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?
