Day 269 - 25 Jun 96 - Page 57


     
     1
     2   MR. JUSTICE BELL:  Yes, thank you.
     3
     4   MR. RAMPTON:  Can we then pass, Professor, to the third page of
     5        the third statement, what I call the present or current
     6        statement?
     7        A.   Yes.
     8
     9   Q.   And there is a heading "Meals Eaten Per Week", 2.1, and you
    10        quote some statistics from the British Heart Foundation and
    11        then you say this:
    12
    13        "There is a similar socio-economic stratification for
    14        cancer."
    15        A.   Yes.
    16
    17   Q.   Where does that come from?  I do not have those figures.
    18        A.   They come from -- if they are not in the Heart
    19        Foundation's publication, they will be in the Black report,
    20        which discusses the inequality of health.
    21
    22   Q.   "Black report".  It is not, in any event, right, is it, so
    23        far as breast cancer is concerned, that the prevalence is
    24        within the lower socio-economic?
    25        A.   Prevalence is more general with breast cancer, yes.
    26
    27   Q.   Indeed it may be that it is higher?
    28        A.   It may be.
    29
    30   Q.   In groups 1 and 2?
    31        A.   Yes.
    32
    33   Q.   And the reasons for that would be social largely, would
    34        they not?
    35        A.   It is difficult to say, Mr. Rampton, because I find
    36        the evidence with breast cancer, in view of the -- we have
    37        had a changing socio-economic contrast in terms of disease
    38        patterns and I would really want to have an expert who knew
    39        something about the cell doubling times to discuss that
    40        particular question, because what I am told by the Imperial
    41        Cancer Research Fund, as I mentioned earlier, that the cell
    42        doubling time for breast cancer is somewhere in the region
    43        of about 20-30 years.  So we are looking at something which
    44        is occurring at a different time from the time that we are
    45        looking at today.
    46
    47   Q.   One of the factors, which is in a sense --
    48
    49   MR. JUSTICE BELL:   Can I check why Professor Crawford says
    50        that?  Why are you looking at a different time from the
    51        time we are looking at today, if it is 20 or 30 years?  You
    52        touched on this earlier.
    53        A.   Yes, I mean, it does seem as though the actual event
    54        which makes a cell malignant occurs at a very long distance
    55        in time, so far as breast cancer, from the time at which
    56        you can palpate a tumour in the breast.
    57
    58   Q.   Yes, I understand that.
    59        A.   So what I am really saying is that the socio-economic
    60        conditions 30 years ago are different to today, and the

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