The following article, which I found very informative and intriguing, was written by Dr. Brind, who attended the health subcommittee hearings on "war on cancer."

It will show you the absurdity and lack of knowledge of those who are trying to hide the truth from the American people.

It was Monday, July 20, at the Rayburn House Office Building in Washington, DC. Dr. Edison Liu, MD, Director of the Division of Clinical Sciences of the National Cancer Institute (NCI), and Dr. Steven A. Rosenberg, MD, NCI Chief of Surgery, appeared before the House Commerce Committee, Subcommittee on Health and Environment. The subject was "The State of Cancer Research".

Drs. Liu and Rosenberg were there, as they had been the previous week at a similar hearing on the Senate side, to tell the Congress what a wonderful job the NCI is doing, making "progress in both our fundamental understanding of this disease (cancer) and in our efforts to prevent and treat it."

But after they had already finished their presentation and answered subcommittee members' questions. Liu and Rosenberg were called back to answer some more questions from Congressman Tom Coburn, MD (R-OK), who had just arrived at the hearing, having flown in from his family medical practice in Okalahoma.

In the July 20 hearing. Dr. Coburn, while very deferential and low-key in his approach, totally surprised Drs. Liu and Rosenberg with some very tough questions.

Dr. Coburn: "Maybe you can educate me on why I'm wrong on this issue. I've gone through and looked at some 31 studies on the risk of breast cancer and induced abortion, and I've also read the web page put out by the NIH (National Institutes of Health, of which the NCI is a division), and I must tell you, I am astounded at what I see on the web page, versus actually, personally as a physician reading the studies on the risk of induced abortion, increasing the risk of breast cancer in our population. And what I really wanna do is just kinda go back and forth a little bit so you can change my mind and educate me on why I'm so wrong as I read these studies, and why NIH has, to me, seems to have taken a position that's not in the best interest of the women in this country in terms of risk. Is it true that there have been 12 studies on induced abortion and the risk of breast cancer in this country?"

Dr. Liu's response was to punt on first down.

Dr. Liu: "Well, Dr. Coburn, I think, I wasn't personally prepared to go through every single study, so I can't answer the specifics of your questions, and I think that we'll be happy to put on the record an appropriate response to them."

He did, however, note that prior to joining the NCI, he served on the faculty of the Epidemiology Dept. of the University of North Carolina, where, he said, "we did discuss this in our faculty discussions, because it was a very important topic, for obvious reasons." Then, he apparently felt compelled to make some sort of general statement attesting to the integrity of the NCI.

Dr. Liu: "I can tell you for sure that, at least with respect to the National Cancer Institute, we would not hide or guide any solution to a problem that the data would not show one way or any other. And if there is some ambiguity then I think it's our responsibility to lay on the table that ambiguity."

At this point. Dr. Liu had already begun to dig himself into a hole, for this very statement already directly contradicts the very topic sentence of the NCI's web page (See "Tangled web site of the NCI". this issue, ABCQ Update):

"Although it has been the subject of extensive research, there is no convincing evidence of a direct relationship between breast cancer and either induced or spontaneous abortion."

Is there even the slightest hint of any ambiguity whatsoever in that sentence?

But Dr. Liu kept on digging.

Dr. Liu: "Now the piece that you, you've talked about, the many studies—having done epidemiological studies, and you may have done yourself—is that one study doesn't make a conclusion," Sorry to interrupt in mid-sentence, but it's just to point out another direct contradiction with the NCI's web page, which relies on one single study from Denmark, to "resolve the controversy" and conclude that "induced abortions have no overall effect on the risk of breast cancer."

Dr. Liu continued: "and there are many problems with smaller epidemiological studies, in particular in the US where reporting biases are quite dramatic for a variety of reasons, social and otherwise."

Pardon my interruption again, but these "quite dramatic reporting biases" in abortion-breast cancer research simply do not exist, in the US or elsewhere.

This is a hypothetical entity for which no credible evidence has ever been produced. (See "Tangled website of the NCI", this issue, and "All about bias", Summer, 1997 ABCQ Update.) But Dr. Liu went on: "This type of bias clearly changes the outcome that is an artifact of the study and has no basis in reality, and for this reason, many of the later, so-called confirmatory studies had to go to databases outside the US where the biases are not so intense."

"Pardon me again, but there's a story spun out of whole cloth: The two studies discussed on the NCI web page which purport to show evidence of reporting bias were actually done on women from Sweden and The Netherlands, respectively."

Dr. Liu continued: "And it's from these studies, as well as studies with meta-analyses, that come to the conclusion that there's no clear association between abortion and breast cancer risk."

Now that statement is completely at odds with the published record.

The truth is that only one study which included a meta-analysis (compilation of the data of other studies on an issue) has yet been published on the ABC link. (I oughtta know—I wrote it, in collaboration with colleagues from Penn State Medical College.) And in this paper, published in the British Medical Association's epidemiology journal, we concluded:

Dr. Coburn: "We believe that the present review and meta-analysis summarizes a literature that documents a remarkably consistent, significant positive association between induced abortion and breast cancer incidence. ... We are convinced that such a broad base of statistical agreement rules out any reasonable possibility that the association is the result of bias or any other confounding variable."

Not surprisingly, Dr. Coburn had a lot more to say to Dr. Liu at this point in the hearing.

Dr. Coburn: "Well then answer me the question why the NCI has not released the data on the Asian-American study that was published in the British Journal of Cancer which you all had some to do with" (i.e., it was performed by NCI scientists in collaboration with researchers from several other institutions.) "You released the data for only a portion of the women in that study ... part of data that showed a correlation between the risk of breast cancer and induced abortion, you all didn't release."

(Only the data for childless women were revealed, but not the majority of the data, which concerned women with children. See "Asia watch", Spring 1998 ABCQ Update.)

"You selectively released the data, and that's the thing that concerns me about it. But when we see a web page that is—to me—is not scientifically driven, on this issue, but is more politically driven..."

Dr. Coburn went on to address the issue of reporting bias as well, citing the 1994 study of Janet Daling, et al., ⁹, which had been published in the JNCI, and in which, the authors had included a separate study on cervical cancer risk in order to establish the lack of reporting bias among their study participants.

Continued

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