Epidemiology Of Cancer
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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…