Day 034 - 11 Oct 94 - Page 04
1 references: "Other cancers that have been related to fat
2 intake are those of the rectum, ovaries and endometrium"
3 -- endometrium, of course, being a portion of the
4 uterus. "Considerable uncertainties remain to be resolved
5 about these relationships. For example, the effects of
6 different types of dietary fat (i.e., saturated versus
7 unsaturated; animal versus plant origin) have not been
8 separated in most human studies. But the weights of the
9 studies to date are strongly suggestive of the role for
10 dietary fat in the etiology of some types of cancer".
11
12 Let me emphasise a few points in this paragraph: As is
13 stated in the very beginning using the word
14 "carcinogenesis", meaning the origins of cancer, using
15 the words "cancer promoting role", and in the final
16 sentence of that paragraph, "the role of dietary fat in
17 the etiology", all of these are references to causation,
18 not simply to association. Moreover, the -----
19
20 MR. JUSTICE BELL: Just pause there, yes. Carry on.
21 A. The Surgeon General does acknowledge that there are
22 some inconsistencies in the data which are well known and
23 quite clearly known to all researchers and have been
24 brought up in this trial. However, the weight of the
25 evidence was such that the Surgeon General felt that there
26 was still, in his words: "The studies to date are
27 strongly suggestive of the role of dietary fat in the
28 etiology"; in other words, cause of some types of cancer;
29 the types of cancer he mentions first, the first two are
30 breast and colon. In other words, what seems to be
31 somewhat in doubt is the mechanisms precisely by which fat
32 does cause the increase in cancer. What seems less in
33 doubt is the fact that there is a role for fat in the
34 causation of cancer.
35
36 Going to the next paragraph under the heading: "Human
37 Epidemiologic Studies. The risk for breast cancer is
38 correlated with total fat consumption in comparisons of
39 countries", then several references are given in
40 parenthesis. " ... districts in Japan and ethnic groups
41 in Hawaii. The risk for cancers of the colon and prostate
42 is also correlated with total fat consumption in
43 international comparisons", and three references are given
44 for that. "A worldwide correlation between breast and
45 colon cancer mortality and total fat consumption has been
46 demonstrated and is illustrated for breast cancer death
47 rates".
48
49 It makes a reference to figure 4.3 which occurs earlier in
50 this document, and simply shows a direct correlation when
51 various countries are compared versus their fat intake.
52 Numerous investigators have described this as a striking
53 correlation.
54
55 The next paragraph: "Although further epidemiologic study
56 is needed to verify the association between diet and
57 breast cancer and to elucidate its biologic basis, the
58 consistency of the evidence derived from the epidemiologic
59 and animal studies suggests that the association may be
60 causal. Table 4.7 summarises certain key (although
