The document provides an overview of cancer, detailing its definition, types, prevalence, risk factors, and approaches for prevention, detection, and treatment. It highlights the increase in cancer cases globally and in India, discusses environmental and genetic factors contributing to cancer, and emphasizes the importance of early detection through various screening methods. Furthermore, it outlines preventive measures and educational initiatives aimed at reducing incidence and improving treatment outcomes.

1. Dr. Animesh Gupta
MD,FDM,FAGE
Associate professor
Dept. of Community medicine, NMCH, Sasaram

2. ▪Group of diseases characterized by:
▪An abnormal growth of cells
▪Ability to invade adjacent tissues and even distant organs
▪The eventual death of affected patient if the tumor has
progressed beyond that stage when it can be successfully
removed
▪Cancer can occur at any site or tissue of the body and may
involve any type of cells.
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3. ▪ Increasing trend
▪ World
▪ Male – Lung, Stomach, Oesophagus, Liver
▪ Female - Breast, Cervix, Lung.
▪ India
▪ Male – Mouth/oropharynx, Oesophagus, Stomach, Lungs
▪ Female – Cervix, Breast, Mouth/oropharynx, Oesophagus
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4. ▪Sarcomas
▪arise from mesodermal cells constituting the various
connective tissues [e.g. fibrous tissue, fat and bone].
▪Carcinomas
▪arise from epithelial cells lining the internal surfaces of
various organs [e.g. mouth, oesophagus, intestine, uterus]
and from the skin epithelium.
▪Lymphomas, Myelomas, Leukaemias
▪arise from the cells of bone marrow and immune system.
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5. ▪Primary tumour” denotes cancer in the organ of origin,
▪Secondary tumour” denotes cancer that has spread to
regional lymph nodes and distant organs.
▪Benign – non cancerous and do not spread
▪Malignant – cancerous and spread to other tissue/ organ
via bloodstream or lymphatic
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6. Environmental
▪ Tobacco
▪ Alcohol
▪ Dietary Factors
▪ Occupational exposures
▪ Viruses
▪ Parasites
▪ Customs, habits, Lifestyles
▪ Others – sunlight, pollution, drugs
Genetic
▪ Retinoblastoma in Children
▪ Leukemia in Mongols
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7. ▪ Tobacco – cancers of lung, larynx, mouth, pharynx, oesophagus,
bladder, pancreas and probably kidney.
▪ Alcohol – excessive intake of alcoholic beverages is associated with
oesophageal and liver cancer.
▪ Dietary Factors – smoked fish related to stomach cancer, beef
consumption to bowel cancer, and high fat diet to breast cancer.
▪ Food additives & contaminants have fallen under suspicion as
causative agents.
▪ Occupational Exposure – exposure to benzene, arsenic, asbestos etc.
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8. ▪ Viruses –
▪ Hepatitis B and C virus related to hepatocellular carcinoma
▪ Kaposi’s sarcoma related to HIV infection
▪ EBV related to Burkitt’s lymphoma
▪ Parasites
▪ Schistosomiasis related to bladder cancer
▪ Customs, habits, life styles
▪ tobacco & betel chewing with oral cancers, smoking with lung
cancers.
▪ Others
▪ Sunlight, radiation, air and water pollution, medications, pesticides.
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9. ▪Genetic factors have long been suspected.
▪Retinoblastoma occurs in children of the same parents.
Mongols are more likely to develop leukaemia than
normal children.
▪There is a complex interrelationship between hereditary
susceptibility & environmental carcinogenic stimuli in the
causation of a number of cancers
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12. ▪Consists of series of measures based on
✓present medical knowledge
✓in the fields of prevention, detection, diagnosis, treatment,
after care and rehabilitation
✓aimed at reducing significantly the no. of new cases,
increasing the no. of cures and reducing the invalidism due to
cancer
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13. Primary Prevention
▪ Control of tobacco & alcohol
consumption
▪ Personal Hygiene
▪ Radiation
▪ Occupational Exposures
▪ Immunization
▪ Foods & drugs
▪ Air pollution
▪ Treatment of precancerous lesion
▪ Legislation
▪ Cancer Education
Secondary Prevention
▪ Cancer Registration
▪ Hospital based registries
▪ Population based registries
▪ Early detection of cases
▪ Treatment
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14. ▪Treatment of precancerous lesion
▪Leukoplakia, Erythroplakia
▪Intestinal polyposis
▪Cervical tears, genital warts
▪Legislation
▪COTPA
▪The Air (Prevention & Control of Pollution) Act
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15. ▪Cancer education
▪It is directed at high risk groups.
▪The aim of cancer education is to motivate people to seek
early diagnosis & early treatment.
▪Cancer organizations remind the public of early warning
signs [danger signals] of cancer
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16. ▪ A lump or a hard area in breast
▪ A change in wart or mole
▪ A persistent change in bowel habits
▪ A persistent cough or hoarseness
▪ Excessive loss during menstrual periods or loss of blood
outside usual dates.
▪ Blood loss from any natural orifice
▪ A swelling that does not get better
▪ Unexplained loss of weight
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17. ▪ C – Change in Bowel or Bladder habit
▪ A – A sore that does not heal
▪ U – Unusual bleeding or discharge
▪ T – Thickening or lump in the breast or elsewhere
▪ I – Indigestion or difficulty in swallowing
▪ O – Obvious change in wart or mole
▪ N – Nagging cough or hoarseness
▪ S – Significant weight loss (more than 10%)
Source: American Cancer Society
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18. Early detection of cases
▪ Cancer screening is the main weapon
for early detection of cases at a pre-
invasive or pre-malignant stage.
▪ It has to be conducted on a large
scale.
▪ It requires mobilization of all
available resources and development
of a cancer infrastructure starting at
the level of primary health care,
ending with complex cancer centers
or institutions at the state or national
levels.
Treatment
▪ Treatment facilities should be
available to all cancer patents.
▪ Certain forms of cancer are
amenable to surgical removal, while
some respond to radiation or
chemotherapy or both.
▪ For those who are beyond the curable
stage, goal must be to provide pain
relief.
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19. Hospital Based
▪ All patients treated by a
particular institution
included and is
considerable value in
evaluation of diagnostic &
treatment programmes.
Population Based
▪ To cover complete cancer situation in a
geographical area.
▪ Size – 2 to 7 million
▪ It provide the incidence rate of cancer
& serve as a useful tool for initiating
▪ Epidemiological enquiries into causes
of cancer,
▪ Surveillance of time trends,
▪ Planning & evaluation of operational
activities in all main areas of cancer
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Cancer- Introduction, Control & Screening Dr. Animesh Gupta

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21. ▪ It means the “search for unrecognized malignancy by means of
rapidly applied tests”.
▪ It is possible because
▪ Precancerous or premalignant lesions
▪ malignant disease is preceded for a period of months or years by
a pre-malignant lesion
▪ Localized lesions initially
▪ most cancers begin as localised lesions
▪ 75% of cancers are at accessible body sites
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22. Selective
screening
Mass
screening of
single site
Mass
screening by
comprehens
ive cancer
detection
examination
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23. ▪ 21 to 29Years Old
▪ Start getting Pap tests at age 21.
▪ If Pap test result is normal, then wait three years for next Pap test.
▪ 30 to 65Years Old
▪ Pap test
If result is normal, then wait three years for next Pap test.
▪ HPV test (primary HPV testing)
If result is normal, wait five years for next screening test.
▪ HPV test along with the Pap test (co-testing)
If both results are normal, wait five years for next screening test.
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24. ▪ Older Than 65
▪ No need to be screened anymore if —
▪ Screening test results was normal for several years, or
▪ Cervix removed (total hysterectomy for non-cancerous conditions, like
fibroids)
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26. ▪ Breast self examination (BSE)
▪ Only feasible approach to wide population coverage
▪ Once a month after 20 years of age
▪ Recommend for raising awareness among women at risk rather than
as a screening method.
▪ Palpation by physician / Clinical Breast examination (CBE)
▪ Once in every 3 years after 30 years of age
▪ Thermography
▪ Not sensitive tool
▪ Not exposed to radiation
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29. ▪ Most sensitive & specific
▪ Best available population-based method to detect breast
cancer at an early stage
▪ Recommended after 35 years of age
▪ Limitation / Drawbacks
▪ Exposure to low dose of radiation
▪ Requires technical equipment along with experienced
Radiologist
▪ Difficult to interpret in younger woman (dense breast tissue -
more glands and ligaments)
▪ False positive or not accurate all the time. 4/29/2020
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30. ▪Chest radiograph
▪Sputum cytology
▪Low-dose Spiral CT Scan (LDCT scan)
▪Series of very detailed pictures of areas inside the Lung
▪Indications
▪ Aged 55 to 74 years and in fairly good health, and
▪ Currently smoke or have quit within the past 15 years, and
▪ Have at least a 30-pack-year smoking history, and
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31. Cancer Screening test / Tumor marker
Colorectal cancer Colonoscopy, Sigmoidoscopy, Fecal
occult blood test, Barium enema
Prostate cancer Prostate specific antigen (PSA) test
Digital rectal examination
Hepatocellular carcinoma Alpha- fetoprotein (AFP)
Germ Cell tumor Human Chorionic gonadotropin
(HCG)
Pancreatic CA19-9 antigen
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33. ThankYou
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