Day 053 - 22 Nov 94 - Page 50


     
     1        into causation.  So, it was just to find out how much was
     2        about causation, rather than just treatment.
     3
     4   MR. JUSTICE BELL:  I do not want to take a point unfairly
     5        against you, but you see then at 5, line 34:  "Right.  What
     6        percentage of all those things..." the question I have just
     7        read, and then he says about a third.  "Right.  In your
     8        opinion what are the risk factors for, say, breast and
     9        colon cancer?"  "Well, I would have thought risk factors
    10        meant what are the sort of the things which might end up
    11        causing cancer".
    12
    13   MS. STEEL:  "What are considered to be risk factors".
    14
    15   MR. JUSTICE BELL:  "What, in your opinion, are the risk factors
    16        for, say, breast and colon cancer?"  What I am saying is
    17        I have interpreted that as another way of saying:  "What
    18        are the various factors which might cause or play a part in
    19        the causation of cancer?"  Then you go into the G's.  Then
    20        page 6, line 23:  "But that could be attributed to some
    21        other factors, for example, environmental, dietary,
    22        whatever; what other factors apart from genetic?"  He talks
    23        about parity and things like that.
    24
    25   MS. STEEL:  The thing is that the initial risk factors are
    26        determined by reference to statistical associations, for
    27        example.
    28
    29   MR. JUSTICE BELL:  The bottom of page 6:  "Has cause and effect
    30        been shown for these?"  "No."  "In your opinion, are there
    31        any dietary factors to be taken into account?"
    32
    33   MS. STEEL:  Yes.  "Has cause and effect been shown for
    34        genetics", that is about.  The point I was making there was
    35        that he was asserting that there was a link for genetics,
    36        but he appeared to me to be denying that there was a link
    37        for diet.  So, what I am asking is: "Has cause and effect
    38        been shown for genetics?"  "No".  "Therefore, why do you
    39        assume that there is a link between genetics and cancer,
    40        when you do not accept the same for diet just on the
    41        basis" -----
    42
    43   MR. JUSTICE BELL:  Would I be wrong if I interpreted your
    44        question at the bottom of page 6 as asking whether there
    45        are any dietary factors which you see as risk factors for
    46        cancer?  That seems the most obvious interpretation.  A
    47        risk factor for cancer must mean, must it not, something
    48        which may lead to cancer?
    49
    50   MS. STEEL:  But whether something is a risk factor is initially 
    51        determined by reference to things such as statistical 
    52        associations.  So, that question is not specifically 
    53        related to whether cause and effect has been shown.
    54
    55        I touched on this this morning when I mentioned about
    56        I think there is a difference as well between cause and
    57        effect and causal, because, as I say with smoking and lung
    58        cancer, the witnesses have agreed that cause and effect has
    59        not been shown with smoking and lung cancer, but that it is
    60        considered to be a causal relationship.

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