Day 035 - 12 Oct 94 - Page 21


     
     1        Dr. Barnard, I would like you to look at is table 4.1
     2        which, I believe, is the table you have just drawn our
     3        attention to in support of what you have been telling us?
     4        A.  Yes, that is right.
     5
     6   Q.   We will have a careful look at it, if we may.  Table 4.1:
     7        "Proportions of Cancer Deaths Attributed to Various
     8        Factors".  There is a list of the factors, in which diet
     9        is the third down.  It says, these are cancer deaths:
    10        "Best estimate 35 per cent; Range of Acceptable Estimates
    11        10 to 70 per cent".
    12        A.  Yes.
    13
    14   Q.   Please look at the footnote (a), it says this:  "It should
    15        be understood that these figures are speculative, and
    16        there is considerable uncertainty associated with them".
    17        You will notice that the source for these figures is the
    18        seminal, the classic report of Sir Richard Doll and
    19        Richard Peto of Oxford University 1981?
    20        A.  Yes, that is correct.
    21
    22   Q.   What do you understand, Dr. Barnard, by the word
    23        "speculative"?
    24        A.  It is very difficult to say if 10 per cent of cancer
    25        deaths are due to diet or 20 per cent or 30.  I think most
    26        researchers would narrow the range, although the Surgeon
    27        General is saying that acceptable estimates go between 10
    28        and 70, most people would narrow that range somewhat.
    29        Also because there is an interaction between factors,
    30        dietary factors interact with other factors here on the
    31        chart, such as tobacco and alcohol, causing the borders to
    32        be fuzzy even if they were exactly known.
    33
    34   Q.   On Monday when you were giving your evidence you told the
    35        court, you were discussing with his Lordship about, as it
    36        were, risk factors and the causation of cancer or the
    37        incidence of cancer.  You had made a comparison then, as
    38        you did, I think, a moment or two ago, between the
    39        evidence in relation to tobacco smoking and lung cancer
    40        and the evidence in relation to diet and other kinds of
    41        cancers, such as colon and breast cancer.  Do you remember
    42        that?  Would you like to have a copy of the transcript?
    43        It may be best if you do.  My Lord, it is page 47 of
    44        Monday's transcript.
    45
    46   MR. JUSTICE BELL:  I will just follow because I, on purpose,
    47        kept all the transcripts in my room.
    48
    49   THE WITNESS:  I had one additional comment on this chart.  We
    50        are not coming back to it? 
    51 
    52   MR. RAMPTON:  If there is anything you want to add, if 
    53        you think I have moved on too quickly, please do so.
    54
    55   MR. JUSTICE BELL:  Go back to the table 4.1.
    56        A.  Just briefly, two points.  Some cancer deaths are
    57        attributable to more than one factor on the chart.  These
    58        factors are not exclusive.  For example, tobacco is
    59        strongly linked to lung cancer.  However, that same cancer
    60        death which may be attributable to tobacco also may have

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