29th October 2003
Abortion and Breast CancerLord Alton of Liverpool rose to ask Her Majesty's Government what evidence links breast cancer with abortion; and what measures they are taking to alert women to any risks involved.
Lord Alton of Liverpool rose to ask Her Majesty's Government what evidence links breast cancer with abortion; and what measures they are taking to alert women to any risks involved.
The noble Lord said: My Lords, as your Lordships will be aware, October is breast cancer awareness month. This is therefore a timely debate and I am grateful for the opportunity to ask this Unstarred Question today.
Breast cancer is the most common cancer in the United Kingdom and affects some 41,000 women every year. It claimed 13,000 lives in 2001, making it the second most common cause of cancer death in women after lung cancer. As the honorary chairman of the "Forget Me Not" appeal for Liverpool's Royal Teaching Hospital, I am glad to report that our appeal raised £4 million for cancer treatment facilities, including the Linda McCartney Centre for Breast Cancer, which I invited Cherie Booth QC to open.
Throughout the country substantial progress has been made in detection and improved treatment of breast cancer. I hope that what I say today will further help to reduce the incidence of breast cancer among women.
I have never made any secret of my position on abortion. I have always believed in the right to life of the unborn. I do not believe that many of those who supported the Abortion Act 1967 ever anticipated that it would lead to some 6 million legal abortions or to the one in five pregnancies that now end in an abortion. I have also argued that being pro-life is not about choosing between a woman and a child. It should surely be about caring for both and affirming life and human dignity at every stage of life from conception to natural death.
So the issue is not whether you are for or against abortion; it is about its possible consequences. My remarks rely entirely on published studies, evolving medical knowledge, judicial settlements and freedom of information.
For some time now, I have been studying the effects of abortion on women and the evidence linking induced abortion to breast cancer. I find the evidence quite compelling, and it is that evidence that I lay before your Lordships' House today.
Twenty-eight out of the 37 independent studies that have been carried out world-wide have linked induced abortion with breast cancer. Thirteen out of 15 studies conducted on American women report increased risk. Seventeen studies are statistically significant, 16 of which found increased risk.
In 1996, Professor Joel Brind of Baruch College in New York and his colleagues at Pennsylvania State Medical College conducted a review and meta-analysis of the studies. It is important to note that half of the Brind team were abortion law supporters. That study found an overall 30 per cent elevated risk among women choosing abortion after their first full-term pregnancy, and a 50 per cent elevated risk among women choosing abortion before their first full-term pregnancy.
It is thought that there are two ways in which abortion may cause breast cancer. First, an induced abortion causes biological changes to occur in a woman's breasts which make her more susceptible to breast cancer. During pregnancy, a hormone called estradiol, a type of oestrogen, causes both the normal and pre-cancerous cells in the breast significantly to multiply. By seven to eight weeks gestation, the estradiol level has increased by 500 per cent over what it was at the time of conception.
If the pregnancy is aborted, the woman is left with more undifferentiated and therefore cancer vulnerable cells than she had before she was pregnant. On the other hand, a full-term pregnancy leaves a woman with more milk-producing differentiated cells, which means that she has fewer cancer-vulnerable cells in her breasts than she had before the pregnancy.
A second way in which it is claimed that induced abortion can cause breast cancer is through delayed first full-term pregnancy. One of the most common ways in which women delay their first full-term pregnancy is of course by abortion.
In February 2000, the New England Journal of Medicine, possibly the world's most influential medical journal, acknowledged evidence of the link between induced abortion and breast cancer in an article written by researchers at the University of Pennsylvania School of Medicine. By contrast, the major studies cited as undermining any link, such as the Lindefors-Harris and others study of 1989 and the Melbye and others study of 1997, are seriously flawed by misclassification and methodological errors.
Over the past six years I have had meetings with Ministers and with the Royal College of Obstetricians and Gynaecologists and I have corresponded with the department. For more than two years now my colleagues and I have been told that Cancer Research UK is looking at this issue and will be producing a report. That report has yet to see the light of day.
In the RCOG's 2000 guidelines on the Care of Women Requesting Induced Abortion and in a recent Written Answer in another place, the RCOG and the Government maintain that evidence of a link between induced abortion and breast cancer is "inconclusive". Yet the RCOG has also acknowledged that the meta-analysis by Professor Brind, "had no major methodological shortcomings and could not be disregarded".
It is impossible to reconcile the RCOG's two statements and I hope that the Minister will be able to clarify that issue today.
The recent scare with HRT supports the argument for a link between induced abortion and breast cancer. HRT and induced abortion share one thing in common they raise oestrogen levels. A low fat diet and avoidance of alcohol also reduce a woman's exposure to the hormone oestrogen, which is the key trigger for breast cancer.
Women have a right to know about every possible risk factor for breast cancer, so why the silence on what appears to be a significant risk factor for breast cancer induced abortion?
If the Government do not place sufficient weight on the mounting evidence of a link between induced abortion and breast cancer, there will be class-action law suits similar to those we are witnessing against the tobacco industry. Years of denial and complacency could lead to claims for billions of pounds in compensation.
In the United States, two more states, Minnesota and Texas, have just passed informed consent statutes requiring abortion clinics to warn potential clients about the link between induced abortion and breast cancer. The world's first known abortion-breast cancer settlement was reported in Australia 2001 because a young woman had been denied information about the possible link. Here at Westminster last year I met the lawyers who acted in that case.
Yesterday, in Washington DC, at the American Senate, I was briefed on the case of a 22 year-old woman from Philadelphia who had an abortion when she was aged 17. Last week she became the first person in the United States successfully to settle a medical malpractice case based on a claim for the failure of her doctor and the abortion clinic to inform her of the increased risk of breast cancer due to abortion.
I also spoke two days ago to Norma McCorvey, who used the pseudonym Jane Roe in the Supreme Court case Roe v Wade in 1973. She is now a leading opponent of abortion, not least because of its effect on women's health.
Today I urge the Government to do two things. First, the Department of Health should, as a matter of urgency, review and publish all the research. Secondly, the Government should press the Cancer Research UK working party to publish its report or at least its interim findings.
Obviously not all women who have breast cancer have had abortions, and no one should imply that. Similarly, not all women who have had abortions will get breast cancer. However, induced abortion causes women to change their childbearing patterns, which in turn leads them to forgo the protective effects of an early first full-term pregnancy. Young girls and women who abort before they have had a child that is, the majority of abortion patients in the United Kingdom are at most danger.
The independent evidence linking induced abortion with breast cancer should be and I am sure will be of concern to every Member of your Lordships' House. Whatever our views on abortion may be, we should surely all oppose the suppression of evidence and debate. We should all be in favour of freedom of information and empirical research. The Abortion Act 1967 gives women the right to choose, but women also deserve the right to know.