Talk:Abortion–breast cancer hypothesis/Archive 4

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Modify and move Views

I'm thinking of modifying the Views section to the following:

The Catholic Medical Association among several other pro-life medical organizations believe an ABC link exists based on "29 out of 38 worldwide epidemiological studies show an increased risk of breast cancer of approximately 30 percent." The scientific consensus is that many of those studies are subject to response bias and are not sufficiently reliable to draw conclusions from. A number of major medical organizations such as the World Health Organization and the United States National Cancer Institute have analyzed larger studies regarding induced abortion and breast cancer. Their uniform conclusion is that there is no causative link between induced abortion and breast cancer. The American Cancer Society noted with concern that: "Breast cancer is the most common cancer, and is the second leading cancer killer in women. Still, 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."

And make it the last paragraph of the Lead. I dislike how it repeats things in the lead, and is simply placed at the top of the article to push back against a perceived imbalance in the Lead.

If we did this, then the "The American Cancer Society concludes that presently the evidence does not support a causal abortion-breast cancer association,[9] yet some pro-life activists continue to champion a causal link" in the lead would have to be moved, deleted, tweaked. Indeed its partly due to this very repetition I want to merge the Views section with the lead. - RoyBoy 21:09, 18 January 2009 (UTC)

Lead revert

ABC link needs to be in the lead because that is actually the primary title of the concept. ABC hypothesis isn't as widely used. So its of significant importance it is in the lead. I added pro-life into the brackets, and move restrict abortion to the next paragraph for improved flow. - RoyBoy 17:31, 8 March 2009 (UTC)

I don't think that the 'pro-life' label is appropriate in the lead. It seems to imply that anti-abortion people are deliberately engaging in lies and scare tactics, and the idea was once taken seriously by people on all sides of that debate. WhatamIdoing (talk) 19:39, 9 March 2009 (UTC)

That's likely why it was removed previously. But regardless of your position on this subject, pro-lifers are engaging in poor science and tactics. While that is important, that isn't the point. abortion breast cancer link brings up 300,000 hits on Google (far more than hypothesis) and is used almost Exclusively by pro-life organizations. In this recent revert I realized I regretted allowing that obvious omission. The fact the article title uses "hypothesis" instead of "link" is a conscious step away from poor scientific interpretation.

At one time the idea was taken very seriously. That's why so much research was done. - RoyBoy 00:14, 11 March 2009 (UTC)

Perhaps the lead could make clear that the idea was once taken seriously across the board, from a scientific standpoint. It could also make clear that accumulated evidence has disproven the hypothesis, and that it has gradually become relegated to a political tool of the pro-life lobby. MastCell ^Talk 05:56, 10 March 2009 (UTC)

Looking at the diff it was addressed in the lead with "it has been a controversial subject", I'll put that back in... if you wish to improve/tweak how the "seriousness" meme is handled I'm listening.

While the ABC hypothesis has become pro-life relegated, that's only because people think its disproven.

That is a political perception, not scientific reality.

Apparently I need do more to make that clear, that's one reason I want to merge the "Views of medical organizations" section. Just to drive my point home, "at the present time, the scientific evidence does not support a causal association" is not the assessment of a disproven concept. If ABC is disproven/has no evidence and in tatters scientifically, the American Cancer Society would not hesitate to say Exactly that. They don't, and it's your preferred source. Please clarify this in your mind so we can continue to improve the article together. - RoyBoy 00:24, 11 March 2009 (UTC)

Just to be crystal clear here. The ACS statement means there is evidence of an association. (hypothesis still alive and well)

But insufficient evidence for a causal (link) interpretation. - RoyBoy 00:35, 11 March 2009 (UTC)

We've had this circular argument often enough that I don't feel like repeating it. I am not going to lecture you for the umpteenth time that a hypothesis which lacks any meaningful scientific support is effectively disproven, rejected, [insert synonym here]. I know you understand the difference between an association and a causal relationship - the ABC hypothesis posits the latter, and has been scientifically rejected. Let's just stick to the reliable sources - which are ample and quite clear - rather than interposing our personal views on the NCI, American Cancer Society, World Health Organization, etc. MastCell ^Talk 01:58, 11 March 2009 (UTC)

I like MastCell's proposal above: We should communicate that it was taken seriously (by just about everyone) at one point, and that it is now rejected by mainstream medical authorities, but promoted by anti-abortion groups.

I'm not convinced that the "ABC link" name is actually important enough to include it in the lead, and removing it would reduce the use of political labels in the first paragraph. No one is likely to reach this article and think, "Hmm... this is about the ABC hypothesis, and I was looking for ABC link, so this must be the wrong article..." WhatamIdoing (talk) 20:47, 11 March 2009 (UTC)

I concede I'm befuddled by that statement. The ABC link is the dominant label for the issue, your level of being convinced doesn't change that in the least. And while I admit confusing the two is a minor concern (especially since ABC link redirect to hypothesis), if people do a Google or Wikipedia search for the Link, it should show up. Otherwise they simply won't find this article. That is a significant concern. Further we are required by Wikipedia to use the standard terms for concepts.

Mastcell is wrong and will continue to be until it is Shown the ABC are not associated. While its good Mastcell appreciates my repeated distinction between "association" and "causal", ze does not appreciate "disproven" is in no uncertain terms not a synonym for the position of "mainstream medical authorities", with the exception of the NCI workshop (which isn't even a medical body). Medical authorities are not politicians, zealots, nor illiterate, if something has no evidence and/or the ABC mechanism is found to be incorrect (only then is it disproven), they are very capable of using the word disproved or a true synonym such as "no evidence", "error in biology" etc etc. I have no choice but to keep re-explaining this as best I can, because Mastcell is wrong. If you continue to agree with Mastcell, that's unfortunate. Try to change the article and I will take issue with it.

If you need clarification or have questions, please ask. Thank you. PS: I have to make effort not to get emotionally involved every time someone tells me I'm the one inserting my POV, while they are truly Neutral. Give me a friggin break. - RoyBoy 23:53, 14 March 2009 (UTC)

Sure. I have to make an effort to let it slide every time someone implies that a 100-member expert panel convened by the National Cancer Institute is "not even a medical body". I'm serious: I don't feel like arguing with you anymore. It's a poor use of both of our times. Do as you like with this article. MastCell ^Talk 02:30, 15 March 2009 (UTC)

Stop assuming the worst. This is about the workshop, not the NCI. I'm pointing out the distinction one should make for a Temporary expert Workshop hurriedly convened and finished because of political actions by Bush conservatives; versus an actual permanent medical group that takes its time; away from public/political scrutiny and motives; to assess the ABC evidence. The NCI is a big time medical body, sure, but their workshop wasn't ideal.

Moreover, they are far from the only credible organization to rely on for an ABC position; hence pushing the NCI workshop position as NPOV and representative of scientific consensus doesn't hold. - RoyBoy 05:14, 15 March 2009 (UTC)

Listen to yourself. You start with ludicrously original attempts to minimize what was - I repeat - a 100+ expert panel of the NCI, which is exactly the sort of source Wikipedia demands. Then you seem to think that the NCI was out on a limb, when every medical and scientific body that has looked at this question has come to the same conclusion. Like I said, do as you see fit. Describe the National Cancer Institute as "biased", "hurriedly convened", "unscientific", etc because of the grumblings of a single marginalized anti-abortion advocate. That's encyclopedic. MastCell ^Talk 06:46, 15 March 2009 (UTC)

A solid perspective, however your focus on the advocate versus his arguments isn't encyclopedic either. My "unscientific" jab is unfair ONLY if stripped of context, but I want to ensure people don't confuse the workshop with a proper scientific study. They are two different things. You believe the NCI workshop is equal or perhaps even better than a study, it isn't. At best the NCI workshop is the equivalent of a meta-analysis. That isn't my opinion, that is the nature of what they did by using Selected "strongest evidence".

Wikipedia does demand that kind of source, hence it is in the lead. But to rely on that particular source is your idea, and to think organizations have "come to the same conclusion" means you don't like/see the distinctions between them. WHO saying no consistent association for "first-trimester abortion" is not the same as the NCI's well-established "no association" period, likewise with ACS's no "causal association". So you want Wikipedia to favor NCI over everything else because they put more PhD's in a room for a few days?

I cannot agree with that because it isn't scientific. You can dismiss and simplify my concerns, but that's my ultimate focus. 100+ or 999+ experts, it doesn't mean much, what matters is the evidence they used and do other neutral parties come to the same conclusion? Yes they reach Similar conclusions, but not identical, nor does anyone say the ABC mechanism is wrong. See colon cleansing for a disproved concept, as its "auto-intoxication" premise has been rejected by scientific progress and ZERO scientific evidence supports it. If that happens to the ABC mechanism, then that's good as we would have clarity on the ABC hypothesis. Until then, please don't jump ahead of science; as science moves slowly when there are inconsistent results. - RoyBoy 18:37, 15 March 2009 (UTC)

Take a look at WP:MEDRS, and WP:OR. Actually, take a look at any text on evidence-based medicine; you'll find that meta-analyses and systematic reviews of primary evidence are at the top of the hierarchy of scientific evidence. Part of editing here is that we focus on external expert interpretations of medical evidence, rather than our own. I don't think you're willing to do so, even within the context of Wikipedia - this article is a testament to that.

Yes, the WHO was somewhat more conservative in its interpretation than NCI and ACS, limiting themselves to 1st trimester abortion. As I'm sure you know, 90-95% of all abortions are performed in the first trimester. Hence this is best characterized as a minor difference in the interpretation of a gray area, rather than a major dispute, ongoing controversy, or evidence of carelessness on the NCI's part. If the two groups are in 90-95% agreement and 5% disagreement, then WP:WEIGHT and common sense indicate pretty clearly what we as Wikipedians should be doing. MastCell ^Talk 03:09, 16 March 2009 (UTC)

(undent) A harsh analysis as I regard my POV as close to neutral, but very well argued. If I could shake your hand I honestly would. Three issues at hand, most previously argued by us, but put in a new, interesting and compelling line of thought which I hope is evidence we aren't wasting our Wikitime together! :"D

1. I allowed you an opening when I said "at best" it would be a meta-analysis. Well, a meta-analysis is a study, and like any other study it shows in writing (a medical publication) the evidence used, adjustments and decisions that were made in interpreting/rejecting studies, and then detailed results with Percentages and any caveats/unknowns. Does the NCI workshop have any of that? They do list unknowns, but my POV is the rest is absent. For example the results are listed and conclusions are clear, but no caveats, high risk groups nor percentages are offered to clarify. Biology isn't a yes/no reality, it is an analog reality. Do you concur?

2. Does it qualify as a systematic review? A closed, very short review, but Absolutely! So does WHO, without caveat(s).

3. 5% (approx. of course, as Melbye's creeping risk increase and Michels sub-groups weight is a matter of opinion) is what our at times torturous circular argument is truly about, and I'm relieved you brought it up again (but more clearly and forcefully this time) to refocus us. See how numbers clarify things much better than saying "well-established" or throwing WP:WEIGHT into it. What a relief!

Well... now, this actually forces me to think. Everything before this was pretty easy and automatic. Since the time change I've been behind in sleep, culminating in little sleep last night; I actually had a short day at work as a result. (I can actually provide a scan of my time card if anyone (I mean Mastcell ;") wants to see, heh reminds me of the Phyesalis days of demanding scans of ABC documents.) My instinct of Wikipolicy and common sense is you are wrong. But I'll need some time to work out why I think that, and if its valid/verifiable. It is an excellent point to make, because for peer review/FAC it requires a sound determination one way or the other.

I'm going to avoid refining the 5%, what I/we need to figure out is if 1% is sufficient cause for the "first-trimester" caveat in the lead. Otherwise we will implement something like SNALWIBMA's suggestion below. Do you have a deadline in mind Mastcell? - RoyBoy 02:18, 17 March 2009 (UTC)

No, no deadline. I'm sorry for getting frustrated. I'm not in a hurry to edit the article at this point, but I do feel fairly strongly about the points mentioned above. MastCell ^Talk 04:21, 17 March 2009 (UTC)

(undent) RoyBoy, I think you need to pay more attention to what MastCell is telling you about scientific evidence. Reviews of previous high-quality studies are stronger than the individual studies: 95% confidence interval means that any individual study has a 5% chance of being wrong, after all. The NCI panel report counts as the opinion of medical authorities. Perhaps more pointfully, there are no widely respected medical authorities that support causality (as opposed to increased risk due to losing the protective effect that early childbearing confers). WhatamIdoing (talk) 20:47, 16 March 2009 (UTC)

Yes Mastcell did a good job, but you're buying into something you haven't scrutinized. As to reviews of previous studies being automatically stronger, well no, as Wikipedia knowingly stipulates they "should be" better. Meta-analysis can be undercut by selection bias and presumptions of high-quality. Yes, if you combine the data in a responsible way the confidence interval can be narrowed (because you have a larger combined dataset), but if you are combining different flaws from different studies... in actuality the confidence internals should be compounded on each other if those flaws are not corrected. If you have no indication of flaws in studies used, then its natural to believe they are high quality.

As to causality, indeed no one of authority supports that, but please stay on point. We are focused on "association". While Mastcell made the point above that the hypothesis hinges on causality, that is very misleading. Let me explain it more plainly, and I think even Mastcell will catch on this time.

For sake of argument, it is shown an abortion at 10 weeks gestation increases risk for certain women (with correct confounding risks) by 24%, is that strong enough to conclude causality? I don't think so because of the likely small sample size, but simply because it does not meet the criteria for a causal determination by scientists; an association remains. I know Mastcell I'm repeating things, but this is friggin important as you confuse people. The hypothesis Does Not Require XX% risk increase for it to be a co-factor in breast cancer risk. To seal the point, recently a report concluded a daily drink could raise breast cancer risk by 12 percent. Now is anyone saying 1 drink causes cancer? No, but it does seem to be an associated factor. Let's take a step back from that, only 12 percent... whereas Melbye shows an average increase of 3% per week of gestation. I agree with Melbye the number of women involved isn't sufficient in the later weeks to draw firm conclusions, but the trend is obvious and that impact is plainly more than 12% for logic sake! (yes I know alcohol studies with heavy drinking show higher risks, but so does delayed abortion, so a non-starter)

Sorry for the long paragraph. As to childbearing, completely valid point and you are showing yourself to be truly engaged in the subject (big thumbs up from Mastcell and me), but that is old news for us; and I made a point of mentioning it in the lead as some previous readers brought that up in talk as they missed the confounding factors detailing that subject. It has no bearing on ABC results we focus on, as they compare like women together. - RoyBoy 02:18, 17 March 2009 (UTC)

Causality is complex. No one study proves it, or disproves it. There is no set percentage or effect size which makes a statistical association "causal". Studies can show associations, but determinations about causality are more an art than a science - witness the back-and-forth about secondhand smoke. In the end, an association becomes "causal" when experts agree that the relevant biological and epidemiologic hurdles have been cleared. One can of course critique the thought processes of those experts - in fact, it's an essential part of being a critically thinking adult - but Wikipedia is not the venue for such analysis. Here, it's called original research. MastCell ^Talk 04:26, 17 March 2009 (UTC)

Certainly, as it is an "art" I want to ensure the "no causality, means disproved" ends. As to OR, I understand your concern from my views, but you seem unwilling to leverage primary sources.

ie. Daling calls out the Lindefors-Harris bias study, its conclusion is retracted, and that puts response bias on unsure footing. IF the NCI workshop asserted response bias as a reason to reject "inconsistent" studies on ABC, that is pertinent. Is any of that inappropriate, or OR? The NCI assertion is a guess by necessity.

Being a Wikipedian is about putting 2 + 2 (both sourced) together to create an interesting factual article. As we can't do that for the NCI workshop, isn't that a problem? Or are we only interested with their conclusions, and their methods aren't required to be explained? Hmmm... I wonder if Wikipolicy addresses this. - RoyBoy 01:51, 18 March 2009 (UTC)

Yes, in is called Synthesis of published material that advances a position. We report the conclusions of people actually qualified to determine the status of medical evidence. If you are so qualified, great - publish in a peer-reviewed journal and then introduce the reference here. Searching PubMed, the best source I can find is Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83?000 women with breast cancer from 16 countries, 2004 (currently reference 61). This review states pretty unequivocally that Pregnancies that end as a spontaneous or induced abortion do not increase a woman's risk of developing breast cancer. They also cover some interesting historical and sociological aspects.

That said, if there are reliable sources parsing and criticizing the NCI report and their methodology, it could certainly be appropriate to include them. Please propose sources and wording in a new section below. - Eldereft (cont.) 03:53, 18 March 2009 (UTC)

I know its SYNTH, as noted by "NCI assertion is a guess by necessity". If their rationale was published, and their references, assuming response bias was a factor in their analysis, references such as Lindefors-Harris would likely be listed; making it not SYNTH. Anyway, can you clarify for us how any reliable source can parse or criticize the NCI report if its methods, interpretation, evidence and evidence criteria are not published?

I would dispute your best source divination, and characterize it as impressive preliminary research, but with little depth, and more importantly, caution. Regardless, you've made a superior edit in the lead; possibly by accident; for that I applaud. - RoyBoy 00:44, 19 March 2009 (UTC)

I agree with Eldereft: RoyBoy's proposed work would be a violation of policy. It's really not our job to analyze whether or not a source did a perfect job or to look for loopholes in their work. Wikipedia is not "figure out if they did a good job." It's "write down what they said." (Now if we could find solid sources that complain about it, that's a different matter.) WhatamIdoing (talk) 04:23, 18 March 2009 (UTC)

I agree. - RoyBoy 00:42, 19 March 2009 (UTC)

OK, I have one additional bone to pick with RoyBoy. He again claims, offhandedly, that Lindefors-Harris' work was "retracted". That would be a pretty serious indictment - if it were true. It's not. Lindefors-Harris' work has not been retracted, and given the ignominy typically attached to retractions, it's irresponsible to bandy about such claims. I know RoyBoy knows better - at least, he should. I've been correcting this particular erroneous claim of his for at least two and a half years, to no apparent effect. Doesn't exactly inspire optimism. MastCell ^Talk 05:19, 18 March 2009 (UTC)

Pardon me? I will assume you just had a fucking brain aneurysm while on Methylenedioxymethamphetamine, or we are somehow talking past each other. Okay, I've calmed myself a bit after reading your diff; I regret not forcefully addressing the issue at the time, perhaps I did and you selectively ignored me, again. Interpretation? What are you talking about? Lindefors-Harris acknowledges they had no cause to classify those women as "overreporting" and there were other likely possibilities, this De Facto makes them wrong. Period. As you point out "officially retracting" something has serious negative consequences... so they didn't do it. So, because they were smart enough not to sabotage their own careers that somehow makes it a wash? Queue The Twilight Zone music now.

I'm willing to take some bruises from y'all for my first paragraph about the collaborative re-analysis in your diff, but if you carry on about Lindefors-Harris being possibly valid, I may have to officially declare you functionally illiterate on this particular topic. That statement is orders of magnitude in better faith than what you puked above. - RoyBoy 00:42, 19 March 2009 (UTC)

If you require, I can retype verbatim Dr. Daling's sharp assessment of Lindefors-Harris. It includes the following statement: "we believe it is reasonable to assume that virtually no women who truly did not have an abortion would claim to have had one" Pg. 1590 So it was Daling, not Brind that brought up the obvious. In replying to Brind, that's another apt political move on their part, as acknowledging Daling could have been more embarrassing for them. Daling took them to task; something I believe Brind took note of in his letter. - RoyBoy 02:19, 19 March 2009 (UTC)

You're welcome to "declare" whatever you like, and to speculate about my recreational drug use (although don't you think I'd be less harsh on you if I were on X?). You are not welcome to claim that a paper has been "retracted" when it has not been, and you are particularly not welcome to use Wikipedia to badmouth respectable researchers - see WP:BLP if you have any questions. I get it - you agree with a sound bite from Janet Daling, and you disagree with the clearly stated conclusions of 100+ other experts under the aegis of the NCI. WP:WEIGHT applies nonetheless. MastCell ^Talk 04:01, 19 March 2009 (UTC)

LMAO! You're on the money with X. Come on MastCell, now I'm expecting better from you. "Sound bite", so Daling's point is too succinct in undermining response bias, which you've obviously bought into regardless of the evidence, so you try (again) to sideline real science over aegis? The workshop does clearly state their Conclusions, but any respectable researcher/Wikipedia article expects more than that. Blind faith isn't welcome by me nor WP:NPOV. If the workshop regards response bias as a statistically significant factor, they aren't exempt from specifying why, and showing how.

This is science, not a classified sophomore political essay for Wikisakes! 1. 2... 100 experts does not change the basics for a systematic review (which they actually don't pass, fiddlesticks I want a mulligan, as they aren't "transparent"). I like that word... Aegis, apparently it counts for everything and has no accountability.
[Insert obvious financial industry joke here] - RoyBoy 04:49, 19 March 2009 (UTC)

Retracted

(undent) I replaced "retracted" from the Lindefors-Harris section. We indeed do not want to risk inferring the conclusion was "officially" retracted. I did not see that danger, I do now. - RoyBoy 16:44, 29 March 2009 (UTC)

Hmm. I don't check this article as closely as I should; I didn't realize that it claimed that Lindefors-Harris had "retracted" their conclusion. Thank you for fixing that incorrect and frankly libelous claim.

I'm not much happier with its replacement, though. It claims that Lindefors-Harris "conceded" that their conclusions "might be incorrect". The source absolutely does not support this still rather remarkable assertion. All I see is an elaboration on various aspects of their methodology (not, incidentally, authored by Lindefors-Harris, so not evidence of them conceding anything). No concessions. I then see Joel Brind, widely regarded as a partisan advocate on the topic, making a bunch of assertions about Lindefors-Harris' data. Accusations from Joel Brind do not equal "concessions" by Lindefors-Harris.

I will reiterate that I am deeply unhappy with the liberties taken by this article. We are being way too cavalier in substituting editorial narratives for honest presentations of the actual content of sources. There are real WP:BLP issues here - the worst of them is probably the incorrect "retraction" claim, but the replacement text - again incorrectly claiming that a respected researcher "conceded" their "error" to Joel Brind - is equally inappropriate. MastCell ^Talk 17:58, 29 March 2009 (UTC)

You're welcome, and thanks for pointing it out. As to the article, we both messed up; reading an article of this length and many sources induces skimming behavior. However, you don't check sources very well either; I concede authorship slipped my mind when doing the section, as I was trying to focus on the content. Though the rest of the authors from the study signed, including Eklund who worked at the same institution as Lindefors-Harris. You go right to Brind, however it's Daling's point on the table.

Legally induced abortion in the first trimester became more easily accessible from the late 1960s, although accessibility varied between hospitals. Some women therefore had induced abortions abroad6 or unrecorded terminations of pregnancy. We are not surprised to find some Swedish women confidentially reporting having had induced abortions during the period 1966–1974 that are not recorded as legally induced abortions. It is plausible that such induced abortions are more susceptible to recall bias than induced abortions performed within the legal context in Sweden.

You will have to clarify for me how this isn't conceding Daling's point. It is actually a retraction. I removed it from Wiki because of possible misinterpretation, which I suppose could be libel, but since that isn't the intended meaning you are misdirecting your critique now, just as you did in 2006. That doesn't change their admission in the least. I feel strongly about this too. Don't you see from the above they admit their records are incomplete and flawed, ergo so goes their conclusion.

I couldn't care less who they admit they are wrong to. The salient point is they were/are wrong, they "are not surprised" as to why, that concedes an error. Doesn't it?! Please clarify MastCell. - RoyBoy 03:35, 30 March 2009 (UTC)

Oh and take care of yourself. Isn't there a vaccine shot for ulcers now? Unless this is a figurative ulcer... in which case, ummmmm, let's go drinking? - RoyBoy 03:49, 30 March 2009 (UTC)

For Lindefors-Harris to concede something, Lindefors-Harris must officially and directly make that statement. What you've written above is not very different from Johnny throwing the baseball through the window and then claiming that Susie did it, on the grounds that they both live in the same house.

What you can support from this source is that the effect of recall bias during that time has been disputed. WhatamIdoing (talk) 22:03, 30 March 2009 (UTC)

You can't even say that. Studies such as these are not only sensitive to historic context, but cultural/geographic context as well. It can be argued the study is only applicable to that country/Euro area. Johnny and Susie, LOL... we've obviously confused you, and/or you hold me in low esteem? The Lindefors-Harris study had four authors, three of those authors signed the source in question. I incorrectly attributed it to Dr. Lindefors-Harris, but the co-authors are certainly in a position to say what they collectively did wrong; including Lindefors-Harris. - RoyBoy 01:27, 31 March 2009 (UTC)

All studies have limitations. The authors are discussing potential limitations of their study. That is a nearly universal aspect of conducting research, not an admission that you "did something wrong". You are taking typical scientific discourse and putting it through a remarkable set of contortions to try to fit it to the points you'd like to make. See WP:SYN. See WP:MEDRS.

If you want to see what it actually looks like when a subset of a paper's authors retract its conclusions, see PMID 9500320 (by Andrew Wakefield) and then see PMID 15016483. I'm asking you as one editor to another to take seriously the objections that you're hearing from us, and not to keep reinserting this material which raises questions not only of verifiability and original research, but of WP:BLP. MastCell ^Talk 06:08, 31 March 2009 (UTC)

Well, I've agreed it wasn't an official retraction; so showing me one doesn't help. Over-reporting isn't merely a limitation. But hey! Good idea, let's run with "limitation" and see where it leads us. Why can't they determine/verify the status of those eight women? Well they do not know whether they in fact had an abortion or not. (an obvious limitation of their data) If that is the case, then why does their study list them as not having abortions? (over-reporting) Mastcell, do they, or do they not, know the status of those eight women? If they don't know what does mean? Say what, we need a Wiki opinion poll or consensus to figure out if they made a mistake?! *Australian accent* Come Onnn Now!

Daling's "virtually no women" statement, while brief was in a scientific study she and her colleagues put their reputations behind. They do not equivocate or permit alternative "interpretations" that bail out the Lindefors-Harris study and the letter concedes the point so clearly and easily you seem to think its therefor unimportant. I have no choice but to take your points seriously as that's one way the article improves, but it's pretty hard when I'm chided for Original Research soon after a straight forward undeniable point from a scientific study becomes a "sound bite"; or the NCI workshop stating only their conclusions clearly is somehow good for Weight. I truly had to hold back when reading that, but it was more important to diffuse things lest we scare off new blood to the article.

Elmridge's edit was good, though it muddies the waters to the other side of the fence; something I can live with for now. I will bring it up (vs. first trimester) if the article is reviewed. Your point of retracted being misleading was applied. Do you want me to start implementing bad ideas too? :'p The idea that Meirik et al. might not have misinterpreted the data in their study is a terrible idea and OR, actually insert all the Wikipolies you've link to here, because I think you're breaking them all. RoyBoy 01:07, 1 April 2009 (UTC)

When it comes down to it, Wikipolicy is about common sense. Daling's point is common sense, Meirik concedes its common sense. Yet the study remains as it was. - RoyBoy 01:36, 1 April 2009 (UTC)

Hopefully this edit is agreeable. - RoyBoy 19:57, 26 April 2009 (UTC)

"No significant association"

I think the statement in the lead that "the current scientific consensus is that there is no significant association between first-trimester abortion and breast cancer risk" is potentially misleading. "Significant" is used in its statistical sense here, but is there not a danger that it will be misinterpreted to mean that there is some association but only a small one? This layman's misreading of "significant" turns it (IMHO) into a weasel word that should be deleted. The consensus is not that there is a small association, but that there is none. I suggest saying either "no association" or (if people feel that's too abrupt) "no statistically significant association." Opinions? SNALWIBMA ( talk - contribs ) 22:16, 16 March 2009 (UTC)

I might choose "no statistically significant association", but either of your suggestions works for me. WhatamIdoing (talk) 22:23, 16 March 2009 (UTC)

Greetings Snalwibma, yes that is an accurate reading of the wording. But, it isn't a "layman's misreading" to think there is "some association" given Melbye's/Michels positive results for some sub-groups, so some association accurately reflects results from those highly regarded studies. If you disagree with me on that, please elaborate and try to give specifics.

If we do ignore that, it will likely depend on the weight given to the NCI workshop interpretation, which is being discussed in detail immediately above. At this point it looks like your suggestion is indeed the front runner if that occurs, but my position isn't exhausted quite yet. - RoyBoy 00:26, 17 March 2009 (UTC)

Rather than bog down in impenetrable hairsplitting, I'd prefer something clear and straightforward. "The current scientific consensus holds that abortion does not increase the risk of breast cancer." That's easily verifiable from the sources given - not just the NCI, but the American Cancer Society, the American College of Obstetricians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists. And, for that matter, the World Health Organization. Yes, yes - first-trimester - but look at the actual WHO source. It's titled, rather unambiguously, "Induced abortion does not increase breast cancer risk". They go on to discuss the first-trimester caveat in the supporting text, which clearly supports the fact that it is a relatively minor caveat - not to be ignored, but not to get in the way of the clear, consistent big picture either. MastCell ^Talk 04:18, 17 March 2009 (UTC)

Tightly written, and almost believable for me. But the ACS doesn't support that position. As frustrating as it is I can't feel bad for hairsplitting, I've read enough material on this subject to understand that's something you do... but is hairsplitting required for the first sentence of the lead? I'm still trying to justify that. Your position is valid, something clear and encapsulates the momentum of consensus, to put people's minds at ease. But that's an affront to my scientific/Wikipedia sensibilities.

I'm trying to formulate a response to the 5%-1% challenge as I type this. Still not fully awake, too many ideas, most old (Wiki transparency vs. lack of NCI workshop details) and I think unconvincing. I'm going to delve into and ask questions of basic Wikipolicies, as I think something has been... overlooked/forgotten, as we cover ancillary policies. I'd hate to have to resort to trying to expanding the 5% assertion, as I believe I could given WHO's "inconsistent" mention. Even though they find it "reassuring" that is the case, it implies as actual results do that the area of contention beyond the extreme late-term ~5%. But that too is a road to nowhere, as 5% to 15% still puts it in the minority that a workshop rejected for, this is key, unspecified reasons. *grumble* :"p - RoyBoy 00:50, 18 March 2009 (UTC)

Eldereft was bold and changed it to "does not cause". Hmmm... very interesting, that deftly threads the consensus more accurately than "does not increase the risk". The problem is it permits the opposite "layman's misreading", that there is no risk/association whatsoever. That isn't accurate and so I don't believe its encyclopedic... something I'll continue to contemplate. I am satisfied though that "does not cause" (parsed correctly by an informed reader) and in good faith, strikes the correct tone for the ABC consensus; and that further down in the lead caveats are mentioned for those interested in actual data/results on "association". Mastcell, WhatamIdoing, Snalwibma? - RoyBoy 23:41, 18 March 2009 (UTC)

There is no risk. There may be an association. Those are two separate concepts. That said, I'm fine with Eldereft's wording. MastCell ^Talk 03:56, 19 March 2009 (UTC)

Any association whatsoever incurs a proportional risk, they are married and the same, be it a set amount or trend. If a neutral researcher says there could be an ABC association for X group, the obvious questions from an interested party would be, how much of an association, for whom, and what's your dataset? That can only be accurately communicated by risk assessment(s). Not sure whom I should give credit to for softening be to the "cause" wording this time, MastCell historically or WhatamIdoing recently... I guess the reality is a bit of both. Oh analog reality, how I love thee. - RoyBoy 05:00, 19 March 2009 (UTC)

pro-life supporters vs supporters

WhatamIdoing makes a decent point when removing "pro life" from the lead sentence, the problem as I see it is pro-choice supporters of the ABC link tend to use much better language, such as ABC association, ABC risk, ABC hypothesis rather than link. Can anyone substantiate WhatamIdoing's: "I believe that all current and past supporters, regardless of political label, called it a "link" when they believed it"? - RoyBoy 03:42, 24 March 2009 (UTC)

I'm changing it back, Dr. Daling has stated in the past she's found an ABC association. All indications are only pro-life supporters are indelicate enough to call it a link. - RoyBoy 16:22, 29 March 2009 (UTC)

External links & response bias

I think Mastcell and I clashed on the Discovery article classification previously. While I love Discover, I think my perspective was that Barry Yeoman had published another article for MotherJones and made me cautious on the author. Ummm, scanning the article I think I remember my primary objection:

Brind dismisses response bias as an unproven hypothesis, but others have found ample evidence for it. In Sweden, epidemiologist Britt-Marie Lindefors-Harris of the Karolinska Institute took advantage of her country's nationwide registry of legal abortions. In a project documented in the American Journal of Epidemiology, Lindefors-Harris conducted a case-control study of abortion and breast cancer, but with a twist: She checked government records to see if the participants were telling the truth about their reproductive histories. Many of them, it turns out, were not. Out of 829 women, 29 appeared to misrepresent their abortion history, with the vast majority of underreporting coming from healthy women in the control group. Based on those numbers, Lindefors-Harris calculated that "an observed increase in risk of up to 50 percent may be caused by response bias."

Five years later, in 1996, Matti Rookus and Flora van Leeuwen of the Netherlands Cancer Institute came up with even more dramatic evidence of bias. The epidemiologists surveyed women in two regions of their country. In the liberal west, Rookus and van Leeuwen found a statistically insignificant relative risk of 1.3—but in the predominantly Roman Catholic southeast, relative risk shot up to an astounding 14.6. The only plausible explanation: Because of the conservative religious values in the southeast, healthy women there lied about their abortions. "Reporting bias is a real problem," the Dutch team concluded.

Mr. Yeoman quotes ludicrously thin (Rookus) and incorrect (Lindefors-Harris) science to back up response bias, and makes it appear solid and authoritative. Consequently its really hard for me to accept it as a reliable scientific article, despite the magazine it was published in. I might lose an RfC on this, but I feel it's a pertinent point. When I'm done playing with my new toys, I'll write another draft for the Lindefors-Harris section, clarifying significant limitations to their 50% conclusion. - RoyBoy 01:21, 17 April 2009 (UTC)

OK. So you don't like the article and disagree with its conclusions. That does not make Discover a "pro-choice" source, any more than Scientific American or New Scientist is "pro-choice". The article was presumably solicited, approved, and fact-checked by editors at Discover. I don't really care whether you accept it as a "reliable scientific article" or not. I do care that we accurately and honestly present our sources. If you really believe that Discover is a "pro-choice" source, then I'll be happy to solicit outside opinions to help break the deadlock, but I'm not willing to have you substitute your personal beliefs for Wikipedia policy here. MastCell ^Talk 16:16, 17 April 2009 (UTC)

Well I think things would be better between us if you read more carefully, and if the Discover fact-checkers did so to. As implied above I believe Barry Yeoman is pro-choice, and Discover is sloppy. They both happen to be wrong and careless on this specific point. Discover being a reliable source doesn't change that, as we have primary sources to demonstrate it. I'll add this to the list of issues needing to be addressed in the upcoming review. Regardless of what we've said to each other, I do truly appreciate you bringing up these points of contention. It should make the next steps easier and more streamlined as others, less familiar with the ABC issue, would point them out as well. - RoyBoy 15:22, 18 April 2009 (UTC)

This seems pretty straightforward. By way of analogy, in 2006 Harper's published a somewhat infamous piece by Celia Farber credulously promoting AIDS denialism. The article was marred by dozens of outright factual errors and an even greater number of misleading statements ([1]). That means that Harper's did a (verifiably) lousy job of editing and fact-checking. I wrote a letter to the editor and canceled my subscription. However, it does not make Harper's an "AIDS denialist source". I didn't go around Wikipedia re-categorizing the magazine as such.

In this case, you (personally) feel that Yeoman's article was sloppy (I have yet to see any reliable, independent sources backing your personal conclusions on that score, though perhaps they exist). That does not, however, make Discover a "pro-choice" source. MastCell ^Talk 17:17, 20 April 2009 (UTC)

Ok analogy, if one were to refer to/link to that Harper's article; would it be open to rebuttal/criticism in the article? The Daling study/Meirik letter and possibly even the Rookus study itself are independent sources that back the absurdity of using the 50% Lindefors-Harris conclusion. Leaving out that Rookus' 14.6 RR finding was based on 1 control/12 case patients is IMO pseudo-science. Both mistakes, particularly the second, are incompatible with a scientific source.

On good faith Discover can be assumed to be a scientific source (if written by a scientist), if we learn better, shouldn't we reflect that?

Yeoman's article is verifiably wrong and sloppy, that isn't an opinion.

So it's given a free pass because we like Discover, or like the conclusion? - RoyBoy 03:11, 21 April 2009 (UTC)

Neutrality and verifiability applies, particularly "painted by words more favorably or negatively than is appropriate". While pro-choice may be too negative putting it next to scientific sources is too positive. For example a scientific source would include the confidence interval. I'm trying to illustrate how the article's focus isn't scientific rigor. I mean the title is pretty unambiguous about that as well. - RoyBoy 03:11, 21 April 2009 (UTC)

Let's try again. The Harper's article was directly criticized by a wide range of reliable sources, making that appropriate for Wikipedia to mention. The Discover article has been criticized by, so far as I can tell from this talk page, zero reliable sources. The link is not presented as "scientific" per se - it's just not categorized by abortion agenda, since Discover doesn't have one. I'm getting really depressed about the circular nature of this discussion. I honestly have no idea what you're talking about when you mention a "free pass", or me "liking" Discover. You're saying we should call the magazine "pro-choice", when it is no such thing, and you're following up with more of the same arguments from personal opinion and original synthesis of primary sources, as if we haven't discussed WP:MEDRS a dozen times already. Either I'm not explaining myself clearly, or you are deeply, deeply opposed to understanding what I'm saying. Either way, I'll leave it for now. Someone else can take a crack. MastCell ^Talk 06:07, 21 April 2009 (UTC)

I second what MastCell says here, and add, just in case it wasn't clear, that the very first and absolutely non-negotiable requirement of a "reliable source" is to be published someplace other than Wikipedia. WhatamIdoing (talk) 19:33, 21 April 2009 (UTC)

True, in the middle of the discussion I realized Scientific sub-header had been removed from the Links sub-section. Which left me without much to go on. I guess I'm depressed about the article being left to its own devices, its an itch I cannot scratch. So I picked at it, sorry. I'll see if there is a Brind reply to the Discover article. - RoyBoy 02:48, 22 April 2009 (UTC)

If experience is any guide, there is a Brind response to everything. Let's keep in mind that Brind is one person, with views that could charitably be described as tiny-minority. We don't need to give Brind the last word on every primary study and on the verdicts of the American Cancer Society, WHO, ACOG, RCOG, and National Cancer Institute - at some point, his rebuttals have to drop below the event horizon of WP:WEIGHT. MastCell ^Talk 04:43, 22 April 2009 (UTC)

(undent) Big LOL, well he's made it a crusade to be sure. Clouds his judgment, but also makes him an expert regardless of being in the tiny-minority; I'd remind all his interpretation of weak data (his meta-analysis) can be valid (of marginal impact, but I emphasize not zero) if response bias turned out to be statistically insignificant.

The weight response bias deserves should be my focus, so apologies again on focusing on Yeoman above.

Bias' blanket effect on verdicts should be given the weight it scientifically (NPOV) deserves, as a statistically insignificant factor Hypothesized by the majority to account for (or create) barely significant positive ABC results. To give it more is charity. It has a liberal/conservative regional comparison in Rookus (bias Within each region would have been more informative and closer to ABC study best practices); an incorrect analysis and possibly bad dataset from Lindefors-Harris. The fact it's used by the majority doesn't change the NPOV assessment from Daling and Brind. Bear in mind the majority do not defend these response bias studies when they are finally scrutinized. Daling/Brind having the last word should indicate to us the weight Rookus and Lindefors-Harris deserve; and consequently how careful we should be on drinking the response bias kool-aid.

In the end, yes again we come full circle. That's okay though, it appears to me established articles go through it. Besides, I might actually be expressing the right ideas more clearly here. If one takes response bias at face (Yeoman asserted) value, then ABC associations nearly evaporate. If one gives bias proper NPOV weight, not based on political majority/minority but on balanced verifiable statements of fact (otherwise known as science), associations remain as the jungle of ABC studies indicate (Michel's drank the kool-aid BTW). One is left with the grey reality of the ABC hypothesis. No link, but not something to ignore either. The fringes are fun, n'est pas? - RoyBoy 04:50, 23 April 2009 (UTC)

WP:NPOV is binding solely on Wikipedia editors, not on the reliable sources that we use. If an expert decides that recall bias is likely unimportant in his/her study (and there are ways of addressing this issue in study design), then our job is to accept his/her professional judgment, not to provide our own analysis. WhatamIdoing (talk) 14:07, 23 April 2009 (UTC)

I'm concerned with the notion of weight being decided on minority status. As I've shown our job goes beyond that if there is a contradiction; in this case reliability of Lindefors-Harris' conclusion. The Discover article reminded me of the contradiction between perception of response bias and the scientific evidence. - RoyBoy 18:49, 26 April 2009 (UTC)

Forgive me if you've answered this repeatedly, but do you have a published reliable source that says that there are problems with the reliability of (specifically) LH's conclusion? Or are you interpreting much more general statements as being applicable to LH? WhatamIdoing (talk) 04:18, 27 April 2009 (UTC)

Okay, no worries, as I didn't reference it for my added line. I thought Daling was more than sufficient, as it refers to the LH study and conclusion. That's what I had in mind when referring to NPOV weight and taking the source which best presents the facts as dominant.

We do need to be clear on the following, LH actually didn't defend the correctness of their conclusion. More accurately they reasserted they were right overall, or on the right track.

They reference Melbye overall conclusion, but avoid positive results that back Brind's, not LH's, interpretation of aggregate interview results. It's an assertion in a letter, after conceding to Daling/Brind. It would be like taking Michael's educated guess on hCG as scientifically valid/scrutinized. To pile on, Brind's conclusions about response bias in his much criticized meta-analysis, carry more weight here than Meirik's optimistic attempt at turning around an embarrassment.

I'll clarify below on "concede" appropriateness. - RoyBoy 02:59, 29 April 2009 (UTC)

I find this mind-boggling. We are tortuously parsing a single letter to the editor for "concessions", when there is absolute and sourceable scientific consensus on this subject. It's not clear to me which core policy this violates most egregiously. MastCell ^Talk 03:38, 29 April 2009 (UTC)

As to concession; I can be wrong on that. Need to work it out. - RoyBoy 03:42, 29 April 2009 (UTC)

Do you realize the Meirik letter refers to the Daling's 1994 study? (ref 4) *sigh* Yes the Daling study refers specifically to LH 1991 50% conclusion, criticizes "over reporting", and then recalculates LH conclusion accordingly. I'm boggled, befuddled, upset that I need to clarify this. I reminded you of it recently, and you replied that you considered it a sound bite. This isn't news, and it has been mentioned by me for several years now... I think I'm going to eat something to feel better. Hopefully sleep will take me. - RoyBoy 04:02, 29 April 2009 (UTC)

Work been cutting down on the sleep, but finally remembered to scan Daling. Can be found here (in blank place: 4shared), I also did 1996 for fun. Pg. 7 of 1994 has the discussion relevant to the Lindefors-Harris study conclusion. - RoyBoy 02:08, 6 May 2009 (UTC)

Michels

Is the table under #Michels taken directly from the paper? WhatamIdoing (talk) 06:02, 17 April 2009 (UTC)

Yes. - RoyBoy 16:10, 17 April 2009 (UTC)

That's strange, the minuses got changed to question marks. Will double check study when I get home. I've changed it for now. - RoyBoy 16:17, 17 April 2009 (UTC)

The question marks are doubtless an artifact of the elderly software I was using to strip out the professional titles; thanks for fixing it.

Would you say that this table is the heart of the Michels paper? WhatamIdoing (talk) 03:10, 18 April 2009 (UTC)

Ah no problem. If by heart you mean the main results, no. Table 2 would be as it reflects their conclusion of a RR of 1.01 (0.88 - 1.17). The purpose of Table 4 is to give context to their caveat for subgroups. Do you think we should add Table 2? - RoyBoy 15:39, 18 April 2009 (UTC)

I am primarily concerned about copyright violations. This appears to be a reproduction of a substantial portion of a copyrighted work, and thus may not be legal, and probably does not comply with Wikipedia's (much more restrictive) policies. WhatamIdoing (talk) 19:52, 18 April 2009 (UTC)

A valid concern. However, I believe the article is using the minimum necessary to provide context to the studies findings; and as I've stated this table is not the heart of the study. Substantial... I'm unsure how to gauge if that's indeed the case; the chart could certainly be altered to avoid such a complication, but we also want to be accurate. - RoyBoy 06:20, 19 April 2009 (UTC)

We should not be reproducing that table here. I am not certain of the copyright stance of that journal nor the norms for the medical field, but there are certainly some cases where it is acceptable for a review work to reproduce or present a table of data from a separate source. It is worth investigating, but I think we are in the clear here given the prominent citation and that the table is not the whole of the article. More importantly, however, adding this table introduces a surfeit of detailed raw data, when all we need to present is the conclusion (with appropriate nuance and context). The subset of readers who will get something out of that table is, I expect, included almost entirely in the subset of readers who have access to the study itself and are perfectly capable of investigating to the desired level of detail. Summarizing the study is perfectly sufficient to our needs. - Eldereft (cont.) 19:06, 19 April 2009 (UTC)

I'm also not convinced that reproducing the entire table is the minimum necessary for commenting on the study. It seems to me that a single sentence, or perhaps even half a sentence, would do. We aren't trying to prove anything on Wikipedia: we could just note that these factors seemed relevant, and go on. WhatamIdoing (talk) 01:03, 20 April 2009 (UTC)

Also, glancing through a few papers on hand, the standard for that sort of thing seems to be "reproduced with permission", so I might be wrong vis-à-vis copyright. But that is secondary to the well-ordered and duly weighted presentation of the main conclusions. - Eldereft (cont.) 11:47, 20 April 2009 (UTC)

After thinking it over, I decided to just kill the whole thing. It is probably a (legal) copyright violation and almost certainly violations Wikipedia's copyright rules. It doesn't really add to the readers' understanding of the conclusions, it's not an encyclopedic style, and it gives inappropriate weight (and tends in the direction of providing our own analysis of the paper) to what is basically a detail. Finally, the few people that really want that level of detail should read the entire study anyway. WhatamIdoing (talk) 18:33, 20 April 2009 (UTC)

Fine, while I question the certainty of violations I'm clueless on this too; ultimately I agree it is too detailed/technical. Besides it shortens the article, a good thing at this stage in the game. As to analysis of a "detail", uh emphasizing results/events of interest (notable) is what we do here. If you consider it not notable; remember you just added your analysis to the mix. - RoyBoy 02:11, 21 April 2009 (UTC)

Just to keep us all on the same page here: WP:Notability concerns itself solely with whether an article on a given topic should exist. Notability is determined by identifying published reliable sources about the topic, with no significant reference to editor judgement. Once you've established that there should be an article on a subject (i.e., whether abortion is associated with breast cancer), then you're done with the entire concept of notability.

At that point, the due weight policy takes over. WP:DUE is implemented according to editor judgment, which is another way of saying that "your analysis" of whether or not something is sufficiently important to get that much attention in the article is exactly what editors are supposed to do. WhatamIdoing (talk) 19:45, 21 April 2009 (UTC)

You got me there, though my emphasis was on the cooperative nature of said analysis. - RoyBoy 02:34, 22 April 2009 (UTC)

Concessions and retractions

RoyBoy, are you familiar with WP:WTA#Synonyms_for_say? Perhaps you're just trying to avoid a boring vocabulary, but factive substitutes for "said" are unacceptable. WhatamIdoing (talk) 05:02, 27 April 2009 (UTC)

I concede you've finally pointed out policy section I haven't read, to my recollection. Right off the bat I'd have to agree with you on the editorial "concede", but it was simply an attempt to summarize Daling study statement and Meirik's "not surprised" that is preambled extensively about 1960s and their 1966-1974 dataset. Forgive my language, but I don't give a dingo's kidneys how they understand the limitations and complications of their dataset.

Although using the "surprised" line might be even more compelling and accurate to boot. Hmmm... - RoyBoy 03:46, 29 April 2009 (UTC)

Recent additions

The following two statements were recently added to the article. I have moved them here, as, at a glance, they seem to conflict with much of the evidence in the rest of the article.

• A 2006 study by the Cancer Research UK Epidemiology Unit, University of Oxford, of 267,361 women from 1992-2000 concluded was some evidence of a 'slight increase in the risk of breast cancer among women who reported having had 2 or more spontaneous abortion' yet the relative risk of breast cancer among women who reported ever having had an induced abortion when compared to women who reported never having had an induced abortion was similar.

Reference: Breast cancer risk in relation to abortion: Results from the EPIC study.

• A 2009 study by the Istanbul University concluded that age and induced abortion were associated with increased breast cancer risk whereas oral contraceptive use was observed to be associated with decreased breast cancer risk.

Reference: Breast cancer risk factors in Turkish women--a University Hospital based nested case control study.

-- Whatever404 (talk) 17:26, 22 June 2009 (UTC)

pubmed and the journals these studies were published in are reliable sources, I fail to see how they conflict with the article since the article itself is named hypothesis, and opposing views are discussed in the article Thisglad (talk) 17:33, 22 June 2009 (UTC)

Well, there is of course an issue with selective citation of primary sources to "debunk" or contradict the unanimous conclusion of medical expert bodies worldwide. The first study suggests a possible (though weak) association with multiple spontaneous abortions - that is, miscarriages. It confirms the scientific consensus that there is no increased risk associated with induced (medical or surgical) abortion.

The second paper is published in a relatively obscure, low-impact publication - PubMed/MEDLINE indexing is probably necessary, though certainly not sufficient, to define a reliable source for a statement of medical fact. More to the point, the findings are at odds with a number of larger, better-conducted studies as well as with unanimous expert synthesis of the literature as a whole. Specifically, the finding that hormone replacement therapy and oral contraceptives decrease the risk of breast cancer is entirely contrary to existing data, and raises some questions (for example, in another cohort of women from Istanbul, oral contraception and hormone replacement raised the risk of breast cancer, as it they commonly understood to do [PMID 17371428]). If this one study causes a revolution or a re-evaluation of current scientific consensus on the issue, then it may be worthwhile discussing at length. As it is, it's probably undue weight to a single primary source which is at odds with numerous stronger studies as well as unanimous expert opinion. MastCell ^Talk 17:43, 22 June 2009 (UTC)

An encyclopedia article is not an essay, there is no undue weight to present the results of epidemiological studies in the relevant section as long as the article does not draw any conclusions not supported by the source. How is 'scientific consensus' relevant to an online encyclopedia and how is it established? such a consensus would only be relevant to change an established scientific fact, and this article is not. Also you state the studies are larger however that is untrue, the one with 267,361 women is larger than most used in this article Thisglad (talk) 17:54, 22 June 2009 (UTC)

Most of your questions, rhetorical though they may be, can be answered by reading WP:NPOV and the section on undue weight, as well as our sourcing guidelines. Briefly, since this is intended to be a serious, respected reference work, our coverage of scientific topics should be in line with respected, mainstream scientific thought. I used the term "scientific consensus" as shorthand to indicate that there is unanimous agreement among every expert medical and scientific body to have studied this question - abortions do not cause breast cancer. If you don't see the "relevance" of that expert opinion to our coverage, then I can only suggest you look at our policies again. MastCell ^Talk 18:08, 22 June 2009 (UTC)

"better-conducted" is presumptuous bias MastCell, and studies are expected to be at odds with each other and consensus! It isn't always a case of bad research, it can also be progress. Thisglad, new studies have minimal impact on a consensus unless they contain something new and are recognized as such.

On the flip side, despite the ironclad obscurity of the low-impact publication, the dataset is substantial on induced abortion 930 controls and 742 cases. This would appear to warrant inclusion in the Interviews section, perhaps a new "Further interview studies" section so we can mention ongoing findings. Adding one or two other studies of mixed (nil results) would be nice, assuming their datasets are almost as juicy. - RoyBoy 00:10, 24 June 2009 (UTC)

"Better-conducted" is a judgment made by every expert medical body that has reviewed the evidence; all have concluded that the better-conducted studies have found no link. Please don't lecture me as if this were me going out on a limb. If you want to call that "presumptuousness", then you might want to check yourself first - you make those sorts of offhand judgments about which studies are "better" in practically every one of your posts here, and your judgments are typically at odds with those of experts in the field. I'll reiterate my objection: this article already does a poor job of representing respected scientific thought on this topic, and substitutes an anonymous Wikipedia editor's judgment for that of the scientific community. This is another step in the wrong direction. MastCell ^Talk 04:29, 24 June 2009 (UTC)

Surprisingly enough I disagree fully. :'D There's a difference between "better-designed" and "better-conducted", while I fully anticipated, acknowledge and appreciate you meant design – as you've patiently reiterated; your actual wording was poor and illustrated your repeated step in the wrong. That you make no distinction between design and conducted (or executed), a well designed study poorly executed (if one can show specific examples/objections of course) should not be continuously referred to as "better" than others. That is bad judgment. Using experts is correct, but expert statements of one design being inherently more reliable than another does not permit blanket determinations, or in this case pre-determinations. It serves as a rule of thumb, but not strictly so.

Every study of significance adds to this topic. When and if experts provide specifics on how this study is not well conducted, those must be added and can even serve to remove the study from the article as non-notable, especially if mistakes are repeated. In my amateur opinion, Turkey is culturally divided and consequently that may impact response bias significance. But I disagree with the idea of predetermining this or any other aspect of how the study was done prior to experts themselves.

Moreover, the facts about study design from the experts are in the article; and in no way permit ignoring interview study results. - RoyBoy 09:55, 24 June 2009 (UTC)

Our inclusion criteria is based on a studies significance, not how we guess the experts will react to it based on generic statements of epidemiological study design. - RoyBoy 09:58, 24 June 2009 (UTC)

I can't say I see the value in the distinction you propose. Design and conduct are both elements of study quality, which is the main issue. Study quality has been assessed and weighted by expert bodies. I remain utterly unable to understand why we insist on substituting our own judgment, as anonymous Wikipedians, for that of recognized experts in the field. Particularly as doing so contravenes this site's basic content policies.

I guess you've summed up the problem: you see me "ignoring" study results, while I see myself as respecting secondary sources rather than lining up primary sources to advance my viewpoint. As to your final point, I couldn't agree more. So far the Turkish study has had no demonstrable significance - it doesn't seem to have prompted any expert or expert body to revise its opinion. Therefore, we should not assign the study substantial weight until/unless experts in the field do so. You're the one "guessing how experts will react". I'm saying that they haven't reacted, yet, so neither should we. MastCell ^Talk 22:38, 24 June 2009 (UTC)

Can't deal with everything thoughtfully covered just now, I've had a nasty root canal infection and need sleep to recover, I don't disagree with your last point; so this means I'm unsure precisely where we are disagreeing on "experts reaction". I understand you find my editorial instincts at odds with Wikipolicy, I accept that as true and check/stop myself when you word objections the right way. But am I guessing in this instance? I point out it is a significant dataset, and how its conducted isn't our concern as yet; since we don't have an experts view. How its designed is pertinent, no doubt, but it isn't an automatic red flag (kicked out of the game).

Because of your reading of expert opinions on interview based studies for the ABC issue, do you think a position of "interview studies are to be taken with a grain of salt" is actually valid???

We are agreed a reaction source hasn't been found. What precisely do you think that means? Zero coverage? To be clear I'm not interested in throwing it in the lead, but mentioning it in an overdue new section about ongoing interview based research. Isn't that encyclopedic?

I know full well its good policy to not allow news (new items) to have undue weight, and we should always keep the long term in mind and give new information that sober context. But zero coverage until we find a source that marginalizes it to your liking? - RoyBoy 04:37, 26 June 2009 (UTC)

Paper Inclusion Rationale

Have we established which ABC hypothesis papers we should include in this article? For example, there is a new paper (April 8, 2009; "Breast cancer risk factors in Turkish women – a University Hospital based nested case control study") that is not currently in the article. Should we mention it? —Preceding unsigned comment added by Geremia (talk • contribs) 09:27, 30 July 2009 (UTC)

the authors of the study state themselves that their survey has certain biases: "selection biases (non response bias, hospital admission bias, exclusion bias), and information bias (interview bias, recall bias, reporting bias).". No reason whatsoever to include such a flawed survey. KillerChihuahua^?!?Advice 11:18, 30 July 2009 (UTC)

Huh? They stipulated these are "potential" biases, then they go on to state these potentials are mitigated by various factors, namely the large sample size that I've stated previously makes it completely notable, and is reason to include it. - RoyBoy 04:11, 5 August 2009 (UTC)

I have written this draft for inclusion. - RoyBoy 05:20, 5 August 2009 (UTC)

Further interview studies

A study (742/930 ABC cases/controls) of outpatients from clinics of the Istanbul University Medical Faculty published in 2009 by Ozmen et al. found a 1.31 (1.13 - 1.53) increased ABC risk. The authors point out various potential biases such as selection, information and even hospital admission bias may have impacted their results. They believe the large pool of patients available to them and the resulting large size of the study "provided reasonably stable risk estimates."

Since this is far from the worst thing in the article, it seems like a waste of effort to complain about it. MastCell ^Talk 04:27, 6 August 2009 (UTC)

Lead rework and laziness

Some pro-life supporters prefer the term abortion-breast cancer link. The subject is controversial.

Whatever404 reworked things a bit trying to clarify things, in good faith. KillerChihuahua removed the brand-new parsed unsourced statements in good faith. They were quite an eye sore once chucked out context. I'll make this brief, there are 112 sources in this article... and no one could be bothered to add a ref to them, or to undo the ugly disconnect created by Whatever404.

"some" pro-life supporters, no actually all of them do. That's is what its called. Do not add weasel words that aren't even necessary. Look it up!

This subject has never been controversial? Do you guys recall the NCI vs. the Bush administration. And that's the no brain required example you all know. There are plenty of historical back and forth from Daling and the fallout from the Howe study. - RoyBoy 04:24, 5 August 2009 (UTC)

I will re-add these essential memes, that's why they were in the lead to begin with, but I do so in good faith by trying to work with the positive aspects of the edits previously done. - RoyBoy 04:40, 5 August 2009 (UTC)

cause vs. risk

Well that confirms to me that I can't rely on as many people around here as I would like. "risk increase" is substantially different from "cause", the inability to differentiate this is unfortunate. I'd ask that those involved do not modify the Lead any further unless they check it with someone who knows what they are doing. The WHO's determination of:

"Historical cohort studies, on the other hand, are more methodologically sound. Two major studies have been carried out using this methodology, and neither found an increased risk of breast cancer associated with first trimester abortion."

does not match recent original research by Wikipedia that there is "no risk" associated with "abortion". - RoyBoy 04:37, 5 August 2009 (UTC)

Yes, thanks for the PTSD flashback to passive smoking, where an endless procession of single-purpose accounts argue that smoking may "increase the risk" of lung cancer but does not "cause" lung cancer. My patience with the endless hairsplitting effort to obscure or undermine the obvious and unanimous verdict of the scientific community on this topic was exhausted about 2 years ago. If you're determined to downplay the 99% agreement between sources and play up the 1% where they don't completely overlap, then do what you like. MastCell ^Talk 04:31, 6 August 2009 (UTC)

Ouch... no intention on inducing undue stress. I'm concerned with doing the right thing. "obvious" I concur, but unanimous simply isn't reflective of ABC reality, 2 years ago or now. I showed ample compromise to reflect the agreement between sources with "does not cause", even though I consider it completely misleading to the lay reader. FYI, Second Hand smoke is considered a risk factor for lung cancer with evidence that is weaker than Melbye's gradually increasing findings.

Mastcell I'm not contrarian for the fun of it, I'm trying to positively effect the public discourse, and with WHO I now have a source that verifies what was hard done original research. As Wikipedia has this primary evidence, in my opinion, this is more relevant to NPOV than a "no risk" consensus reflected by a NCI workshop with no published results. When the article is put forward for peer-review, I promise this will be top of the list to be examined. I'm doubtful my POV will carry the day, but I hope they can at least provide another compromise... perhaps placing the first-trimester meme in the "Views of medical organizations" section?

In the meantime, I will revert it to "does not cause". - RoyBoy 00:27, 7 August 2009 (UTC)

Problem with first paragraph

From my understanding, the hypothesis says abortion increases the risk of developing breast cancer. The second sentence says that scientific consensus is that abortion does not cause breast cancer. I don't think the hypothesis says abortion causes breast cancer, but it can increase the risk. I propose changing the second sentence to reflect this. However, since the first paragraph is important for the article, I wanted to bring it up in the discussion here first.--Minimidgy (talk) 14:39, 19 August 2009 (UTC)

Astute and valid point. However, the second sentence is a compromise between myself and other editors. If the sentence was changed to "does no increase the risk of breast cancer" I would want to term "first trimester" added to reflect the actual scientific evidence on the ABC issue. This isn't acceptable to others, so my idea was to fall back to "caused", which is universally agreed upon in scientific circles. - RoyBoy 02:19, 14 October 2009 (UTC)

Pseudoscience?

I'm sure this is likely to anger those who support the views, but is this a manner of Pseudoscience? --74.232.40.140 (talk) 03:53, 20 October 2009 (UTC)

Arguments made for it certainly can be, but the proposed hypothesis itself is not. Hormones do impact breast cancer risk, early pregnancy involves hormones. This is why so many studies have been conducted on the subject. Dr. Daling is pro-choice and did not consider it pseudoscience. - RoyBoy 03:56, 21 October 2009 (UTC)

Wall of PoV

I was surprised to walk into a wall of POV in the lead to this article. I was previously unaware of the issue, the only thing that crosses my mind on the content side is hearing that pregnancy protects against cancer in a number of ways. I am removing italics, "quibble" marks and infelicitous appositions.

Separately I have refactored the lead since it seemed to be structured in a "they believe this - but look at this research!" way. II am still not convinced that it is NPOV because I know little about the subject, but I hope that it is an improvement.

Rich Farmbrough, 11:29, 19 November 2009 (UTC).

I think overall your edits have been improvements. I'm not sure from your comments what POV you see being advanced here; could I ask you to elaborate? I don't want to assume. MastCell ^Talk 20:32, 19 November 2009 (UTC)

I agree it has improved things (with the exception of the dash spacing), and your reading of "they believe this - but look at this research!" is accurate and intentional. If there are notable responses or addendum's to said research we welcome it. As to pregnancy and cancer, full term pregnancy is excellent when it comes to cancer risk reduction. Understanding why that occurs (hormones specifically in the third trimester) is key to comprehending why a partial pregnancy is a wash, or possibly detrimental to cancer risk. - RoyBoy 17:07, 5 December 2009 (UTC)

Possible correlation

About this: Either the early research in question showed a correlation, or it didn't. Once you've already crunched the numbers, it's silly to talk about a "possible" correlation: Either you found one, or you didn't. "Possible" correlations only exist in proposals to conduct research, not in data. Have we perhaps confused correlation with causation in this sentence? WhatamIdoing (talk) 21:43, 15 December 2009 (UTC)

Undone, good catch. - RoyBoy 04:48, 16 December 2009 (UTC)

Actually, come to think of it Daling 1996 study isn't "early", I did intend that for 2nd ref, the 1989 Howe study. Thoughts? Appropriate for one but not the other, and I do think it important they are both ref'd in the lead. - RoyBoy 04:52, 16 December 2009 (UTC)

How about suggested a correlation - this conveys that the result has been superseded without calling Daling (1996) into question. They list a number of confounding factors, but their statistics look good from the abstract. - 2/0 (cont.) 17:16, 16 December 2009 (UTC)

No, after you have crunched the stats, the correlation is not "suggested", or "possible", or any other weasel words. When you reach the point of saying that your r value is this, or your odds ratio is that, or that you reached a 95% confidence interval, you have already established the existence (or non-existence) of a correlation.

Anecdotes can suggest a correlation. Personal experience can suggest a correlation. Statistics never do. WhatamIdoing (talk) 21:29, 16 December 2009 (UTC)

I dunno, I'm not an absolutist about statistics, since they are only ever approximations of the truth... after all, Daling et al. used exactly 2/0's wording in their report ("Previous research has suggested that a history of induced abortion may be associated with an increased risk of breast cancer", PMID 8712194). But perhaps a more semantically satisfying approach would be say that these earlier studies reported a correlation (which has subsequently been called into question or which may disappear with adjustment for potential confounding variables)? MastCell ^Talk 22:00, 16 December 2009 (UTC)

If multiple previous studies were contradictory, then they might collectively suggest, without demonstrating, a relationship, connection, or association, but if we're going to use a term of the statistical arts like correlation, then IMO we need to use it correctly. (To know whether the early research actually showed a statistical correlation might require a meta-analysis.) WhatamIdoing (talk) 22:35, 16 December 2009 (UTC)

Collectively, well said. - RoyBoy 02:33, 17 December 2009 (UTC)

Reported is a good suggestion, but cannot rest on "may" disappear or "questioned". Such a low standard, if applied equally would permit equivocation of studies you consider more accurate, through methodology alone. - RoyBoy 02:33, 17 December 2009 (UTC)

Reported works for me - good idea. While early research reported a correlation between breast cancer and abortion, the current scientific consensus is backed by large prospective cohort studies which find no clear association between abortion and breast cancer. These studies strive to remove from their results the many confounding factors, such as delayed child bearing (parity), which are known risk factors. (emphasis added, references stripped). Some grammar tweaking might be in order for that paragraph, but I think we are ready to edit the article, yes? - 2/0 (cont.) 06:47, 17 December 2009 (UTC)

If you'll let me nitpick the grammar and word choice: You want "Although" instead of "while", because while implies that the two things (early and current work) happened at the same time. There should be a comma after the word "studies" to introduce the non-restrictive adjective clause ("which find..."), unless you intend to imply that scientists have deliberately excluded studies based on their results (in which case, please change "which" to "that" and alert a cardiologist near MastCell). The "striving" phrase should be omitted as needless, which allows a much simpler statement: "These studies have controlled for confounding variables, such as..." WhatamIdoing (talk) 07:49, 17 December 2009 (UTC)

Except for the change in question, that is the wording that is there now. Do you like "reported"? Nothing else seems to be in dispute. - 2/0 (cont.) 08:00, 17 December 2009 (UTC)

And thank you for your concern for my cardiovascular health. :) MastCell ^Talk 18:15, 17 December 2009 (UTC)

"Reported" works for the Howe ref as they put their own results in proper context of not dealing with genetic (family history) confounding, but I'd object to associating it with the Daling study ref, which endeavored to account for all confounding factors including response bias. I guess if the Daling ref was removed it would be fine. Come to think of it can't recall why it was put there, as I now don't consider it "early" research. I've removed Daling and put in the new wording. I also got bold and tried to merge and shorten the last 2 paragraphs. They seemed terribly redundant and wordy. - RoyBoy 04:49, 18 December 2009 (UTC)

Looking at it further there is a redundancy with the following:

the current scientific consensus is backed by large prospective cohort studies which find no clear association between abortion and breast cancer.

and

which concluded from the "strongest evidence" that it was well-established that abortion is not associated with an increase in breast cancer risk.

These are saying the same thing a sentence apart. It bothered me before now, and I need to do something about it. Hopefully I didn`t muddle it too badly. - RoyBoy 05:16, 18 December 2009 (UTC)

Is there any elegant way to get away from the "that" repeat here:

that it was well-established that

Thanks. - RoyBoy 05:25, 18 December 2009 (UTC)

By omitting needless words. Consider something like this:

In 2003, the NCI convened a workshop with over 100 experts on the issue. Although early abortion-breast cancer research had reported a correlation between breast cancer and abortion,[11] the "strongest evidence",[12] which is from large, prospective cohort studies,[13][14] demonstrates that abortion is not associated with an increase in breast cancer risk.[15] These improved studies controlled for confounding variables, such as age at first full-term pregnancy and the number of full-term pregnancies (parity), which are known risk factors for breast cancer.

Note that the definition of parity is wrong in the existing text, and has been corrected here. WhatamIdoing (talk) 21:43, 18 December 2009 (UTC)

"Strongest evidence" shouldn't be in quotes, since they look a bit like scare quotes. I'd replace it with: "... the panel concluded that the strongest evidence..." MastCell ^Talk 22:13, 18 December 2009 (UTC)

Excellent suggestions from both of you, and parity being half defined entirely my fault. Thought I was going to get annoyed at WhatamIdoing for the word "demonstrates"... a strong word I'd like to avoid, but MastCell's suggestion changed the sentence and clarified it is the workshop's finding. Did small tweaks early > previous, that allowed me to put Daling back in the lead as I now remember that's an important positive finding to highlight.

Can y'all verify my punctuation is optimal, thanks.

Also, reinserted response bias... a point which probably needs to be expanded in the lead given its prominence in how ABC research is accepted / rejected (praised / criticized) by the NCI workshop, and the overall scientific community, without proper validation (a la nature vs. nurture debate and consensus missteps from the past). I also changed context of parity to a "key" factor, as that's why in the lead. - RoyBoy 17:24, 19 December 2009 (UTC)

Selection bias accusations by both sides may also be lead worthy. [2] Forgive me, grabbing notes from 2008 talk prior to archiving. Other links: New Zealand [3] Court cases - Australia [4] Paternalistic? [5] - RoyBoy 17:46, 19 December 2009 (UTC)

Authoritative sources

The section on mainstream medical opinion, which describes the position of AMA, ACOG, NCI, WHO, etc. ought to include the fact that no US Surgeon General has ever recognized the "link". This includes Surgeons General under right-to-lifist Presidents Reagan, Bush I, and Bush II. I have entered this info and linked directly to the searchable site of the US Surgeon General's office. The reader can verify by searching it! I hope that's OK; if not, you know what to do.... SingingZombie (talk) 22:42, 25 December 2009 (UTC)

No, that doesn't work. We need a source that directly and plainly says this, not merely a "well, my keyword search didn't produce any evidence of it in the current version of this website..." WhatamIdoing (talk) 00:28, 26 December 2009 (UTC)

Then how should one source a verifiable fact like the one that the Surgeon General has never issued any warning or recognition of "abc"? Where to find a list of things the SG has NOT said? Surely it ought to be in the article. Who in the world would look up the ABC-hypothesis and NOT want to know that the SG has never recognized it? Oh well, it's your call.

If no reliable source bothers to say this, then it is not WP:DUE and should not be included.

As for your question, I suspect that the billions of people living outside the United States don't care much one way or the other what the US Surgeon General says on a politically charged medical question. WhatamIdoing (talk) 00:58, 26 December 2009 (UTC)

If you are correct, then those billions of people are STUPID! I don't mean that as an insult, just as an objective statement of fact. The fact is it's the Surgeon General's job to warn the public about these things and if the Surgeon General under George W. Bush remained silent, it can only be because he knew that issuing alarms about the "ABC" "link" would be lying to the public. Anyone who cares enough to look up the question on wiki and does NOT care about the SGs' silence is a fool. I mean, what would you call someone who cared about the smoking-lung-cancer link but didn't care about what the Surgeon General had to say about it??? SingingZombie (talk) 14:21, 26 December 2009 (UTC)

I removed the previous addition of Surgeon General as it isn't notable. The Surgeon General carries out health initiatives, they rarely generate their own determinations. When they do its on large scale problems such as tobacco use, childhood obesity and such. - RoyBoy 18:38, 26 December 2009 (UTC)

As we are trying to point out, silence isn't something we can reference. Inference isn't research. Lung cancer findings does not make the Surgeon General a benchmark for all things cancer; they have no position on fringe issues and are concerned with big health care problems and trends facing the US. Therefor the SG not being in the article is appropriate. - RoyBoy 18:46, 26 December 2009 (UTC)

I agree with removing mention of the Surgeon General for the reasons set forth by WhatamIdoing. If the SG's office has not produced a report, then we have nothing to reference. We can't effectively reference the absence of a finding unless someone notable has remarked on it.

I'm not sure I agree with RoyBoy's reasoning. The Surgeon General synthesizes evidence and reaches determinations on a number of health-related issues. It's really up to the SG, and the politicians who appointed him/her, to set the office's priorities. In fact, the Surgeon General's office has addressed abortion, under C. Everett Koop and Ronald Reagan. It's an interesting story - some of the religious conservatives in Reagan's administration pushed for Koop to study abortion, because they were confident he would produce a report indicating that it was harmful to women, thus providing a medical rationale for outlawing abortion. To his credit, Koop (who is himself an evangelical Christian and holds pro-life convictions) ended up finding that abortion was not harmful to women, thus sorely disappointing the pro-life lobby (see [6], for instance). I'm not aware that subsequent Surgeons General have taken up the topic, but they do "generate their own determinations", and abortion-related issues are within their purview. MastCell ^Talk 18:56, 26 December 2009 (UTC)

I did take care to say "rarely" perhaps I should have said "infrequently", but the abortion report is very interesting, thanks for pointing it out. Thinking about it, it may have been in the Frontline documentary on abortion. Checking... nope, hmmm now I'll be up all night trying to figure out which report was thrown in the trash can; ohhh yeah it was Nixon throwing out the report that said marijuana isn't harmful. MastCell should we compile a list of self commissioned reports thrown in the trash by Presidents? Seems more fun than other topics we work on :"D - RoyBoy 04:24, 27 December 2009 (UTC)

SingingZombie, do you care just as deeply what the UK's version of the Surgeon General, which is the Government Chief Medical Officer, says? Should everyone in the UK believe that you are "STUPID" and "a fool" for not doing so?

Most of the world looks to their own government and to international agencies like the World Health Organization, rather than to some unrelated country's government, where conditions may be dramatically different. WhatamIdoing (talk) 19:59, 26 December 2009 (UTC)

See National Cancer Institute andycjp (talk) 04:50, 16 January 2010 (UTC)

Can you clarify what you mean, the NCI workshop? Which Brinton et al study? Please provide links. - RoyBoy 22:53, 16 January 2010 (UTC)

Mixed results in Lead

While the Istanbul study was a one off, with mitigating factors such as small size (for a cohort study) and many possible confounders. But now the Dolle study, co-authored by a chairperson of the NCI workshop (Brinton) finds a small, but statistically significant association for ABC.

Given the prominence of the NCI workshop in the lead I believe we should add a line, in the lead, acknowledging current studies do continue to find small associations. This does not contradict the Views_of_medical_organizations on ABC "causation", but it does contrast with the NCI workshop findings of "no association". - RoyBoy 00:53, 8 April 2010 (UTC)

The Dolle study itself does not claim much of anything about abortion and breast cancer. The authors barely mention abortion, focusing instead on oral contraceptive use and its relationship to breast cancer. It is an obvious abuse of the source to use it to push an abortion-breast cancer connection when it is obviously not a substantial component of the authors' actual work. We have of course worsened the situation further by citing WorldNetDaily as if it were an arbiter of scientific thought rather than a political organ of the extreme right wing. Likewise we do the typical undue-weight thing by giving Joel Brind the last word on everything, despite the fact that his view is that of an extreme minority of the scientific community. I am curious when this editorial effort to undermine the NCI by cherry-picking and juxtaposing various primary sources will end. Certainly it is an abuse of Wikipedia to use it as a platform to argue that the NCI, WHO, American Cancer Society, etc have all got it wrong on the subject. MastCell ^Talk 03:01, 8 April 2010 (UTC)

I reflected some of those sentiments in my initial edits. If by cherry-picking, you mean summarize research, that's how featured articles are created; but granted not by undue weight. WHO's position is different and ACS's position is different; they do not assert a complete "no association" finding. It's an abuse of rational thinking/Wikipedia to compare them as identical; or that they completely reinforce each other. They agree with no ABC "causation" link, big deal, I made that clear above.

Here we go again, really? When was the last time a solid study was found co-authored by a NCI workshop chairperson that explicitly contradicts the NCI workshop finding. I noticed you emphasize his minority status instead of finding fault with the review of the study, both of which are available in PDF. Yes, we are again juxtaposing evidence against incorrect assertions, its research and critical thinking. I'm aware the NCI workshop overall conclusion is an overstep, based on previous evidence I've provided (Melbye), and this new study if you want to maintain otherwise... I question your capacity to incorporate actual reliable sources into your views. (Jill Stanek ain't one, but not my idea to add her)

I added the OC main findings, however their ABC findings are mentioned in the study; and are consistent with previous findings. Do you appreciate that is a scientifically valid and significant finding? In case you are unaware, one mentions things of importance in studies, one does not "barely" mention things that a Wiki-editor can ignore because it does not meet a POV arbitrary word count or prominence within the study. Reminds me of the laughable point that Daling's "found an association" quote is short, and is therefore of little weight. Its there, its significant and they (Dolle et. al.) acknowledge it. Brind as a notable source reiterates it. You do not. Who's in the wrong here?

Find reliable recent studies supporting the NCI workshop finding, and add them. Removing content you don't "like" isn't constructive, nor defendable. I'll re-add when you acknowledge the studies ABC finding of 1.4 (1.1-1.8) is significant, accurate, reliable, notable and belongs in this article. We can and should mention the overall conclusions of the study, but at Wikipedia we try to summarize and deliver pertinent subject information to our readers.

We have an article to update and improve. Get out of the way unless you can better demonstrate undue weight. I would be interested in that, in relation to a lead tweak. Reality moves forward, so should our article, and consequently our lead... especially if it directly relates to memes in our lead. It's fair to say that it does through Brinton and Daling. - RoyBoy 05:07, 9 April 2010 (UTC)

You have some odd ideas. It's not my job to validate and "support" the findings of the National Cancer Institute. It's your job, as a Wikipedia editor, to honestly reflect the conclusions of the experts at the NCI (and for that matter, the experts at the World Health Organization, American Cancer Society, ACOG, and every other reputable medical and scientific body on Earth). You need to start doing that job while you're here. If you personally think that the medical and scientific communities are mistaken here, then there are many venues available to you to advance your viewpoint. Wikipedia is not one of them. MastCell ^Talk 05:47, 9 April 2010 (UTC)

Well said, and exceedingly reasonable tack. But indeed this is Deja Vu, as I've said previous to this point it is our job to also reflect a subject as best we can with the most current, reliable sources. I didn't even seek out the Brinton study when mentioned above, someone else did and brought this reliable source's link to our attention. It was more relevant and significant than I had thought.

The odd idea I see, and upsets me when we lock horns, is the notion we should (or are required?) to minimize (in this case remove) contrary facts, even minority facts are notable. The authority you place in the NCIw is wrong, as it can be challenged by scientific findings. Yes I do have firm position(s) on these matters, and when reality realigns with them, I am pleased. You essentially won (on the lead) last time as I had no direct counter beyond minority report Brind for the NCIw findings. Now I plainly do via Brinton. I did not rush to correct a lead with NCIw findings I know are wrong. Its sat like that for a while.

We should enlist third party(ies) if you genuinely want to dispute that, especially if you are convinced it somehow violates Wiki-policy. And to clarify, I don't even need Brind for the Dolle study, I can quote from it directly on the 1.4 finding agreeing with previous studies. I find it hard to think you can continue to dispute that going in the NCI workshop section with cherry picking, barely, arguments. What is more contentious, and something I do need checked, is my (foolish?) notion that the Brinton connection would permit a line in the lead after the NCI workshop reflecting reliable small ABC associations being found. Wiki-policy is common sense based, I do like to think it wouldn't permit the NCIw findings to continue to stand alone without increasingly hard to ignore contrary primary evidence.

To reiterate, why you are wrong is because the NCIw findings of "no association whatsoever" are a step beyond the scientific consensus presented by every other organization on the planet. They were verifiable incorrect in 2003, and they are even more so now. Sticking to your position is aggravating, but I'm convinced having this good faith discussion will make the article better and stronger. (Assuming the lead is changed.)

I will message WhatamIdoing and Guettarda. - RoyBoy 14:52, 10 April 2010 (UTC)

You seem to be searching for primary sources (that is, cherry-picked individual studies) with which you can editorially "rebut" the conclusions of the NCI, WHO, ACS, ACOG, etc. That's not only out of step with WP:MEDRS, but it creates a misleading article. Brinton et al. clearly don't view their article as a "rebuttal", or a response of any kind, to the NCI workshop. They barely mention abortion at all, spending about 1 sentence on it in the entire paper. Yet you've made it the new centerpiece of your campaign here, employing it in a way clearly not envisaged or intended by the actual authors of the article. MastCell ^Talk 07:22, 11 April 2010 (UTC)

(indent reset)

Mastcell, seriously, please look at my first message of this thread; this is about the NCIw. As my initial edit shows I removed the "changed her position" editorial claiming it as a (direct) rebuttal. 1 sentence, I'll nitpick that as its joined to the previous sentence:

"In analyses of all 897 breast cancer cases (subtypes combined), the multivariate-adjusted odds ratios for examined risk factors were consistent with the effects observed in previous studies on younger women (Table 1). Specifically, older age, family history of breast cancer, earlier menarche age, induced abortion, and oral contraceptive use were associated with an increased risk for breast cancer."

Each sentence by itself is sufficient for mention in this article, combined it demonstrates clearly the NCIw finding is now outdated. As to WP:SYN, I've had a patchy history of recognizing when WP:SYN occurs on my part. So I do take that criticism to heart. However you seem convinced (at least in the past) the NCIw is beyond reproach and forms the backbone of the consensus, it doesn't. If a population based study by NCIw scientists showing an ABC association isn't sufficient to change the lead, I'm at a loss as to what would be. I mean do you think Wikipedia requires an ABC finding to be in the abstract for it to be sufficient weight? I believe the weight you've giving the NCIw, at this point, is utterly incorrect. Yes they all agree to no ABC link, but they do not concur on no ABC association. Conflating them to reinforce the NCIw is your WP:SYN.

The NCI workshop does not pass the standard of a systematic review as they did not use "an objective and transparent approach for research synthesis". Their rejections of studies was based on response bias guesswork, and their synthesis of cohort studies, specifically how they removed the high risk sub-groups in Melbye was not explained in their report. To pile on, the systematic review article emphasizes even proper reviews require updating just a few years after being done.

I don't think we are required to wait for them to update their own position. Nor are we in any way restricted from presenting the latest reliable information in context. In this instance, I believe the correct context is the outdated NCIw conclusion. - RoyBoy 17:41, 11 April 2010 (UTC)

I know that you, personally, have a problem with the conclusions of the NCI workshop. That is of no importance for Wikipedia's purposes. Joel Brind has published criticism of the NCI workshop, which may deserve mention here - so long as it is clear that his is a tiny-minority view from a committed opponent of legal abortion.

You are absolutely required to wait for the medical community to "update" its view before substituting your own - highly idiosyncratic - interpretation of the primary literature. As a separate point, I'm not clear why you insist on harping on the NCI as if they were the sole group that has discounted a link. As you know, the NCI's view is shared in its essentials by numerous other major medical and scientific bodies. MastCell ^Talk 18:01, 11 April 2010 (UTC)

I'm also confused, are you being purposefully obtuse? As previously stated the NCIw, because of George W. Bush's partisan edits to the website, decided to go a step beyond any other organization and determine there is "no association" based on the strongest evidence. The fact remains associations nearly abound in the ABC evidence. This is acknowledged by every other organization. The closest another scientific organization gets to the NCIw is WHO, who (pun intended) determine there is no ABC association for first trimester abortions based on cohorts (the same strongest evidence).

Your position that covers the majority of abortions is disingenuous (or simply naive) and utterly irrelevant to the fact the NCIw has gone beyond anyone else. Their determinations are/were wrong, and the two sentences from the study make "interpretation" unnecessary. Granted weight considerations for a lead mention are another matter, but I can no longer trust you to make that determination. As you seem to think the outdated NCIw findings override the type of primary evidence (population based studies) it was based upon. It can't, that's why waiting to clarify the NCIw finding is inappropriate. - RoyBoy 18:32, 11 April 2010 (UTC)

Primary sources should rarely if ever be used to rebut secondary sources. When WHO, ACOG, &c. all take the same stance on an issue, we should not be in the position of providing a pulpit to the other side out of proportion to the consideration they receive by the wider medical community. - 2/0 (cont.) 18:43, 11 April 2010 (UTC)

I concur, rare, but not automatically wrong? As Brinton/Daling participated in both, I thought it would be appropriate in this case. Can you clarify if this is incorrect? 2/0 do you actually think they took the same stance, or are you fudging for convenience/expediency over accuracy? - RoyBoy 18:58, 11 April 2010 (UTC)

← That's a have-you-stopped-beating-your-wife phrasing. To clarify the relevant stances, here are the links:

• National Cancer Institute: Abortion, Miscarriage, and Breast Cancer Risk
• Induced abortion does not increase breast cancer risk: World Health Organization
• American Cancer Society: "The public is not well-served by false alarms. At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer." (emphasis mine)
• American College of Obstetricians and Gynecologists: Finds No Link Between Abortion and Breast Cancer Risk
• The Care of Women Requesting Induced Abortion, from the Royal College of Obstetricians and Gynaecologists (p. 9: Induced abortion is not associated with an increase in breast cancer risk.)

I think that anyone who reviews these sources objectively will conclude that their stances are virtually identical. You can spend (have spent) a great deal of effort hammering away at the 1% where these groups differ. It might even be appropriate to explore those differences in context somewhere in the body of the article, if we're committed to keeping it at ~100 kb. But for summary purposes, and certainly for the lead, we should be clear that there is >99% agreement rather than focusing on the <1% minor variance. That's not "fugding" - it's a basic matter of honestly and proportionately representing available high-quality sources. MastCell ^Talk 22:39, 11 April 2010 (UTC)

Wow, seriously that was really well put. I concede that I had forgotten RCOG conclusion is the same as the NCI workshop, though they do not list the studies they based that Recommendation to women upon. ACOG... abortion of any kind, well... yikes, that's newish? That's identical to NCI if not harsher, they updated it in 09/09/2009. That's a big nail in the coffin, I'll update the article immediately to reflect they've gone off the dead end. I almost buy into your POV now. To be clear the ACS making that determination with the Melbye study in their references is a travesty of scientific integrity on their part. But give them credit, they at least list the sources. Well done Mastcell. - RoyBoy 02:44, 13 April 2010 (UTC)

Section updated. Great find. If I were them, I'd change it soon to reflect Dolle 2009. Actually I'll e-mail that suggestion to them. Their response, whatever it is could be notable, though a pity, original research. - RoyBoy 02:47, 13 April 2010 (UTC)

Er, thanks, but to be honest, all I did was go to the "External links" section and collate these. (Except for RCOG which had gone dead, so I updated the link). That is, these links have all been part of the article for some time now. MastCell ^Talk 02:59, 13 April 2010 (UTC)

Hehe, fair enough! We both dropped the ball (slightly) on that by not checking in January, given the prominence I've given to that source and how long ago it was accessed, which of course I now regret giving the ACS the nod... then again I didn't expect this change to happen in the present environment and state of mixed ABC findings. :"D Fingers crossed on their review, then I can get back to my shaking my virtual fists at you. - RoyBoy 03:30, 16 April 2010 (UTC)

Lead: Redundant sentence, ABC settled

Why do you insist of having "concluded that abortion does not cause breast cancer" twice, in sentences next to each other? Its not good summary style. If anything, having it twice is undue weight for that meme, even though its accurate.

Also, I'm doubtful Jasen, as good as it is can support the "although it is considered largely settled as a scientific question". Can you clarify. - RoyBoy 19:26, 10 April 2010 (UTC)

If you like, we could cite the views of the NCI, WHO, AMA, ACS, ACOG, etc to support the latter statement. The point is that when every reputable medical and scientific organization on Earth agrees on the topic, it can hardly be presented as a subject of active scientific debate. Jasen and other sociological sources back that seemingly obvious conclusion. MastCell ^Talk 07:24, 11 April 2010 (UTC)

Actually what I'd like is for you to write at your normal above average to excellent standard. You're addition was sloppy and the near blind revert showed a lack of consideration to the content of the edit(s). As to "considered largely settled as a scientific question" is laughable if it were not so appalling. I'm not the one with POV in this instance, you are.

How you can manage to write that in the face of the good research and primary sources I've presented this week, year, lifetime of the article is astounding. Support it, revert it or get ready for a ... I dunno, I really want to threaten you with severe penalties to communicate to you, for the second time in our interactions, my jaw is on the floor. But the article needs you to stay. Toughy... can't you be reasonable 99% of the time instead of 70% of the time. :"D Seriously though, bad call on your part, you've caught up to all my mistakes on this article with that one. I've moved Jasen away from that POV train wreck. - RoyBoy 18:07, 11 April 2010 (UTC)

Daling's quote by itself rebukes your POV, let alone ABC findings. - RoyBoy 18:11, 11 April 2010 (UTC)

If this were an active area of research with many open questions, one would expect a PubMed search to return lots of papers cross-citing each other with contrary intepretations. Instead, a search of abortion breast cancer returns 25 results from the last two years. Far from a raging scientific controversy, most of these sources mention the hypothesis offhand as part of a larger discussion of epidemiological impactors on breast cancer, or focus primarily on various aspects and impacts of pregnancy and breast feeding in some population. Brind (2009) is worth including, but does not by itself support changing the statement in this article that the question has been asked and answered and the scientific community has largely moved on. - 2/0 (cont.) 18:36, 11 April 2010 (UTC)

It has "moved on" relative to the 1990s, but that doesn't permit the sloppy thinking that it has been "concluded". There's a difference. Can you clarify how the Jasen ref actually supports the contention by Mastcell? - RoyBoy 18:49, 11 April 2010 (UTC)

And do you approve of the redundant prose being reverted multiple times? - RoyBoy 18:53, 11 April 2010 (UTC)

I wasn't aware of Brind (2009), thanks. - RoyBoy 19:18, 11 April 2010 (UTC)

• From Jasen:

  Even though proponents of the abortion-breast cancer link have lost credibility in the international research community, their campaign continues to gain willing converts, influence abortion legislation in a number of US states, and raise painful questions for women facing breast cancer or difficult reproductive choices.

  That, combined with unanimous statements from major medical bodies indicating that there is no evidence of a link, plus the near-total absence of any published research on the topic in recent years - all of that suggests that this is not a topic of active scientific controversy. Jasen's article also makes clear that it remains very much a political football, although even that is playing out a bit. MastCell ^Talk 22:29, 11 April 2010 (UTC)

How does "proponents of the abortion-breast cancer link have lost credibility" translate into the ABC being concluded, holy WP:SYN batman! Actually its worse than that, but you should know that already. *shakes head* Put it in the proponents section if you'd like. The primary research dictates ABC's status, not your POV pushing from a great source. As great as it is, its an outdated editorial on ABC link POV pushers using in some cases pseudo-science, and in many others questionable statistical manipulation and significance to purport a causal link to a lay public and a pro-life audience. I question your literacy, and I am removing Jasen again. You move it back without fleshing out your sources to something substantial (several RS representing the scientific communities opinion at LEAST), I'll submit this for mediation. If you can't be bothered to find extraordinary sources for your extraordinary claim in 24 hours, I should revert you for blatant POV pushing. Personally I'd prefer you come to your senses, as I take things to mediation when I'm sure. Near-total absence is your opinion, but even if we take it as a fair assessment, what do the studies during that period conclude? Or is that less relevant than your interpretation and outrageous weight of Jasen on something she doesn't even address directly? - RoyBoy 02:20, 13 April 2010 (UTC)

Uptodate says "Both a large pooled analysis [121] and population-based cohort studies [122-126] do not support an association between abortion (induced or spontaneous) and breast cancer risk. In March 2003, the National Cancer Institute convened a workshop evaluating the link between early reproductive events and breast cancer, which concluded that induced abortion is not associated with an increase in breast cancer risk (available at www.cancer.gov/cancerinfo/ere)."Doc James (talk · contribs · email) 10:27, 12 April 2010 (UTC)

Alright, in cites 121 to 126 do they include the Dolle study? Wikipedia is allowed to be more current, further Melbye contains an association for late term abortions. Look it up please. - RoyBoy 02:15, 13 April 2010 (UTC)

One of the refs is Melbye, Dolle is not included. Dolle however only included 897 breast cancer cases. It was not a review of the literature. It is primary research and as such does not fulfill WP:MEDRS for usage in this sort of article especially when we have better sources. Further more when one compares multiple factors as this paper does one does not use the usual p of .05. This is because if one were to compare 20 associations with a p of .05 there would be a good chance that one of the would meet this p value by chance alone. Thus for multiple comparison the required p decreases. It is clear in this paper that this was not done. See Multiple comparisons for a full explanation.Doc James (talk · contribs · email) 11:24, 13 April 2010 (UTC)

(undent) Sorry Doc James just saw this response just now, thanks for the fast reply. Yes secondary sources are typically preferred if they are better, however you presume they are better. Why? (I understand the allure of larger data sets, but there are also in-built presumptions of these reviews, such as the significance of response bias that put their overall conclusions in as much, if not more, question than a smaller but pure data set) As to p, I concede you lost me a bit, but is this referring to comparing/including confounding factors in the result? Thus reducing p. As to Melbye, you take it as fact that their high risk subgroups are of no consequence? - RoyBoy 17:05, 17 April 2010 (UTC)

Roy, UpToDate is intended, as its name implies, to be up to date. Their article on "Risk factors for breast cancer", which James is quoting, indicates at the top: Last literature review version 18.1: January 2010 | This topic last updated: January 15, 2010. The Dolle study was published in April 2009, and was available for inclusion by the UpToDate authors in their literature review. MastCell ^Talk 20:55, 13 April 2010 (UTC)

That's entirely possible, reasonable even, yet it does not answer my query. I've seen too many RS's miss plenty on this topic. I appreciate you consider Dolle 2009 not very relevant, I hope RS's don't have the same position. - RoyBoy 01:07, 16 April 2010 (UTC)

Oh yeah, Doc James interrupted my anger with a decent reference. Jasen doesn't come close supporting your contention, as you've done good work above and remain rationale, you have until Sunday to do something about refs for "although it is considered largely settled as a scientific question". I'd appreciate it if anyone else can point out to Mastcell ze is not only in error but violating Wikipedia hardcore. I will take this up in mediation if required. The timetable is pretty lax now for when I get to it... but I'll take you to the cleaners! - RoyBoy 01:27, 16 April 2010 (UTC)

And for Wikisakes fix the lead redundancy you created! I'm really unsure what I'm more pissed off about, your flagrant disregard for sourcing, or your crummy prose to make a point... twice, in the same paragraph. *rolls eyes* - RoyBoy 01:33, 16 April 2010 (UTC)

Every reputable medical and scientific body on Earth to have addressed the question has concluded that there's nothing here. There is little or no published research on the topic in the past 5 years. You keep pointing to the Dolle study, which spent one sentence mentioning abortion in passing: your own cherry-picked primary sources support the lack of active scientific dialogue. I suppose we could cite the position statements of the WHO, NCI, American Cancer Society, ACOG, RCOG, etc. as "proof" that the question is considered largely settled from the scientific perspective, but I think that would clutter and over-cite the lead. And I don't think it's worth doing that to satisfy what I think are unreasonable objections.

Personally, I think that the most current and high-quality sources on the topic (all of which are already cited in the article) clearly demonstrate that this is considered largely settled as a scientific question. Rather than responding to ultimatums, I'd rather hear whether anyone else has an opinion about the sentence in question. MastCell ^Talk 04:18, 16 April 2010 (UTC)

I think that the current views in the medical/scientific community about whether abortion causes breast cancer is adequately described as "largely settled", and I think that (especially the first half of the penultimate paragraph of) Jasen is a reasonable source to support this. IMO "largely settled" does not preclude ongoing research: We have ongoing research into all sorts of things, like how many women die from breast cancer each year, without that research implying that we expect to find noticeably different answers. WhatamIdoing (talk) 00:09, 17 April 2010 (UTC)

Well, clearly I disagree as the primary evidence, continues, to indicate otherwise. It's very unfortunate WhatamIdoing and others here whom I consider neutral appear to concur with MastCell's assessment that my views are a "highly idiosyncratic - interpretation of the primary literature". We should acknowledge the consensus view, but to outright ignore contrary findings from RS's is wrong, regardless of length. Had Dolle 2009 written a whole paragraph on the ABC topic, how would that make their findings any different? It is obvious, they mention it in passing as that isn't the focus of the study, which also does not stop us from referring to their findings. - RoyBoy 16:34, 17 April 2010 (UTC)

The concept that we have "high-quality sources" that infer it is "settled as a scientific question" presumes the conclusion is correct. If the conclusion is not quite correct, then the sources are not quite high-quality regardless of pedigree. Moreover the sources do not state it, and it is WP:OR (not even WP:SYN) for Wikipedia to state it or even infer it. If anyone can demonstrate otherwise, great, if not I'll go forward with trying to maintain the GA status of the article. - RoyBoy 16:34, 17 April 2010 (UTC)

(undent) I do not see any evidence that refutes the conclusions of the review articles we reference. Uptodate does state that evidence does not support a link and this is what we should go with IMO. The studies which are being used to attempt to prove a link are not statistically significant.Doc James (talk · contribs · email) 17:11, 17 April 2010 (UTC)

That's fine, I'm not pushing for a "link" (a causal relationship) and I fully acknowledge the consensus Uptodate reflects and Mastcell has put (twice) in the Lead. But I do not want significant statistical associations to be buried as a result. In the case of "largely settled" they aren't just buried, they are outright ignored. That appears inaccurate to me. - RoyBoy 17:20, 17 April 2010 (UTC)

question than a smaller but pure data set. I bear in mind the weaknesses of both, particularly on a topic that has been politically controversial.) -- Removed this from above as Doc James already replied. - RoyBoy 17:24, 17 April 2010 (UTC)

Fundamental Flaw in Presentation: Increased Risk vs. Cause, Misleading Introduction

This article (specifically the introduction) appears pro-abortion biased, in that it responds to the initial paragraph's question, "Does abortion increase the risk of developing breast cancer?" with the emphatic assertion, "Abortion does not cause breast cancer." That sentence leads the average reader to conclude that the debate is settled, but it does not address the question: The question is whether it increases risk, not whether it is a cause.

I say it is pro-abortion biased because such mispeaking can be deliberate to mislead people who think that "increased risk" means only "including more possible causes", e.g. "playing with matches during a gas leak is risky behavior". I am inclined to think it is so deliberate, because there is a clear concerted effort by those in power to promote contraception and abortion when facing the idea of human overpopulation.

In case this point needs clarification: If you are stressed, your immune system is weakened and you are more prone to becoming ill. Stress in this instance does not cause the illness, but it is an obvious factor that directly contributes to your becoming ill. Increasing risk and being the cause are two separate matters.

Please fix these problems. -- Newagelink (talk) 18:16, 10 August 2010 (UTC)

The article is intended to clearly convey the current state of human knowledge on the subject. The current state of knowledge is that having an abortion does not cause breast cancer, nor does it increase the risk of breast cancer. Every reputable expert medical body to have studied the question has reached that conclusion; we provide links to a number of them in the article, so that the reader can verify that we are presenting actual, reliable information rather than "pro-abortion bias". On the subject, it would be biased to pretend that there is still a significant scientific debate on the topic, because there clearly is not.

In the most methodologically sound studies (e.g. PMID 8988884), the rate of breast cancer is the same in women who have had an abortion as in those who have not, so there isn't really an issue of increased risk, much less direct causality. MastCell ^Talk 18:37, 10 August 2010 (UTC)

The use of "cause" was intentional, as it is an accurate statement conveying there is little evidence for a increased risk of significance. It is accurate, as consensus is gelling around the NCI workshop findings of "no association". But as you see above, I also disagree with the leads emphasis of this reality, to exclusion of exceptions; and it also misuses Jasen to support "although it is considered largely settled as a scientific question", the article infers it but does not state it. This is pending a mediation, which hasn't moved forward. I will do something about that. - RoyBoy 00:30, 11 August 2010 (UTC)

First trimester in Lead

The article continues to improve, however the lead still perturbs me. It states "abortion does not cause breast cancer", meanwhile one if the strongest scientific sources for this statement is WHO. They state "show no consistent effect of first trimester induced abortion". While I've argued at length with Mastcell on this, could others weigh in on this. WHO's conclusion mentions first-trimester and we should include this in our lead. I'd emphasize the Melbye cohort study indicates a higher risk for 2nd trimester abortions; it appears WHO makes note of this when they state their conclusion. Wikipedia should as well. - RoyBoy 03:37, 17 March 2011 (UTC)

The title of the WHO source says it all: "Induced abortion does not increase breast cancer risk". The source then makes clear the most methodologically sound studies found no link. I see no reason to change the current wording, especially in the lead. Yobol (talk) 03:46, 17 March 2011 (UTC)

Well I'm proposing this because titles rarely say it all for scientific topics; and I reiterate it found no link for the first-trimester. Maintaining specifics from our scientific sources is important in my view. - RoyBoy 04:31, 21 March 2011 (UTC)