Day 023 - 13 Sep 94 - Page 29
1 heard: "Dietary factors are now known to influence the
2 development of a wide range of chronic diseases including
3 cancer". So what I am saying is that ---
4 A. They are obviously though -----
5
6 Q. -- on the case-control area of evidence, we have heard
7 that population studies and we have heard that animal data
8 are pretty strongly backing the links, but that the area
9 of case-control, I believe, in cohort studies is more
10 controversial, but they seem to feel at this time in 1989,
11 that case-control studies "provide stronger evidence to
12 the effects of diet in relation to major cancers"?
13 A. But in the final page of Conclusions, of course, they
14 are not just referring to one or two types of cancer.
15 They are referring to all the cancers that they have
16 studied. They have actually made the point that they have
17 included alcohol in the diet as well. They are not just
18 restricting themselves to breast cancer and colon cancer.
19
20 MR. MORRIS: Right. I think we have finished
21 cross-examination. Thank you.
22
23 Re-examined by MR. RAMPTON
24
25 MR. RAMPTON: Dr. Arnott, which particular document have you
26 got in front of you because I will use that first?
27 A. Right. This is the WHO 3.3.
28
29 Q. Did you read the whole of section 3.3 while we were
30 outside?
31 A. Yes, I did.
32
33 Q. Did you notice whether the committee, or whatever this
34 body is, made a distinction so far as causation is
35 concerned between, for example, lung cancer and nicotine
36 or tobacco and, for example, colorectal cancer and diet?
37 A. Yes, they did make a distinction.
38
39 Q. Do you notice under 3.3.5 -- it starts at 3.3.4 on page 64
40 -- the last sentence, they say this: "On the basis of
41 evidence in developed countries", this is on liver cancer
42 "consumption of alcoholic beverages is causally related
43 to liver cancer". Did you see that?
44 A. I did.
45
46 Q. As a statement of what one might call reputable medical
47 opinion in 1989/90, would you agree or disagree with that
48 statement?
49 A. I would agree. The problem with all of this is that
50 none of these relationships is just straightforward, but
51 certainly if you look at, for example, countries with a
52 high alcohol consumption, like France which has a higher
53 consumption than this country, there is an increased
54 incidence of cirrhosis of the liver and liver cancer.
55
56 Q. Do you notice at the top of page 67, 3.3.5: "Lung
57 cancer. In most industrialised countries, lung cancer is
58 the leading cause of cancer deaths among men, and it is
59 rapidly approaching this status among women". I think you
60 told us something about that earlier this morning?
