Day 033 - 10 Oct 94 - Page 13


     
     1
     2   Q.   I am going to move on to cancer.  I think, for the court's
     3        clarification, I will probably not refer to specific
     4        documents while we are going through the statement -- it
     5        gets a bit confusing -- I might do that at the end.  So
     6        the US National Cancer Institute estimates that more than
     7        30 per cent of cancers are linked to foods.  Do you want
     8        to say something about that?
     9        A.  Yes.  Estimates vary, but a variety of bodies have
    10        concluded that tobacco accounts for probably 30 per cent
    11        of cancers.  Dietary factors account for anywhere from 30
    12        to perhaps 60, or some authorities would say 70, per cent
    13        of cancers.
    14
    15   Q.   The National Cancer Institute -- what kind of body is that
    16        in America?
    17        A.  It is the largest cancer research body in the United
    18        States with a budget of somewhere between one and two
    19        billion dollars, entirely devoted to research and to
    20        education.  It is an arm of the US government within the
    21        Department of Health and Human Services, part of our
    22        National Institute of Health.
    23
    24   Q.   Do you want to outline the epidemiological evidence for
    25        that conclusion?
    26        A.  Yes.  Would it be helpful if I were to focus on a
    27        particular type of cancer?
    28
    29   MR. JUSTICE BELL:  I think a particular kind of cancer and a
    30        particular kind of diet, because dietary factors could
    31        mean factors which have nothing to do with this case, for
    32        all I know?
    33        A.  Very good.  Dietary fat has received the most
    34        attention and, going back nearly 20 years, reviews have
    35        shown, first of all, in international comparisons that
    36        when you compare many, many different countries, those
    37        with higher fat intakes have higher cancer rates.  The
    38        1988 Surgeon General's report called this a direct
    39        correlation.  It is quite striking that there is a very,
    40        very high correlation between fat intake and cancer
    41        rates.
    42
    43        Now, that alone is an association.  It does not prove
    44        cause and effect, but one can refine epidemiologic
    45        studies, as well as other kinds of studies, to give more
    46        evidence of what the associations may be, and again to
    47        shed some light on whether the factors may, in fact, be
    48        causal.
    49
    50        If we compare, for example, Japan and the United States, 
    51        Japan, historically, has had quite a low intake -- as low 
    52        as seven to 10 per cent of calories -- compared to the 
    53        United States, where the average fat intake is about 37
    54        per cent of calories.  Japan has had correspondingly a
    55        very low incidence of cancer, breast cancer in
    56        particular.  However, Japan and the United States differ
    57        in many other ways, not just in diets but in other aspects
    58        of lifestyle.
    59
    60        So, researchers have initiated and completed other kinds

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