Day 034 - 11 Oct 94 - Page 13
1 But I raise it because these data, as reported here, were
2 sufficient to convince the Surgeon General, in his words
3 referred to on page 194: "Despite some inconsistencies in
4 the data relating dietary fat to cancer causation, animal
5 studies show an effect on carcinogenesis and support a
6 cancer-promoting role, and international epidemiologic
7 studies have suggested that differences in dietary fat
8 intake may provide a meaningful key to prevention of
9 cancer". As he said, strongly suggestive of the role for
10 dietary fat in the etiology of some types of cancer.
11
12 MR. JUSTICE BELL: Where is 4-7 referred to in the report?
13 A. It is referred to in paragraph 3 on page 194.
14
15 MR. MORRIS: So, what is your conclusion from analysing this
16 chart, 4-7?
17 A. When one looks at the overall data one has to agree
18 with the Surgeon General that the links -- to characterise
19 the links here, or the associations, dietary fat must be
20 suspected of contributing to breast cancer risk. The word
21 "link", I know, is one that has been tossed around a
22 great deal. "Link" obviously does not mean "clearly
23 causes". "Link" also does not mean simply a random
24 association.
25
26 In my mind, as a person who reads research reports and
27 sees the word "link" quite frequently used in this
28 context, the word "link" means something along the lines
29 of "suspected of contributing to", although perhaps it
30 means other things to other writers. But, as I review
31 these data, it is quite clear that dietary fat must be
32 suspected of contributing in a significant and substantial
33 way to the risk of breast cancer.
34
35 MR. JUSTICE BELL: I am not sure how much issue there is about
36 that last statement. It is whether it may be important,
37 whether it goes further than that.
38
39 MR. MORRIS: This is just from this chart.
40 A. That is correct.
41
42 Q. Whereas you are saying the link through obesity and
43 through age of menarche, and all the other things you
44 said, and, presumably, the animal studies which the
45 Surgeon General also looks at?
46 A. Yes.
47
48 MR. JUSTICE BELL: You were going to go on to those, were you
49 not?
50 A. Yes. By 1988 that link was clearly described.
51 I recognise that that word is a sensitive word. But by
52 1988 the references to causation were already being made
53 several times in the introductory paragraphs where the
54 Surgeon General says that again studies to date are
55 "strongly suggestive of the role for dietary fat in the
56 etiology of some types of cancer". What he is referring
57 to earlier in that paragraph started out as breast was
58 No. 1, colon was No. 2.
59
60 So, again this does not mean that cause and effect has
