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Archives

/Archive 1: Dec. 2004– Dec. 2006 /Archive 2: Jan. 2007– Dec. 2007 /Archive 3: Jan. 2008– Mar. 2008

The hypothesis is "controversial" not "unsupported"

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

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

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

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

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

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

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

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

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

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

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

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

NCI tweak

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

ACS tweak

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

Lead rework

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

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

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

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

1. Russo J, Russo I (1980). "Susceptibility of the mammary gland to carcinogenesis. II. Pregnancy interruption as a risk factor in tumor incidence". Am J Pathol. 100 (2): 505–506. PMID 6773421. "In contrast, abortion is associated with increased risk of carcinomas of the breast. The explanation for these epidemiologic findings is not known, but the parallelism between the DMBA-induced rat mammary carcinoma model and the human situation is striking. Abortion would interrupt this process, leaving in the gland undifferentiated structures like those observed in the rat mammary gland, which could render the gland again susceptible to carcinogenesis."
2. "WHO". who.int. Retrieved 2007-12-24. {{cite web}}: Text "Induced abortion does not increase breast cancer risk" ignored (help)
3. "Politics & Science - Investigating the State of Science Under the Bush Administration" (HTML). oversight.house.gov. Retrieved 2008-04-14.
4. ^ Jasen P (2005). "Breast cancer and the politics of abortion in the United States". Med Hist. 49 (4): 423–44. PMID 16562329. {{cite journal}}: External link in |title= (help)
5. Russo J, Russo I (1980). "Susceptibility of the mammary gland to carcinogenesis. II. Pregnancy interruption as a risk factor in tumor incidence". Am J Pathol. 100 (2): 497–512. PMID 6773421.
6. Russo J, Tay L, Russo I (1982). "Differentiation of the mammary gland and susceptibility to carcinogenesis". Breast Cancer Res Treat. 2 (1): 5–73. PMID 6216933.{{cite journal}}: CS1 maint: multiple names: authors list (link)
7. Russo J, Russo I (1987). "Biological and molecular bases of mammary carcinogenesis". Lab Invest. 57 (2): 112–37. PMID 3302534.
8. "ACS :: Can Having an Abortion Cause or Contribute to Breast Cancer?". cancer.org. Retrieved 2008-03-31.
9. ^ "Politics & Science - Investigating the State of Science Under the Bush Administration". democrats.reform.house.gov. Retrieved 2007-11-04.
10. ^ "Summary Report: Early Reproductive Events Workshop - National Cancer Institute". cancer.gov. Retrieved 2007-11-04.
11. "Medical Groups Recognizing Link". abortionbreastcancer.com. Retrieved 2008-04-14.
12. "THE PRO-CHOICE ACTION NETWORK". prochoiceactionnetwork-canada.org. Retrieved 2007-11-04.
13. Chris Mooney (2004). "Research and Destroy". washingtonmonthly.com. Retrieved 2008-04-14.
14. "Women's Health after Abortion". deveber.org. Retrieved 2008-04-14.
15. "Weldon Letter". abortionbreastcancer.com. Retrieved 2007-11-04.
16. Daling JR, Brinton LA, Voigt LF; et al. (1996). "Risk of breast cancer among white women following induced abortion". Am. J. Epidemiol. 144 (4): 373–80. PMID 8712194. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
17. Howe H, Senie R, Bzduch H, Herzfeld P (1989). "Early abortion and breast cancer risk among women under age 40". Int J Epidemiol. 18 (2): 300–4. PMID 2767842.{{cite journal}}: CS1 maint: multiple names: authors list (link)
18. Melbye M, Wohlfahrt J, Olsen J, Frisch M, Westergaard T, Helweg-Larsen K, Andersen P (1997). "Induced abortion and the risk of breast cancer". N Engl J Med. 336 (2): 81–5. PMID 8988884.{{cite journal}}: CS1 maint: multiple names: authors list (link)
19. Michels KB, Xue F, Colditz GA, Willett WC (2007). "Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study". Arch. Intern. Med. 167 (8): 814–20. doi:10.1001/archinte.167.8.814. PMID 17452545.{{cite journal}}: CS1 maint: multiple names: authors list (link)
20. Beral V, Bull D, Doll R, Peto R, Reeves G (2004). "Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83?000 women with breast cancer from 16 countries". Lancet. 363 (9414): 1007–16. PMID 15051280.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The hypothesis is "controversial" not "unsupported"

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

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

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

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

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

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

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

Serious POV issues with this article

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

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

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

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

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

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

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

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

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

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

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

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

Waco Billboard

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

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

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

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

Why is this article still on Misplaced Pages?

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

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

Future links

Just external links we may use in the future:

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

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

Hyphenation

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

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

Proponents section

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

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

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

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

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

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

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

This is an archive of past discussions about Abortion–breast cancer hypothesis. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

This'll be a long review, I felt compelled to give a thorough critique of this article. Basically, the lead is pretty much good, reference four could probably do with a non-PP cite for neutrality purposes, but I don't think that's too terrible a problem considering that the fact being referenced doesn't seem silly. I figured i'd start with the lead because that's about the best thing this article has going for it, and now for my long list of problems I have identified:

• "When pro-life advocates link abortion to breast cancer, some claim that the goal is to stop women from having an induced abortion. Because breast cancer elicits disproportionate fear in women, there exists the concern that pro-lifers use it as a scare tactic." "Some claim"? I think its fairly self-explanatory that if the advocates are pro-life, the goal is to convince women to not have an abortion, I don't think there's a need to find claimants for that. The second sentence is very non-neutral and not cited adequatly at all, in addition to being unclear. Disproportionate in comparison to what, the proper amount of fear that a woman should have of getting Brest Cancer? Who defines that proper amount of fear? I certainly hope not some apparently 10 year old reference (Copyright 1997 at the bottom) hosted on a website which seems to be dedicated at the moment to trying to debunk global warming, and is an article written by a person who doesn't even appear to be a notable source, all there is is a name, no hint of possible qualifications is given. I'm not saying this person definenetly isn't notable and therefore this ref is definently inappropriate, but from what the ref gives, I have no reason to conclude otherwise. Also, who is concerned that it is a scare tactic, and why is it relevant? Not all scare tactics are bad.
  • Removed for now. - RoyBoy 03:11, 3 May 2007 (UTC)

• The next two sentences I won't bother quoting, the main problem is there's no reference and they require attribution as to who is accusing whom, and if they are referenced, the content may change based on what's in the refs.
  • Removed for now. - RoyBoy 03:11, 3 May 2007 (UTC)

• "At the same time pro-life organizations lobby to increase obstacles to abortion, such as mandated counseling, waiting periods, and parental notification, and some feel that pro-life advocates treat ABC as simply another weapon in their arsenal. In enacting these obstacles it takes longer for a women to get an abortion and as a result this increases potential breast cancer risk and complications" This is certainly not neutral, its clearly written in a way to make the pro-life efforts seems as negative as possible, by making "abortion" into a victim of sorts, and accusing pro-life organizations of using "women as simply another weapon in their arsenal", and without even referencing the people who make the accusations to boot. The citation given doesn't even seem to be POV pushing at all and even cites its sources making it seem a good deal reliable, so the wording of the article here seems like some POV pushing independant of the citation.
  • Tweaked wording, ref grabbed from above. Abortion is not the victim, nor do I see that inferred in the article. Longer time for a woman to get an abortion makes her the possible victim. ABC used as a weapon, not women. - RoyBoy 03:11, 3 May 2007 (UTC)
    • It's not that its being inferred throughout the article per se, its just the use of language makes that connotation, "increase obstacles to abortion" would have a pro-life counter of "incrase the defense of unborn children" or something like that, and if has a counter-perspective of wording, it's likely not to be neutral in the first place. Plus, lobbyists these days are a pretty negative thing, and the use of "lobby" here also seems to be part of non-neutral wording. I thought it had said women though, perhaps the word being directly below the acronym confused me.... Homestarmy 16:07, 3 May 2007 (UTC)
• " The ongoing and incremental legal challenges to abortion by pro-life groups is documented in Frontline's The Last Abortion Clinic" This seems to be an advertisement, this surely cannot be the only thing that documents legal dealings in this area. Since this also seems to be trying to victimize abortion, perhaps this line and the lines above it are all part of one large advertisment? Recommend just removing them all if so.
  • I can remove wording, but subject matter is critically important... and cover, decades of legal precedents in relation to abortion; the reference and documentary itself are world class. It is certainly not the only thing, but its one of the most comprehensive, notable and reliable sources. - RoyBoy 03:11, 3 May 2007 (UTC)
    • The article didn't seem to justify or demonstrate how important this documentary was, and because it was Frontline, I thought it was just some typical protrayel of Abortion stuff through the mass media, so I was suspicious. Homestarmy 16:07, 3 May 2007 (UTC)
• "In 2005, Life Canada put up billboards in Alberta with large pink ribbons and the statement: "stop the cover up". The Canadian Breast Cancer Foundation was concerned this did not reflect the conclusion of the 2004 meta-analysis done by Dr. Beral et. al, which they felt was the "best piece of evidence" for no ABC connection." These sentences are kind of confusing. "Life Canada" I presume is a pro-life group, but what cover up? might want to give more details about their rational, and the next sentence is sort of ambiguous pronoun-wise, is "this" referring to Life Canada's billboards? Also, a foundation cannot be a "they", only the members, and how is the CBCF certain the Life Canada billboards were put up with Life Canada specifically because of the study? That kind of thing could probably do with some explanation too, and "no ABC connection" to what, abortion?
  • Added clarification on Life Canada rationale. ABC = abortion breast cancer, and CBCF felt Life Canada was ignoring the best scientific evidence. The foundation wasn't, necessarily, inferring a cause between the two. - RoyBoy 03:11, 3 May 2007 (UTC)

I've had no choice but to split this up... just looking at it gives me a headache. - RoyBoy 03:11, 3 May 2007 (UTC)

• "The continued focus, misinformation and promotion of the "ABC link" by pro-life groups has led to a backlash by pro-choice advocates, which has created a confrontational political environment at the expense of science. As a result, the ABC hypothesis is referred to as pseudoscience despite the fact its proposed mechanism remains verified in rats." Ohhh boy. Really, it wouldn't matter if the citations were extremely reliable, Misplaced Pages seems to be making a fact claim here which is entirely POV-pushing to its core. Even if this article was meant as an essay from the pro-choice perspective, it hasn't even demonstrated that pro-life organizations are creating misinformation, the lead even says there's still some controversy, not only does this wording fail NPOV standards, even if it was a positional essay, I think it would still be pretty lousy. I don't care if this one author personally feels that pro-lifers are deceptive on this issue, or even if he is some historian who got his book on PubMed, that doesn't make him reliable enough to usurp WP:NPOV whenever people want him to. If it was attributing an accusation, that might be ok if this person is highly notable. But it isn't attributing the statement, it is simply making it out as if it were absolute fact. What does "Expense of science" even mean anyway?
  • A lot of words to say, reference this uncontroversial statement. Refed with JASEN. Expense of science means, science becomes secondary to politics, POV and misinformation. Misplaced Pages is usually pretty dry, a little flavor couldn't hurt? - RoyBoy 03:11, 3 May 2007 (UTC)
    • A little flavor might not necessarily be bad, but the wording here makes this flavor out to be fact. Homestarmy 16:07, 3 May 2007 (UTC)
• Next, the Pseudoscience thing. Although I haven't had the pleasure of participating heavily in fun Pseudoscience type articles, (I tend to shy away from fighting on Creationism related articles because its just so time consuming and there's easier ways to make Misplaced Pages better) I certainly get the gist of what makes a reliable Pseudoscience classification, and this reference is absolutly not it. The citation given is not scientific nor does it relate any testimony of the scientific community, it is a pro-choice advocacy website which has absolutly no reliable jurisdiction in scientific matters in and of itself at all, and therefore cannot reliably be used in this article or any other to label a topic absolutly as pseudoscientific. To make it worse, the person quoted is a mere Staff Attorney, who does not appear to have any scientific credentials whatsoever. For the article to, if i'm reading this right, label this hypothesis as pseudoscientific because of the testimony of a single staff attorney is compleatly wrong. Now, if the sentence read, "ABC is often referred to by pro-choice groups as Pseudoscience...." this would be ok. But "Is referred to as" with no attribution in the article reads very easily as a claim of fact. Also, the second half of the sentence appears to of been written as a counterbalance to the first half, and two POV wrongs don't make a right, just attribute both claims to references and I don't think there'd be a problem here.
  • It can and should be used as a reflection of pro-choice perceptions, but broader referencing would indeed be more robust. Refed. This is the "Politicization" section after all; it doesn't have to be a scientific reference(s). I don't consider the second half a POV, clarify please. - RoyBoy 03:11, 3 May 2007 (UTC)
    • The second part with "despite" leading it off made it seem like it was there to say that although the ABC hypothesis is considered pseudoscience, this study clearly indicates otherwise, and if it was actually pseudoscience as the sentence seemed to be saying before, then if some study was indicating otherwise legitimatly, (I assumed that since there was no qualification on the counter, that this counterpoint was considered legitimate) that would contradict the claim of pseudosciece. The new wording is still vauge, (It just seemed to say "some say" in the diff I saw) exactly who labels it as pseudoscience seems to be limited to pro-choice organizations instead of an open-ended "some". Homestarmy 16:07, 3 May 2007 (UTC)
      • some > pro-choice organizations Heh, being specific indeed would be helpful in the article. - RoyBoy 20:02, 3 May 2007 (UTC)
• "Scientists are put under significant pressure and criticism if their results contradict the current consensus of no ABC association. This is illustrated by an interview with Dr. Daling that was published on September 28th, 1997 by the Los Angeles Daily News. In it she made the following statement" Are they now? According to whom? Ah, it seems according to nobody, after all, surely if Misplaced Pages says it, it has to be true, and we can just get by with an illustration to help demonstrate our truth claims, even with the top part of the article compleatly contradicting it with other truth claims. No, seriously, this is unnatributed POV pushing as well without any mention of who makes the accusations about pressure and criticism, and why does "Dr. Daling" get a big quote anyway? I don't see how a quote out of a single newspaper article warrents being the only thing quoted on this topic. The reference given isn't even about Dr. Daling, and doesn't say why this doctor is even important, the reference itself is an article written by another doctor, why not quote the person who wrote the article if anyone at all?
  • Seriously, you're good at this. Removed scientist, ref new version. (search for "uncritical" in JASEN ref, do you consider that sufficient? As to Dr. Daling, she is a notable pro-choice ABC researcher; Dr. Angela Lanfranchi isn't. The quote is one of the few instances of a researcher publicly commenting on their experience publishing positive ABC results; making it unique and notable. - RoyBoy 03:11, 3 May 2007 (UTC)
    • It might be nice to note in the article that Dr. Daling is a highly notable pro-choice reasercher, that was only mentioned much in the reference itself, not the article. Homestarmy 16:07, 3 May 2007 (UTC)
      • Wikilinked to her section below Is that sufficient... actually is that even allowed, to Wikilink to another part of the article. I suppose so, since that's what the TOC does. - RoyBoy 20:02, 3 May 2007 (UTC)
• The thing with congress is almost ok, "congressman" should be "congressmen", and it ought to say that its the United States congress that's being talked about here. Also, what exactly was the result of Kindley's law review? Finally, i'm not entirely certain why exactly what these congressman were doing is relevant, the paragraph doesn't give me much to go on as to why it was important to the issue of the ABC hypothesis, if its just about the National Cancer Institute, that seems somewhat off-topic.
  • Added US Congress. The result of the Kindley review is the actions taken by those in congress, and some lawsuits. It's relevant in that politics and the ABC issue are more heavily involved than most people realize. Does it also serve to put the NCI in a lackluster/defensive light, yup, off-topic? Can't see why, since it involves their historic position on ABC research. - RoyBoy 03:11, 3 May 2007 (UTC)
    • Eh, it just seemed too NCI-centric, but that might be debateable, I don't think i'd come back and fail the article again just for this if I saw it still around its present form, it just seemed off to me, so I commented on it. Homestarmy 16:07, 3 May 2007 (UTC)
• "The National Cancer Institute (NCI) conducted a workshop to evaluate the scientific evidence regarding the abortion-breast cancer hypothesis. This was done in response to alterations to the NCI website by the Bush administration in November 2002. The workshop concluded that the evidence was well-established that abortion did not increase a woman's risk of breast cancer." The first reference seems rather poor, althought it is from a government committee, it is quite a POV source, which although cites its sources on some facts, gives a very POV interpretation of the facts when it isn't necessary for the sentence being referenced in the article, it specifically cites the National Cancer Institute several times and the letters sent by congressman, I think it would be much better to cite the article's cites directly instead. Other than that, might want to make it more clear that the NCI didn't do this directly because of the administration, but because some congressman wanted action, its a bit unclear about that.
  • Good call. Expanded. I can also use oversight ref for NCI, Planned Parenthood, Melbye, refing below. Man, you did a lot of reading! - RoyBoy 03:11, 3 May 2007 (UTC)

• The entire next paragraph confuses me. Do these workshops work like courts with dissenting opinions that way? And who is Melbye? And how did Dr. Daling re-appear, he's only introduced as what seems to be a compleatly random quote above. Also, I don't understand "and preterm delivery was listed as an epidemiological "gap"" at all, these medical terms aren't easy on alot of people. The last sentence is unattributed and confusing, so what if he was invited as well, his point was that "many invited scientists" had a conflict of interest, not all of them. The rest is a good point however, which is a problem, as the article should be attributing the points of other people, not making a point on its very own.
  • Not like courts, but they do solicit opinions of experts. As to people introductions, I could move them from below; I thought people could learn about them from the rest of the article. (the entire science section use to be reversed, with NCI at the bottom, after the scientific research and doctor introductions) Removed point(s) until a citation is found.

• "...but this article covers relevant recent ABC research history..." Self-reference bad.
  • Removed. RoyBoy 03:11, 3 May 2007 (UTC)

• "... the large cohort studies and then finishing in 1980 with the first rat study" What's a cohort study?
  • Wikilinked. - RoyBoy 03:11, 3 May 2007 (UTC)

• "The majority of the results in epidemiologic scientific studies are calculated as a relative risk with 1.0 being 0% followed by a 95% confidence interval. This means a relative risk of 1.51 (0.93-1.87) is a 51% increased risk with a 95% chance that the actual risk is within the range given" This scares me. Not just because I have no idea what it means, but that the vocabulary and terminology usage has suddenly ratcheted up like 5 or 6 grade levels from the rest of the article. epidemiologic? Relative risk to what? what's being followed with 0 percent? "Confidence interval"? Less numbers, more words of lower vocabulary level, prefereably with a citation, since there isn't one and for all I know, these numbers just got made up out of thin air.
  • Wikilinked, reworked entire intro. - RoyBoy 03:11, 3 May 2007 (UTC)

• "Genetics is a major factor which plays a role in the long list of socioeconomic factors. " Ehh, if socioecnomic means social + economic factors, i'm not sure what the economy has to do with one's DNA structure.
  • Yeah, that was really awkward. Clarified, refed. - RoyBoy 03:11, 3 May 2007 (UTC)

• The next few sentences appear to be addressing the reader, hardly encyclopedic. It says something needs to be done without saying who says it, the usage of "you" is also a tip-off. Also, the difficulties of the issue are only cited with one thing, so as far as this article is concerned, the only verified source calling the examination of this article difficult is that one institute. Besides, what's the point of the sentence? Trying to justify Misplaced Pages's possible lack of ability to adequalty cover the topic? That definently doesn't seem encyclopedic.
  • Reworded, more wikilinks. - RoyBoy 03:11, 3 May 2007 (UTC)

• "...but they do not significantly affect the results of ABC studies that are properly conducted and take these factors into account with case-control matching." What is case-control matching?
  • Wikilinked, removed interviews as confusing. - RoyBoy 03:11, 3 May 2007 (UTC)

• "The controversial nature of abortion may introduce response bias into interview studies; especially for studies done in decades past when abortion was less accepted." According to....?
  • Re-add excellent old ref. - RoyBoy 03:11, 3 May 2007 (UTC)

• "It should be noted the overall incidence does not effect ABC studies with proper controls because the case and control subjects would be equally affected." Should be noted according to....? There's no need to make things up to make the article more compleate, if what you want to write simply doesn't have any references for it, then it means that it probably isn't considered very important to the subject by important sources, and it doesn't need to be included.
  • Agreed. Though I have seen it used by lay people as a solid rationale for no ABC link. Removed. - RoyBoy 03:11, 3 May 2007 (UTC)

• "The Melbye study's conclusions garnered great attention from the media and many organizations such as the NCI and Planned Parenthood, who use it as a foundation to argue that the best scientific evidence does not support an ABC link." Apparently not enough attention for there to be references....
  • :"D Refs added. - RoyBoy 03:11, 3 May 2007 (UTC)

• "The relative risk after statistical adjustment came to 1.00 (0.94 to 1.06). This led to the conclusion that "induced abortions have no overall effect on the risk of breast cancer." Because the terms introduced that are about the studies are very confusing, I doubt most readers will have any idea why this would indicate a result contradictory to the ABC hypothesis.
  • Hmmmmm. Expanded. - RoyBoy 03:11, 3 May 2007 (UTC)

• "In a large cohort study it is necessary to account for confounding factors that may have increased over time. For example, if oral contraceptives affected breast cancer rates 40 year old women in 1990 (young birth-cohort) would have a higher incidence of breast cancer than 40 year olds in 1970 (older birth-cohort), as the older cohort had little to no access to oral contraceptives during their reproductive years." According to whom, and who gives the example? To tell you the truth, I don't think giving an example itself would necessarily be OR if it has good similarities to the principles given in a reference attributing the fact in question, but without a reference, well....oh, and if the reference at the bottom is actually covering this whole paragraph, how authoritative is this website? It doesn't sound like a medical organization per se, though I can't check it through our school's firewall.
  • The reference merely covers the last sentence. Removed/rewrote explanation as redundant and long, insert more letter and study refs. - RoyBoy 03:11, 3 May 2007 (UTC)

• "Drs. Senghas and Dolan questioned why a statistically significant result for induced...." Whoa there, who's Senghas?
  • It's been a while since I've taken out my stack of studies. They come from Weston, MA; apart from that I get very little from online browsing. Tweaked out names for "letter to the editor".

• "Here is the first section of Table 1...." Self-reference, though not a GA concern. However, is the text below that table copied from the study? It looks very inconsistant with other parts of the article, and seems to fit a bit too neatly with the table to be OR....
  • Tweaked. - RoyBoy 03:11, 3 May 2007 (UTC)

• I won't even go into the next studies, as I don't think that'll be necessary, why exactly should every single one of these studies be in this article with so much detail? There's such a thing as too much information here, and by listing study after study after study like this, it really seems to get away from the topic of the ABC hypothesis and instead is just concerned with talking about individual studies, especially because there's so much detail, its almost like each study should have its own article. And then, that would need some summary style here. That goes for some of the meta-analysis stuff too, and the interview based studies.
  • Well, summary style is being used already. Sigh, will work on it... but it wasn't easy bringing together the ABC scientific debate into one article. Was it a mistake to do so? Well, it goes against articles being short and to the point, but follows the goal of articles being comprehensive and complete. - RoyBoy 03:11, 3 May 2007 (UTC)
    • It's not that the scientific debate itself is a problem here, its just that when I read this, it was just so much about the science and how the science was executed on this matter that it seemed overboard. Does each study already have an article, I didn't assume so since there were no main templates.... Homestarmy 16:11, 3 May 2007 (UTC)
      • Correct, no main articles. Come to think of it; I don't think studies are allowed to be put on Misplaced Pages; maybe Wikisource? But it would be pretty sweet if a WikiProject started, tracking criticism of published studies and allowing a much more open examination and discussion of scientific research. - RoyBoy 01:21, 4 May 2007 (UTC)
• "Furthermore, women in the control group are more likely to have no serious illnesses, and hence have less motivation to be truthful than those trying to diagnose their problem. If this occurred then it would artificially create an ABC link where none existed." According to who concerning the three facts proposed.....?
  • I think someone tweaked that and I didn't notice. Tweaked and refed. Response bias should also clarify this, but it currently does not elaborated on the epidemiological aspect of the term. I actually did that for recall bias, but it doesn't belong there, removed! I love how things can balloon on Misplaced Pages. - RoyBoy 03:11, 3 May 2007 (UTC)

• Three more studies under the response bias part in a similar state to the one's already listed above. This article should primarily be about ABC, and after reading all this stuff about studies, I get the impression it starts out being about ABC, and turns into an article about how to conduct studies on the issue, what happened in every single study on the issue, what were the technical details of every study, etc. etc., and all this is very distracting from the topic when its done in such humungous detail. I'm not saying slice out everything, but radically slim this stuff down, and don't have individual sections for studies unless they were super ultra important and notable and are the most frequently cited or criticized for the purposes of this hypothesis.
  • You make solid point, but if the devil is in the details it is something I'd rather have too much of, than not enough. ABC is not a light topic; while trying to summarize things is certainly the stylistic goal at Misplaced Pages, I will not consciously remove one pertinent aspect of a study that cannot be easily accessed. What a cohort study is, can be easily accessed on Misplaced Pages... other details might be located all over the place; or worded in even more lengthy complicated prose. Maybe implemented after easy stuff taken care of. - RoyBoy 03:11, 3 May 2007 (UTC)

• What's up with this lawsuit section? All it was was that an Abortion clinic used an outdated fact sheet, the judge found that this made them not liable for the possibly wrong information contained therein, there's even a ref stating the plaintiff didn't even read the brochure at all, and with so much pro-choice language in all these quotes, this whole section appears not only worthless to the topic, but changing the whole POV of the article to decidely pro-choice. It doesn't even look like the judges ruled at all on whether ABC was fact or fiction.
  • Which is the point (your last sentence). It is the most notable legal case on the ABC issue, and has to be covered. It also emphasizes that while the case was lost by pro-lifers, the abortion clinic did end up updating/correcting their brochure. I think the section is solidly NPOV, as it balances out the opposing viewpoints and helps clarify how it can be hard to figure out who has the moral high ground. Frankly how you can miss the pro-choice lawyer sounding zealous and dismissive, while the pro-life lawyer sounds reasonable and inclusive; is more than a little confusing to me, and indicates you focused on things you didn't and confused the point of the section as a weakness and/or pointless. It is neither. Unchanged. - RoyBoy 03:11, 3 May 2007 (UTC)
    • Seems odd that the most notable case was barely about ABC anyway since the lawsuits just got failed not for ABC itself but because of things the plaintiff did which made her claim suspicious, but all the quotes started seeming pro-choice, so I didn't realize that pro-life lawyer quote was actually pro-life at all, the plaintiffs name was weird and I guess I didn't see it. It looks like it could be the kind of thing said by both sides really. Homestarmy 16:07, 3 May 2007 (UTC)
      • I understand. Yes, it's pretty unfortunate both sides don't say/follow that philosophy. - RoyBoy 01:10, 4 May 2007 (UTC)
• "These state laws put up further barriers to elective abortion, and critics charge that they have the real potential to misinform women of the actual risks of the procedure." Non-neutral, POV pushing use of pro-choice source to cast abortion as a victim....again. "Critics" is also unattributed, just remove the first part entirely in its present form, its ridiculous anyway, the laws can only be barriers if they deny or impede people's access to abortion. Of course, if pro-choice groups nationwide agree with that interpretation, who am I to recommend that their sillyness be absent from this section, but currently, Misplaced Pages's phrasing affirms this as absolute fact here.
  • Ref 74 and "state laws" is speaking to general tactics of abortion movement, not specifically to ABC issue. As to "misinform", I had a ref that specifically said that... if I remember correctly I got it from the original AP Yahoo link that eventually went dead. Dangit. Removed, rewritten and old ABC ref re-added. - RoyBoy 03:11, 3 May 2007 (UTC)

• A conclusion section? There should not be conclusions in Misplaced Pages articles that are made by Misplaced Pages, this isn't supposed to be a term paper, Misplaced Pages shouldn't be making conclusions about anything anywhere, only reporting the conclusions of other people, and by using differing references to bring together a conclusion not present in the references, it is, in my opinion anyway, a textbook example of WP:OR. If some notable organizations all made some sort of unifying conclusion on this hypothesis, then reporting on their conclusion would be notable, but only in terms of Misplaced Pages reporting on other people's conclusions, not in terms of Misplaced Pages stringing together refs and making its own OR conclusions.
  • Removed. Cut and pasted below for possible future integration. - RoyBoy 03:11, 3 May 2007 (UTC)

Ok, basically, this article probably needs a pretty bug chunk of work for it to be a GA. Overall things i'd do would include removing most of the material in all of the study-related sections except for the stuff most directly relevant to the ABC hypothesis, so all of the technical stuff could easily be removed and put in sub-articles concerning the studies, that will remove a whole bunch of really difficult technical content, and yet leave more than enough things that should be helpful from the studies which have to do with the topic at hand. Focusing on the conclusions of the studies rather than the nitty gritty details is what I think would help here. The POV problems i've highlighted are pretty bad, but probably easier to solve than the studies thing. Homestarmy 17:42, 2 May 2007 (UTC)

Thanks for the detailed review Homestarmy. I'm not sure quite where we go with this as you are correct that this is a very scientifically worded article. I feel that is its strength as it explains the issue using the available data rather than quote mining from pro and anti abortion pamphlets. Its a difficult subject but I feel the only way to walk the NPOV line is to focus on the science. By lowering the language there is a real danger of stepping into OR territory with interpreting what the range and limitation of theses studies are. I personally would rather forego the GA than loose the detail and clarity that we currently have. RoyBoy is the guy who needs to consider this though as he has written most of this. Sophia 18:24, 2 May 2007 (UTC)

Tremendous review, a little snarky... but I've been snarky more times and I can count doing this article. Also helps provide motivation to do something about it, responses within review for readability and traceability. Mistakes are mine, and likely the result of a lack of sleep. - RoyBoy 20:23, 2 May 2007 (UTC)

I replied to these points in reverse order, so more mistake; but it helped make it less daunting... I just scrolled up and addressed each, as best I could for now. I really appreciate the time, and obvious care you have put into reading references and double checking things. Please recognize, that while the article obviously needs some more work; I have absorbed a lot of information on the ABC issue, and that just because everything isn't attributed directly doesn't mean it is off the wall. :"D Unless it is... then um, you wrote it and forgot! Joking!!! Look forward to working further with you on this important subject. God I'm tired, insomnia picked a horrible week to strike me. - RoyBoy 03:11, 3 May 2007 (UTC)

Eh, well, the article topic motivated me to really give it a thorough review, but it's only the second time i've done a review that identifies so much, ordinarily, I stop reviewing most articles and just give the fail when I haven't even made a list half this long :/. And then, the first time, I did only start out with like the top third of American Civil War, but then when someone surprisingly fixed everything, I was obliged to do the whole thing, and that was like the size of three of these reviews, so I guess i'm getting more proficient at really going at articles now. Homestarmy 22:39, 2 May 2007 (UTC)

I'll say! Thanks again Homestarmy, hopefully you'll stick around a bit for continued feedback. - RoyBoy 03:11, 3 May 2007 (UTC)

I would call in another person to help, because i'm not actually amazingly proficient at reviewing things when science is too deeply involved, (It's just most of the errors so far didn't seem to have to do with the science as much as how it was being presented in the article) but I don't know any GA reviewers who do much with these kinds of articles.... Homestarmy 16:07, 3 May 2007 (UTC)

Only in the United States!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Australian case?

An Australian case

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

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

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

My reversion

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

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

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

That's wrong, plain and simple.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Question about the lead

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tweak on "NCI tweak" shown far above

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Undue weight

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

removed "clear" from lead

I removed the word "clear" from this sentence:

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

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

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

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

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

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

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

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

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

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

Does Melbye contain an association? Yes.

Do they mention it in their abstract? Yes.

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

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

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

Selection bias in the Lead

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

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, 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)

1. Weed DL, Kramer BS (1996). "Induced abortion, bias, and breast cancer: why epidemiology hasn't reached its limit". J. Natl. Cancer Inst. 88 (23): 1698–700. PMID 8943995.
2. ^ Melbye M, Wohlfahrt J, Olsen J, Frisch M, Westergaard T, Helweg-Larsen K, Andersen P (1997). "Induced abortion and the risk of breast cancer". N Engl J Med. 336 (2): 81–5. doi:10.1056/NEJM199701093360201. PMID 8988884.{{cite journal}}: CS1 maint: multiple names: authors list (link)
3. ^ Michels KB, Xue F, Colditz GA, Willett WC (2007). "Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study". Arch. Intern. Med. 167 (8): 814–20. doi:10.1001/archinte.167.8.814. PMID 17452545.{{cite journal}}: CS1 maint: multiple names: authors list (link)
4. Medical Medical group: Tell women about abortion-cancer risk
5. Medical Groups Recognizing Link
6. Cite error: The named reference NCI was invoked but never defined (see the help page).
7. Cite error: The named reference WHO was invoked but never defined (see the help page).
8. American College of Obstetricians and Gynecologists: Finds No Link Between Abortion and Breast Cancer Risk. From the American College of Obstetricians and Gynecologists, 2003. Accessed July 17 2008.
9. Cite error: The named reference rcog_2000 was invoked but never defined (see the help page).
10. Cite error: The named reference ACS_ABC was invoked but never defined (see the help page).

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  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, . 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  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 Misplaced Pages 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 Misplaced Pages 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  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 Misplaced Pages 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  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".

Misplaced Pages 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 Misplaced Pages 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 Misplaced Pages - 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  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  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 Misplaced Pages 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 Misplaced Pages is not the venue for such analysis. Here, it's called original research. MastCell  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; for that I applaud. - RoyBoy 00:42, 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. Misplaced Pages 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  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)

"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  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)

• Misplaced Pages good articles
• Natural sciences good articles
• Old requests for peer review
• B-Class Abortion articles
• Unknown-importance Abortion articles
• WikiProject Abortion articles
• Unassessed software articles
• Unknown-importance software articles
• Unassessed software articles of Unknown-importance
• Unassessed Computing articles
• Unknown-importance Computing articles
• All Computing articles
• All Software articles