Day 017 - 25 Jul 94 - Page 30
1 with no allowance for wastage. Furthermore, since
averaging is done over the entire population, no account
2 is taken of differing age and sex patterns. A more
important problem is the fact that comparisons of food
3 balance data with individual-based nutritional studies
have shown that the former are not equally reliable (or
4 unreliable) in all countries, or within a given country,
for each food item.
5
The imperfections are not confined to the nutritional
6 details, since the mortality data include countries with
up to 14% of deaths from senility and other ill-defined
7 causes at ages 35-64.
8 Fat is sometimes singled out in these analyses because of
the magnitude of the correlation coefficient with breast
9 cancer mortality (0.89). In fact, an economic variable,
gross national product also gives a high correlation with
10 breast cancer (0.72). Indeed, for breast cancer
incidence, which in an aetiological context is the more
11 relevant" -- is it more relevant than mortality?
A. It is because obviously some people are "cured", in
12 inverted commas, of their cancers. So that if you are
measuring purely mortality data, you are not getting a
13 true measure of how frequently the cancer develops in that
particular society. You are getting a lower estimate.
14
Q. "For breast cancer incidence ... the value is higher
15 (0.83) with GNP than it is with fact (0.79)". That is
again Armstrong and Doll. "It is therefore possible that
16 some contribution to the high correlation comes from
economic effects on the quality of the incidence data; for
17 these operate not only within a vital statistics office or
cancer registry, but touch many aspects of national life
18 including the availability and organisation of medical
services.
19
The problem is that fat consumption and national wealth
20 are so highly correlated that it is difficult to
distinguish the effects of fat per se from those of other
21 indirect effects of wealth that influence breast cancer
risk. These include early age at menarche, delayed first
22 birth and low family size. One of the most distinctive
aspects of rich developed countries is their
23 overconsumption of food in general. This is highly
relevant sine obesity (and in certain studies, body size)
24 is another determinant of breast cancer risk consistent
with an effect of the oestrogen produced in adipose tissue
25 from" -- you say it, I do not know.
26 A. "Androstenedione".
27 Q. Thank you. Is that what you were telling us earlier?
A. That is what I was telling you earlier, that oestrogen
28 like substances can be produced in adipose tissue and,
therefore, may be changing the hormone environment of an
29 individual, but he mentions these other factors which we
have discussed already, such as menarche, family size and
30 the age at which one has one's first child. These are
certainly socially, at least in part, socially related
