Day 269 - 25 Jun 96 - Page 58


     
     1        risk factor, so far as disease, socio-economic contrast,
     2        were different at that time, and one of the factors which
     3        may well be involved in breast cancer, and it is something
     4        which I have at the back of my mind, might well be the
     5        contrast in breast feeding which has made a big switch
     6        between the -- there is some evidence now to suggest, for
     7        example, that breast feeding is protective, and whereas at
     8        the beginning, the earlier part of the century, breast
     9        feeding used to be practiced more by the lower
    10        socio-economic groups, it is now being practiced more by
    11        the higher socio-economic groups.
    12
    13        It such a complex issue that I would really not like to
    14        answer that question unless you had somebody here who was
    15        an expert to advise us on when these insults originally
    16        occurred in relation to the data that is published today.
    17        There is a big time lag between the event and what we see
    18        in terms of palpable breast tumours, never mind mortality,
    19        which occurs much later.
    20
    21   Q.   And two other features of the higher socio-economic classes
    22        for women are, are they not, later age of first birth and
    23        lower parity?
    24        A.   Yes.
    25
    26   Q.   Neither of which is diet related, is it?
    27        A.   That is correct, that is correct. It has an influence
    28        on the offspring though which is diet related, strangely
    29        enough.
    30
    31   Q.   Yes, but it is not the offspring that are getting the
    32        breast cancer, I am talking about the mothers.  Do the
    33        British Heart Foundation statistics make adjustments for
    34        smoking, drinking, physical activity and so on and so
    35        forth?
    36        A.   Yes, I believe they do. I believe they go into
    37        confounding factors for heart disease.
    38
    39   Q.   Am I also right, I may not be because I have not looked at
    40        the work, but am I also right that the lower socio-economic
    41        groups smoke more?
    42        A.   I think that is true.
    43
    44   Q.   That they are generally fatter?
    45        A.  It is actual not quite strictly true in the sense that,
    46        as you descend the lower socio-economic scale, if I can use
    47        that expression, that there are people at the lower end of
    48        the socio-economic groups which really do not have the
    49        money to burn cigarettes.
    50
    51   Q.   Sure?
    52        A.   And this is true of our population in the East End of
    53        London to a large extent.  Quite a lot of our mothers who
    54        one might have expected to be heavy smokers are not.  So it
    55        is not a clear-cut as one might expect.
    56
    57   Q.   No and quite a lot of your people in, your folk in the East
    58        End of London will be Muslim Bangladeshi's?
    59        A.   Indeed, some of them are.  Although not in our area as
    60        it happens.

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