Day 035 - 12 Oct 94 - Page 18


     
     1        country's National Cancer Institute, is in very guarded
     2        terms, is it not?
     3        A.  I would not describe it in that way, no.
     4
     5   Q.   Put it another way:  It does not assert a causal
     6        relationship between a diet high in fat and low in fibre
     7        and cancer of the colon and rectum, does it?
     8        A.  I believe my reading is different from yours.  To my
     9        reading, there is very abundant evidence that a diet high
    10        in fat and low in fibre -- let me say that clearly -- a
    11        diet high in fat and low in fibre and also, one might say,
    12        a diet that is high in meat products, contributes to a
    13        risk of colon cancer, just as cigarette exposure
    14        contributes to a risk of lung cancer.  But just as there
    15        is a great deal of lack of clarity as to how inhaling
    16        tobacco smoke causes the cells in the lung tissue to
    17        become cancerous, there is still uncertainty as to how a
    18        high-fat/low-fibre meat based diet increases the risk of
    19        colon cancer.  Many mechanisms have been proposed and
    20        there is a substantial body of evidence supporting them
    21        and one would hope that continued research will be done on
    22        them.
    23
    24   MR. JUSTICE BELL:  I will not disregard the answer, but it was
    25        not an answer to the question you were asked.  What you
    26        were asked, firstly, was whether that document from the
    27        NCI was in very guarded terms and you said you would not
    28        describe it that way; then, put another way, it does not
    29        assert a causal relationship between a diet high in fat
    30        and low in fibre and cancer of the colon and rectum.  Do
    31        you agree that it does not assert such a causal
    32        relationship?
    33        A.  The ----.
    34
    35   Q.   Your interpretation of the evidence may be different to
    36        the NCI's, but you are not being asked about that at the
    37        moment.  You are being asked what this publication says or
    38        does not say?
    39        A.  I believe it does assert that there is a
    40        cause-and-effect relationship, if that is responsive to
    41        the question.  However, most of what was read in the
    42        document does not go to that but rather instead deals with
    43        what those mechanisms may be.
    44
    45   MR. JUSTICE BELL:  May I come back to that, Mr. Rampton, you
    46        may be going to do so, but I would like it pointed out to
    47        me where it does assert that, because one of the matters
    48        I may have to consider is just what various committees and
    49        bodies were asserting at materials times.  At the same
    50        time, I would like to ask you again the question I posed 
    51        earlier. 
    52        A.  Regarding the document from the National Cancer 
    53        Institute?
    54
    55   MR. JUSTICE BELL:  Yes.  I would like to ask you at some stage
    56        whether you can identify an NCI publication which does say
    57        that 35 to 50 per cent of cancers are due to diet as
    58        opposed to using some form of words such as, "it has been
    59        postulated that" or "it is believed that" or "it may be
    60        that".

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