Day 031 - 05 Oct 94 - Page 23

     
     1        at the top, which are Netherlands, Denmark, United
     2        Kingdom, Canada, Ireland and so on, United States; so the
     3        same countries that have the high mortality from heart
     4        disease.  Now, it is not an absolute country to country
     5        identity in terms of risk but, in general, the countries
     6        which have high mortalities from heart disease also have
     7        high mortalities from breast, colon and prostate cancer.
     8
     9        I think the same is true if one looks at the migration
    10        evidence; that the migration evidence consistently shows
    11        that the population that moved to the United States of
    12        America or to Australia took on board the same risks for
    13        not just heart disease but also breast, colon and prostate
    14        cancer.  So, it is both the epidemiology and the migration
    15        data that have the same kind of feel to them.
    16
    17   Q.   You go on to say that prompts the question:  "What is the
    18        common denominator?" Then you say that science has not
    19        adequately addressed this question.  Is that because the
    20        association between diet and cancer is something that
         is -----
    22
    23   MR. JUSTICE BELL:  Ask him if he knows of a reason or has a
    24        view about why that is, rather than suggesting it to him.
    25        Let us see what he says.
    26
    27   THE WITNESS:  I think the reason is very simple -- there are
    28        two reasons; the first is that the cancer work has lagged
    29        very far behind in time scales of the cardiovascular
    30        disease studies.  I think our knowledge on cancer is sort
    31        of round about in parallel with what we knew about
    32        cardiovascular disease at the beginning of the, sort of,
    33        70s.  So it lags about two decades behind.
    34
    35        Secondly, I am afraid that both research councils and the
    36        specialisation in biomedical sciences and medicine as well
    37        tend to give people fairly specialised activities in
    38        mind.  It is just simply that this question has not been,
    39        to my knowledge at any rate, addressed as yet.
    40
    MS. STEEL:   The final paragraph on page 8, is that a theory
    42        you are propounding or is that a well established fact?
    43        A.  Well, it is well established that a principal cause
    44        from heart disease of death is the blood clot, the
    45        thrombus.  It is the thrombus that actually kills you.
    46        You can have quite severe atherosclerosis, but if you do
    47        not have a thrombus the blood will still flow, which is
    48        really what it boils down to.  So I think this is well
    49        established.
    50 
    51   MR. JUSTICE BELL:  Could I make sure I understand what you are 
    52        saying?  You say that science has not adequately addressed 
    53        the question of a common denominator for incidence of
    54        heart disease and mortality from cancer of the breast and
    55        colon?
    56        A.  Yes.
    57
    58   Q.   Are you saying that just no-one has carried out adequate
    59        research into the two together, or are you saying they
    60        have not carried on adequate research into the cause of