Day 035 - 12 Oct 94 - Page 56
1 A. There was one point here that struck me as perhaps of
2 interest and that was on page 51, the top, this is near
3 where you asked me to begin reading and it caught my
4 attention, the top paragraph is marked 3.5.4.1.
5
6 Q. Yes?
7 A. In the middle way down, it says: "There is an
8 increased risk of post-menopausal breast cancer with
9 obesity." Then they say that possibly the reason has to
10 do with oestrone production by adipose tissue. I simply
11 thought it was noteworthy that they said there is an
12 increased risk, rather than "there may be" and "could be"
13 and so forth. I appreciated you are drawing that to my
14 attention.
15
16 Q. If you thought that was disputed on this side, it is not.
17 It has already been given in evidence by our expert
18 witnesses that, indeed, there is an increased risk in
19 post-menopausal women who are obese; that is common
20 ground.
21
22 Close that Grey Book, not forgetting that is 1991, and can
23 we go back to Dr. Willett in 1990. I think I had stopped
24 at, if I did not I will read it again, about a third of
25 the way down, the last paragraph on page 389 where you see
26 Key and Pike at the end of the line?
27 A. Yes.
28
29 Q. Do you have that?
30 A. Yes, I think so.
31
32 Q. "Key and Pike concluded in a recent review that the data
33 overall suggest a promoting effect of oestrogens and
34 possibly also of progestagins. For our enlightenment,
35 what are "progestagins"?
36 A. The word comes from the word progesterone which unlike
37 estrogens which is a group name of a variety of hormones,
38 the principal ones are estrodiol estron and estriol,
39 progesterone is a single hormone. It is produced by the
40 ovary. Some writers use a very loose term which takes a
41 variety of forms; sometimes progestin or progestogen. The
42 provice definition seems to vary from one author to
43 another, but they usually seem to mean synthetic near
44 copies of progesterone manufactured by pharmaceutical
45 companies, and in some cases they include natural
46 physiologic progesterone in that category.
47
48 Q. You say "manufactured by pharmaceutical companies" would
49 one find them in the contraceptive pill or something like
50 that?
51 A. Yes, you most likely would.
52
53 Q. Please turn on to page 390 where Dr. Willett writes about
54 risk factors for colon. He has mentioned other factors
55 for breast cancer. He is talking about oral
56 contraceptive, and so on, and radiation. I do not want to
57 read about those.
58 "Risk factors for Colon Cancer. Few specific risk factors
59 for colon cancer have been established. Inflammatory
60 bowel diseases, such as ulcerative colitis and Crohn's
