Day 036 - 13 Oct 94 - Page 34


     
     1   Q.  --- is a cause or part of the cause of cancer of the breast
     2        and colon in some people.
     3        A.  When that is put forth by scientists it is in two
     4        ways; the first being quite definitively through what
     5        I might call a two-step process, such a diet causes
     6        obesity or increases the risk of obesity as well as
     7        increasing body weight which, in turn, does cause an
     8        increase in the risk of breast cancer.  That I think would
     9        be definitively stated.
    10
    11        There are other mediating mechanisms which we have
    12        discussed as well, including the age of menarche which are
    13        quite well accepted.  If one simply jumps then to the
    14        overall link, the way that is typically put forth, is that
    15        there is an association, there is a link.  The link is
    16        believed to be causal.  What is under further
    17        investigation is that, indeed, it is causal.
    18
    19   MR. RAMPTON:  I would like you to look at something which is
    20        not a prospective or epidemiologic study, please.  My
    21        Lord, this is one of Professor Crawford's references.  It
    22        is at line 54 of the two sheets of references which are
    23        attached to Professor Crawford's statement.  It is a study
    24        from 1993.  Those references, my Lord, are on pages 11 and
    25        12.  It is the bottom of page 11.
    26
    27   MR. JUSTICE BELL:  You say this is one of the -----
    28
    29   MR. RAMPTON:  This is one of the ones I handed up this
    30        morning.  I do not know if the witness is going to be
    31        allowed one of these but it is better that he should have
    32        one.  It comes from a journal called Preventative
    33        Medicine, Volume 22, 1993.  It is written by Clement Ip,
    34        Dr. Ip of the Department of Social Surgical Oncology
    35        Buffalo, New York.  Is that a well-known centre of cancer
    36        research?
    37        A.  Yes.
    38
    39   Q.   It is, is it not?  I am going to read the headnote
    40        abstract, or whatever you call it.  "Epidemiological
    41        evidence from different countries worldwide ----"
    42        A.  Roswell Park is known primarily for cancer treatment.
    43
    44   Q.   That is what surgeons call "oncology" is, it not?
    45        A.  Yes, taking tumours out.
    46
    47   Q.   Dr. Ip, this is not the first time that he has ventured
    48        into print on matters of this kind, is it, Dr. Barnard?
    49        A.  I am not sure of the degree which he has published.
    50 
    51   Q.   For example, in 1987 he published a paper on the 
    52        inhibitary effects of omega 3 acids in tumourigenesis. 
    53        This appears to have been a piece of experimental work on
    54        animals:  "Epidemiological evidence from different
    55        countries worldwide has suggested a positive association
    56        between the availability of fat in the diet and variations
    57        breast cancer mortality rate.  A voluminous amount of
    58        information is also available in the literature linking
    59        increased fat consumption, particularly polyunsaturated
    60        fat, and stimulation of mammary tumourigenesis in animal

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