Letter to the editor of the Western Journal of Medicine 

Delayed birth equals more cancers and preterm births.   Western
Journal of Medicine. Brent Rooney.  2001;174;385-386

[The British Medical Group publishes the British Medical Journal
and the Western Journal of Medicine]

To the editor,
Unknown to them, Stein and Susser, by advocating that is all
right to delay birth into a woman's late 30's and early 40's,
are encouraging more preterm births and more cancers for mothers.1 

BREAST CANCER 
Consider "Alice" who is first time pregnant at age 20 years.
Would it be all right if "Alice" "terminates" this pregnancy 
and eventually has a first birth, at say, age 35 years? Stein 
and Susser would have to agree that, in general, such a decision 
is fine and healthy. I would argue that when Alice signs the 
consent form for the termination, she should  be informed
that delaying her pregnancy by 10 to 15 years substantially
increases her relative breast cancer risk. A 15-year delay in 
first full-term pregnancy increases relative breast cancer risk
by 67.3% (absolute increase: 8.41%).2  Nancy  Krieger  wrote,  
"Conversely,  early  age at  FFTP [First Full-Term Pregnancy] 
consistently has emerged as the strongest protective factor
[against breast cancer]".3  A ten-year delay in age at first full-
term pregnancy by terminating earlier pregnancy increases relative 
breast cancer risk by 41% (absolute increase: 5.13%)

PRETERM  BIRTH RISK
Barbara  Luke  and  Judith  Lumley, recognized authorities in the 
field of premature births, have identified induced abortion as a risk
factor for prematurity.4,5 In her book on preventing prematurity Luke
discusses her belief that induced abortion leads to an "incompetent
cervix,"(4) whereas Lumley believes that induced abortion causes 
intrauterine  infection.5  In  1992  Janet  Daling et al. 
reported that women with previous induced abortions had a 140%
elevated  risk  of  intraamniotic  infection  in  subsequent 
pregnancies.6  To my knowledge at least 16  studies  show that  
previous induced abortions boost risk of prematurity.5,7-21
Therefore, an elective procedure that Stein and Susser sanction 
increases the risks of breast cancer and subsequent preterm birth.22

Informed medical consent
In both the United States and Canada induced abortion is legally
considered to be an elective medical procedure.23 For an
elective  procedure even remote-1 in 100,000- risks of
serious adverse side-effects must be disclosed on consent forms.
The risks of breast cancer and preterm birth addressed in this
letter are orders of magnitude higher than one in 100,000 and
must be disclosed on abortion clinic consent forms.2-23 It is
a scandal that these risks are not  currently  disclosed  on 
such consent forms.

"FIRST, DO NO HARM"
   Both medical practitioners and medical researchers have an
ethical  obligation  to,  "First, do no  harm."  For medical 
researchers  this  means  not 'turning a blind eye' to very 
serious adverse side-effects.  How  does  this  specifically
apply to the medical field in the current context? About 2 years
ago Stephanie Carter, at the age of 17 years, had an induced
abortion performed by Dr. Charles Benjamin.  On  the consent
form the words "breast cancer" did not  appear.24  Stephanie
Carter has filed a law suit against Dr. Benjamin in a court of law 
alleging, in part, that Benjamin did not inform her of the breast
cancer risks of that induced abortion.24 


Brent Rooney 

Independent Medical Researcher
Reduce Preterm Risk Coalition
3456 Dunbar St. (146)
Vancouver, Canada V6S 2C2
[email protected]
[web:     www.vcn.bc.ca/~whatsup]

West J Med 2001;174:385-386

..................................................................
References

 1 Stein Z, Susser M. The risks of having children in later life.
   WJM 2000;175:295-296

 2 Trichopoulos D, Hsieh CC, MacMahon B, Lin T, Lowe CR, Mirra AP,
   Ravnihar B, Salber EJ, Valaoras VG, Yussa S:  Age at any birth  
   and birth and breast cancer risk. Int J Cancer 1983;31:701-704

 3 Krieger N. Exposure, susceptibility, and  breast  cancer risk. 
   Breast    Cancer Research and Treatment 1989;13:205-223
   birth and breast cancer risk. Int J Cancer 1983;31:701-704

 4 Luke B.  Every Pregnant Woman's Guide To Preventing Premature 
   Birth.    1995. (Publisher: Times Books, New York). 

 5 Lumley J. The association between prior spon-
   taneous abortion, prior induced abortion and
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 6 Daling JR, Krohn MA, Miscarriage or Termination
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 7 Zhou W, Sorenson HT, Olsen H. Induced Abortion
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 8 Pickering RM, Forbes J. Risk of preterm delivery
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10 Berkowitz GS. An Epidemiologic Study of Preterm
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11 Lieberman E, Ryan KJ, Monson RR, Schoenbaum SC.
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13 Mueller-Heubach E, Guzick DS. Evaluation of 
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14 Shiono PH, Lebanoff MA.  Ethnic  Differences  
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15 Pantelakis SN, Papadimitriou GC, Doxiadis SA.
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16 Van Der Slikke JW, Treffers PE. Influence of 
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17 Richardson JA, Dixon G. Effect of legal termination 
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19 Koller O, Eikhom SN. Late Sequelae of Induced
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20 Bognar Z, Czeizel A.  Mortality  and  Morbidity  
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21 Papaevangelou G, Vrettos AS, Papadatos D, Alexiou
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22 Rooney B. Racism, Poverty, Abortion, and Other Reproductive
   Outcomes. EPIDEMIOLOGY 2000;11:740-741

23 Picard EI, Robertson GB. Legal Liability  of  Doctors and Hospitals in
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24 Brind J. Case filed by PA  teen  for  NJ abortion with no ABC
   warning. Abortion Breast Cancer Quarterly Update. 2000;4(2):3 & 8