Day 033 - 10 Oct 94 - Page 17
1 If a group of women -- for example, in the American
2 Journal of Epidemiology a recent study showed that women
3 who have higher levels of oestrogen circulating in their
4 blood have a substantially higher risk of breast cancer.
5 If those same women modified the fat content of their diet
6 today, within a month one will register lower levels of
7 oestrogen -- I am specifically speaking of oestradiol,
8 which is the principal oestrogen circulating in the blood
9 -- their risk of breast cancer would be presumed to have
10 dropped as a result of that. So, yes, the links do seem
11 to be causal by any reasonable standard.
12
13 I should say that there are studies that have not
14 identified this link and that has led to some controversy
15 about it. That is certainly true. The preponderance of
16 evidence, however, suggests that the link is quite
17 strong. If I might draw an analogy, it is rather like if
18 we send a group of search parties of policemen, perhaps,
19 out into the woods to try to find a culprit, to find a
20 criminal, to find traces of an individual's passage in the
21 woods, and if I send 20 search parties out it may be that
22 15 of them will come up empty handed; but if five of them
23 have found traces of this individual, or perhaps found the
24 culprit himself or herself, the fact that 15 were unable
25 to find any trace or did not find anything that they felt
26 was very positive does not diminish the power of those
27 that have found clear evidence that, in fact, there is a
28 problem with the diet; and the problem appears to be
29 causative.
30
31 MR. MORRIS: We will come to that a bit later on, the specific
32 reports. Regarding breast cancer and cancers in general
33 and links with diet, is this something which is a
34 developing area of research and conviction? What I am
35 saying is, is it a fairly young area of specific ----?
36 A. Well, the evidence linking dietary fat and cancer goes
37 back more than 20 years, such that summaries of this have
38 been appearing in literature for at least two decades, but
39 research is continuing. The current focus of research in
40 the United States is not so much on establishing these
41 links because the associations and the hypothesis that is
42 a cause and effect relationship is now quite widely
43 accepted. We have now turned to intervention trials to
44 show the feasibility of actually modifying cancer risk.
45 So, yes, it is an ongoing area of research.
46
47 Q. But it is not as highly developed as, say, heart disease
48 research was?
49 A. Yes, I think that is a -----.
50
51 Q. Or is now?
52 A. Yes, I think that is a fair characterisation.
53
54 Q. Just very briefly, you have mentioned uterine cancer.
55
56 MR. JUSTICE BELL: If you are moving to that topic, we will
57 have our five minute break now.
58
59 (Short Adjournment)
60
