Day 033 - 10 Oct 94 - Page 13
1
2 Q. I am going to move on to cancer. I think, for the court's
3 clarification, I will probably not refer to specific
4 documents while we are going through the statement -- it
5 gets a bit confusing -- I might do that at the end. So
6 the US National Cancer Institute estimates that more than
7 30 per cent of cancers are linked to foods. Do you want
8 to say something about that?
9 A. Yes. Estimates vary, but a variety of bodies have
10 concluded that tobacco accounts for probably 30 per cent
11 of cancers. Dietary factors account for anywhere from 30
12 to perhaps 60, or some authorities would say 70, per cent
13 of cancers.
14
15 Q. The National Cancer Institute -- what kind of body is that
16 in America?
17 A. It is the largest cancer research body in the United
18 States with a budget of somewhere between one and two
19 billion dollars, entirely devoted to research and to
20 education. It is an arm of the US government within the
21 Department of Health and Human Services, part of our
22 National Institute of Health.
23
24 Q. Do you want to outline the epidemiological evidence for
25 that conclusion?
26 A. Yes. Would it be helpful if I were to focus on a
27 particular type of cancer?
28
29 MR. JUSTICE BELL: I think a particular kind of cancer and a
30 particular kind of diet, because dietary factors could
31 mean factors which have nothing to do with this case, for
32 all I know?
33 A. Very good. Dietary fat has received the most
34 attention and, going back nearly 20 years, reviews have
35 shown, first of all, in international comparisons that
36 when you compare many, many different countries, those
37 with higher fat intakes have higher cancer rates. The
38 1988 Surgeon General's report called this a direct
39 correlation. It is quite striking that there is a very,
40 very high correlation between fat intake and cancer
41 rates.
42
43 Now, that alone is an association. It does not prove
44 cause and effect, but one can refine epidemiologic
45 studies, as well as other kinds of studies, to give more
46 evidence of what the associations may be, and again to
47 shed some light on whether the factors may, in fact, be
48 causal.
49
50 If we compare, for example, Japan and the United States,
51 Japan, historically, has had quite a low intake -- as low
52 as seven to 10 per cent of calories -- compared to the
53 United States, where the average fat intake is about 37
54 per cent of calories. Japan has had correspondingly a
55 very low incidence of cancer, breast cancer in
56 particular. However, Japan and the United States differ
57 in many other ways, not just in diets but in other aspects
58 of lifestyle.
59
60 So, researchers have initiated and completed other kinds
