A new study from researchers at Harvard University is adding to the confusion and disagreement over when and how often women should get mammograms. The study suggests that women who are screened for breast cancer earlier and more often have a greater chance of surviving the disease should they get it than those who did not get mammograms until later in life. Though these researchers see this as cause to conclude that women should get regular mammograms beginning in their 40s, others are critical of the new study and see no reason to change the current guidelines.
Researchers analyzed the health records of over 7,000 women diagnosed with breast cancer between 1990 and 1999 in several Boston hospitals. The data on these women continued through 2007, by which point 609 of them had died of the disease (additional women had died of other causes). About half of the women who died from breast cancer were under age 50, while 13 percent of the women who died were 70 or older, and the causes of most of their deaths were not linked to the disease. Researchers found that 71 percent of the women studied who diedfrom breast cancer had not undergone regular screening, whereas 29 percent of them who died had done so.
The researchers describe their method as “failure analysis,” because the point is to look back and see where things went wrong. Dr. Blake Cady, professor emeritus of surgery at Harvard Medical School and Massachusetts General Hospital in Boston, who conducted the research, explained to U.S. News and World Report, “It’s the converse of a randomized trial, which starts at point A and follows people until the end of the study. We follow people who have died and go backward to their original diagnosis and find out the details.”
Cady also noted that breast cancer tends to be more aggressive in younger women. To that end, the research findings support “less, or less frequent screening at ages older than 69 years, but more, or more frequent screening for women younger than 50 years,” which could save lives in the long run. Cady would like to see mammogram screening begin at age 40.
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Some cancer experts say they find these results compelling. Dr. Barbara Monsees, chair of the American College of Radiology Breast Imaging Commission, who was not involved in the research, told U.S. News and World Report, “It corroborates what we have known for a long time. … Screening doesn’t reduce the risk of getting breast cancer, but it does reduce the risk of dying from it.”
Robert Smith, director of screening for the American Cancer Society, echoed that sentiment. “Regular screening was associated with a much, much lower likelihood of dying [from breast cancer] compared to no screening or long-ago screening,” he said. “[T]he message here is that mammography is a good part of your prevention plan.”
Still, some are skeptical of the new findings and don’t believe they show the whole picture. Dr. H. Gilbert Welch, a professor of medicine at Dartmouth Institute for Health Policy and Clinical Practice, told LiveScience that the data was incomplete because it didn’t look at women who survived breast cancer: “If, among women who live, 30 percent were screened and 70 percent were not, everyone would agree that screening had no effect.” Moreover, Welch noted that the researchers didn’t look at other explanations for why some women survived and others did not, such as the type of treatment they received. Welch also pointed to a study that he had done, which found that “while mammograms have increased detection of early-stage breast cancers, they have done little to reduce the risk of death from advanced stage breast cancer.”
Currently, the Centers for Disease Control and Prevention (CDC) recommend that women between the ages of 50 and 74 get mammograms every two years. The CDC suggests that women in their 40s talk to their health-care providers to determine if there are reasons—such as family history—for them to start getting mammograms earlier. These guidelines were developed by the U.S. Preventative Services Task Force in 2009 and represented what some saw as a drastic change from earlier recommendations, which had suggested women receive mammograms starting at age 40.
The task force argued that there was moderate harm from mammography at any age and little benefit was gained by starting it earlier than 50. It was also concerned with the downside of mammography: unnecessary biopsies and anxiety. Moreover, the task force pointed to the problem of over-diagnosis, in which women are treated for cancers that would not cause any noticeable illness during their lifetime. (A 2012 study found that 1 million U.S. women had been overdiagnosed with breast cancer and suggested that up to one-third of breast cancers—about 50,000 to 70,000 cases a year—don’t need treatment.) To cut down on these issues, the task force also recommended that doctors stop teaching self-breast exam techniques.
The new recommendations were controversial when they were released in part because they came out during the debate over health-care reform. Some feared they would be used as a reason for insurance providers, including Medicaid, not to cover mammograms for women under 50. The Obama administration promised this would not be the case. Still, not everyone agreed with these changes. In fact, the American Cancer Society still recommends yearly mammograms starting at age 40.
Today’s research is likely to add to both the debate among experts over when to recommend mammograms and to the confusion women already have over when to make their first, or next, appointment.
Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.
“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote theNew York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”
“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”
Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equality; declaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.
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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”
Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.
But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:
Myth #1: Planned Parenthood Profits From Fetal Tissue Donations
Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:
We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.
Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:
We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.
The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.
Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.
Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”
Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt
In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:
We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.
The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewireexplained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:
As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”
All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”
Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain
The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:
Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.
Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.
Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.
Myth #4: Abortion “Endangers the Health and Well-being of Women”
In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:
Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.
Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”
There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”
As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.
Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”
Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:
We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.
Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.
In a series of workshops over a three-day conference in Herndon, Virginia, self-proclaimed medical and scientific experts renewed their debunked efforts to promote the purported links between abortion and a host of negative outcomes, including breast cancer and mental health problems.
Less than two weeks after the Supreme Court rejected the anti-choice movement’s unscientific claims about how abortion restrictions make patients safer, the National Right to Life Convention hosted a slate of anti-choice “experts,” who promoted even more dubious claims that fly in the face of accepted medical science.
In a series of workshops over the three-day conference in Herndon, Virginia, self-proclaimed medical and scientific experts, including several whose false claims have been exposed by Rewire, renewed their efforts to promote the purported links between abortion and a host of negative outcomes, including breast cancer and mental health problems.
Some of those who spoke at the convention were stalwarts featured in the Rewire series “False Witnesses,” which exposed the anti-choice movement’s attempts to mislead lawmakers, courts, and the public about abortion care.
During a Thursday session titled “The Abortion-Breast Cancer Link: The Biological Basis, The Studies, and the Fraud,” Lanfranchi, one of Rewire’s “False Witnesses,” pushed her debunked talking points.
Throughout the presentation, which was attended by Rewire, Lanfranchi argued that there is “widespread fraudulent behavior among scientists and medical organizations to obfuscate the link” between abortion and breast cancer.
In a statement, the irony of which may have been lost on many in the room, Lanfranchi told attendees that sometimes “scientists in the pursuit of truth can be frauds.”Lanfranchi went on to point to numerous studies and texts she claimed supported her theories and lamented that over time, textbooks that had previously suggested a link between abortion and breast cancer in the ’90s were later updated to exclude the claim.
Lanfranchi later pivoted to note her inclusion in Rewire’s “False Witnesses” project, which she deemed an “attack.”
“We were one of 14 people that were on this site … as liars,” said Lanfranchi as she showed a slide of the webpage. “Now when people Google my name, instead of my practice coming up,” Rewire’s story appears.
Priscilla Coleman, another “False Witness” best known for erroneously claiming that abortion causes mental health problems and drug abuse, similarly bemoaned her inclusion in Rewire’s project during her brief participation in a Thursday session, “The Conspiracy of Silence: Roadblocks to Getting Abortion Facts to the Public.”
After claiming that there is ample evidence that abortion is associated with suicide and eating disorders, Coleman suggested that many media outlets were blocking the truth by not reporting on her findings. When it came to Rewire, Coleman wrote the outlet off as a part of the “extreme left,” telling the room that “if you look deeply into their analysis of each of our backgrounds, a lot of it is lies … it’s bogus information.”
An extensive review conducted by the American Psychological Association in 2008, however, found “no evidence sufficient to support” claims such as Coleman’s that “an observed association between abortion history and mental health was caused by the abortion.”
Rounding out the medical misinformation pushed in that session was Eve Sanchez Silver, the director and founder of the International Coalition of Color for Life. According to the biography listed on her organization’s website, Silver bills herself as a “bioethicist” who focuses on “the Abortion-Breast cancer link.”
Silver, who previously worked at the Susan G. Komen Foundation but left, she said, after finding out the organization gave money to Planned Parenthood, spent much of her presentation arguing that abortion increases the risk of breast cancer. She also detailed what she referred to as the “Pink Money Cycle,” a process in which, as she explained, money is given to Komen, which in turn donates to Planned Parenthood. As Silver told it, Planned Parenthood then gives people abortions, leading to more cases of breast cancer.
The seemingly conspiracy-driven theory has popped up in several of Silver’s presentations over the years.
Though Komen does in fact provide some funding to Planned Parenthood through grants, a July 2015 press release from the the breast cancer organization explains that it does “not and never [has] funded abortion or reproductive services at Planned Parenthood or any grantee.” Instead, the money Planned Parenthood receives from Komen “pays for breast health outreach and breast screenings for low-income, uninsured or under-insured individuals.”
On Saturday, another subject of Rewire’s “False Witnesses” series, endocrinologist Joel Brind, doubled down on his claims about the link between abortion and breast cancer in a workshop titled “New American Export to Asia: The Cover-Up of the Abortion-Breast Cancer Link.”
Brind described the Indian subcontinent as the ideal place to study the purported link between abortion and breast cancer. According to Brind, “The typical woman [there] has gotten married as a teenager, started having kids right away, breastfeeds all of them, has lots of them, never smokes, never drinks, what else is she going to get breast cancer from? Nothing.”
When it came to research from Asia that didn’t necessarily support his conclusions about abortion and breast cancer, Brind chalked it up to an international cover-up effort, “spearheaded, obviously, by our own National Cancer Institute.”
Although five states require counseling for abortion patients that includes the supposed link between abortion and breast cancer, Brind told Rewire that the link has become “the kind of thing that legislators don’t want to touch” because they would be going “against what all of these medical authorities say.”
Brind also dedicated a portion of his presentation to promoting the purported cancer-preventing benefits of glycine, which he sells in supplement form through his company, Natural Food Science LLC.
“If I sprain my ankle it doesn’t swell up, the injury will just heal,” Brind claimed, citing the supposed effects of glycine on inflammation.
In a Thursday session on “the rise of the DIY abortion”, panelist Randall O’Bannon questioned the U.S. Food and Drug Administration’s (FDA) March update to regulations on mifepristone, a drug also known as RU-486 that is used in medical abortions. Noting that the drug is “cheap,” O’Bannon appeared to fret that the new regulations might make abortion more accessible, going on to claim that there could be “a push to make [the drug] available over the counter.”
O’Bannon claimed there are “documented safety issues” associated with the drug, but the FDA says mifepristone is “safe and effective.” A 2011 post-market study by the agency of those who have used the drug since its approval found that more than 1.5 million women had used it to end a pregnancy in the U.S. Of those women, just roughly 2,200 experienced an “adverse event.”According to the Association of Reproductive Health Professionals, mifepristone “is safer than acetaminophen,” aspirin, and Viagra.
Speculating that misoprostol, another drug used in medication abortions, was less effective than medical experts say, O’Bannon later suggested that more embryos would “survive” abortions, leading to an “increased numbers of births with children with club feet, webbed toes, and fingers [and] full and partial facial paralysis.”
According to the World Health Organization, “Available data regarding a potential risk of fetal abnormality after an unsuccessful medical abortion are limited and inconclusive.”