This presentation includes the following- Definition, Prevalence, Causes of cancer ,Cancer screening & Cancer prevention.

1. CANCERPresented By- Aastha Singh
MPH 3rd Sem
DPSRU Delhi

2. Contents
1) Definition of cancer
2) Prevalence of cancer
3) Causes of cancer
4) Cancer screening
5) Cancer prevention

3. Definition-
Cancer
A term for diseases in which abnormal cells divide
without control and can invade nearby tissues. Cancer
cells can also spread to other parts of the body through
the blood and lymph systems.

4. Thereare
severalmain
typesof cancer
▪ Carcinoma is a cancer that begins in the skin or in tissues that
line or cover internal organs.
▪ Sarcoma is a cancer that begins in bone, cartilage, fat, muscle,
blood vessels, or other connective or supportive tissue.
▪ Leukemia is a cancer that starts in blood-forming tissue, such
as the bone marrow, and causes large numbers of abnormal
blood cells to be produced and enter the blood.
▪ Lymphoma and multiple myeloma are cancers that begin in the
cells of the immune system.
▪ Central nervous system cancers are cancers that begin in the
tissues of the brain and spinal cord. Also called malignancy.

5. Processof
Cancer
Development

6. PREVALENCE

7. Prevalence of
CancerInthe
World
▪ Cancer is the second leading cause of death globally,
and is responsible for an estimated 9.6 million deaths in
2018. Globally, about 1 in 6 deaths is due to cancer.
▪ Approximately 70% of deaths from cancer occur in low-
and middle-income countries.
▪ Around one third of deaths from cancer are due to the 5
leading behavioral and dietary risks: high body mass
index, low fruit and vegetable intake, lack of physical
activity, tobacco use, and alcohol use.
▪ Tobacco use is the most important risk factor for cancer
and is responsible for approximately 22% of cancer
deaths

8. Continue..
THE MOST COMMON CANCERS ARE:
▪ Lung (2.09 million cases)
▪ Breast (2.09 million cases)
▪ Colorectal (1.80 million cases)
▪ Prostate (1.28 million cases)
▪ Skin cancer (non-melanoma) (1.04 million cases)
▪ Stomach (1.03 million cases)
THE MOST COMMON CAUSES OF CANCER
DEATH ARE CANCERS OF:
▪ Lung (1.76 million deaths)
▪ Colorectal (862 000 deaths)
▪ Stomach (783 000 deaths)
▪ Liver (782 000 deaths)
▪ Breast (627 000 deaths)

9. Prevalenceof
CancerInINDIA
Cancer Statistics in India
▪ Estimated number of people living with the disease:
around 2.25 million
▪ Every year, new cancer patients registered: Over 11,57,294
lakh
▪ Cancer-related deaths: 7,84,821
▪ Risk of developing cancer before the age of 75 years
Male: 9.81%
Female: 9.42%
Total deaths due to cancer in 2018
▪ Total: 7,84,821
▪ Men: 4,13,519
Women: 3,71,302
▪ Risk of dying from cancer before the age of 75 years is
7.34% in males and 6.28% in females.

10. Continue..
▪ One woman dies of cervical cancer every 8 minutes in
India
▪ For every 2 women newly diagnosed with breast
cancer, one woman dies of it in India
▪ Mortality due to tobacco use in India is estimated at
upwards of 3500 persons every day
▪ Tobacco (smoked and smokeless) use accounted for
3,17,928 deaths (approx) in men and women in 2018.
▪ Cancers of oral cavity and lungs account for over 25%
of cancer deaths in males and cancer of breast and oral
cavity account for 25% cancers in females

11. Thetopfivecancersinmenand
womenaccountfor47.2%ofall
cancers

12. BreastCancer
▪ Breast cancer is the most common cancer in women in
India and accounts for 14% of all cancers in women
Globocan 2018 data:
New cases registered: 1,62,468
Deaths: 87,090
▪ The incidence rates in India begin to rise in the early
thirties and peak at ages 50-64 years.
▪ Overall, 1 in 28 women is likely to develop breast
cancer during her lifetime.
▪ In urban areas, 1 in 22 women is likely to develop breast
cancer during her lifetime as compared to rural areas
where 1 in 60 women develops breast cancer in her
lifetime

13. CervicalCancer
▪ Cervical cancer is the second most common cancer in India in women
accounting for 22.86% of all cancer cases in women and 12% of all cancer
cases in both men and women
Globocan 2018 data
New cases registered: 96,922
Deaths: 60,078
▪ Median age: 38 years (age 21–67 years).
▪ Rural women are at higher risk of developing cervical cancer as compared to
their urban counterparts
▪ Cervical cancer is less common in Muslim than in Hindu women
▪ Cervical cancer is the third largest cause of cancer mortality in India
accounting for nearly 10% of all cancer related deaths in the country
▪ Survival rate
▪ The relative five year survival averages to 48.7%
▪ Length of survival depends on the cancer stage at the time of detection.
▪ The survival chance of a person becomes better if the cervical cancer is
detected and treated at earlier stages.Therefore it is important to avail of
cervical cancer screening.

14. OralCancer
Globocan 2018 data:
▪ Oral cancer is the most common cancer in India amongst men
(16.1 % of all cancers),
New cases registered: 92,011
▪ Oral cancer is the second most common cancer in India amongst
women (10.4 % of all cancers),
New cases registered: 1,19,992
Total number of deaths in men and women together : 72,616
▪ Around 80-90% of oral cancers are directly attributable to tobacco
use
▪ The mean age of oral cancer is 50 years
▪ The incident rate for oral cancer among females is significantly
higher than males.
▪ Survival rate (5-year)
▪ Patients with early stage oral cancer: 82%
Patients with advanced stages: 27%

15. Causesof cancer
1. 1. ENVIRONMENTAL FACTORS
2. 2. GENETIC FACTORS

16. ENVIRONMENTAL
FACTORS
▪ TOBACCO:Tobacco in various forms of its usage
(e.g.,smoking, chewing) is the major environmental cause
of cancers of the lung,larynx,mouth,pharynx,oesophagus,
bladder,pancreas and probably kidney. It has been
estimated that, in the world as a whole, cigarette smoking is
now responsible for more than one million premature
deaths each year
▪ ALCOHOL : Excessive intake of alcoholic beverages is
associated with oesophageal and liver cancer. Some recent
studies have suggested that beer consumption may be
associated with rectal cancer
▪ DIETARY FACTORS: Dietary factors are also related to
cancer. Smoked fish is related to stomach cancer, dietary
fibre to intestinal cancer, beef consumption to bowel
cancer and a high fat diet to breast cancer.
▪ A variety of other dietary factors such as food additives and
contaminants have fallen under suspicion as causative
agents.

17. ENVIRONMENTAL
FACTORS
▪ OCCUPATIONAL EXPOSURES :These include exposure
to benzene,arsenic,cadmium,chromium,vinyl chloride,
asbestos,polycyclic hydrocarbons,etc.
▪ PARASITES : Parasitic infections may also increase the
risk of cancer, as for example, schistosomiasis in Middle
East producing carcinoma of the bladder.
▪ CUSTOMS, HABITS AND LIFESTYLES :To the above
causes must be added customs, habits and lifestyles of
people which may be associated with an increased risk
for certain cancers.The familiar examples are the
demonstrated association between smoking and lung
cancer, tobacco and betel chewing and oral cancer, etc

18. ENVIRONMENTAL
FACTORS
▪ VIRUSES: An intensive search for a viral origin of human
cancers revealed that hepatitis B and C virus is causally related
to hepatocellular carcinoma.
▪ The relative risk of Kaposi's sarcoma occurring in patients with
HIV infection is so high that it was the first manifestation of the
AIDS epidemic to be recognized.
▪ Non-Hodgkin’s lymphoma, a cancer of the lymph nodes and
spleen is a late complication of AIDS.
▪ Cytomegalovirus (CMV) is a suspected oncogenic agent and
classical Kaposi’s sarcoma is associated with a higher
prevalence of antibodies to CMV.
▪ Human papiloma virus (HPV) is a chief suspect in cancer
cervix.
▪ OTHERS :There are numerous other environmental factors
such as sunlight, radiation, air and water pollution, medications
(e.g., oestrogen) and pesticides which are related to cancer

19. GENETICFACTORS
▪ Eg. - Retinoblastoma occurs in children of the same
parent.
▪ Mongols are more likely to develop cancer than normal
children
▪ Genetic factors are less conspicuous and more difficult
to identify. There is probably a complex
interrelationship between hereditary susceptibility and
environmental carcinogenic stimuli in the causation of a
number of cancers.

20. CANCER SCREENING
defined as the "search for unrecognized
malignancy by means of rapidly applied tests"

21. METHODSOF
CANCER
SCREENING
1. Mass screening by comprehensive cancer
detection examination: A rapid clinical examination,
and examination of one or more body sites by the
physician is one of the important approaches for
screening for cancer.
2. Mass screening at single sites :This comprises
examination of single sites such as uterine cervix,
breast or lung.
3. Selective screening :This refers to examination of
those people thought to be at special risk, for
example, parous women of lower socio-economic
strata upwards of 35 years of age for detection of
cancer cervix, chronic smokers for lung cancer, etc.

22. Screeningfor
lungcancer
▪ Two techniques for screening for lung cancer,
1) chest radiograph
2) sputum cytology

23. Screeningfor
breastcancer
1) breast self-examination (BSE) by the patient
2) palpation by a physician
3) thermography
4) mammography

24. CANCER PREVENTION
1. PRIMARY PREVENTION
2. SECONDARY PREVENTION

25. PRIMARY
PREVENTION
➢CONTROL OF TOBACCO AND ALCOHOL
CONSUMPTION- Primary prevention offers the greatest
hope for reducing the number of tobacco-induced and
alcohol related cancer deaths
➢PERSONAL HYGIENE- improvements in personal
hygiene may lead to declines in the incidence of
certain types of cancer, e.g., cancer cervix.
➢RADIATION: Special efforts should be made to reduce
the amount of radiation (including medical radiation)
received by each individual to a minimum without
reducing the benefits

26. PRIMARY
PREVENTION
➢OCCUPATIONAL EXPOSURES :The occupational
aspects of cancer are frequently neglected. Measures to
protect workers from exposure to industrial
carcinogens should be enforced in industries
➢IMMUNIZATION: In the case of primary liver cancer,
immunization against hepatitis B virus and for
prevention of cancer cervix immunization against HPV
presents an exciting prospect
➢FOODS, DRUGS AND COSMETICS:These should be
tested for carcinogens
➢AIR POLLUTION : Control of air pollution is another
preventive measure

27. PRIMARY
PREVENTION
▪ TREATMENT OF PRECANCEROUS LESIONS : Early
detection and prompt treatment of precancerous
lesions such as cervical tears, intestinal polyposis,
warts, chronic gastritis, chronic cervicitis, and
adenomata is one of the cornerstones of cancer
prevention.
▪ LEGISLATION- legislation to control known
environmental carcinogens (e.g., tobacco, alcohol, air
pollution)
▪ CANCER EDUCATION : An important area of primary
prevention is cancer education. It should be directed at
"high-risk" groups.The aim of cancer education is to
motivate people to seek early diagnosis and early
treatment.

28. ▪ Cancer organizations in many countries remind the public of
the early warning signs ("danger signals") of cancer.These
are:
1) a lump or hard area in the breast
2) a change in a wart or mole
3) a persistent change in digestive and bowel habits
4) a persistent cough or hoarseness
5) blood outside the usual dates
6) blood loss from any natural orifice
7) a swelling or sore that does not get better
8) unexplained loss of weight
DANGER
SIGNALS

29. SECONDARY
PREVENTION
▪ CANCER REGISTRATION- Cancer registration is
important for any cancer control programme. Cancer
registries are basically of two types
A. HOSPITAL BASED REGISTRIES:The hospital-based
registry includes all patients treated by a particular
institution, whether inpatients or out-patients
B. POPULATION-BASED REGISTRIES - aim is to cover the
complete cancer situation in a given geographic area

30. SECONDARY
PREVENTION
▪ EARLY DETECTION OF CASES- Effective screening
programmes have been developed for cervical· cancer,
breast cancer and oral cancer
▪ It is possible to increase the efficiency of screening
programmes by focusing on high-risk groups
▪ Early detection programmes will require mobilization
of all available resources and development of a cancer
infrastructure starting at the level of primary health
care, ending with complex cancer centres or institutions
at the state or national levels

31. SECONDARY
PREVENTION
▪ TREATMENT- Treatment facilities should be available to
all cancer patients.
▪ Certain forms of cancer are amenable to surgical
removal, while some others respond favourably to
radiation or chemotherapy or both.
▪ Since most of the known methods of treatment have
complementary effect on the ultimate outcome of the
patient, multi-modality approach to cancer control has
become a standard practice in cancer centres all over
the world

32. THANK YOU