Talk:Abortion–breast cancer hypothesis: Difference between revisions

Well here is the article. I apologize for all the references, but I felt it necessary given the subject matter to have the first draft contain them. Then as time passes I, or others can remove them. I hope it isn't a total disaster. --RoyBoy 18:36, 7 Dec 2004 (UTC)

Context of the Devra Davis quote

The quote from When Smoke Ran Like Water is talking about pollution, not abortion. The context of this quote makes it sound like Davis is critical of abortion, and I have no information to suggest that she is. There is certainly no moral equivalency between polluting the environment and elective abortion. NTK 13:49, 9 Dec 2004 (UTC)

That is indeed true, however it was not my intention to imply she is critical of abortion; or even is supporting the ABC link. That is why I put "feminist" and "ABC skeptic", but I am confident it is an appropriate quote on the validity of rat-human comparisons. Whether she is talking about environmental pollution or something else entirely I believe the quote stands on its own. I can certainly attempt to clarify that since I do not want to provide a false impression. BTW, is there such a thing as a feminists against abortion? I put in "pro-choice" prior to feminist, but that seems redundant. --RoyBoy 18:08, 9 Dec 2004 (UTC)

Roy you said you were moving the Lancets meta-analysys here off the main abortion page because it fit you page better and was more on topic. Yet its not HERE. I can look it up again although it shouldn't be hard for you to find by going through drafts on the abortion page (if you don't know how to look through the different edits i can explain it). I still think there is a LOT of bias on this page. Since it is a debate posting articles that are generally only in support of your view/position is inappropriate. As a debate (and it is a debated topic) there should be more links to the other side and a better explanation of them when they occur (ie to the same level as the original studies are explained.)--Marcie 10:24, 11 Dec 2004 (UTC)

Yes it is. It is labeled as the Beral study, which I think is more appropriate. I should throw in a reference to it being in Lancet since that is how it is being described by the media. --RoyBoy 00:37, 12 Dec 2004 (UTC)

Lancet etc

It isn't just the Lancet study. This entry has serious POV problems. The problem is not so much with the facts presented as the tone, which seems to give equal weight to both proposition (which is not neutrality). I'm inserting a npov notice and I'll be back to elaborate. --[[User:Tony Sidaway|Tony Sidaway|Talk]] 20:05, 11 Dec 2004 (UTC)

What took you so long :)... although I'm confused by 'equal weight' not being neutrality. Because current public sentiment of the issue is not reflected in the article? And "Lancet" is in there as Beral; oh yeah, and 1,2,3,4 I declare an edit war! My first, this should be fun! I'm reverting the mention of Lancet in the intro to provide "perspective" on the debate before they even read the article... give me a break. As I mentioned to Marcie elevating a study on the ABC issue to the intro is hardly NPOV.

This is one example of non-equal weighting being part of the NPOV article and the reason i was concerned with it. If 75% of the world thinks one way 25% the other way and we don't know for sure which is which there should be clear evidence of the 75% going into the talk then a discussion of why others think differently--Marcie 22:07, 12 Dec 2004 (UTC)

Good point. As you probably noticed, I decided to sleep on it instead of reverting it right away; and after reading this I'll probably concede to keeping a mention of it in the intro. However I likely will still insist on altering it in some way, perhaps putting back my sentence about it still not being disproven. And as of now I dislike the fact the Beral study is mentioned twice; but I may have to live with it as long as its flavor of the month. Since that is indeed the case I'm putting back the Media Bias section. (not part of the ABC issue my foot, if necessary I'll make it explicit to avoid re-deletion)

Also I'm wondering myself about the naming convention for pro-life. I threw in variations because of style and my personal feeling different terms can and should be used since there are pro-lifers (just opposed to abortion), and anti-choicers (who actively seek remove a womens right to choose). So I'm actually trying to be precise in my terms (currently my use of different terms isn't consistent in that regard), although I gotta admit putting "pro-life" in quotes is kind of asking for controversy. --RoyBoy 05:22, 13 Dec 2004 (UTC)

I agree with what most of your edits were attempting to accomplish. But for example removing the quote (the out of context opinion) on Rats makes the other opinion that is left unbalanced... although, it guess it is balancing Drs. Brind and Russo's... fine you win that one. Removing Media Bias... what were you thinking? I'm going to fight you on that one in Discussion.

As to "tightening" up the Conclusion, come on! BTW, I changed "was" to "is" not because of my final paragraph, but because of the recent shift in opinion you were so kind to leave in the conclusion. Anyway... I agree with the change to present tense. --RoyBoy 00:43, 12 Dec 2004 (UTC)

Do you know me? Public sentiment isn't an issue. The appropriate weight to give to the sides of a debate is determined primarily by commonsense. Let me know what you think of my changes. --[[User:Tony Sidaway|Tony Sidaway|Talk]] 00:55, 12 Dec 2004 (UTC)

No, don't know you... just glad to see the inevitable occur... gives my brain something to do. You seem to be an intelligent guy, so I'll let you sort out why I would be aggravated at the mention of 'commonsense'... especially when Media Bias has been stripped clean from the article. Commonsense doesn't exist in debated subjects with inconclusive evidence, Pinker's The Blank Slate makes that abundantly clear with scientists siding with the philosophically popular nurture instead of the increasingly scientifically backed nature. In the end both wrong and both right. OTOH I'm willing to concede it was commonsense to give nurture the upper hand while scientists said it had the upper hand. In that regard I'm ambivalent to commonsense being commonfolly. :'D --RoyBoy 01:25, 12 Dec 2004 (UTC)

Is this a "hot debated" subject? I'm not interested in debating it, I don't know anybody who is. I would like to make sure this turns out to reflect the current state of human knowledge. As it happens I have a copy of Pinker's The Blank Slate on my bookshelf. We're not restricted to convention here, so don't worry about being forced into a straitjacket. But remember that the purpose here is accurately to reflect the state of the debate, not to try to second-guess the state of reality. --[[User:Tony Sidaway|Tony Sidaway|Talk]] 01:33, 12 Dec 2004 (UTC)

I took 'hot debated' out you'll notice :)... reflect the current state of human knowledge, which is what? That the Beral, no sorry "Lancet collaborative", study is great because it happens to be most recent "no ABC link" study out there. The flaws of meta-analysis should be clear to you, and since you are human... I assume, as previously conceeded I don't know you... that means it's part of human knowledge that meta-analysis ain't new, its subjective review of existing human knowledge. I certainly appreciate you kept the Brind link, but to remove the guts of his critique while a critque is left of his meta-analysis (which did make it to the Media), is uh... disappointing.

A copy of The Blank Slate... darnit, now I guess I have to like you! Hehehe... anyway, accurately reflect the state of the debate, no wait, the hypothesis... that sounds reassuring. Now this is important, which debate are we trying to reflect? The public (media) debate or the scientific debate? As to second guessing reality... hey man, that's fun... might not be encyclopedic, but I think the evidence does speak for itself. You keep this up I'll have to include a Melbye pre-term pregnancy study chart. --RoyBoy 02:20, 12 Dec 2004 (UTC)

Brind

Sometimes it happens that a maverick champions a particular idea. Sometimes he's right, sometimes wrong. An article about an issue shouldn't give him the special rights to the issue that he might want. There are points in which statements are characterised as refutations of Brind's position (if he was the only person who held them, they wouldn't be worth of refutation) and others where critiques of a given study are represented as Doctor Brind's. Is he the only person with opinions on these studies? If not, why are his opinions considered so important? --[[User:Tony Sidaway|Tony Sidaway|Talk]] 01:03, 12 Dec 2004 (UTC)

For the most part there is another Dr. Chinchilli, who I assume is anti-choice, and is also attached to the letters. The reason it is important is two fold. For many of the references it is correspondence in peer reviewed journals, so I think that makes it as least presentable. :'p As to why his opinions are important at all... well without them there would be very little public criticism of studies (and their presentation) and in essence there wouldn't be a public debate (there still would have been a scientific one... I hope). As I (attempted) to show in the Dr. Brind section, people attempt to marginalize him even further than he actually is. Without that context (and no I do not think it belongs in a Dr. Brind article, it belongs here since it is misrepresenting his postion on the ABC link)... anyway without the context people would write him off immediately as an anti-abortion nutter. Well sorry, he might be an anti-abortion nutter... but to marginalize and misrepresent his informed opinions is not right, it isn't true... and it sure as heck ain't NPOV! It's all too easy to cast doubt on someone by pointing out they're pro-life, there needs to be some balancing for that by noting pro-choicers aren't exactly angels... nor are they more informed than Dr. Brind on the ABC issue. --RoyBoy 01:42, 12 Dec 2004 (UTC)

I'm moving my relevant comments here for the moment. Although they fit in different spots i wanted them to be visible not just part of the back...

Context of the Devra Davis quote

I agree the quote is innapropriate. If you want to put in an explanation of when and how she said it it could be appropriate. Otherwise you are going to need to find another quote (there are lots of differences between pro choice feminists in the first place or just plain feminist without the quoting of people getting messed up. Perhaps a quote by a feminist on the topic in discussion or vaguely related to it would be more appropriate--[[User:

This is one example of non-equal weighting being part of the NPOV article and the reason i was concerned with it. If 75% of the world thinks one way 25% the other way and we don't know for sure which is which there should be clear evidence of the 75% going into the talk then a discussion of why others think differently--Marcie 22:07, 12 Dec 2004 (UTC)

Convention on Wiki is to use Pro Life Pro Choice. If the situation is so far out of the normal its done special (look at the other section of the Abortion in the United States of someone who was killing doctors.--Marcie 10:20, 13 Dec 2004 (UTC)

Scientific Study Headings

Someone changed the headings so that Interviews, Meta Analysis and Cohorts no longer fall under Scientific Studies. Why was that done, and does it make any sense? Because now looking at the article... it's difficult to tell where discussion of scientific studies stops, just makes it harder IMO to easily see the scientific study sections. --RoyBoy 07:54, 15 Dec 2004 (UTC)

NCI link added back in

You have more than enough links elsewhere in your page that taking out the NCI link shows bias. If there were no other links i might feel differently. As it is i have put it back to try and lessen the bias that is on this page.--Marcie 11:19, 15 Dec 2004 (UTC)

Okay, but as I noted in my edit it is a redundant link. Probably one of several, but it was an obvious one because of the NCI workshop section. --RoyBoy 20:51, 15 Dec 2004 (UTC)

Effect of length of pregnancy on ABC theory

Roy i noticed something i'd missed (or maybe it was added in, this is certainly a busy page). The article (or one of the studies) noted that there was much less problem if there was going to be an abortion if the abortion occured within the first 8 weeks or pregnancy. I'm going to see if i can track down the stats on 8 weeks (i already have some stats on 16 weeks). Maybe you can track it down to (i think we use different sources which is fine...finding someone to say 8 weeks in particular may or may not be hard).

I think that this is important enough that it should be moved onto the main abortion page. Whether you are pro choice or pro life IF the ABC theory is correct it would be a good argument for good early access to abortion, because it would reduce breast cancer [i guess that only applies if you will allow abortion, but for a lot of people it is not black and white and i think its an interesting thing to add.] Why didn't i just add it myself. Well certain pages i do more writing, others i do more talking...research and some writing. As for the main abortion page i thought i'd ask you to see how you could word it...maybe we'll end up arguing over it or maybe you'll refuse (in which case i will get involved) but since this is your baby in many ways i thought i'd see if you wanted to do it first--Marcie 18:32, 16 Dec 2004 (UTC)

You mean mention a study in the introduction along with the Lancet study? Although I totally agree women should be given some sort of advise and reassurance there is "something" they can do IF there is an ABC link, which I had in the conclusion previously. However, Tony removed it (I don't know specifically why) and as the article currently (with the Lancet study in the intro) it would be difficult to put it in right after a study says there is no link.

If we were to put the warning back in I think it should go back into the conclusion, not in the intro (that I still have to tweek) which would make it contradictory and confusing. And with it back in the conclusion it would help alleviate any anxiety a women reading this article would have. Additionally the only study really worth mentioning in this regard is the Melbye study with its large dataset. However Daling 1994 also showed a 1.4 risk (1-8 weeks) vs 1.9 (9-12 weeks); then again a Rookus study showed the opposite. Although I don't know why that occurred in Rookus; generally speaking for studies earlier is indeed better. So in the end if we put it back; it should be in the conclusion not the introduction.

PS: The source I cited for that warning was the pro-choice Religious Tolerance website. --RoyBoy 16:56, 18 Dec 2004 (UTC)

Don't have time to answer the whole thing at the moment. I thought you might find it interesting (amusing?) that i came across the religious tolerance page before i noticed you using it...i think it WAS in relation to this article but it was a fair way back. Serendipity? Right at the moment i'm heavily involved in another page which is going through a full NPOV POV conflict, and it is taking up just about all the research time i have...some of the issues are related and if i have a chance i'll try to find the data. But so far what i'm seeing is abortions by the 16 week period not the 8 week. I think that is because it is mid second trimester.

If you are interested you might want to look at that discussion as its abortion related as well. The article is Abortion in Canada. At the moment all of the old archives (which detail how the decisions for the page were made) have been archived because the thing was getting huge (personally i wouldn't have archived quite as much...but its not that big a deal since they are findable...in a way it makes very clear there was previous talk). As far as i can tell all of the people in the discussion are pro choice but the problems surround what and how much information is necessary as well as if more case law needs to be added.

also the whole discussion at the moment is only being done by 3 folks (and i'm the only one that worked on the original page out of that....but that's related to me originally asking about how it is decided a NPOV is taken off...it had been changed to something about the article not being POV but the wording being a problem....with no suggestions and it had been there for a couple of months i think....

seems to me it would be good to have more than 3 folks there, agree, disagree with them if a huge part of the page is going to be reviewed for NPOV. Also it appears to me that some of the issues should be on the medicare page...but i'm perfectly able to argue that one myself ;-)

i just finished reading all of the majority opinion of a Supreme Court Ruling....actually fairly understandable, somewhat interesting and most importantly it shows preceding cases and precedent cases that might be useful and answers some of the questions we are looking into. But it is VERY dry!--Marcie 18:03, 18 Dec 2004 (UTC)

Since I'm Canadian I'll definitely take a look, but I won't intervene unless I can help in some way. What I would say is anything to do with Medicare and Canadian Abortion should probably be in Canadian Abortion under a Medicare section. As to Religious Tolerance... yeah quite the coincidence, but then again it is the best website I've come across on the ABC issue. One of my goals for the Wiki article is that its better than Religious Tolerance on the scientific side of the debate.

Also I came across a lot of dry stuff in the ABC research I did. But if you reduce it to a paragraph it can be insightful and worth it. Assuming of course it had a meaningful impact on the subject in question. --RoyBoy 00:36, 19 Dec 2004 (UTC)

Re Brind: "very" little support

Saying he has "very little support" isn't accurate given Drs. Russo & Russo, Dr. Daling and the RCOG... all mainstream scientists (and organizations) support directly or indirectly Dr. Brind's theory and findings. Furthermore, Melbye acknowledge some of their research is in agreement with the Russo and Russo hypothesis. Hence Dr. Brind's interpretation of mainstream science is not baseless. And Tony if you do read this, please reiterate/clarify what is disputed for NPOV. I think that having the article renamed "hypothesis" allows for Brind to put forward his ideas, criticisms without a NPOV flag being pulled at a moments notice.

(PS: I know I'm unlikely to win this, and even if I did with you given your unconventional reading ;' P, someone else would just come along and find something else "wrong" with the article... but at least I want to go through the motions. Because the NPOV notice seems to put a lot of good work and research in doubt unnecessarily. Thanks.) - RoyBoy [∞] 07:01, 2 Feb 2005 (UTC)

Removed text

I've removed the following text: "Furthermore how Dr. Brind is mischaracterized by pro-choice advocates [1] and publications [2] illustrates the lack of scientific rigor on both sides of the public ABC debate." This has been done because a) it's someone's POV (hardly neutral) and b) it is unsubstantiated exactly how Dr. Brind is mischaracterized and how this illustrates the lack of scientific rigour on both sides of the debate! - Ta bu shi da yu 06:25, 15 Feb 2005 (UTC)

Copyedit needed

There are many areas of this article that are unclear because of poor grammar and writing style (no offense to the original author). I can see that the original author has made a valiant attempt at being neutral, however this has made the article worse. As such I've added the Template:cleanup-copyedit tag to it. - Ta bu shi da yu 06:29, 15 Feb 2005 (UTC)

I think I'd be hard pressed to find a greater compliment! Since my grammar is indeed lackluster on anything over a paragraph long no offense taken. - RoyBoy ⁸⁰⁰ 07:50, 2 Mar 2005 (UTC)

I did a massive copy edit. This article still needs a lot of work though. It has some POV problems, but more importantly it goes into too much detail. I don't think it's necessary to list every study and its criticisms. A couple paragraphs on each side of the debate would be sufficient. At any rate, I think I've fixed enough of the grammatical errors to remove the copy edit tag. Anyone concur? DaveTheRed 07:33, 1 Mar 2005 (UTC)

You did a great job, and I concur. If you need to discuss any of my reverts, POV issues, and such I'm more than willing. As to the level of detail; I selected every study if it met a series of criteria... it was referred to by both sides of the debate, illustrated a necessary point of understanding, and ultimately is deemed important in the debate. My goal was to create an article where the current state of the discussion on the best research could be referenced. I would advise against removing studies; I agree the article could use some shortening (for Melbye and Daling especially)... but at the same time I did my best to keep a complex (and very wordy) subject to the essentials to begin with. - RoyBoy ⁸⁰⁰ 07:50, 2 Mar 2005 (UTC)

I must commend you for being thorough in your research. I don't think we should eliminate the studies completely, but I think we could get away with briefly summarizing their impact on the debate. Covering the current state of discussion on the debate is all well and good, but I think that the level of detail here is too large. Unfortunately, I'm not really familiar with the ABC debate, so I would not be a good person to do this. DaveTheRed 20:07, 14 Mar 2005 (UTC)

Much thanks, well I reduced the article by 2k mainly by paraphrasing Melbye study debate, Daling repetition, nip and tucks here and there. Do you want more? If so what should be my goal? - RoyBoy ⁸⁰⁰ 03:29, 16 Mar 2005 (UTC)

Much better. I'm much happier with the article as it is (which isn't to say it can't be improved, of course). DaveTheRed 03:44, 16 Mar 2005 (UTC)

May edits

Hi, I took a stab at it, too. The article isn't about Brind, so I moved mention of him down; seems to me the science should speak for itself and the issue of Brind's demonization/allegations/whatever should be dealt with in a story/page about him. I also removed some of the statistical analysis paragraphs and replaced them with wikilinks to those topics. Kaisershatner 18:26, 18 May 2005 (UTC)

I added back some of the Brind info to the lead, after reviewing this page in greater detail. The ABC article isn't about him, but I see that his studies and his personal politics are at issue in a parallel sense. Kaisershatner 18:31, 18 May 2005 (UTC)

As are the scientific allegations which impact key points in the debate. On balance your edits are good; however your editing of spontaneous abortion is atrocious. It was made incomprehensible; and cuts out a key dinstinction between cause and characterized, and "some" abortions associated with low hormone levels is simply incorrect. I was quite happy with your edits until I spotted that; which makes me wary of keeping any of your contributions. I'll try to examine them on a case by case basis. I had the article ordered logically; with counfounders coming prior to the science that would be affected by said factors. - RoyBoy ⁸⁰⁰ 18:39, 18 May 2005 (UTC)

Cool, but don't revert the WHOLE thing- just fix the para that isn't readable (I agree btw could be better). Kaisershatner 18:53, 18 May 2005 (UTC)

I apologize, but let me clarify something here... it is You that needs a wait a second, not me. You have made dramatic, in cases illogical changes to the article without discussion. Then you do mention you are partially reverting some of your own changes (poorly I might add, added bio info of Brind to the lead isn't advisable). It's simply a mess; I will revert and you should take it slower this time around. Additionally I'm removing that goddam clean-up tag until you can explain it. - RoyBoy ⁸⁰⁰ 19:01, 18 May 2005 (UTC)

Also the main reason I'm moving Brind to his own article is because of the length of the ABC article. However I had the Brind section in there for easy reading and to understand a key person mention throughout the rest of the ABC article. - RoyBoy ⁸⁰⁰ 19:04, 18 May 2005 (UTC)

Roy, I didn't mean to cause offense. I don't think you need to toss around "goddam (sic) cleanup tag," and in any case, I think it can be removed now. I put it up because most of the scientific writing in the article used totally nonstandard language and there was enormous digression into Brind and the personal attacks, as well as the explanatory paragraphs about statistical analysis. Can you tell me what your objection is to the miscarriage section? And what about my changes is illogical? Kaisershatner 19:10, 18 May 2005 (UTC)

You tell me if inserting "milieu", removing the statistics (replacing it with the incorrect "some miscarriages") increases accuracy and readability? You list Brind's politics in the lead; but have disconnected it from his credentials and pro-choice bias that causes the reader to reconsider unfair preconceptions. I find it humourous you maintain scientific improvements are needed then remove scientific information.

I'd hardly call the first two lines in Brind section a HUGE digression. The rest of the section dealt DIRECTLY with important ABC evidence, and how it relates to Brind who indeed is the leading advocate for the ABC hypothesis.

It's illogical to move Evidence for confounding factors into the hinterlands when it plainly belongs where it was to begin with. (don't bother fixing it) Your edits maximize making Brind bad, minimizing pro-choice mistakes (re: spontaneous abortion), and to top it all off; and they are aesthetically worse. I will calm down, and then I will revert you (re-adding good additions such as recall bias in confounding factors, which I neglected to put because Recall Bias has its OWN SECTION, nevertheless it was a good call on your part). Also I'll reconsider if I should have created a Joel Brind article to begin with given only two lines belong in there while the rest belongs here. Seperating it makes the article LESS readable; even though it technically removes a minor bio side-track; but since its a RELEVANT bio, is it REALLY a problem? No. Also, discussion of Brind has no place in Meta-analysis.

I await your response prior to me reverting you; which is common courtesy to the person who has put in the most effort into an article. Translation, you offended Me when you reverted; as to the clean-up... that was just sloppy (no discussion) and unnessesary (when you did discuss, turned out it was over something I find misguided (re: digression); and something that remains to be explained (re: non-standard language)). Indeed, perhaps the language does need cleaning up... but, lol, I gotta tell ya "milieu" isn't a step in that direction. - RoyBoy ⁸⁰⁰ 20:02, 18 May 2005 (UTC)

Roy, thanks for your patience. I will attempt to answer your detailed points. Please Wikipedia: Assume good faith. My changes are honestly not intended to further one side but to present the facts. Also, I can understand that you're passionate about this article, having done most of the work in writing it.

Alrighty... thx.

About miscarriage, I'm not wedded to the phrase "hormonal milieu." The point I was trying to communicate, which I thought was the same point the section covered, is that miscarriages may not be comparable to abortions because some of the time, miscarriages occur in the setting of abnormal hormone concentrations (ie low progesterone) and so the fact that there is no clear association between spontaneous abortion and breast cancer cannot necessarily be extrapolated to imply that there is no assn. between elective abortion and breast cancer. Incidentally, that is a point that is supportive of the ABC hypothesis, so I'm not sure why you assume I disagree with that hypothesis. If you don't think "hormonal milieu" is a step forward, I would be happy for you to change it. Miscarriages, by the way, do not ALWAYS occur in the setting of abnormal hormones, as they may be caused by medical complications as in lupus for example, clotting disorders, etc. That's why I changed the language. And finally, I don't think I removed any of the evidence, I cited all of the studies you had in there but changed them to footnotes. At least I think I did.

Looking at my version of miscarriages, why would you get the impression that was the articles treatment. Part of the reason its important to quotes statistics in the article. 89% is not alwasy, and its far clearer than "some". Further my version contains the word "predominantly"... well its not as clear as I would have liked (hence the stat backup)... but if you didn't think it was clear enough shove another "usually" in there; don't rearrange the section and make it clash with the rest of the article that makes a consistent showing of percentages. (again, it wasn't that broken to begin with, tweak... don't rearrange)

About Brind, I thought the case of the ABC hypothesis is stronger when separated from the personality of Brind. Whether or not I even know who he is, the scientific evidence can be considered objectively. I realize he's a part of this story, as are efforts to portray him negatively, so I agree that he should be mentioned in the intro (as it stands now) but shouldn't the hypothesis, research, etc. stand on its own?

It should; but it doesn't. And to not openly acknowledge the politics is to invite ppl from both sides to call the article biased. Despite my best efforts the article is still biased. I had a pro-life anon change the lead; and guess what... he was right, having "concluded" and not mentioning criticism of the only named study in the lead is biased; so I changed it.

My last edit moved confounding factors out of "the hinterlands" and up into the second section, since I agree with you that it logically goes higher up. I thought: (1) present the hypothesis (2) mention the controversy and the politics behind the science, (3) explain that there is a lot of research, (4) present the confounding factors that make the research harder to design and interpret, (5) list the prominent studies and their pros/cons. Where appropriate, include Brind's view.

That's all well and good, and you did (1) well. The hinterlands was talking about the new "Evidence for confounding factors" section; ripped out of confounding factors. Ugly as hell, and doesn't read as easily.

Actually I retract that... (1) isn't even good, it provides the impression having an abortion gives you breast cancer. I know it says "association", but that's not precise... I added "higher risk".

Re: Brind, as noted my initial thought was "this is an article about the hypothesis, not about the demonization of Brind," but also as stated I agree with you that the politics of this cannot necessarily be 100% separated from the science, so that's why I essentially reverted myself.

And putting it where it didn't belong; the lead and in meta-analysis. Making a respectable comprimise, which acknowledged Brind's prominance in the issue, a mess.

Hope that helps, and again, sorry if I offended. Please assume good faith.

Kaisershatner 00:51, 19 May 2005 (UTC)

I'll try; but when you removed a very clear, important... ironically key scientific distinction between "caused" and "characterized" in miscarriages; you either had an agenda or didn't know what you were doing! Then you revert. As you may tell, I'm still a little disjointed over this. I'm reverting, I'm tired, and I'm going to sleep on it. - RoyBoy ⁸⁰⁰ 05:57, 19 May 2005 (UTC)

Roy, I still think the right thing to do is to make changes to the parts you disagree with rather than reverting all of my changes. But I don't care that much, I don't really have an agenda either way, I was just interested in the subject and trying to copyedit it into some form of clarity. Maybe you've been reading it too long to see that the writing is incoherent in more than one place (I'll provide an example here), but good luck either way.

Pro-choice advocates have routinely stated that spontaneous abortions (miscarriage) consistently show no ABC correlation. [1] (http://www.prochoiceactionnetwork-canada.org/abclink.html) How about presenting the medline evidence for the lack of association between miscarriage and breast cancer - the way you have it makes it look like an opinion, rather than an opinion supported by more than a little medical research.

They argue that this is compelling evidence of no ABC link because miscarriages usually are not caused by low hormone levels. Huh? How does this follow? At best, this sentence is a poor explanation of their position.

It doesn't follow, but that (has been) one of their arguments. Miscarriages no ABC link, not CAUSED by low hormones; hence the hormonal argument for ABC link is rubbish. From my feminist reference:

"Brind claims the "raging-hormones-cut-short" problem does not affect miscarriage, since most miscarriages are caused by a lack of pregnancy hormones. Not so—the majority of miscarriages are actually caused by genetic defects in the egg/embryo, and other causes; only an estimated 10% or so of miscarriages are caused by hormonal deficiencies. This means there is probably no significant difference between the effects of miscarriage and abortion—so if miscarriage does not lead to an increased risk of breast cancer, then of course neither would abortion."

Opponents claim that while this is true it is also disingenuous, since miscarriages are characterized by low hormone levels. The difference being that low hormones levels predominantly do not initiate the abortion; they are lower as a result of a miscarriage in progress. [2] The last part isn't even a sentence. The first part goes right into a counterargument without even making it clear what the argument is about.

Just my two cents. If you would like some constructive criticism I'd be happy to continue to try to edit the article with you. So far, it doesn't seem to me like you'll permit too much changing of your work, even the parts that are fairly poorly written. Kaisershatner 13:16, 19 May 2005 (UTC)

I'm down with that; part of it is protectionism on my part... but also I've debated and reached consensus on this article a few times; and it has been changed and looked at by 1/2 dozen writers. So I thought its pretty good as a result... and I think that's still the case (no clean up necessasary). Although I disagree that I make it sound like an opinion, since in the next sentence it says "true"; I'm in agreement a reference and a reworking will help (even essential to get this key point across); and was actually thinking of how to rework it as I fell asleep. (for example "Opponents claim" is Tony's not mine, the sentence fragment is probably mine). - RoyBoy ⁸⁰⁰ 15:56, 19 May 2005 (UTC)

Spontaneous editing

Here is the section, lets rework it; i've done a little already.

Pro-choice advocates have routinely stated that spontaneous abortions (miscarriage) consistently show no ABC correlation. [3] They argue that this is compelling evidence of no ABC link because miscarriages should increase breast cancer risk since they are not caused by low hormone levels, while this is true it neglects the fact that miscarriages are characterized by low hormone levels. The difference being that low hormones levels predominantly do not initiate the abortion; they are lower as a result of a miscarriage in progress. [4]

One of the first studies on hormone levels and spontaneous abortion by Kunz & Keller (1976) [5] showed that when progesterone is abnormally low a miscarriage occurs 89% percent of the time. This is also reflected in studies published by Hertz et al. (1979) [6] and in more detail by Stewart et al. (1993) [7] conducted at a fertility clinic, which focuses the ABC debate on induced abortion.

Great, I'd be happy to try to contribute.

The proposed mechanism of the ABC Hypothesis rests on the hormonal effects of a terminated early pregnancy on breast tissue development. Investigators have sought to establish whether such an effect exists in women who have had spontaneous abortions (ie miscarriages) as opposed to elective abortions. Several research studies have showed no link between miscarriage and breast cancer risk: Brewster et al. in 2005 found no elevated risk in a series of over 20,000 patients [8], Robertson et al. in 2001 observed no increased risk of breast cancer after spontaneous abortion (although there was a statistically insignificant increased risk after elective abortion under certain conditions)[9], and Paoletti and Clavel-Chappelon in 2003 observed no increased risk associated with a low number of miscarriages[10], but noted a "suggestion of increased risk" after 3 or more pregnancy losses, (an odds ratio of 1.2 and a confidence interval of 0.92 to 1.56).

Pro-choice advocates have argued that this evidence shows early pregnancy loss, including abortion, is not a risk factor for breast cancer, but there is debate over whether it is appropriate to extrapolate conclusions about elective abortion from evidence about miscarriage, given the association of most miscarriages with hormonal abnormalities that might result in a different effect on breast tissue, and the fact that most abortions are performed on healthy pregnancies. One of the first studies on hormone levels and spontaneous abortion by Kunz & Keller (1976) [11] showed that when progesterone is abnormally low a miscarriage occurs 89% percent of the time. This is also reflected in studies published by Hertz et al. (1979) [12] and in more detail by Stewart et al. (1993) [13]. If the hormonal impact of miscarriage is different from the hormonal impact of a terminated healthy pregnancy, then the risk of breast cancer in each situation would not necessarily be comparable, and a conclusion about abortion risk based on conclusions from miscarriage risk would be unwarranted.

Let me know what you think. Kaisershatner 17:50, 19 May 2005 (UTC)

It's certainly an improvement in many ways; but reduces the sections impact IMO. For example, its great you got detailed research on miscarriage and breast cancer; but its a well established fact there is little connection. We can concede that point in a short sentence or three (making sure to include the exceptions you ably site). What I think the section should focus on, and state unequivocally, is that miscarriages in fact (not "If") are mostly "characterized" by low hormones; and are different than induced abortions; despite pro-choice claims to the contrary focusing on "cause". - RoyBoy ⁸⁰⁰ 18:36, 19 May 2005 (UTC)

But I do like your version better; so I'll try and insert the important aspects (language) I'd like to see; and to make it shorter to increase impact; be more encyclopedic and definitive (this aspect is not a debate, miscarriages typically have lower hormones, your softer language is nice... and I'll try to incorporate that tone; but its simply misleading to call miscarriage hormones levels equivalent to normal pregnancies; or imply it by focusing on "cause"). - RoyBoy ⁸⁰⁰ 22:33, 19 May 2005 (UTC)

RoyBoy's Version (shortened it, put back links... maybe change unwarranted to misleading):

Studies of spontaneous abortions (miscarriages) have consistently shown no increase in breast cancer risk. [14] However, there is a "suggestion of increased risk" in a Paoletti study (2003) of 1.2 (0.92 to 1.56) after 3 or more pregnancy losses. [15] A distinction should also be made for miscarriages that occur in the second trimester as their hormonal characteristics are different from first trimester miscarriages.

The level of hormones during early pregnancy is key since the ABC hypothesis rests on the hormonal effects on breast tissue development. Pro-choice advocates have argued since miscarriages show little effect on breast cancer risk, and only ~10% of miscarriages are caused by low hormones, this is strong evidence against the ABC hypothesis. [16] While it is true most miscarriages are not caused by hormones; it is also true miscarriages are characterized by low hormone levels. [17] One of the first studies on hormone levels and spontaneous abortion by Kunz & Keller (1976) [18] showed that when progesterone is abnormally low a miscarriage occurs 89% percent of the time. This is also reflected in studies published by Hertz et al. (1979) [19] and in more detail by Stewart et al. (1993). [20]

Given the association of most miscarriages with low hormone levels it is not analogous to an induced abortion of a healthy pregnancy, and a conclusion about ABC risk based on miscarriage is unwarranted.

Roy, first of all, thanks for finding a way for us to work together on this, it's much nicer than the revert wars and acrimony that are typical of most controversial subjects around here. Second, I think your changes are overall very good. See what you think of mine; one of the major points of language we're debating is how definitively to conclude that miscarriage and abortion are not comparable. I favor softer terms, as below - the italics are for convenience, not intended for the final text. Also, I'd rather not attribute all of the arguments to "advocates" of one side or the other - some of the people doing this research are just scientists looking for answers and phenomena, and might not be making advocacy arguments, just reporting their findings. See below:

Studies of spontaneous abortions (miscarriages) have generally shown no increase in breast cancer risk, [21] although a study by Paolilli et al. concluded there is a "suggestion of increased risk" 1.2 (0.92 to 1.56) after 3 or more pregnancy losses. [22] Some argue that this apparent lack of effect of miscarriages on breast cancer risk, is evidence against the ABC hypothesis, and some pro-choice advocates have claimed it is proof that neither early pregnancy loss nor abortion are risk factors for breast cancer. [23]

One of the problems with comparing miscarriage to abortion is the issue of hormone levels in early pregnancy, a key point because the ABC hypothesis rests on hormonal influence over breast tissue development. Given the association of most miscarriages with abnormally low hormone levels it is not analogous to an induced abortion of a healthy pregnancy, and a definitive conclusion about ABC risk based on miscarriage data alone is probably unsupported. While it is true most miscarriages are not caused by low hormones, most miscarriages are characterized by low hormone levels. [24] One of the first studies on hormone levels and spontaneous abortion by Kunz & Keller (1976) [25] showed that when progesterone is abnormally low a miscarriage occurs 89% percent of the time. This is also reflected in studies published by Hertz et al. (1979) [26] and in more detail by Stewart et al. (1993). [27]

A distinction should also be made for second trimester miscarriages as their hormonal characteristics are different from first trimester miscarriages.

Kaisershatner 14:21, 20 May 2005 (UTC)

Your changes are marvelous! I've put in the link, removed the italics and would be delighted to have you do the honors of putting it into the article; since this was your initiative. :'D - RoyBoy ⁸⁰⁰ 01:03, 21 May 2005 (UTC)

Although I would add; its softer than necessary; I decided to change "may not be analogous" to "not analogous" because I added "healthy pregnancy". While its true 89% leaves 11% in the normal hormone levels range; even then... a miscarriage is defacto not a healthy pregnancy. Also in the next line I'd like to either remove "definitive" or "probably" from the sentence. It's just very weasily... because it allows someone to say, oh so having a conclusion (so long as its not definitive) based on miscarriage might be okay. Hopefully that's coo with u? - RoyBoy ⁸⁰⁰ 05:13, 21 May 2005 (UTC)

Roy, thanks for the compliment. Believe it or not, it's the science I'm interested in, I'm really not pushing one way or the other politically, just curious about the facts. I see where you feel it is not strong enough, but my view is that unless there is explicit scientific evidence that says conclusions from miscarriage are definitively inappropriate, then we should say a definitive conclusion is probably unsupported. Otherwise, we're just writing your (or our) view that the conclusion is unwarranted, rather than letting the reader look at the facts and come to their own opinion. To you, the 11% or whatever isn't important, to others it might be. Let them decide, it's not our role to make that statement for them. Let's just give them the facts. At your invitation I will put in the text as it stands and maybe we can resolve what I think is a basically minor disagreement about the final words- hope that's ok. Kaisershatner 14:56, 23 May 2005 (UTC)

Agreed. - RoyBoy ⁸⁰⁰ 17:45, 23 May 2005 (UTC)

Media-bias section forward

IMHO (of course), the entire article beginning at and following the "media bias" section needs editing. The issue involved here is whether or not there is a scientific link between abortion and breast cancer,

That is not the only issue; it is the primary issue and as such the science comes first in the article. But there is also politics, law and a "debate" (actually its mostly people talking past each other). The article needs to describe all of that in summary form.

and while I understand the importance of the various efforts that have been made in the media to prove the existence of such a link, I don't belivee these sections of the article do so.

That doesn't make any sense. Granted some conservative elements of the media have pointed to a link; but far and wide the link (if present) is ignored or minimized.

I will agree that my response is hard to understand, so let me try again. I don't think that these sections give a celar taste of the battle that's been waged in the media regarding the propriety of the abortion-breast cancer link. I don't have any specific suggestions for improving them (besides what I've already stated) but they just don't "feel" right to me.

First, the discusson of What Liberal Media doesn't seem relevant, because it doesn't touch on or in any way show how reporting on abortion (or the Shaw study) relates to the scientific discussion of a link between abortion and breast cancer.

Nor does it need to; it does point out in a very clear way the media generally is pro-choice; hence a bias against an ABC link is a distinct possibility (something I could insert in the section to make the reason for the section clear). That is very relevant to the public discourse of the ABC link. I've thought about moving that section to abortion, but for a number of reasons (such as edit wars on that article) I've held off moving it there. You may force me to move it after all, but I would rather tweak it and keep it here for the time being. :"D

But here's my issue -- I agree that it would be appropriate for the abortion article. But abortion is a moral issue as to which there is no "right" answer -- depending on your moral views, you either support a right to abortion or not, but there is no generally neutral way of determining which position is "right." For the question of whether abortion raises the risk of breast cancer, there can be such an answer (even if it's not totally clear right now). Now, it may be that journalists who favor abortion rights would also be skeptical (or at least more so than is appropriate based on the evidence) of claims that having an abortion is a risk factor for breast cancer. But without more, it doesn't necessarily follow that their pro-choice leanings are affecting their coverage of this distinct issue.

If it didn't, I'd eat my hat; and that's prior to me doing the research; evidence to that effect is already in the article, but its subtle. It's clear when evidence showing no link appears it is broadcast to the four corners of the earth (specifically regarding the "Lancet study", or the "Denmark study"); otherwise positive findings are not covered; or when they are caveats and criticisms are included. Which is fine; but its a double standard. However, its mostly the lack of coverage that stands out to me.

The "anti-abortion bias" section doesn't seem to accomplish much either, though I'm not sure how my uneasiness relates; maybe it's that I think this would be better fit in a dicsussion of the abortion debate in general, not in this article. It just seems too cursory, with a lot of "many say" and "these advocates" and not a whole lot of substance.

Your uneasiness, I think, comes indeed from all the weasily language... however that is necessary to maintain an accurate and NPOV on the issue, and it does accomplish one thing; it reminds everyone there are those who seek to use the ABC issue to push their agenda.

Well, unless someone has any better ideas, I'll drop this, because I sure don't. I'll give it some thought though.

Finally, I think that the final paragraph of the "State Laws" sectino should be truncated. It's the paragraph that says:

While one reason these state laws were written is to circumvent federal abortion laws, another reason is to protect hospitals against lawsuits. With malpractice lawsuits continuing to be a problem in the United States, to the point it was discussed in the Presidential debates, there is a legal need to ensure full disclosure is made regardless of the ABC debate.

The "protect hospitals against lawsuits" business is hogwash. Show me a (reputable) source that says this. The cited article (from Mtoher Jones) doesn't. It's clearly not true. I can go into detail if you want, but it's pretty obvious on the face that this is not true. Normally I would just go ahead and delete it, but because there is an NPOV dispute, and because others of you I'm sure have invested lots of time in this, I thought I'd float my concerns here first. Geoff.green 14:20, 31 July 2005 (UTC)

I appreciate the care you took with your objections... however, I fail to see how disclosing possible risks of a medical proceedure is not a legal responsibility of the doctor. This is common knowledge; rather than hogwash.

"There are two dominant approaches to defining the standard of disclosure of information by which the physician's duty to their patients is measured.23 A slim majority of states follow the "professional standard," requiring a physician to disclose information that other physicians possessed of the same skills and practicing in the same or a similar community would disclose in the same situation.24 A large minority of courts apply the "materiality" or "prudent patient" approach, allowing the jury to decide whether risk or other information would have been considered significant by the reasonable patient in making a decision, therefore requiring disclosure.25" [28]

I agree that it is a legal responsibility of a doctor to get "informed consent" from a patient before beginning any regimine of medical treatment. This is a clear-cut matter of common-law (or state statute, if it's been codified) Therefore, standing alone, if there is a risk to a procedure, and a doctor doesn't disclose it, that can be grounds for a malpractice lawsuit. Any doctor or other medical professional who doesn't want to be sued (or wants to increase their chances that they'll win such a lawsuit) is therefore going to make sure they tell patients about all risks before beginning a procedure, and make sure they document this giving of consent. So if abortion causes breast cancer, you don't need a statute requiring disclosure of that fact to protect doctors against lawsuits; doctors just need to make those disclosures themselves, and make sure the patient understands them. A statute requiring such a disclosure accomplishes little. Now, if the statute included a provision saying something like "by making these disclosures, the medical professional shall not be held liable for malpractice if breast cancer occurs," then that would be something. And please correct me if I'm wrong, but it's my impression that none of these statutes have such liability limiting language. Moreover, how consistent are the state's various disclosures with the NCI's conclusion? Do they require that patients be told there is no evidence of a link, or do they say otherwise? (The cited article says the state statues are mixed, but I'm too lazy to look it up right now. Maybe later.)

I claim "hogwash" because the disclosure requirements merely require dislcosures, they don't absolve doctors of any legal liability otherwise. Moreover, you'll be hard-pressed to find any state-mandated disclosure requirements related to any other procedure, be it open-heart surgery, ACL repair, or what-have-you. Because of this, I don't see how it can be claimed that their intention is to protect hospitals or doctors from malpractice claims. If you have an article arguing otherwise, please show me, because I'm deeply skeptical.

Maybe I made a bobo by calling it a "malpractice" lawsuit? Simply from my reading of things such as the North Dakota case; I had the impression that providing ABC information they are absolved of any potential liability in that regard. I too am not sure what the statues say regarding liability; but I thought making the information available automatically does that, hence there isn't a need for it to be included in the statute. It just makes sense to me that if you inform someone about a potential side-effect, they cannot come back and complain/sue if that side-effect surfaces. And as there are different criteria for informed consent; I thought I made my case as abortion providers want to cover themselves just in case a jury finds it reasonable "informed consent" was not provided. I didn't mean to imply the statutes included liability clauses, but rather that informing people about the ABC potential, informed consent is provided... just in case.

I can add the link to the article if you feel it necessary. - RoyBoy ⁸⁰⁰ 16:05, 31 July 2005 (UTC)

Thanks. Geoff.green 17:03, 31 July 2005 (UTC)

Your welcome, actually you can add where you want, because I'm starting to get confused. Maybe a quick shower would clear things up. - RoyBoy ⁸⁰⁰ 18:42, 31 July 2005 (UTC)