Day 017 - 25 Jul 94 - Page 50


     
     1   Q.   "However, a prospective study failed to demonstrate an
              increased risk of colorectal cancer in patients with low
     2        selenium levels".  Again, are we in the position that we
              look with interest at selenium as a possible inhibitor for
     3        right-sided colon cancer, but go no further than that?
              A.  I think one would have to say that.  This question of
     4        oxidation and the influence of oxidative processes as a
              possible link in carcinogenesis are very fashionable,
     5        shall I say, at the present time.  Selenium is one element
              which has been suggested that might act in an inhibitory
     6        way.  But we cannot go further than that.  That is as far
              as we are able to go at the present time.
     7
         Q.   I would like to leave 1990 and Dr. Morson and proceed to
     8        1992 which I think is probably about as up to date as we
              get in this volume -- tab 19 which is the Journal of the
     9        National Cancer Institute, so it is an American
              publication?
    10        A.  Yes, it is.
 
    11   Q.   The team was led my Michael Tuhn?
              A.  Yes, Michael Tuhn.
    12
         Q.   Again, is he a respected figure in this field?
    13        A.  Yes.  He is I would say a fairly well regarded person.
 
    14   Q.   He is an epidemiologist?
              A.  He is an epidemiologist.
    15
         Q.   Again I read only the abstract because everybody can read
    16        the text at their leisure.  I read it for this purpose
              really.  I will read it first then I will ask you the
    17        question.  It is headed: "Risk Factors for Fatal Colon
              Cancer in a Large Prospective Study".  Does that tell us
    18        that the study was concerned with mortality and not with
              incidence?
    19        A.  Yes.  In fact this has been -- I mean they
              realistically put this forward as a criticism in the sense
    20        they are looking only at people dying of colon cancer.  As
              we were talking about breast cancer this morning,
    21        treatment can successfully treat people with colon
              cancer.  Therefore, you are not necessarily measuring
    22        incidence; you are only measuring fatality.
 
    23   Q.   If you quickly whip over to page 1498 it is
              pre-penultimate page of the report in the left-hand
    24        column, the second paragraph -- well, the first paragraph,
              the second complete sentence: "Our data provide only
    25        limited evidence that obesity and a sedentary lifestyle
              may increase risk in men.  The findings that neither fat 
    26        nor red meat consumption was associated with fatal colon 
              cancer, and our study should be interpreted cautiously for 
    27        reasons discussed below." The two reasons if one runs
              one's eye down the page appear to be first of all that it
    28        was a mortality study?
              A.  Yes.
    29
         Q.   Which may discount a number of cases, as you explained,
    30        and also they were not altogether happy with their
              questionnaire.  Is that right?

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