Introduction
Research- Induced and spontaneous abortion and incidence of breast cancer among young women: A prospective cohort study by Karin B. Michaels, ScS, PhD; Fei Xue, MD; Graham A. Colditz, MD, DrPH; Walter C. Willet,MD, Dr PH.
This is an analysis of a cohort study carried out to establish whether induced abortion was a likely cause of breast cancer; the study was carried out on 105716 women aged between 29 and 46 years. It seeks to establish whether there is a relationship between induced and spontaneous abortion and breast cancer in young women. The study concluded that there was no relationship between induced and spontaneous abortion and breast cancer.
Study quality
This will be based on the CASP questions which are answered in the following part taking a in a continuous prose form.
The study did not address a clearly focused issue as the population included women with a very wide age gap that is from ages 29-45. Participant were asked to state their health detail for the past two years regarding the number of pregnancies , miscarriages’ and induced abortion which appears a bit construed. Health history in other years and family health history was considered but with no evidence on medical reports then the study looked far from specific.
The authors have not used an appropriate way to answer their question this is because; their questionnaire did not consider a possibility of women not miscarriaging. There is also no part concerning the cause of the miscarriage. Cohort study may not be the best way to carry out this study, this is because, and almost all women are at a risk of contracting breast cancer. Therefore comparing those who have contracted the disease with those that are not infected is not the best option (Smith et al 2007). In addition to this there are also other factors that may have caused the disease among those infected and not necessarily miscarriage or abortion. The study has also not addressed the question as there is no clear evidence to conclude that abortion does not cause cancer. In addition the study assumed that those who did not answer the questions are those who have not done an abortion. This may not be the case in all circumstances. The cohort recruitment is biased in that it only assumed that all those interviewed had an abortion. There is also no question as to whether those who had breast cancer was only as a result of abortion the cohort study does not define the total number of women in population. We therefore cannot be certain that the number picked is a representative of the whole population (Smith et al 2007). The cohort study has also focused more on the previous studies and has based its conclusion on the basis of these studies. The research could have involved hospitals to provide details of the number of breast cancer cases that had been reported. It could also have focused more on the upcoming trends of abortion. Research institutions that have current data on breast cancer infections and the factors contributing to the breast cancer infections could also have been consulted. The range of years is too big to come up with conclusive data or report. Most of those who had been originally interviewed had died. The cause of the deaths could not be said with certainty to be breast cancer (Gray 2006). The results interpretation was more focused on the number of women reporting induced or spontaneous abortions. The method of measurement is more subjective than objective. This is because the data is actually measured in comparison to data collected previously. There is also a general misstatement of women who have undertaken abortion. Thus the results cannot be true as it does not give the rate of abortion reports.
The authors may not have identified all the important confounding factors. There are other factors that may have been a cause of breast cancer. Sometimes, the disease may be as a result of long term effects of an abortion. The time limit in which abortion’s effects are felt should have been defined to clearly exonerate abortion as a cause of breast cancer (Gray 2006). Other ways to get information on women who were difficult to reveal intimate information was also not considered. The final results of this study were that there was no association between pregnancy termination and breast cancer.
The results could not lead to absolute certainty on conclusions. This is because there a lot of questions which have gone unanswered for example: has the firm taken into account the infections on those who could not be traced? What are the findings from doctors and those others who have carried similar research? For conclusive results, all factors must be put into consideration the methods used are sufficiently flowed to an extent that the result obtained cannot be relied on (Friedman et al, 1996). The questionnaires are designed in a way that they have leading answers. They also assume that all ladies interviewed must have construed an abortion; the report also cannot be nationalized as the sample population is very small compared to the current UK’s population (Gray 2006). The research is also based on observations only there is no scientific evidence to proof the findings. People may tend to believe scientific evidence especially due to the sensitivity of health matters, more than mere observations.
Study Benefits
Benefits resulting from this study are that, the study gives the population some confidence especially when an induced abortion has to be carried out though it may not have fully articulated the issue considering the variability of the topic it gives some hope to mothers who may have fears resulting from past abortions and miscarriages. Patient relying on this study will not worry over risks of contracting breast cancer (Daly et al, 1998) The study may also be used as a basis for carrying out other researches for example, whether breast cancer can be inherited or not among other related topics. Lastly the study provides a platform for medical practitioners who may want some understanding on issues to do with cancer in Britain this study through data gathered may provide this understanding. It may also give clues on various diseases which may affect women between ages 29-45 as this was provided for in the questionnaires.
References
Daly, J. Kelleher, A. & Gliksman, M. (1998).The public health researcher: A methodological Guide 1st edition, Oxford University Press, USA.
Friedman, C. & Wyatt, J. (1996). Evaluation methods in biomedical informatics, 2nd edition Springer, New York.
Gray, M. (2006). Evidence-Based health care and public health and public health: How to make decisions about health services and public health 3rd edition, Churchill Livingstone: New York
Smith, N. & Brandon, P. (2007). Fundamental issue in evaluation 1st edition, The Guilford Press; New York