Dr RajkumarPatil<br />Asstt.Prof.,Community Medicine<br />AVMCH,Pondicherry<br />
Definition<br />A group of diseases characterized by : <br /><ul><li>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 remo...
II.<br />“Primary tumour” –<br />cancer in the organ of origin<br />“Secondary tumour”- <br />cancer that has spread to re...
Problem statement<br />Worldwide<br />22.4 million living with cancer<br />10 million diagnosed every year<br />6 million ...
Worldwide<br />INCIDENCE<br />Lung (12.3%)<br />Breast (10.4%)<br />Colorectal (9.3%)<br />MORTALITY<br />Lung (17.4%)<br ...
Gender wise (Person) distribution of Cancer<br />WORLD<br />Males (LSC)<br />Lung <br />Stomach<br />Colorectal<br />Femal...
Time trends<br /><ul><li>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</li></li></ul><li>Place distribution<br />Developed countries: lifestyle and dietary habits<...
Causes of cancer<br />I.Environmental factors<br /><ul><li>Tobacco
Alcohol: oesophageal ,liver cancer,rectal cancer
Dietary factors:</li></ul>Smoked fish-stomach cancer, beef-bowel cancer,high fat diet-breast cancer<br />Also food additiv...
Components of a cigarette<br />
Artificial sweetner (Saccharin)and bladder cancer<br />
Diseases associated with Tobacco<br />
Drugs causing Cancer<br />
OCPs and Breast Cancer<br />
Carcinogens in different occupations<br />
Immunosuppressive agents and cancer<br />
Radiations and cancer<br />
Infections and Cancer<br />
Schistosomiasis and bladder cancer<br />
Automobile emissions<br />
PAH exposure<br />
Industrial emissions<br />
Aflatoxins<br />
NHL in AIDS case<br />
Asbestos and lung cancer<br />
Textile dyeing exposure<br />
Chernobyl nuclear tragedy<br />
        II. Genetic Factors<br />1.Mutations in genes result <br />    in altered proteins<br /><ul><li>During cell division
External agents</li></ul>2. Most cancers result from<br />    mutations in somatic cells<br />3. Some cancers are caused b...
Cancer prevention and control More than 30% of cancer deaths can be preventedPrimary prevention<br />Control of tobacco an...
                           Primary prevention contd…<br />Cautious use of foods, drugs and cosmetics<br />Control of Air p...
Cancer education:Warning signs of cancer<br />
Secondary prevention<br />Cancer registration<br />Hospital-based registry<br />Population-based registry: <br />    Banga...
Cancer screening<br />Why screening is possible?<br />Precancerous or premalignant lesions<br />Localized lesions initiall...
Methods of cancer screening<br />Mass  screening of more than one site<br />                                              ...
Epidemiology of Oral cancer<br />Commonest cancer in India (70%)<br />90% of oral cancers due to tobacco <br />Alcohol<br ...
Oral Cancer<br />
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Epidemiology Of Cancer

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Epidemiology Of Cancer

  1. 1. Dr RajkumarPatil<br />Asstt.Prof.,Community Medicine<br />AVMCH,Pondicherry<br />
  2. 2. Definition<br />A group of diseases characterized by : <br /><ul><li>abnormal growth of cells
  3. 3. ability to invade adjacent tissues & even distant organs
  4. 4. the eventual death of the affected patient if the tumourhas progressed beyond that stage when it can be successfully removed </li></li></ul><li>Major categories of Cancer <br />I.<br />Carcinoma - arise from epithelial cells lining internal surfaces of various organs & from skin epithelium <br />Sarcoma- arise from mesodermal cells constituting various connective tissues<br />Lymphoma, myeloma & leukaemia- arise from cells of bone marrow & immune systems <br />
  5. 5. II.<br />“Primary tumour” –<br />cancer in the organ of origin<br />“Secondary tumour”- <br />cancer that has spread to regional lymph nodes and distant organs <br />
  6. 6. Problem statement<br />Worldwide<br />22.4 million living with cancer<br />10 million diagnosed every year<br />6 million deaths every year<br />India<br />2.5 million living with cancer<br />7 lakhdiagnosed every year<br />3.5 lakh deaths every year<br />
  7. 7. Worldwide<br />INCIDENCE<br />Lung (12.3%)<br />Breast (10.4%)<br />Colorectal (9.3%)<br />MORTALITY<br />Lung (17.4%)<br />Stomach (10.4%)<br />Liver (8.8%)<br />
  8. 8. Gender wise (Person) distribution of Cancer<br />WORLD<br />Males (LSC)<br />Lung <br />Stomach<br />Colorectal<br />Females (BCC)<br />Breast<br />Cervix<br />Colorectal <br />INDIA<br />Males<br />Oral <br />Oesophagus<br />Stomach<br />Trachea/ bronchus<br />Females<br />Cervix<br />Breast<br />Oral <br />Oesophagus<br />
  9. 9. Time trends<br /><ul><li>6th cause of death in the 1900s
  10. 10. 2ndcause of death in 2000 because of:
  11. 11. Increase in life expectancy
  12. 12. Better & accurate diagnosis
  13. 13. Increase in cigarette smoking</li></li></ul><li>Place distribution<br />Developed countries: lifestyle and dietary habits<br /> e.g. Ca lung, Ca breast, Ca colorectal<br />Developing countries: infective origin<br /> e.g. Ca Cervix, Ca Liver, Ca stomach<br />Ca stomach common in Japan, not in US<br />Ca Cervix more common in SEAR, not in Japan<br />
  14. 14. Causes of cancer<br />I.Environmental factors<br /><ul><li>Tobacco
  15. 15. Alcohol: oesophageal ,liver cancer,rectal cancer
  16. 16. Dietary factors:</li></ul>Smoked fish-stomach cancer, beef-bowel cancer,high fat diet-breast cancer<br />Also food additives & contaminants-suspicion as causative agents<br />Low fruit and vegetable intake<br />
  17. 17.
  18. 18. Components of a cigarette<br />
  19. 19. Artificial sweetner (Saccharin)and bladder cancer<br />
  20. 20. Diseases associated with Tobacco<br />
  21. 21. Drugs causing Cancer<br />
  22. 22. OCPs and Breast Cancer<br />
  23. 23. Carcinogens in different occupations<br />
  24. 24. Immunosuppressive agents and cancer<br />
  25. 25. Radiations and cancer<br />
  26. 26. Infections and Cancer<br />
  27. 27. Schistosomiasis and bladder cancer<br />
  28. 28. Automobile emissions<br />
  29. 29. PAH exposure<br />
  30. 30. Industrial emissions<br />
  31. 31. Aflatoxins<br />
  32. 32. NHL in AIDS case<br />
  33. 33. Asbestos and lung cancer<br />
  34. 34. Textile dyeing exposure<br />
  35. 35.
  36. 36. Chernobyl nuclear tragedy<br />
  37. 37. II. Genetic Factors<br />1.Mutations in genes result <br /> in altered proteins<br /><ul><li>During cell division
  38. 38. External agents</li></ul>2. Most cancers result from<br /> mutations in somatic cells<br />3. Some cancers are caused by<br /> mutations in germline cells<br />
  39. 39. Cancer prevention and control More than 30% of cancer deaths can be preventedPrimary prevention<br />Control of tobacco and alcohol consumption<br />Personal hygiene<br />Radiation protection<br />Occupational protection<br />Immunization: HPV,Hep.B<br />
  40. 40. Primary prevention contd…<br />Cautious use of foods, drugs and cosmetics<br />Control of Air pollution<br />Treatment of precancerous lesions<br />Legislation<br />Cancer education <br />
  41. 41.
  42. 42. Cancer education:Warning signs of cancer<br />
  43. 43. Secondary prevention<br />Cancer registration<br />Hospital-based registry<br />Population-based registry: <br /> Bangalore, Mumbai, Delhi, Chennai, Bhopal<br />Early detection of case: Screening<br />3. Treatment:Surgery,Radiotherapy,chemotherapy<br />4. Palliative care: Relief from pain <br /> and other problems <br />
  44. 44. Cancer screening<br />Why screening is possible?<br />Precancerous or premalignant lesions<br />Localized lesions initially<br />75% Of cancer are at accessible body sites<br />
  45. 45. Methods of cancer screening<br />Mass screening of more than one site<br /> (of cancer)<br />Mass screening at single site<br />Selective screening: high risk group<br />
  46. 46. Epidemiology of Oral cancer<br />Commonest cancer in India (70%)<br />90% of oral cancers due to tobacco <br />Alcohol<br />High risk groups: <br />tobacco smokers & chewers,<br />bidismokers, betel quid, tobacco quid<br />Cultural patterns:<br />Cigarttes,bidi,cigar,chilum,<br /> hookah(hubble-bubble),khaini,nasswar,snuff<br />Ca palate in Andhrapradesh: <br /> with habit of reverse smoking of cigar<br />
  47. 47.
  48. 48. Oral Cancer<br />
  49. 49. Leukoplakia<br />
  50. 50. Smoking in females<br />
  51. 51. Smoking in young population<br />
  52. 52. Prevention and control of oral cancer<br />1.Primary<br />Education,motivation,legislative<br />2.Secondary<br /><ul><li>Early case detection and treatment
  53. 53. Leukoplakia treatment:</li></ul>Cessation of tobacco use<br />Surgery<br />Radiotherapy<br />
  54. 54. Stomach Cancer<br />World’s 2nd most common cancer<br />1 million new cases/year<br />2/3 cases in developing countries<br />Most are adenocarcinoma<br />Causes:H.pyloriinf.,improper preservation of foods,smoked fish<br />Symptoms nonspecific<br />Diagnosis: barium x-ray,biopsy<br />Treatment:Surgery,chemotherapy<br />
  55. 55. Smoked fish and stomach Ca<br />
  56. 56. Thank you…<br />
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