Day 254 - 22 May 96 - Page 48


     
     1        etiological component in carcinogenesis with some cancers
     2        showing an association with affluence, eg those with a
     3        colon breast prostate ovary and endometrium and some with
     4        poor diet, eg those with the oesophagus stomach and oral
     5        cavity."
     6
     7        That is general consensus in the medical scientific
     8        community he is referring to there; is it?
     9        A.  Well, I think it is a general statement.  As I said
    10        before, as I understand it, what we are talking about
    11        today, are cancers of the breast and large bowel, and they
    12        are certainly mentioned in association with affluence.  But
    13        I personally would feel that he is making a general
    14        statement that diet overall is important in terms of
    15        carcinogenesis, but the exact place and mechanisms, I do
    16        not think we know which is what he then goes on to discuss
    17        in the remainder of the article.
    18
    19   Q.   But there is a general medical scientific consensus that
    20        diet is an important etiological component in
    21        carcinogenesis; yes?
    22        A.  It is difficult to explain this.  I think that people
    23        certainly feel that diet must have a role in the
    24        development of cancers, but exactly what that role is,
    25        except in very clearly defined special circumstances.  And
    26        we have talked about, for example, a diet in its wider
    27        sense, like including alcohol, in terms of oral and
    28        pharyngeal carcinoma.  In other respects, I think there is
    29        much less clear thinking about exactly the mechanisms by
    30        which diet is involved in carcinogenesis.
    31
    32   Q.   So the position is, as you said on page 8 of your
    33        statement, the fourth paragraph: "The review points out
    34        that the cancers most strongly associated with diet are
    35        those of the digestive tract", which would include colon
    36        cancer; would it not?
    37        A.  Yes.
    38
    39   Q.   "and the hormone related cancer such as breast cancer".
    40        Basically, the position is that the general consensus
    41        particularly applies to that: It is just that people are
    42        unsure of exactly the individual components leading to the
    43        individual different cancer types, or that is the view put
    44        forward in this paper; yes?
    45        A.  Yes.  I think the review is stating that -- and I go
    46        back to what I said this morning -- it looked from the
    47        earlier studies as though you can explain the variations in
    48        cancer incidence throughout the world, 80 per cent of that,
    49        by dietary variations, but what has happened is that as we
    50        have tried to identify those mechanisms, the situation has 
    51        become less clear. 
    52 
    53   Q.   In this study is there anything about alcohol or is
    54        that----
    55        A.  Yes, there is.  If you actually look, he goes through
    56        cancer site by site.
    57
    58   Q.   Right.  But in terms of the section where they are looking
    59        at dietary factors, there is not a specific section on
    60        alcohol?

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