Day 017 - 25 Jul 94 - Page 34
1 the beginning of the line "breast cancer". I do not know
how bad your copy is; mine is not very good: "We lack any
2 good evidence", do you have that?
A. Yes.
3
MR. JUSTICE BELL: It is halfway through that large paragraph.
4
MR. RAMPTON: "We lack any good evidence - at either level - to
5 make this distinction and incriminate fat per se. The
associations with fat may be due to the effects of
6 overnutrition, and it sees seems scientifically more sound
of this was assumed to be the explanation until evidence
7 of an effect of fat per se is found. This would surely be
more helpful in finding any such evidence than assuming it
8 is already in hand. An analogy may be drawn with age at
menarche, which is known to be influenced by nutrition
9 (that is, calories), but there is no evidence that the
source", in italics, "of a given quantity of calories is
10 important; the position is similar in breast cancer. The
possible confusion of the effect of fat and that of excess
11 calories should continually be borne in mind in designing
studies and evaluating findings."
12
The human evidence for fat as a cause of large bowel
13 cancer is also not as strong as often suggested, with
geographical correlations (together with laboratory
14 findings and the availability of theoretical mechanisms)
distracting from the largely negative findings in
15 individual based studies."
16 The general question I was going to ask about that study
by Dr. Kinlen, Dr. Arnott, which will save us time in the
17 immediate future, is this: As an approach to the
question, what factors maybe implicated in the aetiology
18 of breast cancer, how do you rate that piece of work by
Dr. Kinlen?
19 A. I would think this is a very good summary of the
evidence as we understand it today, that there are
20 accepted risk factors for breast cancer which we know
about and these seem to be the predominant factors; what
21 the influence of diet is remains unclear. Certainly,
there is no clear evidence that fat is responsible for the
22 development of breast cancer. There is suggestive
evidence that it may be overnutrition in a general sense
23 with the calories coming from other sources than fat.
24 I mean, there are many causes of obesity or over weight in
people besides taking in fat. I think he is making this
25 point, that we should be studying, using this information
to go forward and should be conducting studies which are
26 structured to try to differentiate where the calories come
from and what the influence that this might have in the
27 development of breast cancer.
28 Q. I just want to glance at one or two other papers on the
subject of breast cancer. Then we will move on, if we
29 may, to cancer of the colon and the rectum. Can you look
-- I am sorry, these are late editions or they were
30 editions to your report which are not referred to in your
text -- tab 23 near the back of the file, which is a paper
