Abortion-cancer link disputed 

UAMS oncologists says evidence is to the contrary.


One of the reasons the Catholic Diocese of Little Rock gave when it asked church members in early February to end their support of Susan G. Komen for the Cure, a foundation that focuses on breast cancer awareness, was Komen's refusal to acknowledge that abortion can cause breast cancer.

The diocese has since reversed itself on Komen; its leader, Msgr. Gaston Hebert, apologized for acting on misinformation.

Hebert acknowledged that the “preponderance of scientific research” says there's no link between abortion and cancer, but added that a “minority opinion” says there is, and writers on Catholic blogs have suggested a conspiracy among abortion supporters has kept the truth at bay.

The Times interviewed two oncologists who specialize in breast cancer at the University of Arkansas for Medical Sciences to see where they stood. It is firmly with the majority. One of those doctors, Laura Hutchins, the director of hematology/oncology for UAMS and director of clinical research at the Rockefeller Cancer Research Center, is herself a Catholic and an opponent of abortion.

“My assessment is that there does not appear to be a definite increased risk,” Hutchins said. She pointed to research published in 2004 in the medical journal Lancet that analyzed data from 53 studies in 16 countries involving 83,000 women. It concluded that neither spontaneous abortion (miscarriage) nor induced abortion increased a woman's risk of breast cancer.

The Lancet analysis said that epidemiological studies that found a link — such as those done by Dr. Joel Brind, the physician whose research the diocese relied on for its position — were “misleading,” relying on volunteered information from women already diagnosed with cancer rather than medical records from all study participants.

Brind was the sole dissenter at a 2003 National Cancer Institute meeting of more than 100 experts that concluded there was no statistically significant link between abortion and cancer. The report can be found on the NCI website, www.cancer.gov. Others who've taken a similar position include the World Health Organization, the New England Journal of Medicine and the College of Obstetricians and Gynecologists.

Brind, who describes himself as a born-again Christian, and four other doctors make up the Breast Cancer Prevention Institute. His criticisms of the NCI workshop — which include that most of the experts attending had received federal funding — can be found at bcpinstitute.org.

“There's a lot of literature that says there is an increased risk,” Hutchins said, but “you can find a lot of literature that finds all sorts of things.”

Dr. Kent Westbrook, distinguished professor in surgery at UAMS and the former director of the cancer research institute, which sees 300 new cases of breast cancer a year, said abortion is a moral, not an oncological, issue.

“I have a lot of confidence in the scientific process,” Westbrook said. Political and social opinion can fuel outcomes — “We see what we want to see,” he acknowledged — but it is a diverse, “open and above-board” medical community that has dismissed a link between abortion and breast cancer. “You can't argue with 100 people coming together and reaching a conclusion” that evidence does not support a link between abortion and breast cancer, he said.

What can a woman do to avoid breast cancer? Not much, said Westbrook. Breast cancers are different from other cancers, like lung, that are linked to behavior (like smoking). Genetics plays a role, as does both endogenous and external hormonal stimulation. Women who get pregnant early in life seem to have a reduced risk, but those with early menarche and late menopause an increased risk. Recent studies have linked hormone therapy to breast cancer.

Women can, of course, get better outcomes, by monitoring their breast health with mammograms and being informed about treatment, which is what Komen for the Cure (formerly the Komen Foundation) promotes.

The national Komen organization recently awarded two $300,000 grants to UAMS husband and wife researchers Fred Kadlubar, for a study of the cancer drug Tamoxifen, and Susan Kadlubar, for studying the relationship between genes and response to chemotherapy. UAMS has received another $2 million from Komen for cancer screening and education and what are called “navigator” programs to help the newly diagnosed get services.

The Arkansas affiliate, which sponsors one of the most successful Race for the Cure events in the country, has provided $7.5 million in grants to Arkansas organizations and $2.2 million to the national organization, which funds only research (and not Planned Parenthood, as the initial church position said). The Ozark affiliate, which is sponsoring its Race for the Cure on April 22, has contributed $4.4 million in-state and $1.1 million nationally.

Sherrye McBryde, director of the Arkansas affiliate of the Komen foundation, anticipated the diocese's turnaround. She said the foundation could not oppose prevailing medical opinion. “It's no longer a [medical] question,” she said; “It is only a political question.”

Dr. Suzanne Klimberg, another noted oncologist at UAMS, is on the board of the local Komen affiliate.



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