Day 036 - 13 Oct 94 - Page 45
1
2 MR. MORRIS: He needed some kind of official letter or document
3 or something so that he can show to the airline company to
4 say why he has been delayed, then he will not have to pay
5 extra money.
6
7 MR. JUSTICE BELL: Tell me what letter you need. (Discussion
8 concerning flight details)
9
10 (Short Adjournment)
11
12 Re-Examined by the Defendants
13
14 MR. MORRIS: First of all, a question about methodology in
15 epidemiological studies. We looked at one study which you
16 may recall -- I do not think you need to get hold of it
17 now -- which was the Yvonne Jones' study, Dietary Fat and
18 Breast Cancer and the National Health and Nutrition
19 Examination Survey?
20 A. Yes.
21
22 Q. Is it "she"?
23 A. Yes, "she".
24
25 Q. She talked about -- Mr. Rampton read them out -- certain
26 standard breast cancer risk factors which, unless I am
27 contradicted, included -- sorry: "The standard breast
28 cancer risk factors generally showed the expected
29 associations". This was page 502 of the Arnott bundle.
30 It talked about the upper quartile of fatness, also showed
31 a significant elevation in risk, and older age at
32 menopause increased risk. Later on it says older age at
33 menarche increased risk.
34
35 I do not know in this particular survey, unless we go into
36 it in depth (which I do not want to again), but when there
37 are risk factors which may compound a survey that is
38 focusing just on one thing such as purely, maybe, the
39 linear relationship of fat and breast cancer, are those
40 risk factors generally removed from the assessment of the
41 results?
42 A. Typically, one would do assessments both with and
43 without controlling for the risk factors, so, yes, one
44 would try to do that, although to the extent that that is
45 possible.
46
47 Q. I seriously do not know the answer, that is why I am
48 asking. If a study concluded, for example, that they
49 could not find a correlation between fat and breast
50 cancer, is it possible they may have removed some of the
51 risk factors that could have fat implications, those
52 I have mentioned, and that actually may weaken the -----
53 A. Yes. Forgive me. I interrupted you.
54
55 Q. You explain.
56 A. If, for example, one recognises that obesity is a risk
57 factor for breast cancer and if one controls for obesity,
58 by that I mean tries to remove the effect of obesity, that
59 may inadvertently appear to remove the effect of, say, a
60 high-fat diet because those people who are obese may,
