The NCI has downplayed the research findings of their own funded study (Daling et al, 1994) which found a direct link between abortion and breast cancer. The National Cancer Institute continues to say that the meta-analysis findings are flawed because of recall bias. This, despite the current findings of 25 out of 31 worldwide epidemiologic studies which determined that even one induced abortion increases the risk for any woman of developing breast cancer later in life.

Dr. Brind's goal was to demonstrate that any claims of reporting bias (aka recall or response bias) made by those attempting to discredit the findings of his 1996 meta-analysis were without substance. Dr. Brind advised the delegates that the Swedish team of researchers, who had suggested in 1991 that 'recall bias' had distorted the outcome of some breast cancer studies, had officially retracted this idea in March 1998 (Merik et al, J Epidem Comm Hth, 52:209). Originally, they had proposed that a woman who had an abortion but did not develop breast cancer was more likely to under-report her abortion than would a woman who had developed breast cancer and had undergone an abortion.

Dr. Brind systematically explained why there was no evidence for reporting bias in specific studies, despite several interruptions by another panellist and expressions of personal doubt by the moderator, Dr. Davis. At one point, Dr. Davis left the podium, during Dr. Brind's talk.

In answer to a question as to why he had not discussed the much embraced 1997 Danish study which proposed that abortions which occur during the early period of pregnancy do not show women to be at increased risk of breast cancer, Dr. Brind explained that the Melbye et al study was not valid. Danish researchers had presumed there were no legal abortions in Denmark before 1973 when, in fact, abortion was legal in 1939. Thus, the team had mis-classified 60,000 women who had an abortion as not having had an abortion. Dr. Davis expressed surprise (as "I have read the abstract") that such an error in mis-classification could have been published in the prestigious New England Journal of Medicine.

Joel Brind reviewed the meta-analysis delivered at the 1997 Conference and explained the protective nature of a full term pregnancy. He described the 20 fold rise of oestrogen levels in a normal pregnancy and what happens to the breast tissue should the pregnancy be interrupted by abortion (Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis, Brind J, Chinchilli VM, Severs WB, Summy-Long J, - J. Epidem Comm Hlth, 1996).

One woman in the audience reminded the delegates that both Dr. Samuel Epstein and Dr. Devra Davis had invoked the "precautionary principle" for research in their key-note speeches. That is: we must carefully examine any evidence which suggests a serious connection to breast cancer because science can never be 100% positive and we simply cannot wait for absolute proof before taking action. Several delegates then asked what message about induced abortion should be taken home to their countries from this conference?

Finally, Dr. Davis said, "Yes, women should be told that there is a possibility of increased risk and that therefore what they need to do is avoid unwanted pregnancies."

Dr. Brind responded, "That's really very paternalistic: Why don't we just tell women what we know and let them decide what to do about it? And as far as avoiding unwanted pregnancies is concerned, remember that all this discussion is about women who are already pregnant, and they should have a right to know that choosing abortion increases their risk of getting breast cancer."

There was a solid round of applause and many had questions for Dr. Brind after the session.