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Epidemiology Of Cancer
 

Epidemiology Of Cancer

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    Epidemiology Of Cancer Epidemiology Of Cancer Presentation Transcript

    • Dr RajkumarPatil
      Asstt.Prof.,Community Medicine
      AVMCH,Pondicherry
    • Definition
      A group of diseases characterized by :
      • abnormal growth of cells
      • ability to invade adjacent tissues & even distant organs
      • the eventual death of the affected patient if the tumourhas progressed beyond that stage when it can be successfully removed
    • Major categories of Cancer
      I.
      Carcinoma - arise from epithelial cells lining internal surfaces of various organs & from skin epithelium
      Sarcoma- arise from mesodermal cells constituting various connective tissues
      Lymphoma, myeloma & leukaemia- arise from cells of bone marrow & immune systems
    • II.
      “Primary tumour” –
      cancer in the organ of origin
      “Secondary tumour”-
      cancer that has spread to regional lymph nodes and distant organs
    • Problem statement
      Worldwide
      22.4 million living with cancer
      10 million diagnosed every year
      6 million deaths every year
      India
      2.5 million living with cancer
      7 lakhdiagnosed every year
      3.5 lakh deaths every year
    • Worldwide
      INCIDENCE
      Lung (12.3%)
      Breast (10.4%)
      Colorectal (9.3%)
      MORTALITY
      Lung (17.4%)
      Stomach (10.4%)
      Liver (8.8%)
    • Gender wise (Person) distribution of Cancer
      WORLD
      Males (LSC)
      Lung
      Stomach
      Colorectal
      Females (BCC)
      Breast
      Cervix
      Colorectal
      INDIA
      Males
      Oral
      Oesophagus
      Stomach
      Trachea/ bronchus
      Females
      Cervix
      Breast
      Oral
      Oesophagus
    • Time trends
      • 6th cause of death in the 1900s
      • 2ndcause of death in 2000 because of:
      • Increase in life expectancy
      • Better & accurate diagnosis
      • Increase in cigarette smoking
    • Place distribution
      Developed countries: lifestyle and dietary habits
      e.g. Ca lung, Ca breast, Ca colorectal
      Developing countries: infective origin
      e.g. Ca Cervix, Ca Liver, Ca stomach
      Ca stomach common in Japan, not in US
      Ca Cervix more common in SEAR, not in Japan
    • Causes of cancer
      I.Environmental factors
      • Tobacco
      • Alcohol: oesophageal ,liver cancer,rectal cancer
      • Dietary factors:
      Smoked fish-stomach cancer, beef-bowel cancer,high fat diet-breast cancer
      Also food additives & contaminants-suspicion as causative agents
      Low fruit and vegetable intake
    • Components of a cigarette
    • Artificial sweetner (Saccharin)and bladder cancer
    • Diseases associated with Tobacco
    • Drugs causing Cancer
    • OCPs and Breast Cancer
    • Carcinogens in different occupations
    • Immunosuppressive agents and cancer
    • Radiations and cancer
    • Infections and Cancer
    • Schistosomiasis and bladder cancer
    • Automobile emissions
    • PAH exposure
    • Industrial emissions
    • Aflatoxins
    • NHL in AIDS case
    • Asbestos and lung cancer
    • Textile dyeing exposure
    • Chernobyl nuclear tragedy
    • II. Genetic Factors
      1.Mutations in genes result
      in altered proteins
      • During cell division
      • External agents
      2. Most cancers result from
      mutations in somatic cells
      3. Some cancers are caused by
      mutations in germline cells
    • Cancer prevention and control More than 30% of cancer deaths can be preventedPrimary prevention
      Control of tobacco and alcohol consumption
      Personal hygiene
      Radiation protection
      Occupational protection
      Immunization: HPV,Hep.B
    • Primary prevention contd…
      Cautious use of foods, drugs and cosmetics
      Control of Air pollution
      Treatment of precancerous lesions
      Legislation
      Cancer education
    • Cancer education:Warning signs of cancer
    • Secondary prevention
      Cancer registration
      Hospital-based registry
      Population-based registry:
      Bangalore, Mumbai, Delhi, Chennai, Bhopal
      Early detection of case: Screening
      3. Treatment:Surgery,Radiotherapy,chemotherapy
      4. Palliative care: Relief from pain
      and other problems
    • Cancer screening
      Why screening is possible?
      Precancerous or premalignant lesions
      Localized lesions initially
      75% Of cancer are at accessible body sites
    • Methods of cancer screening
      Mass screening of more than one site
      (of cancer)
      Mass screening at single site
      Selective screening: high risk group
    • Epidemiology of Oral cancer
      Commonest cancer in India (70%)
      90% of oral cancers due to tobacco
      Alcohol
      High risk groups:
      tobacco smokers & chewers,
      bidismokers, betel quid, tobacco quid
      Cultural patterns:
      Cigarttes,bidi,cigar,chilum,
      hookah(hubble-bubble),khaini,nasswar,snuff
      Ca palate in Andhrapradesh:
      with habit of reverse smoking of cigar
    • Oral Cancer
    • Leukoplakia
    • Smoking in females
    • Smoking in young population
    • Prevention and control of oral cancer
      1.Primary
      Education,motivation,legislative
      2.Secondary
      • Early case detection and treatment
      • Leukoplakia treatment:
      Cessation of tobacco use
      Surgery
      Radiotherapy
    • Stomach Cancer
      World’s 2nd most common cancer
      1 million new cases/year
      2/3 cases in developing countries
      Most are adenocarcinoma
      Causes:H.pyloriinf.,improper preservation of foods,smoked fish
      Symptoms nonspecific
      Diagnosis: barium x-ray,biopsy
      Treatment:Surgery,chemotherapy
    • Smoked fish and stomach Ca
    • Thank you…