Day 034 - 11 Oct 94 - Page 39


     
     1        A.  I was not attempting to say that.  What I was
     2        attempting simply to point out is that meat does contain
     3        cancer causing substances.  That is the main point
     4        I wished to make, although I might point out also that,
     5        regrettably, in medicine the use of qualifiers such as
     6        "may" and "might" are used in common parlance perhaps
     7        much more than they should be.
     8
     9        But the point I was trying to make with this was simply to
    10        show that cancer causing substances are in fried meats
    11        and, for example, when a hamburger is fried carcinogens
    12        can be identified on its surface.  When I had raised this
    13        earlier I had the impression that, perhaps, this might be
    14        a piece of new information, but I bring this along simply
    15        to show that it has been quite well known and is thought
    16        to be one of the mechanisms by which meat may cause colon
    17        cancer.
    18
    19   Q.   Why did the Surgeon General, do you think, spoke in terms
    20        of possibilities?  He obviously wanted to give what he
    21        thought would be sound advice, but, if your reasoning is
    22        right, by the time of his report there was an overwhelming
    23        case for animal fat and breast cancer, was there not?
    24        A.  There was.  Oddly enough, when people -----
    25
    26   Q.   But he did not put it in terms of an overwhelming case at
    27        all, did he?  Is that fair?
    28        A.  It is hard for me to reconstruct what Dr. Koop might
    29        have been thinking at that time.  However, I can say that
    30        when one looks at much of the data on breast cancer and
    31        diet, as, in fact, Dr. Arnott did and others, they often
    32        have talked about, is there a direct cause and effect
    33        simply between diet and the breast cancer cell with no
    34        intervening variables, or in the absence of looking at the
    35        mediators for that causation; and there, there is
    36        considerably more hedging about the degree of relationship
    37        and the dozens and dozens of studies are looked at and, as
    38        every observer notes, the association is found over and
    39        over again.
    40
    41        But the data and the observations on the causal links
    42        which I drew in numerous studies are, perhaps, a separate
    43        matter, but are clearly causal nonetheless, even though
    44        those people who have tried to look at the overall
    45        associations have tended to not get into the mechanisms
    46        with such detail.
    47
    48   MR. MORRIS:  Can I just ----
    49
    50   MR. JUSTICE BELL:  The fact is that the Surgeon General did not 
    51        speak in as positive terms as you would have done 
    52        yourself, did he? 
    53        A.  Well, if I look at his last sentence in the first
    54        paragraph of page 194, while it is not quite as
    55        declarative as my sentences might have been or as the
    56        other researchers we have reviewed, he is nonetheless
    57        quite strong where he says:  "But the weights of the
    58        studies to date are strongly suggestive of the role for
    59        dietary fat in the etiology of some types of cancer",
    60        referring earlier to breast and colon among others, which

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