest evidence",[12] which is from large, prospective cohort studies,[13][14] demonstrates that abortion is not associated with an increase in breast cancer risk.[15] These improved studies controlled for confounding variables, such as age at first full-term pregnancy and the number of full-term pregnancies (parity), which are known risk factors for breast cancer.
Excellent suggestions from both of you, and parity being half defined entirely my fault. Thought I was going to get annoyed at WhatamIdoing for the word "demonstrates"... a strong word I'd like to avoid, but MastCell's suggestion changed the sentence and clarified it is the workshop's finding. Did small tweaks early > previous, that allowed me to put Daling back in the lead as I now remember that's an important positive finding to highlight.
Can y'all verify my punctuation is optimal, thanks.
Also, reinserted response bias... a point which probably needs to be expanded in the lead given its prominence in how ABC research is accepted / rejected (praised / criticized) by the NCI workshop, and the overall scientific community, without proper validation (a la nature vs. nurture debate and consensus missteps from the past). I also changed context of parity to a "key" factor, as that's why in the lead. - Roy Boy 17:24, 19 December 2009 (UTC)
Selection bias accusations by both sides may also be lead worthy. [2] Forgive me, grabbing notes from 2008 talk prior to archiving. Other links: New Zealand [3] Court cases - Australia [4] Paternalistic? [5] - Roy Boy 17:46, 19 December 2009 (UTC)
The section on mainstream medical opinion, which describes the position of AMA, ACOG, NCI, WHO, etc. ought to include the fact that no US Surgeon General has ever recognized the "link". This includes Surgeons General under right-to-lifist Presidents Reagan, Bush I, and Bush II. I have entered this info and linked directly to the searchable site of the US Surgeon General's office. The reader can verify by searching it! I hope that's OK; if not, you know what to do.... SingingZombie ( talk) 22:42, 25 December 2009 (UTC)
I'm not sure I agree with RoyBoy's reasoning. The Surgeon General synthesizes evidence and reaches determinations on a number of health-related issues. It's really up to the SG, and the politicians who appointed him/her, to set the office's priorities. In fact, the Surgeon General's office has addressed abortion, under C. Everett Koop and Ronald Reagan. It's an interesting story - some of the religious conservatives in Reagan's administration pushed for Koop to study abortion, because they were confident he would produce a report indicating that it was harmful to women, thus providing a medical rationale for outlawing abortion. To his credit, Koop (who is himself an evangelical Christian and holds pro-life convictions) ended up finding that abortion was not harmful to women, thus sorely disappointing the pro-life lobby (see [6], for instance). I'm not aware that subsequent Surgeons General have taken up the topic, but they do "generate their own determinations", and abortion-related issues are within their purview. MastCell聽 Talk 18:56, 26 December 2009 (UTC)
See National Cancer Institute andycjp ( talk) 04:50, 16 January 2010 (UTC)
While the Istanbul study was a one off, with mitigating factors such as small size (for a cohort study) and many possible confounders. But now the Dolle study, co-authored by a chairperson of the NCI workshop (Brinton) finds a small, but statistically significant association for ABC.
Given the prominence of the NCI workshop in the lead I believe we should add a line, in the lead, acknowledging current studies do continue to find small associations. This does not contradict the Views_of_medical_organizations on ABC "causation", but it does contrast with the NCI workshop findings of "no association". - Roy Boy 00:53, 8 April 2010 (UTC)
(indent reset)
Mastcell, seriously, please look at my first message of this thread; this is about the NCIw. As my initial shows I removed the "changed her position" editorial claiming it as a (direct) rebuttal. 1 sentence, I'll nitpick that as its joined to the previous sentence:
"In analyses of all 897 breast cancer cases (subtypes combined), the multivariate-adjusted odds ratios for examined risk factors were consistent with the effects observed in previous studies on younger women (Table 1). Specifically, older age, family history of breast cancer, earlier menarche age, induced abortion, and oral contraceptive use were associated with an increased risk for breast cancer."
Each sentence by itself is sufficient for mention in this article, combined it demonstrates clearly the NCIw finding is now outdated. As to WP:SYN, I've had a patchy history of recognizing when WP:SYN occurs on my part. So I do take that criticism to heart. However you seem convinced (at least in the past) the NCIw is beyond reproach and forms the backbone of the consensus, it doesn't. If a population based study by NCIw scientists showing an ABC association isn't sufficient to change the lead, I'm at a loss as to what would be. I mean do you think Wikipedia requires an ABC finding to be in the abstract for it to be sufficient weight? I believe the weight you've giving the NCIw, at this point, is utterly incorrect. Yes they all agree to no ABC link, but they do not concur on no ABC association. Conflating them to reinforce the NCIw is your WP:SYN.
The NCI workshop does not pass the standard of a systematic review as they did not use "an objective and transparent approach for research synthesis". Their rejections of studies was based on response bias guesswork, and their synthesis of cohort studies, specifically how they removed the high risk sub-groups in Melbye was not explained in their report. To pile on, the systematic review article emphasizes even proper reviews require updating just a few years after being done.
I don't think we are required to wait for them to update their own position. Nor are we in any way restricted from presenting the latest reliable information in context. In this instance, I believe the correct context is the outdated NCIw conclusion. - Roy Boy 17:41, 11 April 2010 (UTC)
You are absolutely required to wait for the medical community to "update" its view before substituting your own - highly idiosyncratic - interpretation of the primary literature. As a separate point, I'm not clear why you insist on harping on the NCI as if they were the sole group that has discounted a link. As you know, the NCI's view is shared in its essentials by numerous other major medical and scientific bodies. MastCell聽 Talk 18:01, 11 April 2010 (UTC)
鈫 That's a have-you-stopped-beating-your-wife phrasing. To clarify the relevant stances, here are the links:
I think that anyone who reviews these sources objectively will conclude that their stances are virtually identical. You can spend (have spent) a great deal of effort hammering away at the 1% where these groups differ. It might even be appropriate to explore those differences in context somewhere in the body of the article, if we're committed to keeping it at ~100 kb. But for summary purposes, and certainly for the lead, we should be clear that there is >99% agreement rather than focusing on the <1% minor variance. That's not "fugding" - it's a basic matter of honestly and proportionately representing available high-quality sources. MastCell聽 Talk 22:39, 11 April 2010 (UTC)
Why do you insist of having "concluded that abortion does not cause breast cancer" twice, in sentences next to each other? Its not good summary style. If anything, having it twice is undue weight for that meme, even though its accurate.
Also, I'm doubtful Jasen, as good as it is can support the "although it is considered largely settled as a scientific question". Can you clarify. - Roy Boy 19:26, 10 April 2010 (UTC)
That, combined with unanimous statements from major medical bodies indicating that there is no evidence of a link, plus the near-total absence of any published research on the topic in recent years - all of that suggests that this is not a topic of active scientific controversy. Jasen's article also makes clear that it remains very much a political football, although even that is playing out a bit. MastCell聽 Talk 22:29, 11 April 2010 (UTC)Even though proponents of the abortion-breast cancer link have lost credibility in the international research community, their campaign continues to gain willing converts, influence abortion legislation in a number of US states, and raise painful questions for women facing breast cancer or difficult reproductive choices.
(undent) Sorry Doc James just saw this response just now, thanks for the fast reply. Yes secondary sources are typically preferred if they are better, however you presume they are better. Why? (I understand the allure of larger data sets, but there are also in-built presumptions of these reviews, such as the significance of response bias that put their overall conclusions in as much, if not more, question than a smaller but pure data set) As to p, I concede you lost me a bit, but is this referring to comparing/including confounding factors in the result? Thus reducing p. As to Melbye, you take it as fact that their high risk subgroups are of no consequence? - Roy Boy 17:05, 17 April 2010 (UTC)
Personally, I think that the most current and high-quality sources on the topic (all of which are already cited in the article) clearly demonstrate that this is considered largely settled as a scientific question. Rather than responding to ultimatums, I'd rather hear whether anyone else has an opinion about the sentence in question. MastCell聽 Talk 04:18, 16 April 2010 (UTC)
(undent) I do not see any evidence that refutes the conclusions of the review articles we reference. Uptodate does state that evidence does not support a link and this is what we should go with IMO. The studies which are being used to attempt to prove a link are not statistically significant. Doc James ( talk 路 contribs 路 email) 17:11, 17 April 2010 (UTC)
This article (specifically the introduction) appears pro-abortion biased, in that it responds to the initial paragraph's question, "Does abortion increase the risk of developing breast cancer?" with the emphatic assertion, "Abortion does not cause breast cancer." That sentence leads the average reader to conclude that the debate is settled, but it does not address the question: The question is whether it increases risk, not whether it is a cause.
I say it is pro-abortion biased because such mispeaking can be deliberate to mislead people who think that "increased risk" means only "including more possible causes", e.g. "playing with matches during a gas leak is risky behavior". I am inclined to think it is so deliberate, because there is a clear concerted effort by those in power to promote contraception and abortion when facing the idea of human overpopulation.
In case this point needs clarification: If you are stressed, your immune system is weakened and you are more prone to becoming ill. Stress in this instance does not cause the illness, but it is an obvious factor that directly contributes to your becoming ill. Increasing risk and being the cause are two separate matters.
Please fix these problems. -- Newagelink ( talk) 18:16, 10 August 2010 (UTC)
In the most methodologically sound studies (e.g. PMID聽 8988884), the rate of breast cancer is the same in women who have had an abortion as in those who have not, so there isn't really an issue of increased risk, much less direct causality. MastCell聽 Talk 18:37, 10 August 2010 (UTC)
The article continues to improve, however the lead still perturbs me. It states "abortion does not cause breast cancer", meanwhile one if the strongest scientific sources for this statement is WHO. They state "show no consistent effect of first trimester induced abortion". While I've argued at length with Mastcell on this, could others weigh in on this. WHO's conclusion mentions first-trimester and we should include this in our lead. I'd emphasize the Melbye cohort study indicates a higher risk for 2nd trimester abortions; it appears WHO makes note of this when they state their conclusion. Wikipedia should as well. - Roy Boy 03:37, 17 March 2011 (UTC)
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This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
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I'm thinking of modifying the Views section to the following:
And make it the last paragraph of the Lead. I dislike how it repeats things in the lead, and is simply placed at the top of the article to push back against a perceived imbalance in the Lead.
If we did this, then the "The American Cancer Society concludes that presently the evidence does not support a causal abortion-breast cancer association,[9] yet some pro-life activists continue to champion a causal link" in the lead would have to be moved, deleted, tweaked. Indeed its partly due to this very repetition I want to merge the Views section with the lead. - Roy Boy 21:09, 18 January 2009 (UTC)
NCI
was invoked but never defined (see the
help page).WHO
was invoked but never defined (see the
help page).rcog_2000
was invoked but never defined (see the
help page).ACS_ABC
was invoked but never defined (see the
help page).ABC link needs to be in the lead because that is actually the primary title of the concept. ABC hypothesis isn't as widely used. So its of significant importance it is in the lead. I added pro-life into the brackets, and move restrict abortion to the next paragraph for improved flow. - Roy Boy 17:31, 8 March 2009 (UTC)
Yes, the WHO was somewhat more conservative in its interpretation than NCI and ACS, limiting themselves to 1st trimester abortion. As I'm sure you know, 90-95% of all abortions are performed in the first trimester. Hence this is best characterized as a minor difference in the interpretation of a gray area, rather than a major dispute, ongoing controversy, or evidence of carelessness on the NCI's part. If the two groups are in 90-95% agreement and 5% disagreement, then WP:WEIGHT and common sense indicate pretty clearly what we as Wikipedians should be doing. MastCell聽 Talk 03:09, 16 March 2009 (UTC)
(undent) RoyBoy, I think you need to pay more attention to what MastCell is telling you about scientific evidence. Reviews of previous high-quality studies are stronger than the individual studies: 95% confidence interval means that any individual study has a 5% chance of being wrong, after all. The NCI panel report counts as the opinion of medical authorities. Perhaps more pointfully, there are no widely respected medical authorities that support causality (as opposed to increased risk due to losing the protective effect that early childbearing confers). WhatamIdoing ( talk) 20:47, 16 March 2009 (UTC)
(undent) I replaced "retracted" from the Lindefors-Harris section. We indeed do not want to risk inferring the conclusion was "officially" retracted. I did not see that danger, I do now. - Roy Boy 16:44, 29 March 2009 (UTC)
I'm not much happier with its replacement, though. It claims that Lindefors-Harris "conceded" that their conclusions "might be incorrect". The source absolutely does not support this still rather remarkable assertion. All I see is an elaboration on various aspects of their methodology (not, incidentally, authored by Lindefors-Harris, so not evidence of them conceding anything). No concessions. I then see Joel Brind, widely regarded as a partisan advocate on the topic, making a bunch of assertions about Lindefors-Harris' data. Accusations from Joel Brind do not equal "concessions" by Lindefors-Harris.
I will reiterate that I am deeply unhappy with the liberties taken by this article. We are being way too cavalier in substituting editorial narratives for honest presentations of the actual content of sources. There are real WP:BLP issues here - the worst of them is probably the incorrect "retraction" claim, but the replacement text - again incorrectly claiming that a respected researcher "conceded" their "error" to Joel Brind - is equally inappropriate. MastCell聽 Talk 17:58, 29 March 2009 (UTC)
Legally induced abortion in the first trimester became more easily accessible from the late 1960s, although accessibility varied between hospitals. Some women therefore had induced abortions abroad6 or unrecorded terminations of pregnancy. We are not surprised to find some Swedish women confidentially reporting having had induced abortions during the period 1966鈥1974 that are not recorded as legally induced abortions. It is plausible that such induced abortions are more susceptible to recall bias than induced abortions performed within the legal context in Sweden.
If you want to see what it actually looks like when a subset of a paper's authors retract its conclusions, see PMID聽 9500320 (by Andrew Wakefield) and then see PMID聽 15016483. I'm asking you as one editor to another to take seriously the objections that you're hearing from us, and not to keep reinserting this material which raises questions not only of verifiability and original research, but of WP:BLP. MastCell聽 Talk 06:08, 31 March 2009 (UTC)
Hopefully this is agreeable. - Roy Boy 19:57, 26 April 2009 (UTC)
I think the statement in the lead that "the current scientific consensus is that there is no significant association between first-trimester abortion and breast cancer risk" is potentially misleading. "Significant" is used in its statistical sense here, but is there not a danger that it will be misinterpreted to mean that there is some association but only a small one? This layman's misreading of "significant" turns it (IMHO) into a weasel word that should be deleted. The consensus is not that there is a small association, but that there is none. I suggest saying either "no association" or (if people feel that's too abrupt) "no statistically significant association." Opinions? SNALWIBMA ( talk - contribs ) 22:16, 16 March 2009 (UTC)
Eldereft was bold and changed it to "does not cause". Hmmm... very interesting, that deftly threads the consensus more accurately than "does not increase the risk". The problem is it permits the opposite "layman's misreading", that there is no risk/association whatsoever. That isn't accurate and so I don't believe its encyclopedic... something I'll continue to contemplate. I am satisfied though that "does not cause" (parsed correctly by an informed reader) and in good faith, strikes the correct tone for the ABC consensus; and that further down in the lead caveats are mentioned for those interested in actual data/results on "association". Mastcell, WhatamIdoing, Snalwibma? - Roy Boy 23:41, 18 March 2009 (UTC)
WhatamIdoing makes a decent point when removing "pro life" from the lead sentence, the problem as I see it is pro-choice supporters of the ABC link tend to use much better language, such as ABC association, ABC risk, ABC hypothesis rather than link. Can anyone substantiate WhatamIdoing's: "I believe that all current and past supporters, regardless of political label, called it a "link" when they believed it"? - Roy Boy 03:42, 24 March 2009 (UTC)
I think Mastcell and I clashed on the Discovery article classification previously. While I love Discover, I think my perspective was that Barry Yeoman had published another article for MotherJones and made me cautious on the author. Ummm, scanning the article I think I remember my primary objection:
Brind dismisses response bias as an unproven hypothesis, but others have found ample evidence for it. In Sweden, epidemiologist Britt-Marie Lindefors-Harris of the Karolinska Institute took advantage of her country's nationwide registry of legal abortions. In a project documented in the American Journal of Epidemiology, Lindefors-Harris conducted a case-control study of abortion and breast cancer, but with a twist: She checked government records to see if the participants were telling the truth about their reproductive histories. Many of them, it turns out, were not. Out of 829 women, 29 appeared to misrepresent their abortion history, with the vast majority of underreporting coming from healthy women in the control group. Based on those numbers, Lindefors-Harris calculated that "an observed increase in risk of up to 50 percent may be caused by response bias."
Five years later, in 1996, Matti Rookus and Flora van Leeuwen of the Netherlands Cancer Institute came up with even more dramatic evidence of bias. The epidemiologists surveyed women in two regions of their country. In the liberal west, Rookus and van Leeuwen found a statistically insignificant relative risk of 1.3鈥攂ut in the predominantly Roman Catholic southeast, relative risk shot up to an astounding 14.6. The only plausible explanation: Because of the conservative religious values in the southeast, healthy women there lied about their abortions. "Reporting bias is a real problem," the Dutch team concluded.
Mr. Yeoman quotes ludicrously thin (Rookus) and incorrect (Lindefors-Harris) science to back up response bias, and makes it appear solid and authoritative. Consequently its really hard for me to accept it as a reliable scientific article, despite the magazine it was published in. I might lose an RfC on this, but I feel it's a pertinent point. When I'm done playing with my new toys, I'll write another draft for the Lindefors-Harris section, clarifying significant limitations to their 50% conclusion. - Roy Boy 01:21, 17 April 2009 (UTC)
In this case, you (personally) feel that Yeoman's article was sloppy (I have yet to see any reliable, independent sources backing your personal conclusions on that score, though perhaps they exist). That does not, however, make Discover a "pro-choice" source. MastCell聽 Talk 17:17, 20 April 2009 (UTC)
(undent) Big LOL, well he's made it a crusade to be sure. Clouds his judgment, but also makes him an expert regardless of being in the tiny-minority; I'd remind all his interpretation of weak data (his meta-analysis) can be valid (of marginal impact, but I emphasize not zero) if response bias turned out to be statistically insignificant.
The weight response bias deserves should be my focus, so apologies again on focusing on Yeoman above.
Bias' blanket effect on verdicts should be given the weight it scientifically (NPOV) deserves, as a statistically insignificant factor Hypothesized by the majority to account for (or create) barely significant positive ABC results. To give it more is charity. It has a liberal/conservative regional comparison in Rookus (bias Within each region would have been more informative and closer to ABC study best practices); an incorrect analysis and possibly bad dataset from Lindefors-Harris. The fact it's used by the majority doesn't change the NPOV assessment from Daling and Brind. Bear in mind the majority do not defend these response bias studies when they are finally scrutinized. Daling/Brind having the last word should indicate to us the weight Rookus and Lindefors-Harris deserve; and consequently how careful we should be on drinking the response bias kool-aid.
In the end, yes again we come full circle. That's okay though, it appears to me established articles go through it. Besides, I might actually be expressing the right ideas more clearly here. If one takes response bias at face (Yeoman asserted) value, then ABC associations nearly evaporate. If one gives bias proper NPOV weight, not based on political majority/minority but on balanced verifiable statements of fact (otherwise known as science), associations remain as the jungle of ABC studies indicate (Michel's drank the kool-aid BTW). One is left with the grey reality of the ABC hypothesis. No link, but not something to ignore either. The fringes are fun, n'est pas? - Roy Boy 04:50, 23 April 2009 (UTC)
Is the table under #Michels taken directly from the paper? WhatamIdoing ( talk) 06:02, 17 April 2009 (UTC)
After thinking it over, I decided to just kill the whole thing. It is probably a (legal) copyright violation and almost certainly violations Wikipedia's copyright rules. It doesn't really add to the readers' understanding of the conclusions, it's not an encyclopedic style, and it gives inappropriate weight (and tends in the direction of providing our own analysis of the paper) to what is basically a detail. Finally, the few people that really want that level of detail should read the entire study anyway. WhatamIdoing ( talk) 18:33, 20 April 2009 (UTC)
RoyBoy, are you familiar with WP:WTA#Synonyms_for_say? Perhaps you're just trying to avoid a boring vocabulary, but factive substitutes for "said" are unacceptable. WhatamIdoing ( talk) 05:02, 27 April 2009 (UTC)
The following two statements were recently added to the article. I have moved them here, as, at a glance, they seem to conflict with much of the evidence in the rest of the article.
-- Whatever404 ( talk) 17:26, 22 June 2009 (UTC)
The second paper is published in a relatively obscure, low-impact publication - PubMed/MEDLINE indexing is probably necessary, though certainly not sufficient, to define a reliable source for a statement of medical fact. More to the point, the findings are at odds with a number of larger, better-conducted studies as well as with unanimous expert synthesis of the literature as a whole. Specifically, the finding that hormone replacement therapy and oral contraceptives decrease the risk of breast cancer is entirely contrary to existing data, and raises some questions (for example, in another cohort of women from Istanbul, oral contraception and hormone replacement raised the risk of breast cancer, as it they commonly understood to do [ PMID聽 17371428]). If this one study causes a revolution or a re-evaluation of current scientific consensus on the issue, then it may be worthwhile discussing at length. As it is, it's probably undue weight to a single primary source which is at odds with numerous stronger studies as well as unanimous expert opinion. MastCell聽 Talk 17:43, 22 June 2009 (UTC)
"better-conducted" is presumptuous bias MastCell, and studies are expected to be at odds with each other and consensus! It isn't always a case of bad research, it can also be progress. Thisglad, new studies have minimal impact on a consensus unless they contain something new and are recognized as such.
On the flip side, despite the ironclad obscurity of the low-impact publication, the dataset is substantial on induced abortion 930 controls and 742 cases. This would appear to warrant inclusion in the Interviews section, perhaps a new "Further interview studies" section so we can mention ongoing findings. Adding one or two other studies of mixed (nil results) would be nice, assuming their datasets are almost as juicy. - Roy Boy 00:10, 24 June 2009 (UTC)
I guess you've summed up the problem: you see me "ignoring" study results, while I see myself as respecting secondary sources rather than lining up primary sources to advance my viewpoint. As to your final point, I couldn't agree more. So far the Turkish study has had no demonstrable significance - it doesn't seem to have prompted any expert or expert body to revise its opinion. Therefore, we should not assign the study substantial weight until/unless experts in the field do so. You're the one "guessing how experts will react". I'm saying that they haven't reacted, yet, so neither should we. MastCell聽 Talk 22:38, 24 June 2009 (UTC)
Have we established which ABC hypothesis papers we should include in this article? For example, there is a new paper (April 8, 2009; " Breast cancer risk factors in Turkish women 鈥 a University Hospital based nested case control study") that is not currently in the article. Should we mention it? 鈥擯receding unsigned comment added by Geremia ( talk 鈥 contribs) 09:27, 30 July 2009 (UTC)
A study (742/930 ABC cases/controls) of outpatients from clinics of the Istanbul University Medical Faculty published in 2009 by Ozmen et al. found a 1.31 (1.13 - 1.53) increased ABC risk. The authors point out various potential biases such as selection, information and even hospital admission bias may have impacted their results. They believe the large pool of patients available to them and the resulting large size of the study "provided reasonably stable risk estimates." [3]
Some pro-life supporters prefer the term abortion-breast cancer link. citation needed The subject is controversial. citation needed
Whatever404 reworked things a bit trying to clarify things, in good faith. KillerChihuahua removed the brand-new parsed unsourced statements in good faith. They were quite an eye sore once chucked out context. I'll make this brief, there are 112 sources in this article... and no one could be bothered to add a ref to them, or to undo the ugly disconnect created by Whatever404.
"some" pro-life supporters, no actually all of them do. That's is what its called. Do not add weasel words that aren't even necessary. Look it up!
This subject has never been controversial? Do you guys recall the NCI vs. the Bush administration. And that's the no brain required example you all know. There are plenty of historical back and forth from Daling and the fallout from the Howe study. - Roy Boy 04:24, 5 August 2009 (UTC)
Well that confirms to me that I can't rely on as many people around here as I would like. "risk increase" is substantially different from "cause", the inability to differentiate this is unfortunate. I'd ask that those involved do not modify the Lead any further unless they check it with someone who knows what they are doing. The WHO's determination of:
"Historical cohort studies, on the other hand, are more methodologically sound. Two major studies have been carried out using this methodology, and neither found an increased risk of breast cancer associated with first trimester abortion."
does not match recent original research by Wikipedia that there is "no risk" associated with "abortion". -
Roy
Boy
04:37, 5 August 2009 (UTC)
From my understanding, the hypothesis says abortion increases the risk of developing breast cancer. The second sentence says that scientific consensus is that abortion does not cause breast cancer. I don't think the hypothesis says abortion causes breast cancer, but it can increase the risk. I propose changing the second sentence to reflect this. However, since the first paragraph is important for the article, I wanted to bring it up in the discussion here first.-- Minimidgy ( talk) 14:39, 19 August 2009 (UTC)
I'm sure this is likely to anger those who support the views, but is this a manner of Pseudoscience? -- 74.232.40.140 ( talk) 03:53, 20 October 2009 (UTC)
I was surprised to walk into a wall of POV in the lead to this article. I was previously unaware of the issue, the only thing that crosses my mind on the content side is hearing that pregnancy protects against cancer in a number of ways. I am removing italics, "quibble" marks and infelicitous appositions.
Separately I have refactored the lead since it seemed to be structured in a "they believe this - but look at this research!" way. II am still not convinced that it is NPOV because I know little about the subject, but I hope that it is an improvement.
Rich聽 Farmbrough, 11:29, 19 November 2009 (UTC).
About this: Either the early research in question showed a correlation, or it didn't. Once you've already crunched the numbers, it's silly to talk about a "possible" correlation: Either you found one, or you didn't. "Possible" correlations only exist in proposals to conduct research, not in data. Have we perhaps confused correlation with causation in this sentence? WhatamIdoing ( talk) 21:43, 15 December 2009 (UTC)
Looking at it further there is a redundancy with the following:
and
These are saying the same thing a sentence apart. It bothered me before now, and I need to do something about it. Hopefully I didn`t muddle it too badly. - Roy Boy 05:16, 18 December 2009 (UTC)
In 2003, the NCI convened a workshop with over 100 experts on the issue. Although early abortion-breast cancer research had reported a correlation between breast cancer and abortion,[11] the "strongest evidence",[12] which is from large, prospective cohort studies,[13][14] demonstrates that abortion is not associated with an increase in breast cancer risk.[15] These improved studies controlled for confounding variables, such as age at first full-term pregnancy and the number of full-term pregnancies (parity), which are known risk factors for breast cancer.
Excellent suggestions from both of you, and parity being half defined entirely my fault. Thought I was going to get annoyed at WhatamIdoing for the word "demonstrates"... a strong word I'd like to avoid, but MastCell's suggestion changed the sentence and clarified it is the workshop's finding. Did small tweaks early > previous, that allowed me to put Daling back in the lead as I now remember that's an important positive finding to highlight.
Can y'all verify my punctuation is optimal, thanks.
Also, reinserted response bias... a point which probably needs to be expanded in the lead given its prominence in how ABC research is accepted / rejected (praised / criticized) by the NCI workshop, and the overall scientific community, without proper validation (a la nature vs. nurture debate and consensus missteps from the past). I also changed context of parity to a "key" factor, as that's why in the lead. - Roy Boy 17:24, 19 December 2009 (UTC)
Selection bias accusations by both sides may also be lead worthy. [2] Forgive me, grabbing notes from 2008 talk prior to archiving. Other links: New Zealand [3] Court cases - Australia [4] Paternalistic? [5] - Roy Boy 17:46, 19 December 2009 (UTC)
The section on mainstream medical opinion, which describes the position of AMA, ACOG, NCI, WHO, etc. ought to include the fact that no US Surgeon General has ever recognized the "link". This includes Surgeons General under right-to-lifist Presidents Reagan, Bush I, and Bush II. I have entered this info and linked directly to the searchable site of the US Surgeon General's office. The reader can verify by searching it! I hope that's OK; if not, you know what to do.... SingingZombie ( talk) 22:42, 25 December 2009 (UTC)
I'm not sure I agree with RoyBoy's reasoning. The Surgeon General synthesizes evidence and reaches determinations on a number of health-related issues. It's really up to the SG, and the politicians who appointed him/her, to set the office's priorities. In fact, the Surgeon General's office has addressed abortion, under C. Everett Koop and Ronald Reagan. It's an interesting story - some of the religious conservatives in Reagan's administration pushed for Koop to study abortion, because they were confident he would produce a report indicating that it was harmful to women, thus providing a medical rationale for outlawing abortion. To his credit, Koop (who is himself an evangelical Christian and holds pro-life convictions) ended up finding that abortion was not harmful to women, thus sorely disappointing the pro-life lobby (see [6], for instance). I'm not aware that subsequent Surgeons General have taken up the topic, but they do "generate their own determinations", and abortion-related issues are within their purview. MastCell聽 Talk 18:56, 26 December 2009 (UTC)
See National Cancer Institute andycjp ( talk) 04:50, 16 January 2010 (UTC)
While the Istanbul study was a one off, with mitigating factors such as small size (for a cohort study) and many possible confounders. But now the Dolle study, co-authored by a chairperson of the NCI workshop (Brinton) finds a small, but statistically significant association for ABC.
Given the prominence of the NCI workshop in the lead I believe we should add a line, in the lead, acknowledging current studies do continue to find small associations. This does not contradict the Views_of_medical_organizations on ABC "causation", but it does contrast with the NCI workshop findings of "no association". - Roy Boy 00:53, 8 April 2010 (UTC)
(indent reset)
Mastcell, seriously, please look at my first message of this thread; this is about the NCIw. As my initial shows I removed the "changed her position" editorial claiming it as a (direct) rebuttal. 1 sentence, I'll nitpick that as its joined to the previous sentence:
"In analyses of all 897 breast cancer cases (subtypes combined), the multivariate-adjusted odds ratios for examined risk factors were consistent with the effects observed in previous studies on younger women (Table 1). Specifically, older age, family history of breast cancer, earlier menarche age, induced abortion, and oral contraceptive use were associated with an increased risk for breast cancer."
Each sentence by itself is sufficient for mention in this article, combined it demonstrates clearly the NCIw finding is now outdated. As to WP:SYN, I've had a patchy history of recognizing when WP:SYN occurs on my part. So I do take that criticism to heart. However you seem convinced (at least in the past) the NCIw is beyond reproach and forms the backbone of the consensus, it doesn't. If a population based study by NCIw scientists showing an ABC association isn't sufficient to change the lead, I'm at a loss as to what would be. I mean do you think Wikipedia requires an ABC finding to be in the abstract for it to be sufficient weight? I believe the weight you've giving the NCIw, at this point, is utterly incorrect. Yes they all agree to no ABC link, but they do not concur on no ABC association. Conflating them to reinforce the NCIw is your WP:SYN.
The NCI workshop does not pass the standard of a systematic review as they did not use "an objective and transparent approach for research synthesis". Their rejections of studies was based on response bias guesswork, and their synthesis of cohort studies, specifically how they removed the high risk sub-groups in Melbye was not explained in their report. To pile on, the systematic review article emphasizes even proper reviews require updating just a few years after being done.
I don't think we are required to wait for them to update their own position. Nor are we in any way restricted from presenting the latest reliable information in context. In this instance, I believe the correct context is the outdated NCIw conclusion. - Roy Boy 17:41, 11 April 2010 (UTC)
You are absolutely required to wait for the medical community to "update" its view before substituting your own - highly idiosyncratic - interpretation of the primary literature. As a separate point, I'm not clear why you insist on harping on the NCI as if they were the sole group that has discounted a link. As you know, the NCI's view is shared in its essentials by numerous other major medical and scientific bodies. MastCell聽 Talk 18:01, 11 April 2010 (UTC)
鈫 That's a have-you-stopped-beating-your-wife phrasing. To clarify the relevant stances, here are the links:
I think that anyone who reviews these sources objectively will conclude that their stances are virtually identical. You can spend (have spent) a great deal of effort hammering away at the 1% where these groups differ. It might even be appropriate to explore those differences in context somewhere in the body of the article, if we're committed to keeping it at ~100 kb. But for summary purposes, and certainly for the lead, we should be clear that there is >99% agreement rather than focusing on the <1% minor variance. That's not "fugding" - it's a basic matter of honestly and proportionately representing available high-quality sources. MastCell聽 Talk 22:39, 11 April 2010 (UTC)
Why do you insist of having "concluded that abortion does not cause breast cancer" twice, in sentences next to each other? Its not good summary style. If anything, having it twice is undue weight for that meme, even though its accurate.
Also, I'm doubtful Jasen, as good as it is can support the "although it is considered largely settled as a scientific question". Can you clarify. - Roy Boy 19:26, 10 April 2010 (UTC)
That, combined with unanimous statements from major medical bodies indicating that there is no evidence of a link, plus the near-total absence of any published research on the topic in recent years - all of that suggests that this is not a topic of active scientific controversy. Jasen's article also makes clear that it remains very much a political football, although even that is playing out a bit. MastCell聽 Talk 22:29, 11 April 2010 (UTC)Even though proponents of the abortion-breast cancer link have lost credibility in the international research community, their campaign continues to gain willing converts, influence abortion legislation in a number of US states, and raise painful questions for women facing breast cancer or difficult reproductive choices.
(undent) Sorry Doc James just saw this response just now, thanks for the fast reply. Yes secondary sources are typically preferred if they are better, however you presume they are better. Why? (I understand the allure of larger data sets, but there are also in-built presumptions of these reviews, such as the significance of response bias that put their overall conclusions in as much, if not more, question than a smaller but pure data set) As to p, I concede you lost me a bit, but is this referring to comparing/including confounding factors in the result? Thus reducing p. As to Melbye, you take it as fact that their high risk subgroups are of no consequence? - Roy Boy 17:05, 17 April 2010 (UTC)
Personally, I think that the most current and high-quality sources on the topic (all of which are already cited in the article) clearly demonstrate that this is considered largely settled as a scientific question. Rather than responding to ultimatums, I'd rather hear whether anyone else has an opinion about the sentence in question. MastCell聽 Talk 04:18, 16 April 2010 (UTC)
(undent) I do not see any evidence that refutes the conclusions of the review articles we reference. Uptodate does state that evidence does not support a link and this is what we should go with IMO. The studies which are being used to attempt to prove a link are not statistically significant. Doc James ( talk 路 contribs 路 email) 17:11, 17 April 2010 (UTC)
This article (specifically the introduction) appears pro-abortion biased, in that it responds to the initial paragraph's question, "Does abortion increase the risk of developing breast cancer?" with the emphatic assertion, "Abortion does not cause breast cancer." That sentence leads the average reader to conclude that the debate is settled, but it does not address the question: The question is whether it increases risk, not whether it is a cause.
I say it is pro-abortion biased because such mispeaking can be deliberate to mislead people who think that "increased risk" means only "including more possible causes", e.g. "playing with matches during a gas leak is risky behavior". I am inclined to think it is so deliberate, because there is a clear concerted effort by those in power to promote contraception and abortion when facing the idea of human overpopulation.
In case this point needs clarification: If you are stressed, your immune system is weakened and you are more prone to becoming ill. Stress in this instance does not cause the illness, but it is an obvious factor that directly contributes to your becoming ill. Increasing risk and being the cause are two separate matters.
Please fix these problems. -- Newagelink ( talk) 18:16, 10 August 2010 (UTC)
In the most methodologically sound studies (e.g. PMID聽 8988884), the rate of breast cancer is the same in women who have had an abortion as in those who have not, so there isn't really an issue of increased risk, much less direct causality. MastCell聽 Talk 18:37, 10 August 2010 (UTC)
The article continues to improve, however the lead still perturbs me. It states "abortion does not cause breast cancer", meanwhile one if the strongest scientific sources for this statement is WHO. They state "show no consistent effect of first trimester induced abortion". While I've argued at length with Mastcell on this, could others weigh in on this. WHO's conclusion mentions first-trimester and we should include this in our lead. I'd emphasize the Melbye cohort study indicates a higher risk for 2nd trimester abortions; it appears WHO makes note of this when they state their conclusion. Wikipedia should as well. - Roy Boy 03:37, 17 March 2011 (UTC)
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