Day 035 - 12 Oct 94 - Page 22


     
     1        dietary factors that influence it.  Individuals who
     2        consume large amounts of certain antioxidant vitamins, for
     3        example, have lower rates of lung cancer deaths, even if
     4        smoking is held constant.  What I am suggesting is that
     5        there is an interaction of factors here.
     6
     7        So, even when they are quite well established, even when
     8        cause-and-effect is no longer in doubt, these estimates
     9        will remain somewhat inexact because the very same cancer
    10        death is attributable to more than one factor.  This is
    11        also true for cancer of the oesophagus where tobacco and
    12        alcohol overlap.
    13
    14        The only other point I would like to make is the source
    15        was the Journal of the National Cancer Institute published
    16        in 1981, I believe the work done by Doll and Peto, as you
    17        mentioned.
    18
    19   MR. JUSTICE BELL:  That appears beneath the table.
    20        A.  Yes.  Those are the only comments I wanted to offer.
    21
    22   MR. RAMPTON:  Sorry, Dr. Barnard, if I cut you off too early.
    23        It is actually, I hope, open at page 47.  I would like you
    24        to look at something halfway down the page where his
    25        Lordship is asking you some questions.  Line 29, his
    26        Lordship says:
    27
    28        "I have to say I am more concerned with what the evidence
    29        established, if anything, in the late 80s and now, insofar
    30        as it is relevant, rather than, I think, probably a
    31        comparison with cigarette smoking and lung cancer because,
    32        if the truth is that the evidence is less complete in
    33        relation to cancer than it is to lung, than it is to
    34        smoking or, rather, diet and cancer, than it is between
    35        cigarette smoking and lung cancer, I have probably got to
    36        put the latter factors on one side, have I not?  Have
    37        I not got to focus in on dietary factors and the various
    38        cancers which might have been mentioned?"
    39
    40        You say, Dr. Barnard:  "I wonder if there might be one
    41        brief point I might make, just to draw that to a close?
    42        To this day when animals inhale cigarette smoke, they do
    43        not develop lung cancer as human beings do.  Moreover, the
    44        mechanisms have never been clearly sustained.  So, there
    45        are many, many holes in the links between tobacco and lung
    46        cancer, and yet the preponderance of evidence has been
    47        sufficient that the sceptics are a small minority."
    48
    49        I want to pause there.  Is it your evidence to this court
    50        that the circumstantial evidence pointing to diet as a 
    51        cause of colon and breast cancer is as strong as it is in 
    52        the case of cigarette smoking and lung cancer? 
    53        A.  I am not suggesting that.
    54
    55   Q.   Then you go on:  "Finished with that and talking only
    56        about diet, the animal studies say with dietary factors,
    57        particularly fat and breast cancer" ----
    58        A.  Forgive me.  Where are we, please?
    59
    60   Q.   Line 49 on page 47:  I am going on with your answer.

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