Day 269 - 25 Jun 96 - Page 35


     
     1        before publication?
     2
     3   MR. RAMPTON:  A review, my Lord.
     4
     5   MR. JUSTICE BELL:  But you did not mean "present" in that way?
     6        A.   I did not mean that.  I mean he presented it to the
     7        court or handed it to the court.
     8
     9   MR. RAMPTON:  And it was a recent paper in the New England
    10        Journal of Medicine by Hunter and others, one of whom was
    11        Professor Willett?
    12        A.   Yes.
    13
    14   Q.   And there were substantial cohort studies.  One was the
    15        American Nurses study with 9,000 people with an eight year
    16        review?
    17        A.   Yes.
    18
    19   Q.   And they produced no positive association between dietary
    20        fat and breast cancer?
    21        A.  That is perfectly correct.  I think it does need
    22        qualifying, as I have qualified in it my statement, that I
    23        mean not sure that we really have, as I said earlier,
    24        advanced in cancer as far as the people in cardiovascular
    25        disease advanced, and I think these kind of studies are
    26        still in their infancy.  The point I would make about this
    27        is that actually virtually, although there have been many
    28        studies on long-term follow-ups, they suffer, particularly
    29        in cancer, from the problem of when is the initial insult
    30        that generates the cancer happening?
    31
    32        And if you talk to the cancer research people or the
    33        imperial cancer research fund, they will say that cancer of
    34        the breast may require up to 30 years of cell doubling time
    35        before you can feel a palpable tumour.  So what one is
    36        looking at is a time when the cancer is actually being
    37        promoted could have been many years before the studies were
    38        done.
    39
    40        So I do not, in my own opinion, give these studies the same
    41        kind of credit - and this is the opposite view to which Dr.
    42        Arnott expressed - I personally do not give these studies
    43        the same kind of opinion as I do the epidemiological
    44        studies which have consistently, in relation to a variety
    45        of major diseases of importance, led to causative factors
    46        which have in some cases led to the elimination,
    47        particularly in the aniline dye industry, as I mentioned in
    48        my evidence in-chief, to the elimination of both risk and
    49        cancer itself.
    50
    51   MR. JUSTICE BELL:  When you say the epidemiological studies, you
    52        mean the population studies?
    53        A.   The population-based studies, yes.
    54
    55   MR. RAMPTON:  Professor Crawford you say right at the end of
    56        this present statement of yours that cancer research is
    57        about at the place that cardiovascular research was at in
    58        1953?
    59        A.   Yes.  I think that is rather an extreme view.  I,
    60        perhaps, would like to qualify that.  Some of my cancer

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