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Trump's New HHS Appointee Yoest Thinks Abortion Raises Breast Cancer Risk, But Where's The Evidence?

This article is more than 6 years old.

Anti-abortion activist Charmaine Yoest, whom President Donald Trump on Friday named assistant secretary for public affairs at the Department of Health and Human Services, has gone on record as saying she believes that having an abortion increases a woman’s risk of breast cancer.

From 2008 to 2016, Yoest, herself a breast cancer surivor, served as president and CEO of an anti-abortion organization that makes the same claim, in all caps, on its website. "Abortion is associated with an increased risk of breast cancer," according to Americans United for Life (AUL), an Arlington, Va.-based group that describes itself as the "legal architect of the pro-life movement."

"The association between having an induced abortion and a subsequent increased risk of breast cancer has been examined in 70 studies," according to AUL. "Of these studies, 57 showed a positive association between having an abortion and developing breast cancer, 34 of which were statistically significant." In part because of model legislation drafted by AUL, five states require that women be counseled about the purported breast cancer link before they undergo an abortion.

And yet, the National Cancer Institute (NCI)--which, like the rest of the National Institutes of Health, the Centers for Disease Control and Prevention and the Food and Drug Administration, falls under the HHS umbrella--has concluded that induced abortion does not affect breast cancer risk. So have the World Health Organization, the American Cancer Society, the American College of Obstetricians and Gynecologists and Susan G. Komen. (Interestingly, Komen decided to defund Planned Parenthood as a result of a 2011 AUL report entitled "The Case for Investigating Planned Parenthood.")

As far as I can tell, only anti-abortion organizations such as AUL, the American Association of Prolife Obstetricians and Gynecologists and the American College of Pediatricians claim research shows that having an induced abortion--one performed surgically or with medication--increases a woman's breast cancer risk. These groups argue that since a full-term pregnancy at a young age appears to protect against breast cancer, terminating a pregnancy must increase a woman's risk of the disease.

Scientists are pretty much agreed that women who deliver a full-term baby before age 20 have a lower risk of one type of breast cancer than women who don't have their first baby until after age 30. But that doesn't necessarily mean that ending a pregnancy before it is full term raises a woman's breast cancer risk above that of someone the same age who has never been pregnant.

The confusion, say the scientific bodies that found no connection between abortion and breast cancer, stems from the fact that earlier studies of a possible link between the two were flawed.

For the most part, that research took the form of "case-control" studies in which scientists would compare the abortion histories of breast cancer patients and women who did not have the disease. These studies sought information about medical history from the women themselves, not from their medical records. The problem is that women diagnosed with breast cancer, eager to find an explanation for their illness, are more likely to reveal that they had an abortion than healthy women, a tendency referred to as "recall bias."

Newer studies, on the other hand, collected data about abortion history and other purported or known breast cancer risk factors from large numbers of women who had not yet been diagnosed with the disease. Scientists then followed the women over time, collecting information about their health from their medical records. These prospective studies have consistently found no connection between induced abortion or miscarriage--which, of course, also ends a pregnancy before it is full term--and breast cancer risk.

As described on the HHS website, the assistant secretary for public affairs "serves as the principal point of contact regarding communications and press issues" for the department, raising concerns that, under Yoest's direction, agencies such as the NCI will scrub their websites of scientific information that is not politically correct under the Trump administration. After all, HHS Secretary Tom Price, an orthopedic surgeon, has been a member of the Association of American Physicians and Surgeons, which opposes abortion.

"Someone who opposes abortion and contraception, along with other forms of reproductive healthcare, has no business shaping policy or handling communications for our nation’s health department," Andrea Miller, president of the National Institute for Reproductive Health, said in a prepared statement about Yoest's appointment.

Yoest's beliefs shouldn't supersede the science, says Dr. David Grimes, a retired obstetrician/gynecologist who formerly served as chief of the abortion surveillance branch at the Centers for Disease Control and Prevention. One chapter in Grimes' 2014 book, Every Third Woman in America: How Legal Abortion Transformed Our Nation, is entitled "Breast cancer: the jury is in."

"I don't know about the claims of Yoest, but her beliefs are unimportant. As are mine," Grimes told me. "The important thing is the evidence...and the judgments of major medical and public health organizations around the world."

"What insight might Ms. Yoest have that has escaped notice at the WHO, CDC, NIH, etc.? And by virtue of what special training and expertise does she reach her opinion? What are her scientific credentials? What research has she done in this field?"

Well, Yoest did earn a Ph.D. from the University of Virginia in 2004. But it was in American government, not a STEM field.

“Women rely on HHS for accurate information about their health,” Cindy Pearson, executive director of the National Women’s Health Network, a nonprofit advocacy organization based in Washington, D.C., told me. “How can we trust HHS if their spokesperson  has supported requiring doctors to lie to women” about an abortion-breast cancer link?