Day 035 - 12 Oct 94 - Page 58
1 Q. Yes. "Strongly suggest that international comparisons are
2 seriously confounded by factors related to
3 industrialisation"?
4 A. Yes.
5
6 Q. "Fat intake ranged from 5 to 47 per cent of energy but
7 breast cancer rates did not vary with fat intake and were,
8 at most, about 1/10th of those in the United States"?
9 A. Yes. You are quite right referring to Dr. Campbell's
10 characterisation of this sort of language.
11
12 Q. You would agree with Professor Campbell.
13 A. When we are speaking of Dr. Campbell's own research, I
14 think Dr. Campbell is probably the best person to speak
15 for it, rather than Dr. Willett.
16
17 Q. It may be. We will have to look and see what is written
18 and compare the two which we have not been able to yet.
19 "Case-control studies and prospective cohort studies
20 provide more opportunity to measure and adjust other
21 factors that might be related to risk of cancer. For
22 breast cancer no material association with fat intake has
23 been found in case control studies from New York, Hawaii,
24 Australia, Greece and Japan. Although a study from Canada
25 was originally reported as showing a positive association
26 it was not statistically significant" ----
27 A. Can you hold there for a moment?
28
29 Q. Yes, sure.
30 A. Thank you.
31
32 Q. That study from Canada was probably by Howard, but I will
33 have to check it -- no, it is by Miller. "It was
34 not" -----
35
36 MR. JUSTICE BELL: It was one of the ones referred to by
37 Kinlen.
38
39 MR. RAMPTON: Yes. "It was not statistically significant and
40 examination of the data indicates that the average fat
41 intake reported by cases was virtually identical to that
42 reported by control. In other case-control studies only a
43 limited list of foods was included, some have construed
44 sporadic associations with foods containing fat as
45 evidence that fat causes breast cancer. These data are
46 difficult to interpret because of the tendency to focus on
47 foods within a study from which associations are seen, and
48 because other aspects of the diet, including total energy
49 intake, cannot be controlled for." Do you agree with
50 those criticisms of the defect in case-control studies?
51 A. Overall, the majority of case-control studies have
52 found no relationship between fat and breast cancer.
53
54 Q. Exactly.
55 A. It is not universally true, but that has been the
56 trend, yes.
57
58 Q. Now we come to some work done by Dr. Willett himself: "The
59 potential for distortion of associations because of
60 differential recall" -----
