4. Global Incidence Flashcards

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1
Q

Fill in the blanks:

There were ___ cancer cases and ___ cancer deaths in 2020.
Accounted for __% of all global deaths in 2017, second to _________.

A
  1. 19.3 million
  2. 10 million
  3. Cardiovascular disease
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2
Q

What are the most commonly diagnosed cancers in the world? What are the most common cancer causes of cancer death?

A

Diagnosed: breast (11.7%), lung (11.4%), colorectal (10%)
Death: lung (18%), colorectal (9.4%), liver (8.3%)

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3
Q

What are some key differences in cancer incidence between Europe, Asia, and Africa?

A
  • Incidence per 100,000 is highest in Europe, lowest in Asia
  • Lung is second most prevalent in Asia, and is lower in Europe (4th) and Africa (6th)
  • Cervix uteri has a high incidence in Africa, but not as high in. Europe/Asia (virus)
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4
Q

What are the leading risk factors for:
- Breast
- Lung
- Colorectal

A
  • Breast: genetics, radiation, alcohol, obesity
  • Lung: tobacco, asbestos, air pollution
  • Colorectal: diet, alcohol
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5
Q

What are the leading risks factors for:
- Cervical
- Pancreatic
- Liver
- Skin

A
  • Cervical: HPV
  • Pancreatic: Alcohol, obesity
  • Liver: Hep B/C, alcohol, schistosomiasis
  • Skin: UVA/B exposure
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6
Q

What % of cancers in the UK are attributable to known risk factors?

A

4 in 10, 40%

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7
Q

What risk factors have the highest contribution to cancer in the UK?

A

-Tobacco smoking (15%)
-Radiation/ occupational exposure (9%)
-Overweight/ obesity (6%)
-Diet (5%)
-Alcohol (3%)

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8
Q

Fill in the blanks:
____ global deaths are associated with tobacco use annually.
Between ___-___% of those who smoke will die of tobacco-related causes.
____% of tobacco deaths occur between 35-___ years.

A
  1. 5 million
  2. 50-66%
  3. 50%
  4. 69
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9
Q

What % of females and males smoke in high income countries?

A

22% - females
37% - males

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10
Q

Which of these countries have a high/low smoking prevalence in males?:
Serbia, Nigeria, Turkey, Tunisia, Ecuador, Sweden

A

High:
Serbia (31.9%), Turkey (39.0%), Tunisia (44.8%)
Low:
Nigeria (7.5%), Ecuador (10.3%), Sweden (12.3%)

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11
Q

What type of study is used to find the incidence and prevalence of smoking between males and females in countries around the world?

A

Ecological analysis

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12
Q

How many cancer deaths is alcohol responsible for each year?
What types of cancer have established risk with alcohol consumption?

A

330,000/year

Liver, Mouth, Pharynx, Larynx, Oesophagus, Colorectal, Breast (moderate)

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13
Q

In the larynx, what % increase in cancer risk is caused by 10g/day increase in alcohol consumption?

A

44

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14
Q

What % of cancers are attributable to alcohol worldwide versus in Europe?

A

3.6 Worldwide
10 Europe

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15
Q

Fill in the blanks:
In Eastern Europe, ____L of pure alcohol/person is consumed each year, compared to 0.7L/person in _____.
In low-middle income ountries, % of cancers attributible to alcohol is ____.
Across all countries, attributable fraction is ____ in men than women.

A
  1. 12.2
  2. Eastern Mediterranean
  3. Higher
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16
Q

What % of cervical cancers occur in low/middle income countries?

A

85%

17
Q

Rank the continents from highest to lowest incidence of cervix uteri cancer

A

Highest:

Africa
Latin America, Caribbean
Asia
Europe
Oceania
North America

Lowest

18
Q

Fill in the blanks:

Cervical cancer is the ____ most common cancer globally among women, with approximately ____ cases and ____ deaths per year.
It is caused by _____.

A
  1. Fourth
  2. 600,000
  3. 340,000
  4. HPV
19
Q

T or F:
1. 14 of the 100 types of HPV are known to cause cancer
2. HPV is responsible for 70% of cervical cancers
3. Three types of HPV (16,17, 18) cause 70% of cervical cancers

A
  1. True
  2. False: HPV is responsible for almost all (99.75)
  3. False: Two type of HPV (16 and 18) cause 70% of all cervical cancer
20
Q

What cause high incidence of liver cancer in Asia?

A

Hep B, blood born disease.

21
Q

Fill in the blanks:

Hepatitis B infection increases the risk of liver cancer by ___-fold.
Chronic infection gives a __% life-time risk of developing liver cancer.
____ cells attack the infected liver cells to bring about ____ ____.

A
  1. 100
  2. 20
  3. Killer T
  4. Liver regeneration
22
Q

Describe the molecular effect of Hep B on carcinogenesis

A

HBV X protein (HBx) binds to p53 tumour suppressor protein leading to p53 inactivation.
P53 inactivation can lead to cell cycle arrest, and apoptosis

23
Q

By how much is the rate of melanoma higher in Australia than Europe by?

A

Over 10x higher

24
Q

T of F:
- Melanoma is more prevalent than non-melanoma skin cancer
- It is 19th most common cancer globally (both sexes combined)
- Melanoma is mostly caused by UV radiation

A
  • F: melanoma is less prevalent
  • T
  • T
25
Q

Describe some environmental causes of cancer

A
  • UV exposure
  • Air pollution, eg particulates, open flames (gas cookers)
  • Occupational exposures (arsenic, paints, glass manufacturing, e-waste, smelting, construction/mining in arsenic-containing soil)
  • Radiation (household ad medicinal exposure)
26
Q

What cancers are attributable to:
- UV radiation
- Asbestos (occupation)
And what is the % of attribution for each?

A
  • UV: melanoma 87%
  • Asbestos: mesothelioma 94%
27
Q

Describe the difference in the types of cancer prevalent between the ages of 15-44 compared to 65+

A

15-44, breast is the most prevalent (double the second most prevalent, cervix), due to genetic factors
15-44 the scale is much lower, 24/100,000 compared to 280/100,00 scale
In 65+, prostate, breast, and lung are the 3 highest. Less to do with genetic factors.

28
Q

Why does the incidence of cancer rise with age?

A
  • Build up of specific risks
  • aging populations (demographic time bomb)
29
Q

Why is ethnicity difficult to assess?

A

Studies may reflect geographical differences rather than specifically ethnicity

30
Q

Why is the incidence of breast cancer lower in South Asian & Black women than White?

A

Risk factors:
Deprivation, age at menarche, childbearing/breastfeeding history, BMI, height, alcohol consumption, hormone therapy, family history.
Mainly due to risk factors rather than tan specific ethnicity/genetics

31
Q

What are some disease-control priorities to help prevent cancer worldwide?

A
  • Hep B vaccination
  • Increased taxation on cigarette products, warning labels
  • Opportunistic screening for cervical cancer
  • School-based HPV immunization
  • Early identification & treatment of breast cancer
  • Diagnosis & treatment of curable childhood cancers
  • Tackling obesity pandemic
32
Q

Overall, how come lung cancer has decreased in incidence in Uk & US, but prostate has increased?

A

Coal mining and tobacco smoking have decreased, so lung cancer incidence has decreased.

Older age & increased life span increases incidence of prostate

33
Q

What is the estimate change in number of cancer cases from 2020 -> 2040?

A

2020: 19.3 million
2040:30.2 million predicted

34
Q

What does HDI stand for?

A

Human Development Index

35
Q

How much are each HDI groups predicted to increase by between 2020-2040?

Explain the differences

A

Low: +96% (0.65->1.27)
Medium: +64.7% (2.33->3.83)
High: +56.2% (7.37>11.5)
Very High: +32.2% (8.93->11.8)

In higher HDI, there are already high rates of cancer. As lower HDi increase asseessibiltiy to healthcare and age increases, cancer incidence will increase