Talk:Abortion-breast cancer hypothesis

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/Archive 1: Dec. 2004 – Dec. 2006 /Archive 2: Jan. 2007 –

Contents 1 LH small cohort 2 Interesting piece from Columbia Journalism Review 3 WHO source 4 Daling quote 5 Conspiracy of silence 6 URL date 7 Disputed status 7.1 Parity explained 8 CWA 9 The hypothesis is "controversial" not "unsupported" 9.1 NCI tweak 9.2 ACS tweak 9.3 Lead rework 9.3.1 Comments 9.4 The hypothesis is "controversial" not "unsupported" 9.5 Serious POV issues with this article 10 Waco Billboard 11 Why is this article still on Wikipedia? 12 Future links

[edit] LH small cohort

While I have yet to find a direct source for stipulating LH study with 65 cases is small, I did find this stipulating a 1981 study as an "extremely small cohort size" for 163 breast cancer cases. This same website refers to the 1989 study (and 49,000), but fails to mention what the cohort actually consisted of. Am I missing something, or is this an obvious double standard? - RoyBoy ⁸⁰⁰ 03:57, 6 December 2007 (UTC)

Sorry, can you give me a quick link to the LH study? Having trouble keeping up. MastCell ^Talk 21:32, 12 December 2007 (UTC)

It is Lindefors-Harris et al. (1989). Link. - RoyBoy ⁸⁰⁰ 00:22, 13 December 2007 (UTC)

Aha. I was thinking luteinizing hormone. That makes more sense. MastCell ^Talk 05:21, 13 December 2007 (UTC)

[edit] Interesting piece from Columbia Journalism Review

Not sure if this has already been discussed here, but I found this old piece from the Columbia Journalism Review topical and interesting - not sure exactly how/whether to work it in, though. MastCell ^Talk 00:13, 21 December 2007 (UTC)

I read the Columbia Review Journal often because they go beyond "he said/she said" journalism, and the editors do not put "balance" ahead of accuracy. The CRJ is neutral and well researched. The article you linked to above is certainly pertinent. It goes to the heart of the problems with the ABC hypothesis - and sheds light on things like "Post-Abortion Syndrome" as well.--IronAngelAlice (talk) 00:30, 21 December 2007 (UTC)

I recall something about this being mentioned a long time ago, indeed it is an excellent article. Though the section could be expanded to include political snipping by both sides; however, I do not have a source which analyzes... if I remember correctly Jasen touches on it. I need to get to bed, 1am isn't good. - RoyBoy ⁸⁰⁰ 05:54, 21 December 2007 (UTC)

I see this piece was removed from the lead as "partisan". While I don't have a strong feeling on whether it belongs in the lead, it seems a bit ironic to label it partisan. Mooney's point was that journalists often create a debate where none exists in an attempt to appear "neutral" or non-partisan. Reporting which states clearly that the ABC hypothesis has been rejected by the scientific community and is currently a pro-life political tool is not partisan, but accurate and neutral. Reporting which quotes the WHO/NCI/ACOG/etc on one hand and Joel Brind on the other, as if they were on nearly equal footing, is the truly skewed or partisan reporting. At least that's what I take his point to be. MastCell ^Talk 07:00, 25 December 2007 (UTC)

A strong conclusion does not make for a balanced article. I only had the read the first paragraph to reject the article as suitable for the lead: "only anti-abortion activists do", while mostly true it is also flat wrong, and in a good faith attempt to analyze skewed journalistic balance, he seems to have forgotten his. Ironic indeed, and I'm a little frustrated you guys didn't notice that after all our back and forth here. - RoyBoy ⁸⁰⁰ 22:31, 25 December 2007 (UTC)

A bit off topic, but curious: is there notable current support for ABC outside of pro-life activist circles? The remaining proponents of the idea seem to all move in such circles. MastCell ^Talk 07:19, 26 December 2007 (UTC)

It is the height of hubris for Mooney to think he knows the minds of Howe, Daling (even Michaels and Melbye) and other neutral scientists who have raised questions about the ABC issue from their research. While they may not believe the ABC "link" exists as pro-life advocates do; Mooney's statement goes beyond that to say no scientist takes ABC seriously, and/or it has been entirely "rejected". Which is very foolish and irresponsible, epidemiologists are examining this issue in depth not because of some phantom mechanism or merely facing down pro-life propaganda. There is a real question of biology they are examining, and they come up with mixed results; every... single... time, even with improved methodologies. As such, Mooney's surety has its place on the politics but not on the science nor the nuanced determinations of scientists. I only got the backbone to change the lead back (to unsupported) when I saw the WHO interpretation, and I came up with a way to keep "rejected" in the lead; but in a more accurate context. (it still may not be entirely accurate, as again it is difficult to know the actual opinions of individual scientists on the ABC issue in its entirety) - RoyBoy ⁸⁰⁰ 22:13, 26 December 2007 (UTC)

MastCell, please correct me if I am wrong, but you have supported "rejected" on numerous occasions, as have I. Royboy, you've come up with a way to keep it out of the lead because you don't want it in the lead, because (it seems) you think ABC is legit. Yet, even though they are still researching it, with every single round of improved methodology reliable science finds less and less of a correlation. No reliable study supports a causal relationship. I'm having a hard time seeing this as anything other than POV pushing. We've managed to keep this whole dispute rather civil. I'd hate to see that go to waste. If we can't resolve this quickly, I say we move to an RfC. Phyesalis (talk) 18:26, 29 December 2007 (UTC)

I concur with less and less correlation from overall findings, but high risk sub-groups continue to exist and cannot be ignored. (a case of throwing out the baby with the bath water) More to the point, no study has ever stipulated Russo's hypothesis as incorrect and hence "rejected"; regardless of correlative or causal determinations. The closest is the NCI "well established" conclusion, but as previously discussed they did not create any new evidence; rather they rendered a verdict on the evidence they considered valid. As WHO has shown, there are more precise scientific verdicts on the evidence. I currently see WHO and the NCI as being in agreement, however WHO is simply more precise in their wording (alternatively WHO is merely more conservative in its interpretation of the evidence); which clarifies to us the state of current scientific knowledge. We should prioritize that over editorial assertions by journalists. - RoyBoy ⁸⁰⁰ 19:58, 29 December 2007 (UTC)

[edit] WHO source

I find the WHO source in the lead excellent thanks to IronAngelAlice. However, I figured out after review; it is currently being misused per SYNTH misquoted. The website specifies, quite accurately, that "first trimester" abortions do not pose an ABC risk, per cohort studies. It is my opinion this should be precisely reflected in our lead, to more accurately communicate the state of scientific evidence on this subject. Objections? - RoyBoy ⁸⁰⁰ 22:31, 25 December 2007 (UTC)

Sure, no problem with that. The finding is based on the fact that >90% of abortions occur in the first trimester, not on any demonstrated risk of later abortions, but I suppose we don't need to belabor that point. MastCell ^Talk 07:22, 26 December 2007 (UTC)

I have changed rejected back to unsupported, and moved "largely rejected" to replace the third paragraph "rejected". This I believe makes the lead the most accurate it has ever been. - RoyBoy ⁸⁰⁰ 21:55, 26 December 2007 (UTC)

Eh, "rejected" is the better and more accurate word there. It's actually not completely "unsupported", in that a basic-science rationale exists and a handful of (flawed) studies have reported an association. But it is, in fact, rejected by the WHO, NCI, ACOG, and every other reputable medical/scientific body that has looked at the supporting and contradicting evidence. MastCell ^Talk 22:01, 26 December 2007 (UTC)

That was fast, sorry WHO has not rejected it completely; and by handful and flawed are you including Melbye and Michaels cohort studies? As I see them as flawed and with sub-groups that WHO have accurately seen as possible associations. WHO makes it very clear the evidence they considered, unlike the NCI, and they make it equally clear the determinations those studies allow: "neither found an increased risk of breast cancer associated with first trimester abortion." - RoyBoy ⁸⁰⁰ 22:18, 26 December 2007 (UTC)

Do you have MSN or some other chat mechanism we can use? I think it would increase productivity at times like this. - RoyBoy ⁸⁰⁰ 22:19, 26 December 2007 (UTC)

"Rejected" is clearly better. "Unsupported" suggests that there hasn't been enough study or that things are inconclusive. Not so. ABC is about as rejected as phrenology (and if phrenology said that abortion was bad, I'm thinking it too would be supported by some pro-lifers). MastCell makes a good point in that pro-lifers still support the theory, despite the fact that it is has been rejected. Phyesalis (talk) 16:05, 27 December 2007 (UTC)

That has never been the case; with WHO it's now verifiably not better. Please take a second reading of WHO. They do not say "ABC is not associated with abortion"; they specify "first trimester abortion". So your comparison just isn't helpful. - RoyBoy ⁸⁰⁰ 03:55, 28 December 2007 (UTC)

Additional notes, some things still are inconclusive (as per WHO and the evidence); hence unsupported is better than rejected in the first sentence. MastCell does make good points the rejected meme is still in the lead; but in its accurate context. Saying "despite the fact that it is has been rejected" makes a statement of fact with no specifics. How exactly is it rejected? The lead specifies exactly how; no more and no less. Prior to my edits it seemed ABC was proven wrong; that just isn't true.

"Unsupported" does imply "there hasn't been enough study"; more study is needed on sub-groups; as specified by Melbye and Michaels themselves. No scientific study I'm aware of says no more research is needed on the ABC issue; many of them call for more research. Hence, this is something important to communicate, while still maintaining your accurate "rejected by the scientific community." Something can be "rejected by them", and still in need of clarification.

We could reword it to something like: "not associated with first term abortion." But the line, while more specific and informative has implications of its own. Perhaps merging "rejected by the scientific community" into the first sentence would be more to your liking? But it might make it long, awkward and more confusing. While my version(s) are more confusing, that is certainly preferable to misconceptions. How it was before, created misconceptions simply not in line with the evidence and state of knowledge. WHO is a sober clarification of the evidence; the NCI's findings supports "rejected by the scientific community" (adding it as a ref now) but does not go beyond that. Do not continue to think it does. - RoyBoy ⁸⁰⁰ 04:41, 28 December 2007 (UTC)

Lastly, your version implies certainty where it does not exist. I acknowledge MastCell's points, but I think he has temporarily mixed up clarity with accuracy. While a very liberal interpretation of "unsupported" may lead one to think there is no science rationale; "rejected" has the same danger of doing that and more; nes't pas? Hence, was a part of my initial resistance to that word. It implies the rationale (mechanism) has been rejected. Unsupported is safer in that regard as well, but since you guys seem to think it has (or should be rejected) that apparently hasn't occurred to either of you. *sad face* - RoyBoy ⁸⁰⁰ 05:06, 28 December 2007 (UTC)

While WHO may say unsupported, there are multiple sources which state that a causal relationship is either nonexistent and/or irresponsible. Rejected is clearly the more responsible since the theory is supported by pro-life advocates and rejected by scientific consensus. When the lead states that the hypothesis has been rejected, it means that a causal hypothesis has been rejected. Your point about implications for the mechanism seem irrelevant. Scientific consensus's implications of certainty are in the eye of the reader. Those readers familiar with scientific methods will understand that consensus is a reflection of evidence at any given time, open to new and different data that may or may not arrive in the future. You seem to be reading certainty into assertions of consensus that do not exist. We seem to go over this issue repeatedly, with MastCell and I arguing for "rejected" and you arguing for some alternative. I'm changing it back to "rejected". If you disagree, perhaps you could open an RFC? I don't see the constructive value of going over the same ground every other week. Phyesalis (talk) 05:42, 29 December 2007 (UTC)

We probably will need one, or even mediation, if you continue to believe Mooney is more reliable than WHO. That simply doesn't make sense, and I am still awaiting MastCell's response. You're jumping to a consensus prior to it actually being formed. The WHO's assessment is conservative and beyond reproach; and does not have the political context and media scrutiny the NCI workshop unfortunately had.

I'd mention IronAngelAlice's contributions have helped the article in the long run, but have been partisan in the past and have had a bloggish prose and focus on the politics/personality of the ABC issue rather than the science. Avoid this if you want to effect NPOV changes to the scientific context. Mooney is not NPOV, his first paragraph makes that abundantly clear. - RoyBoy ⁸⁰⁰ 18:02, 29 December 2007 (UTC)

As to what "readers familiar with scientific methods" will read into the lead paragraph, I think they will be very confused by a "rejected hypothesis" having a plausible mechanism being referred to by Melbye as a possible explanation for their positive results. This touches on the "reinterpreted" meme of Russo's.

I need to look into it further, but based on my reading of their 1980 study: "In contrast, abortion is associated with increased risk of carcinomas of the breast.5,14-16 The explanation for these epidemiologic findings is not known [...] Abortion would interrupt this process, leaving in the gland undifferentiated structures like those observed in the rat mammary gland, which could render the gland again susceptible to carcinogenesis." It would appear Russo's did indeed propose (no reinterpretation) the ABC hypothesis for previous studies positive findings; and as a possible explanation for their own weak findings. Now indeed, they didn't say "more" susceptible; but rather "again"... on the flip side Russo didn't take any firm stand one way or the other... so "reinterpreted" implies Russo disagrees/never proposed an ABC mechanism; but neither of those is true (as of 1980). - RoyBoy ⁸⁰⁰ 18:21, 29 December 2007 (UTC)

Plausible mechanisms exist for all sorts of proposals but once the scientific evidence comes in, that is when the process of acceptance or rejection begins. I have pointed out before that research will continue to be done in this area in the same way that vaccination vs disease control takes place. This does not imply uncertainty - just thoroughness. This theory is rejected by all the main scientific bodies and to hint otherwise in the lead is to play into pro-life POV. The picking apart of what each study did/concluded is for the main body of the article, however the first paragraph should faithfully represent the current scientific consensus. To not do so is to push this into the realms of pseudoscience (and we have been there ;-) Sophia 07:55, 30 December 2007 (UTC)

Well argued on plausible, but very wrong on "is rejected by all the main scientific bodies". You do not have a basis to even believe that anymore given WHO. I have changed the lead back to rejected using the ONLY pertinent reliable source – which can be argued rejects (because it doesn't actually state it) – the ABC link (I do not believe it is judging the hypothesis, and as such is another ref being misquoted). A plausible mechanism defacto makes "rejected" inaccurate from a NPOV scientific context; whereas the consensus is faithfully represented in the Third Lead Paragraph with an appropriate ref. Keep in mind the state of scientific knowledge is the priority at Wikipedia and can be different than the consensus (eg. prions, nature vs. nurture). I ask you to change your mind; and Mastcell's opinion would be very appreciated. - RoyBoy ⁸⁰⁰ 19:42, 30 December 2007 (UTC)

I plan on removing "reinterpreted" from the lead, any objections to this? And frankly I'm alittle annoyed of having to go through this. I have the studies, and as things stand, it appears others are basing statements and interpretations on only the abstracts. - RoyBoy ⁸⁰⁰ 20:04, 30 December 2007 (UTC)

I have an issue with it. You have your interpretation of the studies, I have a documented secondary source (not based on my interpretation of an abstract). We agreed, I thought, that "reinterpretation" was a compromise for "misinterpreted" as supported by Jasen. If you feel like opening this up again, I'm going to have to argue for "misinterpreted" as "reinterpreted" was a compromise. If you reject the previous compromise, I'm thinking "misinterpreted" is actually more accurate. I have added more info to footnote for this statement. (Jasen, #23) Phyesalis (talk) 21:39, 30 December 2007 (UTC)

Okay, but Jasen took that from the abstract. Within that context it is misinterpreted/reinterpretation; but the results do not support that determination. It doesn't take a great deal of interpretation to know which number is larger than the other. On the flip side number of tumors per tumor animal is lower for Abortion (2.1) than for Virgins (2.6). That does seem to mitigate Abortion (77.7) vs Virgin (71.4). Hmmmm... I guess I will have to leave this one be in place of something firmer.

there was no evidence to suggest that abortion would result in a higher incidence of carcinogenesis

Given Russo references 4 studies which do exactly that, the line should be deleted. Especially since the following sentence implies confirmation of that phantom finding. - RoyBoy ⁸⁰⁰ 23:26, 30 December 2007 (UTC)

Actually, even given the abstract; that does not permit you to conclude: "found no increased risk associated with induced abortion." While Russo says "the same risk" you simply cannot say "no increased risk," they are not equivalent as Russo said one, but not the other. I am changing it to "similar" or something else less wrong. - RoyBoy ⁸⁰⁰ 23:37, 30 December 2007 (UTC)

The abstract is fine as it provides us with a concise overview of the relevant information. Russo says "same risk", trying to sort through to the nitty-gritty to try and present the study contrary to the author's conclusions seems like cherry picking. If PI rats are the same as virgin rats, then there is no increased risk because virgin rats are the baseline. I thought we went over this before. You argument would be valid if parous rats were the baseline, but they're not. Phyesalis (talk) 02:50, 31 December 2007 (UTC)

Something's being miscommunicated here, what you just said makes no sense. Parous rats should never serve as a baseline, it is meaningless to do that as Virgin and PI (abortion) rats are much higher than that. (see table 2 on pg 502, pregnancy (parous) rats have zero tumors) The entire point of the ABC hypothesis is assessing risk relative to nulliparous (virgin) subjects; in order to know if ABC is independent from delayed/no child rearing.

"no increased risk" is original research. You are interpreting their results which contradicts their statements, results and ABC carcinoma references within the study. A concise "same risk" in an abstract simply does not allow you to elaborate on their results. If ANY part of their study, stated "no increased risk" or the results were in fact exactly the same, we wouldn't be having this discussion, again. However, my abstract of the situation is this: Russo clearly references 5, 14-16 as having "abortion is associated with increased risk of carcinomas..." It is very simple, their study does contain evidence (as footnoted references) in contradiction of your statement. - RoyBoy ⁸⁰⁰ 05:06, 31 December 2007 (UTC)

Also please don't avoid the nitty-gritty. Too many people have, hence my struggle with so many misinformed people. The nitty-gritty establishes the state of scientific knowledge, the hop-scotch validity of response bias, and the NCI being "dismissive" of Daling and "uncritical" of Melbye. The abortion-breast cancer issue is excruciatingly challenging... and you haven't been surprised by it as many times as I have. - RoyBoy ⁸⁰⁰ 05:16, 31 December 2007 (UTC)

Actually I think I gave up too easily on the "reinterpreted". As I stated, and should have focused on in my discussion (but got distracted by the above and Jasen), is that Melbye refers to Russo and Russo hypothesis as an explanation for their positive findings. Now this remains a complicated issue, because maybe Melbye is saying Russo's proposed a correlative hypothesis... if this is the case, then changing your "causal hypothesis" to correlative (to reflect Russo's original context) would remove reinterpreted/misinterpreted from the equation. Because Russo & Russo did state the ABC hypothesis as a possible explanation for positive findings; it would appear to me that it is a causative proposal, and that pro-lifers such as Brind interpreted it correctly. Even so, it certainly doesn't change the fact pro-lifer's indulge in misinterpreting the significance and weight of results. I think I'm going to change the pseudoscience note to more precisely reflect that meme. - RoyBoy ⁸⁰⁰ 06:14, 31 December 2007 (UTC)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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)

[edit] 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;^[1] it is a controversial subject and the current scientific consensus has concluded there is no significant association between abortion and breast cancer risk.^[2][3][4] 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.^[5][6][7]

The American Cancer Society concludes that presently the evidence does not support a causal abortion-breast cancer association,^[8] yet a causal link continues to be championed by pro-life activists like Dr. Joel Brind, Dr. Angela Lanfranchi and Karen Malec.^[4] 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.^[9] 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."^[10]

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 and medical associations is seen by others as merely a part of the current pro-life "women-centered" strategy against abortion.^[11][12][13] Pro-life groups maintain they are providing legally necessary informed consent;^[14] a concern shared by conservative Congressman Dr. Dave Weldon.^[15] While early research indicated a correlation between breast cancer and abortion;^[16][17] 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.^[18][19] 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.^[4]

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."^[20] 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.

[edit] 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)

[edit] 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)

[edit] 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 [11]

• Helen Ownby et al “Interrupted pregnancy as an indicator of poor prognosis in T1, 2, N0, M0 primary breast cancer” 1983 [12]

• Holly Howe, et al “Early Abortion and Breast Cancer Risk among Women under Age 40” 1989 [13]

• Janet Daling, et al “Risk of Breast Cancer among White Women following Induced Abortion” 1994 [14]

• Polly Newcomb et al “Lactation and a Reduced Risk of Premenopausal Breast Cancer” 1994 [15]

• Polly Newcomb et al “Lactation in Relation to Postmenopausal Breast Cancer” 1999 [16]

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)

[edit] Waco Billboard

Is there anything in [17] 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)

[edit] 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)

[edit] 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)