Day 033 - 10 Oct 94 - Page 17


     
     1        If a group of women -- for example, in the American
     2        Journal of Epidemiology a recent study showed that women
     3        who have higher levels of oestrogen circulating in their
     4        blood have a substantially higher risk of breast cancer.
     5        If those same women modified the fat content of their diet
     6        today, within a month one will register lower levels of
     7        oestrogen -- I am specifically speaking of oestradiol,
     8        which is the principal oestrogen circulating in the blood
     9         -- their risk of breast cancer would be presumed to have
    10        dropped as a result of that.  So, yes, the links do seem
    11        to be causal by any reasonable standard.
    12
    13        I should say that there are studies that have not
    14        identified this link and that has led to some controversy
    15        about it.  That is certainly true.  The preponderance of
    16        evidence, however, suggests that the link is quite
    17        strong.  If I might draw an analogy, it is rather like if
    18        we send a group of search parties of policemen, perhaps,
    19        out into the woods to try to find a culprit, to find a
    20        criminal, to find traces of an individual's passage in the
    21        woods, and if I send 20 search parties out it may be that
    22        15 of them will come up empty handed; but if five of them
    23        have found traces of this individual, or perhaps found the
    24        culprit himself or herself, the fact that 15 were unable
    25        to find any trace or did not find anything that they felt
    26        was very positive does not diminish the power of those
    27        that have found clear evidence that, in fact, there is a
    28        problem with the diet; and the problem appears to be
    29        causative.
    30
    31   MR. MORRIS:  We will come to that a bit later on, the specific
    32        reports.  Regarding breast cancer and cancers in general
    33        and links with diet, is this something which is a
    34        developing area of research and conviction?  What I am
    35        saying is, is it a fairly young area of specific ----?
    36        A.  Well, the evidence linking dietary fat and cancer goes
    37        back more than 20 years, such that summaries of this have
    38        been appearing in literature for at least two decades, but
    39        research is continuing.  The current focus of research in
    40        the United States is not so much on establishing these
    41        links because the associations and the hypothesis that is
    42        a cause and effect relationship is now quite widely
    43        accepted.  We have now turned to intervention trials to
    44        show the feasibility of actually modifying cancer risk.
    45        So, yes, it is an ongoing area of research.
    46
    47   Q.   But it is not as highly developed as, say, heart disease
    48        research was?
    49        A.  Yes, I think that is a -----.
    50 
    51   Q.   Or is now? 
    52        A.  Yes, I think that is a fair characterisation. 
    53
    54   Q.   Just very briefly, you have mentioned uterine cancer.
    55
    56   MR. JUSTICE BELL:  If you are moving to that topic, we will
    57        have our five minute break now.
    58
    59                            (Short Adjournment)
    60

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