This document summarizes cancer epidemiology in Saudi Arabia based on data from the Saudi Cancer Registry. It finds that:
1) In 2007, there were 12,309 new cancer cases reported in Saudi Arabia, with an overall age-adjusted incidence rate of 82.1 per 100,000 people.
2) The most common cancers among Saudi males were breast cancer, followed by colon cancer and non-Hodgkin's lymphoma. The most common cancers among Saudi females were breast cancer, thyroid cancer, and colon cancer.
3) Cancer incidence rates varied by region, with the highest rates in Riyadh, Tabuk, and the Eastern regions, and the lowest in Madinah.
This document summarizes a study on cervical cancer prevalence at King Abdulaziz University Hospital. The study aimed to estimate HPV prevalence in cervical cancer cases and identify the most common histological type. It found that 167 cases were identified, with squamous cell carcinoma being the most frequent at 83%. Adenocarcinoma represented 7.7% of cases. Few other studies in Saudi Arabia found HPV DNA in 31.6-89% of cervical cancer cases. The study concluded that cervical cancer frequency and histological types at KAUH were generally consistent with literature, though keratinizing and non-keratinizing types were similar prevalence locally.
(1) This study evaluated outcomes of 60 cervical cancer patients treated with concurrent chemoradiotherapy including high-dose-rate brachytherapy at a single institution in Saudi Arabia. (2) The 2- and 4-year overall survival rates were 82% and 79% respectively, with prolonged overall treatment time and low pretreatment hemoglobin negatively impacting survival. (3) The 2- and 4-year disease-free survival rates were 80% and 69% respectively, with vaginal extension being the only significant factor for relapse.
Human papillomavirus (HPV) is implicated in several cancers including cervical cancer. A study of 174 cervical cancer patients in Saudi Arabia found that 83% were HPV-positive, with HPV-16 and HPV-18 being the most common genotypes detected, together representing 80% of HPV infections. While cervical cancer incidence is low in Saudi women, HPV vaccination may prevent over three-quarters of cervical cancers. However, a national HPV vaccination program may not be cost-effective given the already low incidence of cervical cancer in the country. HPV is also associated with other cancers and vaccination may help reduce cases if shown to be effective against additional cancer types.
This document provides information about cancer epidemiology and burden globally and in Egypt. It discusses that cancer is characterized by uncontrolled growth and spread of abnormal cells, which is caused by external and internal factors. It then provides details on cancer rates, definitions, and statistics for assessing cancer burden for different populations. Specifically for Egypt, it shares data on estimated new cancer cases and cancer deaths in 2012 and projected for 2020, finding increases expected due to demographic changes. Overall, the document analyzes global and local cancer incidence, mortality and prevalence data.
Cancer epidemiology is the study of cancer occurrence and distribution in human populations. Some key points from the document include:
- The earliest known descriptions of cancer come from ancient Egyptian medical texts from 3000-1500 BC.
- Important historical discoveries in cancer epidemiology include linking tobacco smoking to lung cancer in 1950 and occupations like chimney sweeping to scrotum cancer in 1775.
- Common sources of cancer epidemiology data include registries like SEER in the US and IARC internationally, which provide statistics on incidence, mortality, survival rates.
- Cancer risk varies based on age, sex, race, and other demographic factors. Globally, lung cancer is the most commonly diagnosed cancer while breast
Introduction to cancer epidemiology basics mr es021012Portobellochris
This document discusses key concepts in cancer epidemiology including definitions, incidence, mortality, survival rates, and prevalence. It provides statistics on cancer occurrences and outcomes in the UK. Some key points made are that cancer incidence is increasing, about 320,000 new cases are diagnosed in the UK annually, and survival rates have been improving over time for most cancers though the UK still lags behind some of Europe. Cancer epidemiology helps inform how cancer services, research, and education are organized across large populations.
This document discusses cancer screening for seniors and whether it makes sense. It notes that reasons not to screen everyone include costs, potential harms from false positives or procedures, and factors related to life expectancy and health status. It provides examples of famous people who died of pancreatic cancer and notes that screening for pancreatic cancer is not recommended. It asks questions about the most common cancers, typical cancer ages, beneficial screening tests, and best screening advice. It discusses stopping screening at age 75 but continuing for those expected to live 10 more years. It provides resources on cancer screening guidelines.
This document summarizes a study on cervical cancer prevalence at King Abdulaziz University Hospital. The study aimed to estimate HPV prevalence in cervical cancer cases and identify the most common histological type. It found that 167 cases were identified, with squamous cell carcinoma being the most frequent at 83%. Adenocarcinoma represented 7.7% of cases. Few other studies in Saudi Arabia found HPV DNA in 31.6-89% of cervical cancer cases. The study concluded that cervical cancer frequency and histological types at KAUH were generally consistent with literature, though keratinizing and non-keratinizing types were similar prevalence locally.
(1) This study evaluated outcomes of 60 cervical cancer patients treated with concurrent chemoradiotherapy including high-dose-rate brachytherapy at a single institution in Saudi Arabia. (2) The 2- and 4-year overall survival rates were 82% and 79% respectively, with prolonged overall treatment time and low pretreatment hemoglobin negatively impacting survival. (3) The 2- and 4-year disease-free survival rates were 80% and 69% respectively, with vaginal extension being the only significant factor for relapse.
Human papillomavirus (HPV) is implicated in several cancers including cervical cancer. A study of 174 cervical cancer patients in Saudi Arabia found that 83% were HPV-positive, with HPV-16 and HPV-18 being the most common genotypes detected, together representing 80% of HPV infections. While cervical cancer incidence is low in Saudi women, HPV vaccination may prevent over three-quarters of cervical cancers. However, a national HPV vaccination program may not be cost-effective given the already low incidence of cervical cancer in the country. HPV is also associated with other cancers and vaccination may help reduce cases if shown to be effective against additional cancer types.
This document provides information about cancer epidemiology and burden globally and in Egypt. It discusses that cancer is characterized by uncontrolled growth and spread of abnormal cells, which is caused by external and internal factors. It then provides details on cancer rates, definitions, and statistics for assessing cancer burden for different populations. Specifically for Egypt, it shares data on estimated new cancer cases and cancer deaths in 2012 and projected for 2020, finding increases expected due to demographic changes. Overall, the document analyzes global and local cancer incidence, mortality and prevalence data.
Cancer epidemiology is the study of cancer occurrence and distribution in human populations. Some key points from the document include:
- The earliest known descriptions of cancer come from ancient Egyptian medical texts from 3000-1500 BC.
- Important historical discoveries in cancer epidemiology include linking tobacco smoking to lung cancer in 1950 and occupations like chimney sweeping to scrotum cancer in 1775.
- Common sources of cancer epidemiology data include registries like SEER in the US and IARC internationally, which provide statistics on incidence, mortality, survival rates.
- Cancer risk varies based on age, sex, race, and other demographic factors. Globally, lung cancer is the most commonly diagnosed cancer while breast
Introduction to cancer epidemiology basics mr es021012Portobellochris
This document discusses key concepts in cancer epidemiology including definitions, incidence, mortality, survival rates, and prevalence. It provides statistics on cancer occurrences and outcomes in the UK. Some key points made are that cancer incidence is increasing, about 320,000 new cases are diagnosed in the UK annually, and survival rates have been improving over time for most cancers though the UK still lags behind some of Europe. Cancer epidemiology helps inform how cancer services, research, and education are organized across large populations.
This document discusses cancer screening for seniors and whether it makes sense. It notes that reasons not to screen everyone include costs, potential harms from false positives or procedures, and factors related to life expectancy and health status. It provides examples of famous people who died of pancreatic cancer and notes that screening for pancreatic cancer is not recommended. It asks questions about the most common cancers, typical cancer ages, beneficial screening tests, and best screening advice. It discusses stopping screening at age 75 but continuing for those expected to live 10 more years. It provides resources on cancer screening guidelines.
This document discusses the use of radiosurgery, specifically CyberKnife, for gastrointestinal (GI) tumours. It provides an overview of common GI cancers such as liver, pancreatic and colorectal cancers. It then discusses various treatment options for these cancers including surgery, chemotherapy, radiotherapy, radiosurgery, stereotactic body radiation therapy and targeted therapies. It focuses on the use of CyberKnife for treatment of liver tumours such as hepatocellular carcinoma and liver metastases. Key benefits of CyberKnife highlighted are its precision, ability to track tumour motion, and delivery of high radiation doses in a short course of treatment.
Understanding how intermittent fasting may not only help weight loss but have multiple other health benefits including life prolongation, preventing cancer and dementia
This document discusses cancer prevention and screening. It provides information on lifestyle and environmental factors that can increase cancer risk, such as smoking, obesity, alcohol consumption, certain chemicals and radiation. Maintaining a healthy diet, being physically active, avoiding tobacco and excessive sun exposure can help prevent some cancers. Screening guidelines and key websites for cancer information are also listed. The document emphasizes that prevention through modifying risk factors is the best approach to reducing the cancer burden.
5th Annual Early Age Onset Colorectal Cancer - Session VI: Palliative Care: Why Early is Best Including Guidance, Support and Resources to Patients and Caregivers During Their Treatment Journey/Continuum of Care. Epigenetics and its Future Role in the Diagnosis and Treatment of Individuals More Specifically and Accurately.
This document outlines a research protocol to study the psychosocial predictors and mitigation of problems among diabetes clients. The study aims to determine psychosocial factors that influence patients' ability to learn diabetes self-care and aims to improve quality of life by conducting an education program. Psychosocial factors like depression are known to interfere with diabetes management. The study rationale is that knowledge about diabetes is low in Nepal and complications are high, so there is a need for diabetes education. The implications are that psychosocial support from nurses and specialists can improve outcomes for diabetes patients.
This document provides information on cancer prevention and screening strategies. It discusses overall prevention approaches, strategies for specific cancers like breast and lung, and where to find screening guidelines. Key websites for cancer prevention and statistics are listed. The document discusses estimating cancer risk based on lifestyle factors like diet, exercise and smoking. It provides cancer statistics in the US and probabilities of developing different cancers. Screening is recommended only when proven beneficial and cost-effective. Healthy lifestyle choices can significantly reduce cancer and other disease risks.
This case study evaluated the effectiveness of adding cetuximab to radiotherapy for the treatment of squamous-cell carcinoma of the head and neck. 424 patients were randomly assigned to receive radiotherapy alone or radiotherapy plus cetuximab. The study found that combining cetuximab with radiotherapy significantly increased both the duration of control of locoregional disease and overall survival rates compared to radiotherapy alone, with a 32% reduced risk of locoregional progression and a 26% reduced risk of death. Common adverse effects of cetuximab included rash and hypersensitivity reactions.
This document debunks 25 common myths about breast cancer. Some key facts presented include:
- Breast cancer is the most common cancer in women worldwide and the leading cause of cancer death in women. The global burden will continue increasing to over 19 million new cases per year by 2025.
- While genetics play a role, lifestyle factors like obesity, lack of exercise, alcohol consumption, and reproductive/hormonal factors account for the majority of breast cancer cases.
- Regular self-exams and mammograms can help detect lumps early. Early detection does not guarantee a pain-free process but does increase chances of successful treatment.
- While not a complete cure, treatment which may include surgery
This document provides information about breast cancer and prostate cancer. It discusses the types, stages, risk factors, symptoms, diagnosis, and treatment of breast cancer. It also discusses statistics on breast cancer worldwide and in Guyana. For breast cancer in men, it covers what it is, signs and symptoms, and how it is diagnosed and treated. Prostate cancer is also briefly introduced.
Rush Radiosurgery presents the American Cancer Society Facts and Figures 2013 annual report outlining the estimated numbers of new cancer cases and deaths in 2013 as well as current cancer incidence, mortality, and survival statistics and information on cancer symptoms, risk factors, early detection, and treatment.
Anal dysplasia: Diagnosis and Management, OR Everything you ever wanted to kn...CBRC
Screening, treatment and prevention of Anal
Intraepithelial Neoplasia (AIN) Presented by Joel Palefsky, UCSF School of Medicine, San Francisco at the 5th Annual Gay Men's Health Summit held in Vancouver, BC on November 9th and 10th, 2009.
YCN Breast Educational Meeting 2015 -Network breast data-Geoff HallJay Naik
This document discusses using data from the Patient Pathway Manager (PPM) database to analyze breast cancer outcomes and patterns of recurrence over time. It analyzed data on 1,000 breast cancer patients diagnosed between 1999-2002, following them through 2012 to record survival rates, progression-free survival, and time to recurrence. The data showed declining survival rates with each subsequent recurrence. The document proposes expanding PPM to integrate additional data sources to better analyze comorbidities and their impact on cancer outcomes. This would allow more comprehensive study of topics like how diabetes affects outcomes for different cancer types.
Alterations of the genes involved in the PI3K and estrogen-receptor pathways ...Enrique Moreno Gonzalez
Chemotherapy with trastuzumab is widely used for patients with human epidermal growth
factor receptor 2-positive (HER2+) breast cancer, but a significant number of patients with
the tumor fail to respond, or relapse. The mechanisms of recurrence and biomarkers that indicate the response to the chemotherapy and outcome are not fully investigated.
This document discusses cancer in general and in India. It defines cancer and describes the major categories. Worldwide, over 10 million new cancer cases and 6 million cancer deaths occur annually. The most common cancers worldwide are lung, breast, and colorectal cancers. In India, the most common cancers are oral, esophageal, stomach and lung cancers in men and breast, cervical, oral, and esophageal cancers in women, largely due to tobacco use. Environmental factors like tobacco, alcohol, diet, occupation, and viruses can increase cancer risk. Genetic factors also play a role. Cancer control involves prevention, early detection, treatment and rehabilitation. Breast cancer is the most common cancer in women worldwide. Cervical cancer is
This document discusses cancer statistics in the Gulf region. It finds that average annual cancer incidence rates from 1998-2007 were similar for males and females in GCC countries at 79.3 per 100,000 population. The highest incidence was among Qatar women at 172.2 per 100,000, while the lowest was Saudi women at 71.2 per 100,000. Cancer rates increase dramatically with age in all Gulf countries. Most cancers in the GCC are diagnosed at late stages, indicating a need for improved early detection efforts.
This document discusses liver cancer rates in the Arab world. It finds that liver cancer incidence has tripled over the last three decades. The majority of new cancer cases and deaths occur in less developed regions like the Arab world. Hepatitis B and C are major risk factors and their high prevalence in the Arab world helps explain the region's high liver cancer rates. For example, Egypt has very high rates of hepatitis C and over 90% of its liver cancers are associated with the virus. The document calls for increased regional cooperation through a Pan Arab hepatocellular carcinoma group to address the growing challenge of liver cancer in the Arab world.
This study analyzed data from the Saudi Cancer Registry from 1999-2008 to summarize the incidence and histopathological types of Malignant Ovarian Germ Cell Tumors (MOGCTs) in Saudi Arabia. The results showed that MOGCTs accounted for 13.8% of all ovarian tumors and the most common histopathological types were dysgerminoma (41.1%), malignant teratoma (25.1%), and yolk sac tumor (18.3%). The incidence of different histopathological subtypes in Saudi Arabia was generally similar to international populations, with 74.3% of MOGCT cases occurring in patients aged 0-24 years. This highlights the importance of further studying these tumors which commonly affect
Pelvic floor dysfunction can cause uterine prolapse, where the uterus descends from its normal position. There are three degrees of uterine prolapse: first degree involves descent below the ischial spine but not reaching the vaginal opening, second degree has the cervix visible at the vaginal opening, and third degree or procidentia means the entire uterus protrudes outside the vaginal opening. Management of pelvic organ prolapse includes treating any underlying causes, conservative options like Kegel exercises or pessaries, and surgical procedures such as anterior colporrhaphy.
Neha is a Chartered Accountant with over 2.5 years of experience in accounting and taxation. She is currently working as an Associate Tax Consultant at KPMG Global Services where her responsibilities include maintaining client portfolios, preparing tax computations and returns, analyzing financial statements, and ensuring compliance. Previously she worked as a Revenue Analyst at Oracle India where she assisted with contract processing and ensured stakeholder expectations were met. She is pursuing an M.Com and has strong communication, analytical, and teamwork skills.
L'Atlante è una raccolta aperta di materiali documentari, scelti dal MIBACT, georiferiti. Utile per le valutazioni di impatto, le commissioni paesaggistiche, il dibattito sui progetti e il turista curioso.
This document discusses the use of radiosurgery, specifically CyberKnife, for gastrointestinal (GI) tumours. It provides an overview of common GI cancers such as liver, pancreatic and colorectal cancers. It then discusses various treatment options for these cancers including surgery, chemotherapy, radiotherapy, radiosurgery, stereotactic body radiation therapy and targeted therapies. It focuses on the use of CyberKnife for treatment of liver tumours such as hepatocellular carcinoma and liver metastases. Key benefits of CyberKnife highlighted are its precision, ability to track tumour motion, and delivery of high radiation doses in a short course of treatment.
Understanding how intermittent fasting may not only help weight loss but have multiple other health benefits including life prolongation, preventing cancer and dementia
This document discusses cancer prevention and screening. It provides information on lifestyle and environmental factors that can increase cancer risk, such as smoking, obesity, alcohol consumption, certain chemicals and radiation. Maintaining a healthy diet, being physically active, avoiding tobacco and excessive sun exposure can help prevent some cancers. Screening guidelines and key websites for cancer information are also listed. The document emphasizes that prevention through modifying risk factors is the best approach to reducing the cancer burden.
5th Annual Early Age Onset Colorectal Cancer - Session VI: Palliative Care: Why Early is Best Including Guidance, Support and Resources to Patients and Caregivers During Their Treatment Journey/Continuum of Care. Epigenetics and its Future Role in the Diagnosis and Treatment of Individuals More Specifically and Accurately.
This document outlines a research protocol to study the psychosocial predictors and mitigation of problems among diabetes clients. The study aims to determine psychosocial factors that influence patients' ability to learn diabetes self-care and aims to improve quality of life by conducting an education program. Psychosocial factors like depression are known to interfere with diabetes management. The study rationale is that knowledge about diabetes is low in Nepal and complications are high, so there is a need for diabetes education. The implications are that psychosocial support from nurses and specialists can improve outcomes for diabetes patients.
This document provides information on cancer prevention and screening strategies. It discusses overall prevention approaches, strategies for specific cancers like breast and lung, and where to find screening guidelines. Key websites for cancer prevention and statistics are listed. The document discusses estimating cancer risk based on lifestyle factors like diet, exercise and smoking. It provides cancer statistics in the US and probabilities of developing different cancers. Screening is recommended only when proven beneficial and cost-effective. Healthy lifestyle choices can significantly reduce cancer and other disease risks.
This case study evaluated the effectiveness of adding cetuximab to radiotherapy for the treatment of squamous-cell carcinoma of the head and neck. 424 patients were randomly assigned to receive radiotherapy alone or radiotherapy plus cetuximab. The study found that combining cetuximab with radiotherapy significantly increased both the duration of control of locoregional disease and overall survival rates compared to radiotherapy alone, with a 32% reduced risk of locoregional progression and a 26% reduced risk of death. Common adverse effects of cetuximab included rash and hypersensitivity reactions.
This document debunks 25 common myths about breast cancer. Some key facts presented include:
- Breast cancer is the most common cancer in women worldwide and the leading cause of cancer death in women. The global burden will continue increasing to over 19 million new cases per year by 2025.
- While genetics play a role, lifestyle factors like obesity, lack of exercise, alcohol consumption, and reproductive/hormonal factors account for the majority of breast cancer cases.
- Regular self-exams and mammograms can help detect lumps early. Early detection does not guarantee a pain-free process but does increase chances of successful treatment.
- While not a complete cure, treatment which may include surgery
This document provides information about breast cancer and prostate cancer. It discusses the types, stages, risk factors, symptoms, diagnosis, and treatment of breast cancer. It also discusses statistics on breast cancer worldwide and in Guyana. For breast cancer in men, it covers what it is, signs and symptoms, and how it is diagnosed and treated. Prostate cancer is also briefly introduced.
Rush Radiosurgery presents the American Cancer Society Facts and Figures 2013 annual report outlining the estimated numbers of new cancer cases and deaths in 2013 as well as current cancer incidence, mortality, and survival statistics and information on cancer symptoms, risk factors, early detection, and treatment.
Anal dysplasia: Diagnosis and Management, OR Everything you ever wanted to kn...CBRC
Screening, treatment and prevention of Anal
Intraepithelial Neoplasia (AIN) Presented by Joel Palefsky, UCSF School of Medicine, San Francisco at the 5th Annual Gay Men's Health Summit held in Vancouver, BC on November 9th and 10th, 2009.
YCN Breast Educational Meeting 2015 -Network breast data-Geoff HallJay Naik
This document discusses using data from the Patient Pathway Manager (PPM) database to analyze breast cancer outcomes and patterns of recurrence over time. It analyzed data on 1,000 breast cancer patients diagnosed between 1999-2002, following them through 2012 to record survival rates, progression-free survival, and time to recurrence. The data showed declining survival rates with each subsequent recurrence. The document proposes expanding PPM to integrate additional data sources to better analyze comorbidities and their impact on cancer outcomes. This would allow more comprehensive study of topics like how diabetes affects outcomes for different cancer types.
Alterations of the genes involved in the PI3K and estrogen-receptor pathways ...Enrique Moreno Gonzalez
Chemotherapy with trastuzumab is widely used for patients with human epidermal growth
factor receptor 2-positive (HER2+) breast cancer, but a significant number of patients with
the tumor fail to respond, or relapse. The mechanisms of recurrence and biomarkers that indicate the response to the chemotherapy and outcome are not fully investigated.
This document discusses cancer in general and in India. It defines cancer and describes the major categories. Worldwide, over 10 million new cancer cases and 6 million cancer deaths occur annually. The most common cancers worldwide are lung, breast, and colorectal cancers. In India, the most common cancers are oral, esophageal, stomach and lung cancers in men and breast, cervical, oral, and esophageal cancers in women, largely due to tobacco use. Environmental factors like tobacco, alcohol, diet, occupation, and viruses can increase cancer risk. Genetic factors also play a role. Cancer control involves prevention, early detection, treatment and rehabilitation. Breast cancer is the most common cancer in women worldwide. Cervical cancer is
This document discusses cancer statistics in the Gulf region. It finds that average annual cancer incidence rates from 1998-2007 were similar for males and females in GCC countries at 79.3 per 100,000 population. The highest incidence was among Qatar women at 172.2 per 100,000, while the lowest was Saudi women at 71.2 per 100,000. Cancer rates increase dramatically with age in all Gulf countries. Most cancers in the GCC are diagnosed at late stages, indicating a need for improved early detection efforts.
This document discusses liver cancer rates in the Arab world. It finds that liver cancer incidence has tripled over the last three decades. The majority of new cancer cases and deaths occur in less developed regions like the Arab world. Hepatitis B and C are major risk factors and their high prevalence in the Arab world helps explain the region's high liver cancer rates. For example, Egypt has very high rates of hepatitis C and over 90% of its liver cancers are associated with the virus. The document calls for increased regional cooperation through a Pan Arab hepatocellular carcinoma group to address the growing challenge of liver cancer in the Arab world.
This study analyzed data from the Saudi Cancer Registry from 1999-2008 to summarize the incidence and histopathological types of Malignant Ovarian Germ Cell Tumors (MOGCTs) in Saudi Arabia. The results showed that MOGCTs accounted for 13.8% of all ovarian tumors and the most common histopathological types were dysgerminoma (41.1%), malignant teratoma (25.1%), and yolk sac tumor (18.3%). The incidence of different histopathological subtypes in Saudi Arabia was generally similar to international populations, with 74.3% of MOGCT cases occurring in patients aged 0-24 years. This highlights the importance of further studying these tumors which commonly affect
Pelvic floor dysfunction can cause uterine prolapse, where the uterus descends from its normal position. There are three degrees of uterine prolapse: first degree involves descent below the ischial spine but not reaching the vaginal opening, second degree has the cervix visible at the vaginal opening, and third degree or procidentia means the entire uterus protrudes outside the vaginal opening. Management of pelvic organ prolapse includes treating any underlying causes, conservative options like Kegel exercises or pessaries, and surgical procedures such as anterior colporrhaphy.
Neha is a Chartered Accountant with over 2.5 years of experience in accounting and taxation. She is currently working as an Associate Tax Consultant at KPMG Global Services where her responsibilities include maintaining client portfolios, preparing tax computations and returns, analyzing financial statements, and ensuring compliance. Previously she worked as a Revenue Analyst at Oracle India where she assisted with contract processing and ensured stakeholder expectations were met. She is pursuing an M.Com and has strong communication, analytical, and teamwork skills.
L'Atlante è una raccolta aperta di materiali documentari, scelti dal MIBACT, georiferiti. Utile per le valutazioni di impatto, le commissioni paesaggistiche, il dibattito sui progetti e il turista curioso.
Intervento di Oriol Porcel (Direttore Recep) al convegno "Il paesaggio per: strategie al tempo della crisi per abitare meglio sempre". Torino, 10 dicembre 2010.
Min presentation på webbdagarna i Malmö den 14/11-2011. E-handel är mycket svårare än du tror. Det är dags att vi börjar prata sanning om ehandeln i Sverige.
Every individual who comes to us will find the team at Driven Properties to be passionate about real estate dubai.
http://www.drivenproperties.ae/real-estate-dubai
O documento fornece dois links para vídeos no Vimeo que mostram exemplos do PHOTOJOJO, um serviço de fotografia online que permite aos usuários adicionar efeitos visuais e filtros às suas fotos.
Божевілля: : причини, молекулярні механізми, методи відтворення та профілактикиVictor Dosenko
Що знають вчені про психічні захворювання? Чому "таргани" регулярно заводяться в мозку людини? Генетичні та епігенетичні механізми виникнення наркоманії, шизофренії, маніакально-депресивного психозу та інших патологій.
From Good to Great: Rethinking Skanska's global intranetIntranätverk
Presented by Hanna Karppi from Skanska at Intranätverk 2016: Malmö, 29 september.
- Focusing on usability: User’s needs as source of inspiration and development
- Leveraging on being a global company: Encouraging knowledge sharing and collaboration
- Leading business critical change process involving multiple countries and units
Key take-aways:
- How to lead a successful implementation project
- How to focus on the user and organizational needs
- Implementing digital workplace step by step
Scania - global och digital arbetsplatsIntranätverk
Presenterad av Karin Gustavsson på Intranätverk 2016: Göteborg den 26 maj.
I slutet av 2014 initierade Scania projektet att skapa ett nytt, globalt intranät. Det innebär många och stora utmaningar, inte minst mot bakgrunden att man försöker möta både centrala och lokala behov, med användare i över 100 länder. Karin kommer också att berätta om hur Scania med en best-of-breed-lösning skapar en modern plattform som ska stötta kunskapsöverföring och interaktion, och skapa värde för användare över hela världen.
El documento describe el Modelo OSI y el Modelo TCP/IP. El Modelo OSI fue desarrollado por la ISO para facilitar la interoperabilidad entre redes, y consta de 7 capas que describen las funciones de red. El Modelo TCP/IP, desarrollado para Internet, consta de 4 capas y combina algunas capas del Modelo OSI. Ambos modelos son importantes para entender cómo viaja la información a través de una red.
Suresh Kumar Bandi is applying for a relevant position in the Process Safety and Engineering department. He has 10 years of experience in process safety and engineering activities in his previous roles at Divi's Laboratories Ltd and Laurus Labs Ltd. He is seeking a senior position in a well-established organization where he can take on creative and challenging assignments with responsibility and sincerity. He has included his resume detailing his academic qualifications and technical experience evaluating chemical processes for hazards, implementing process safety, and solving issues related to crystallization, scale-up, and solvent recovery.
This document discusses cancer statistics in the Gulf region. It notes that cancer incidence is expected to rise significantly in coming decades globally and in the Eastern Mediterranean region specifically. The Gulf Center for Cancer Registration was established in 1998 to collect cancer data across GCC states and monitor trends over time through measures like incidence, prevalence, and age-standardized rates. Analysis of GCCR data from 1998-2007 shows the total number of cancer cases reported by nationality and distribution of cancer extent at diagnosis across the GCC states.
This document provides an overview of cancer including its causes, diagnosis, treatment and prevention. It discusses that cancer is caused by genetic mutations that disrupt normal cell growth and can be due to factors such as viruses, radiation, chemicals and heredity. The diagnosis of cancer involves tissue biopsies, imaging tests and tumor marker tests to determine the cancer type and stage. Treatment may include surgery, radiation therapy, chemotherapy and targeted therapies to cure early stage cancer or control later stage cancer. Screening tests can help detect some cancer types early when they are more likely to be cured. Prevention strategies include avoiding risk factors, vaccinations, chemoprevention and healthy behaviors.
Cancer remains a leading cause of death in the US. While cancer death rates have declined, incidence rates are increasing for some cancers. Lung cancer is the leading cause of cancer death among men and women. African Americans have higher death rates than whites for several cancers. Survival rates are lower for African Americans compared to whites for many cancers.
Breast Cancer in Lebanon: overview and statistical dataNajla El Bizri
Breast cancer is the most common cancer in Lebanese women, accounting for over one third of all cancers in females. The age-specific rates are typical of low-risk countries, with a peak incidence around menopause at age 50. Some districts have seen significant increases in breast cancer incidence rates in recent years. Strong risk factors include family history, inherited genetic mutations, and previous breast cancer diagnosis. Moderate risk factors include breast density on mammograms and prior biopsy abnormalities. Other risk factors include reproductive history, hormone exposure, obesity, alcohol use, and other cancers.
CANCER, LINKING CANCER WITH ITS RISK FACTORS, A STUDY CONDUCTED IN NRS MEDICA...Naushad Alam
Cancer is a dreadful disease.But like any other disease it depends on certain risk factors which predisposes certain people to have it and certain people to not have it.This slide shows details of a project undertaken by 20 medical students of the reputed Nil Ratan Sircar Medical College of Kolkata, so as to understand cancer and associate it with its risk factors. This study has been conducted in NRS itself selecting various groups of cancer and non cancer patients with varying pathologies.This project attempts to establish the fact that simple lifestyle modifications may reduce your chances of actually acquring Cancer.Simple changes in diet like avoiding junk food can actually lower the risk of getting Colon Cancer. So please go through the slides so as to get a perspective of the disease and what simple measures can be taken, on your behalf to avoid it.
This document discusses the epidemiology of cancer globally and in Nepal. Some key points:
- Cancer is a leading cause of death worldwide, responsible for 1 in 8 deaths. Incidence and mortality are increasing, especially in developing countries.
- Major risk factors for cancer include tobacco use, chronic infections, alcohol, diet, obesity, radiation, and genetic factors.
- In Nepal, the most common cancers are lung, oral, stomach, and cervical cancers. The highest burden is in the BPKIHS region.
- Prevention strategies include reducing exposure to risk factors, screening programs, and early detection and treatment. Molecular epidemiology uses biomarkers to better understand cancer causes and prognosis.
This document discusses cancer, including what cancer is, risk factors, screening, and treatment. It provides the following key points:
1. Cancer is a set of diseases in which abnormal cells multiply uncontrollably and spread, forming tumors. There are many types of cancer including carcinoma, sarcoma, lymphoma, and leukemia.
2. Risk factors for cancer include tobacco use, diet, alcohol use, physical inactivity, obesity, genetic factors, environmental toxins, ultraviolet radiation, infectious agents, stress, depression, and childhood adversity.
3. Cancer screening tests can help detect cancers early and reduce cancer deaths for certain types of cancer like breast, cervical, colorectal, and lung cancers.
This document discusses lung cancer and colon cancer in Taiwan. It provides statistics on the top 10 cancers by incidence and mortality rates in Taiwan in 2012. For lung cancer, it notes that most cases are discovered at late stages. It also discusses lung cancer survival rates by stage. For colon cancer, it provides statistics on case numbers and percentages by clinical, pathological and stage at diagnosis. It further discusses a screening study comparing the diagnostic follow-up of positive tests between low-dose CT and chest radiography for lung cancer screening.
Estadísticas del Cáncer: Un análisis detallado sobre su incidencia y impacto ...FabrizzioJamancaAgue
The document discusses cancer statistics globally and in different countries. It notes that approximately 10 million new cancer cases are diagnosed worldwide each year, with 6 million cancer deaths. The most common cancers vary by sex and level of development - lung, breast, prostate and colon cancers are among the most frequent. Factors like infections, lifestyle, and environment contribute to higher rates of specific cancers in certain regions. Obesity, diet and tobacco are leading causes of cancer worldwide.
This document discusses cancer prevention and screening. It provides statistics on the cancer burden worldwide and in India. The most common cancer sites in India are oral cavity, lungs, esophagus and stomach in males, and cervix, breast and oral cavity in females. Tobacco-related and cervical cancers account for a large number of new cases and deaths annually in India. Over 70% of cancer cases in India present at advanced stages. The document outlines various screening guidelines and programs for common cancers, including breast self-examination, clinical breast exam, visual inspection with acetic acid for cervical cancer, and screening recommendations for oral, prostate, lung and colorectal cancers. It discusses the objectives and methodology of community-based screening camps in India
This study analyzed cancer mortality patterns over 14 years at a teaching hospital in Lagos, Nigeria. A total of 1436 cancer deaths were recorded out of 30,287 total deaths. The male to female ratio of cancer deaths was 1:2.2. The peak age of death was 51-60 years. Breast cancer accounted for the most cancer deaths at 25.6% of the total. The study aims to provide data on cancer mortality patterns in Nigeria where data is limited, and recommends increased screening for early detection and reduction of mortality.
This document summarizes a hospital seminar presentation on cancer incidence in Borno State, Nigeria. It discusses that cancer is a major public health problem worldwide and in Africa. Data from cancer registries in Nigeria show increasing cancer incidence over time, with female cancers like breast and cervical cancer being most common. The presentation recommends establishing a national cancer institute, improving cancer screening and diagnostics, and increasing research collaborations to address the growing cancer burden in Nigeria.
Testicular cancer is one of the most curable cancers, with a 5-year survival rate now over 95% due to improved treatments. It typically affects young men between puberty and age 35. Successful treatment involves radical orchiectomy, chemotherapy, and sometimes radiation or retroperitoneal lymph node dissection. A radical orchiectomy surgically removes the testicle and is the standard treatment for suspected testicular cancer based on findings such as a painless testicular mass. While scrotal violations during surgery were once thought to worsen prognosis, evidence now suggests this is not the case if there is no tumor spillage.
Introduction .
Statics.
Risk factors.
survival rate.
Staging , Grading.
Special investigations.
WHO Classification .
Most common Benign and Malignant salivary gland Tumors
Clinical presentation and prognosis.
Surgical Treatment .
Summary.
Salivary gland tumors account for 2% to 6.5% of all head and neck neoplasms, are more common in female with a peak incidence in their 60s and 70s, but can occur in all age groups.
The majority of neoplasms occur in the parotid, and pleomorphic adenoma is the most common benign tumor and mucoepidermoid carcinoma the most common malignant tumor.
Irregular margins, bony invasions, the presence of metastatic lymph nodes and perineural spread can all be signs of malignancy.
Necrosis can also characterize malignancy.
Benign tumors were more common than malignant ones.
The prevalent benign tumor was PA, and the prevalent malignant tumors were ACC and MEC.
The smaller the gland more likely that a mass is malignant.
This document discusses cancer risks associated with hereditary cancer syndromes like BRCA1/2 mutations and HNPCC. It provides lifetime risk percentages for various cancers in mutation carriers compared to the general population. It describes screening and prevention strategies like surveillance, chemoprevention, and prophylactic surgery that can reduce cancer risk. Genetic testing considerations and the importance of informing at-risk relatives is also covered.
Demonstrate the essential risk factors for developing cancer, and the predisposing factors for cancer.
Demonstrate a map of the prevalence of cancer throughout the world
Demonstrate how can we prevent the occurrence of cancer, by avoiding the predisposing risk factors.
Demonstrate the practical recommendation to avoid cancer
Cancer Awareness - Kaplan University Dept. of Public Healthsmtibor
Cancer awareness, including general definitions, detection, prevention, treatment, and risk factors. Emphasis on skin and prostate cancers and at-risk populations.
This document discusses cancer incidence and mortality rates around the world. It notes that there are approximately 10 million new cancer cases diagnosed worldwide each year and 6 million cancer deaths. The most common cancers vary by region, with lung, colon, breast and prostate cancers being among the most common globally. Cancer rates also differ between developed and developing countries, with infections linked to some cancers in developing areas. Lifestyle factors like diet, tobacco use and physical activity are major contributors to cancer risk.
Cancer rates are higher in countries with very high Human Development Index (HDI) scores compared to countries with low HDI scores. The age-standardized rate of all cancers was 2.5 times higher in very high HDI countries than in low HDI countries. Similarly, rates of most individual cancer types, such as breast cancer and prostate cancer, were higher in very high HDI nations. However, cervical cancer and liver cancer rates were higher in low HDI countries. Tobacco use, diet, environmental factors, and lifestyle habits contribute to higher cancer risks in more developed countries with long lifespans and prosperous economies according to the HDI.
This document provides information about colorectal cancer, including:
- Colorectal cancer is the third leading cause of cancer death in Colombia. Survival rates are much lower in Colombia than the US.
- Risk factors include diet high in fat and low in fiber, obesity, inflammatory bowel disease, family history, and hereditary syndromes.
- Hereditary syndromes associated with colorectal cancer include Lynch syndrome, familial adenomatous polyposis (FAP), and MUTYH-associated polyposis (MAP).
- Diagnosis involves screening via colonoscopy to detect polyps which can be removed to prevent cancer development. Staging determines cancer extent and guides treatment.
This document summarizes stem cell research projects conducted by Dr. Mohammad Abbas at King Abdulaziz University. It outlines 5 research groups: 1) Isolation and characterization of bone marrow mesenchymal stem cells from osteoarthritis patients, 2) Effect of heat shock on bone marrow MSCs from OA patients, 3) Evaluation of ex-vivo cartilage regeneration using MSCs from OA patients, 4) Impact of MSCs impregnated with cartilage paste on repairing cartilage defects in rabbits, and 5) Impact of a hyaluronic acid scaffold impregnated with MSCs and cartilage paste on surgically induced arthritis in rabbits. Additional research includes studies on the effects of catecholamines and NSAIDs
This document outlines the establishment of a stem cell research chair at King Abdulaziz University from 2009-2015. It begins with the author attending a knee surgery course in 2009 where he learned about cartilage regeneration techniques. He then proposed creating a research chair to RACI in 2010, which involved a lengthy approval process. He built up a research team of professors and clinicians from various specialties. Research projects focused on isolating and characterizing mesenchymal stem cells, cartilage regeneration, and animal studies on rabbits. The chair fulfilled regulatory requirements like submitting annual reports and had an organizational structure to oversee the research groups.
Bone marrow mesenchymal stem cells (BM-MSCs) and cartilage fragments were evaluated for their ability to enhance cartilage formation in an ex-vivo osteochondral defect model. BM-MSCs alone, cartilage fragments alone, or a combination of BM-MSCs and cartilage fragments were seeded into osteochondral defects. The combination of BM-MSCs and cartilage fragments showed improved cartilage formation and defect filling compared to BM-MSCs or cartilage fragments alone, as seen on histological and biochemical analysis. The results suggest that a combination of BM-MSCs and cartilage fragments may provide a more effective approach for cartilage repair.
The document describes a study that used whole-exome sequencing to identify novel genetic variations associated with osteoarthritis (OA) patients. Several variations were found in genes involved in cartilage development, extracellular matrix organization, and inflammatory/immune responses. Two novel mutations were validated by Sanger sequencing, including a mutation in the SELP gene and another in the COL6A6 gene. The approach identified variations in genes impacting pathways relevant to OA pathogenesis.
This study investigated the effects of heat from an arthroscope on human bone marrow-derived mesenchymal stem cells (hBMMSCs). hBMMSCs were isolated from osteoarthritis patients and exposed to heat from an illuminated arthroscope for various time periods as single cell suspensions or cell pellets. Cell suspensions exposed to heat showed decreased viability over time, while cell pellets maintained or increased viability. Gene expression analysis found increased expression of heat shock and inflammatory genes in cell suspensions compared to pellets after heat exposure. The results suggest that transplanting hBMMSCs as cell pellets may better protect them from heat effects during arthroscopic procedures and thus support cartilage regeneration.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document provides an agenda and speaker information for a 3-day international colposcopy workshop taking place in Jeddah, Saudi Arabia from January 12-14, 2014. The workshop will focus on cervical cancer prevention, advances in understanding HPV, and management of lower genital tract diseases. It will include lectures, hands-on training, and case reviews led by experts from Europe, Canada, and Saudi Arabia. The goal is to train participants and raise awareness of cervical cancer screening and prevention methods.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document summarizes the stages of human development from dust, to sperm and egg, to embryo, to fetus, and finally to a child that reaches maturity. It notes that some people die early while others live to a very old age, having gone through the full cycle of knowledge and then forgetting. It also describes how the earth appears barren but grows diverse plants when watered, relating this to human development from simple beginnings. The summary conveys the key points about human origins and development and the cycle of life in a concise three sentences.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
The document discusses how God created humans from dust, then a sperm-drop, then a clinging clot, and then a lump of flesh to show how He develops humans. It notes that God determines the term people will stay in the womb, then brings them out as children to reach maturity. It also mentions that some people die early while others live to a very old age. The document ends by describing how the earth appears barren but grows beautiful plants when watered.
This document discusses treatment approaches for early stage cervical cancer. It notes that for invasive cervical cancers measuring less than 2 cm, removal of the parametrium may be omitted. For some very small tumors, pelvic lymphadenectomy can also be omitted as the risk of lymph node metastasis is limited. It also discusses outcomes from vaginal trachelectomy and laparoscopic pelvic lymphadenectomy for early stage cancers. The document considers conservative treatment approaches for stage IA2-IB1 cancers less than 3 cm in size, including a proposed study design stratifying patients based on tumor diameter.
Adenocarcinoma in situ (AIS) is the only known precursor to cervical adenocarcinoma. Appropriate management of AIS can prevent invasive adenocarcinoma in many cases. Cytology has lower sensitivity for detecting AIS compared to HPV testing. The usual interval between detectable AIS and invasive adenocarcinoma is at least 5 years, allowing time for screening and intervention. Glandular neoplasms account for about 25% of annual cervical cancer diagnoses. Management of AIS typically involves conization, though hysterectomy is the standard treatment due to the high risk of residual disease with conization alone. HPV testing can help monitor women with AIS who wish to preserve fertility after
This document discusses vulvar and vaginal diseases. It begins with anatomical considerations of the vulva and describes various benign and infectious vulvar lesions. It then discusses non-neoplastic epithelial disorders of the vulva and classifications of vulvar dermatological disorders. The document provides details on various vulvar diseases including lichen sclerosus and pigmented lesions. It concludes with a brief section on vaginal intraepithelial neoplasia.
This document summarizes key findings about HPV natural history and HPV testing for cervical cancer screening. It was found that HPV infection is very common but rarely leads to cancer. While persistent HPV infection can cause cervical cancer after 10-15 years, many cofactors are also involved in cancer development. Studies showed that HPV becomes undetectable within 2 years for most women. HPV testing was found to detect more pre-cancer than pap smears but also detected more lesions that may regress. HPV testing allows longer screening intervals for HPV-negative women and better protection against cancer compared to pap smears alone. While HPV testing is more effective, implementing new screening strategies poses challenges where pap smear systems are already in place.
1) The document discusses the HPV vaccine and summarizes data from clinical trials of the Cervarix and Gardasil vaccines. It finds that Cervarix demonstrated 93.2% efficacy against CIN3+ lesions irrespective of HPV type, while Gardasil demonstrated 43.0% efficacy against the same endpoint.
2) Long-term follow up data of the Cervarix vaccine showed sustained high antibody levels and protection against CIN3+ lesions up to 9 years post-vaccination. Challenge studies found Cervarix elicited an anamnestic response.
3) Both vaccines were well tolerated and showed cross-protection against non-vaccine HPV types. However, Cervarix demonstrated higher long
4 prof james bently management guidelines 2014Tariq Mohammed
This document provides guidelines for colposcopy management from the IFCCP Jeddah Jan 2014 conference and the ASCCP Management Guidelines 2012 and SOGC SCC Colposcopy Guidelines 2012. It discusses recommendations and algorithms for evaluating and managing various abnormal cytology results and histological findings identified during colposcopy, including ASCUS, LSIL, ASC-H, HSIL, AGC, cervical intraepithelial neoplasia grades, and other conditions. Management may involve repeat testing, colposcopy, biopsy, excisional procedures, or return to routine screening depending on the abnormality, risk level, and other factors.
Genital HPV is very common, with a lifetime risk of 70% for HPV infection and 10% for genital warts. Spontaneously, genital warts resolve in 20-30% of cases within 3 months. Biopsy is usually not required for healthy women under 35 years old with typical genital warts. Treatment choices depend on factors like patient preference, provider experience, and pregnancy status. Combination therapies may be used. Even after treatment, the latent virus remains, with a 30% recurrence rate of warts and potential for transmission to partners.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
4. • The study of the factors affecting cancer, as a way to
infer possible trends and causes.
• The study of cancer epidemiology uses epidemiological
methods to find the cause of cancer and to identify and
develop improved treatments.
5. • This area of study must contend with
problems of
• lead time bias
• length time bias.
6.
• Lead time bias is the concept that early
diagnosis may artificially inflate the
survival statistics of a cancer, without
really improving the natural history of
the disease.
7. • Length bias is the concept that slower
growing, more indolent tumors are more likely to be
diagnosed by screening tests, but improvements in
diagnosing more cases of indolent cancer may not
translate into better patient outcomes after the
implementation of screening programs.
8. • A similar epidemiological concern is overdiagnosis,
the tendency of screening tests to diagnose diseases
that may not actually impact the patient's longevity.
This problem especially applies to prostate cancer
and PSA screening.
• Some cancer researchers have argued that negative
cancer clinical trials lack sufficient statistical power
to discover a benefit to treatment.
9.
• Observational epidemiological studies that show
associations between risk factors and specific
cancers mostly serve to generate hypotheses
• Randomized controlled trials then test whether
hypotheses generated by epidemiological studies
and laboratory research actually result in reduced
cancer incidence and mortality.
• Programmatic trials.
10. Robert A. Weinberg, "If we lived long enough, sooner or later we all
would get cancer."[10]
• Over a third of cancer deaths worldwide are due to potentially
modifiable risk factors
§ Tobacco smoking, lung cancer, mouth, and throat cancer;
§ Drinking alcohol, oral, esophageal, breast, and other cancers;
§ A diet low in fruit and vegetables,
§ Physical inactivity, colon, breast,
§ Obesity, is associated with colon, breast, endometrial
§ Sexual transmission of human papillomavirus, which causes
cervical cancer &anal cancer.
11.
• Men with cancer are twice as likely as women to have a
modifiable risk factor .[11]
• lifestyle and environmental factors known to affect
cancer risk .
• use of exogenous hormones (e.g.,
hormone replacement therapy causes breast cancer)
• exposure to ionizing radiation and ultraviolet radiation,
and certain occupational and chemical exposures.
12.
• Every year, at least 200,000 people die worldwide from
cancer related to their workplace.[12]
• Millions of workers run the risk of developing cancers
such as pleural and peritoneal mesothelioma from
inhaling asbestos fibers, or leukemia from exposure to
benzene .[12]
• It is estimated that approximately 20,000 cancer deaths
and 40,000 new cases of cancer each year in the U.S. are
attributable to occupation.[13]
13.
14. • The Saudi Cancer Registry (SCR) of Saudi Arabia is
a population-based registry established in 1992
under the the Ministry of Health (MOH) by the
order of His Excellency the Minister of Health.
• The SCR commenced reporting cancer cases from
01 January 1994.
15. Objec'ves:
• The primary goal of the SCR is to define the
population-based incidence of cancer in Saudi
Arabia. Additional objectives include programs
for early detection and cancer screening, as well
as cancer research projects.
18. Cancer report Total reporting
cancer cases
Estimated
population at
K S A
Absolute
incidence
1994-‐1996
23092
14089156
54.36
per
1000000
1997-‐1998
14529
15121791
48.03
per
1000000
1999-‐2000
14856
15588805
47.06
per
1000000
2001
5616
16056470
34.72
per
1000000
2002
5876
15612781
37.63
per
1000000
2003
8840
16109198
54.78
per
1000000
2004
9381
16527340
56.76
per
1000000
2005
10513
16945484
62.47
per
1000000
2006
11040
17270181
63.92
per
1000000
2007
12,309
17493364
70.63
per
1000000
24. § The total number of cancer incident cases reported to
the SCR was 12,309.
§ Overall cancer was slightly more among women than
men.
§ Cancers affected 5,982 (48.6%) males and 6,321
(51.4%) females with a male to female ratio of 95:100.
§ 9,347 cases were reported among Saudis,
§ 2,590 among Non-Saudis.
25. • 11,651 cases were analyzed, of which
9,124 (78.3%) were Saudis and 2,527
(21.7%) were Non-Saudis.
Among the Saudis
• 4,351 (47.7%) were male
• 4,773 (52.3%) were female.
• The male to female ratio
• was 91:100.
47%
53%
proportion
Males
Female
26. Confirmation of Diagnosis of
malignancy
• Histologically in 86.2% of the cases.
• Haematological & cytologically in 8% of cases.
• Clinically confirmed cases were 0.3%.
• Radiologically confirmed cases were 2%.
• Cases confirmed by Death Certificate Only were
2.7% .
• The method of diagnosis was unknown for 0.8%
of the cases.
28. 47
48
49
50
51
52
53
total
Men
Women
CIR
CIR per
100,000
Total 52.3%
Men 49.4 %
women 51.5%
29. Age adjusted rate (ASR) of all cancers
among Saudi Population
77
78
79
80
81
82
83
84
85
Total
Men
Women
ASR
ASR per
100,000
Total 82.1
Men 80
women 84.2
30. The age-specific incidence
rate (AIR) increased with
age for gender.
After the age of 64 years,
the increase was nearly one
and one half fold for males
compared to females.
The median age at diagnosis
is was 59 years for men and
50 years for women
31. § Riyadh Region
108.5/100,000
§ Tabuk Region
105.0/100,000
§ Eastern Region
104.4/100,000
§ Makkah Region
89.3/100,000
§ Madinah Region
73.8/100,000.
0
20
40
60
80
100
120
ASR
ASR
32.
33.
34.
35. Percentage
distribu'on
of
most
frequent
type
of
cancer
by
gender
2007
age
(0-‐14
year)Saudi
children
84. Summary Of Primary Preventive
Actions
Prospects seem bright for ultimately preventing many
cancers. There is already much that can be done:
1. Quit smoking and use of tobacco in any from, and
encourage all nonusers not to start (especially the young).
2. Stop alcohol.
3. Control exposures to known carcinogens in the
workplace.
4. Reduce exposures outside the workplace to known
carcinogens such as arsenic, chromium, nickel, vinyl
chloride, and asbestos.
85. 5.
Restrict use of drugs that are known/suspected to be
carcinogenic.
6. Prudent use of diagnostic x-rays.
7. Avoid excess exposure to sunlight, especially for fair
skinned persons, and encourage use of protective
creams and sunscreen.
8. Avoid giving estrogens to pregnant women. Use the
lowest dose necessary and include a progestin in the
regimen.
Summary Of Primary Preventive
Actions
86. 5.
Restrict use of drugs that are known/suspected to be
carcinogenic.
6. Prudent use of diagnostic x-rays.
7. Avoid excess exposure to sunlight, especially for fair
skinned persons, and encourage use of protective
creams and sunscreen.
8. Avoid giving estrogens to pregnant women. Use the
lowest dose necessary and include a progestin in the
regimen.
Summary Of Primary Preventive
Actions
88. SCREENING AND 2 RY PREVENTION
• By means of early detection followed by
definitive treatment.
• Screening is one component of early
detection Secondary prevention can be
achieved only if there is a stage of that
cancer that is amenable to cure, and if
there are means of detecting the cancer
at that stage.
89. Natural history of a disease over time, including the pre-
clinical stage in which a screening test can detect the
presence of disease.
A screening test can identify
diseased individuals before
Detection by routine diagnosis
(Occurance of symptoms).
Treatment at the time of
detection by screening, as
opposed to the time of routine
diagnosis, results in an
improved chance of survival.
Biologic onset
of disease
Disease detectable
by screening
Detection by
Screening test
Detectable by
routine methods
Death
treatment
90. The clinical decision-making is
based on probability.
Probability of breast cancer (percent)
0 20 40 60 80 100
Before
mammogram
After positive
mammogram
After positive
FNA results
0.3 13 64
Diagnostic test (screening test) is to move the estimated
probability of the presence of a disease toward either end
of probability scale, thereby providing information that
will alter subsequent diagnostic or treatment plans.
91. Bias in Screening
lead-time bias
DNAdamage
Cancerbegins
Cancer
firstscreendetectable
Lead
time
Death
Patient diagnosed from clinical symptoms
Apparent survival
Apparent survivalPatient diagnosed by screening
Lead
time
Lead time bias is an increase in survival as measured
From detection of disease to death, without lengthening of life.
92. Advanced Uses of Screening Tests
-To Determine the probability that a disease is
present’
-To assess the severity of an illness’
-To predict the disease outcome’
-To monitor response to therapy’
-To estimate the probability of an outcome.
94. Evaluation of a Diagnostic Test.
Truth (gold standard)
Test results
(Screening
test)
No diseaseDisease
b
False-positive
Non diseased+
positive test
a
True positive
Disease present
+test positive
Positive
d
True negative
Non diseased with
negative test
c
False-
negative
Have the disease
with negative test
results
Negative
95. Evaluation of a Diagnostic Test.
Sensitivity and Specificity
Sensitivity and specificity are descriptors of
the accuracy of a test.
The sensitivity of a test is defined as the percentage
of persons with the disease of interest who have
positive test results: few false positive
Sensitivity = X 100
= a/a + c X100 = 14/14+1 X100 = 93 %
True positives
True positive+ false negatives
96. Evaluation of a Diagnostic Test.
Sensitivity and Specificity
Specificity of a test is defined as the percentage
of persons without the disease of interest who
have negative test results
It is the ability of the test to rule out the non-
diseased few false negative
Specificity = X 100
= d /d + b X 100
= 91/91+8 X100 = 92 %
True negatives
True negatives + false-positives
98. Positive and Negative Predictive Value
Two measures concerning the estimation of the
probability of the presence or absence of
disease are the positive predictive value (PV+)
and the negative predictive value (PV-).
The PV+ is defined as the percentage of who
actually have the disease of interest to persons
with positive test results (allow us to estimate
how likely it is the disease of interest is present
if the test is positive).
PV+= X 100
= a/a + b X100 = 14/ 14+8 X100 = 64 %
True positives
True positives +false positives
99. Positive and Negative Predictive
Value
The PV- is defined as the percentage of who do
not have the disease of interest to persons with
negative test results :
PV- = X 100
= d/ d + c X100
= 91 /91+1 X100 = 99 %
True negatives
True negatives + false negatives
101. Likelihood Ratios
An LR+ of 1, indicates a test of no value in sorting
out persons with and without disease.
The larger the LR+more than 1 , the stronger the
association between having a positive test
result and having the disease.
LR+ of more than 10 is an indication of a test of
high diagnostic value.
The smaller the LR- value, the better the
diagnostic value of the test.
An LR- of 0.1 or less is an indication of a good
diagnostic test.
102. 1.
WHO
Disease
and
injury
country
esHmates".
World
Health
OrganizaHon.
2009.
hMp://www.who.int/healthinfo/global_burden_disease/esHmates_country/en/
index.html.
Retrieved
Nov.
11,
2009.
2. Brawley
OW
(2004).
"Prostate
cancer
screening:
clinical
applicaHons
and
challenges".
Urol.
Oncol.
22
(4):
353–7.
doi:10.1016/j.urolonc.2004.04.014.
PMID
15283896.
3. Bedard
PL,
Krzyzanowska
MK,
PinHlie
M,
Tannock
IF
(2007).
"StaHsHcal
power
of
negaHve
randomized
controlled
trials
presented
at
American
Society
for
Clinical
Oncology
annual
meeHngs".
J.
Clin.
Oncol.
25
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3482–7.
doi:
10.1200/JCO.2007.11.3670.
PMID
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4. SEER
Surveillance
Epidemiology
and
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