4. Global Incidence Flashcards
Fill in the blanks:
There were ___ cancer cases and ___ cancer deaths in 2020.
Accounted for __% of all global deaths in 2017, second to _________.
- 19.3 million
- 10 million
- Cardiovascular disease
What are the most commonly diagnosed cancers in the world? What are the most common cancer causes of cancer death?
Diagnosed: breast (11.7%), lung (11.4%), colorectal (10%)
Death: lung (18%), colorectal (9.4%), liver (8.3%)
What are some key differences in cancer incidence between Europe, Asia, and Africa?
- 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)
What are the leading risk factors for:
- Breast
- Lung
- Colorectal
- Breast: genetics, radiation, alcohol, obesity
- Lung: tobacco, asbestos, air pollution
- Colorectal: diet, alcohol
What are the leading risks factors for:
- Cervical
- Pancreatic
- Liver
- Skin
- Cervical: HPV
- Pancreatic: Alcohol, obesity
- Liver: Hep B/C, alcohol, schistosomiasis
- Skin: UVA/B exposure
What % of cancers in the UK are attributable to known risk factors?
4 in 10, 40%
What risk factors have the highest contribution to cancer in the UK?
-Tobacco smoking (15%)
-Radiation/ occupational exposure (9%)
-Overweight/ obesity (6%)
-Diet (5%)
-Alcohol (3%)
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.
- 5 million
- 50-66%
- 50%
- 69
What % of females and males smoke in high income countries?
22% - females
37% - males
Which of these countries have a high/low smoking prevalence in males?:
Serbia, Nigeria, Turkey, Tunisia, Ecuador, Sweden
High:
Serbia (31.9%), Turkey (39.0%), Tunisia (44.8%)
Low:
Nigeria (7.5%), Ecuador (10.3%), Sweden (12.3%)
What type of study is used to find the incidence and prevalence of smoking between males and females in countries around the world?
Ecological analysis
How many cancer deaths is alcohol responsible for each year?
What types of cancer have established risk with alcohol consumption?
330,000/year
Liver, Mouth, Pharynx, Larynx, Oesophagus, Colorectal, Breast (moderate)
In the larynx, what % increase in cancer risk is caused by 10g/day increase in alcohol consumption?
44
What % of cancers are attributable to alcohol worldwide versus in Europe?
3.6 Worldwide
10 Europe
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.
- 12.2
- Eastern Mediterranean
- Higher
What % of cervical cancers occur in low/middle income countries?
85%
Rank the continents from highest to lowest incidence of cervix uteri cancer
Highest:
Africa
Latin America, Caribbean
Asia
Europe
Oceania
North America
Lowest
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 _____.
- Fourth
- 600,000
- 340,000
- HPV
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
- True
- False: HPV is responsible for almost all (99.75)
- False: Two type of HPV (16 and 18) cause 70% of all cervical cancer
What cause high incidence of liver cancer in Asia?
Hep B, blood born disease.
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 ____ ____.
- 100
- 20
- Killer T
- Liver regeneration
Describe the molecular effect of Hep B on carcinogenesis
HBV X protein (HBx) binds to p53 tumour suppressor protein leading to p53 inactivation.
P53 inactivation can lead to cell cycle arrest, and apoptosis
By how much is the rate of melanoma higher in Australia than Europe by?
Over 10x higher
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
- F: melanoma is less prevalent
- T
- T
Describe some environmental causes of cancer
- 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)
What cancers are attributable to:
- UV radiation
- Asbestos (occupation)
And what is the % of attribution for each?
- UV: melanoma 87%
- Asbestos: mesothelioma 94%
Describe the difference in the types of cancer prevalent between the ages of 15-44 compared to 65+
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.
Why does the incidence of cancer rise with age?
- Build up of specific risks
- aging populations (demographic time bomb)
Why is ethnicity difficult to assess?
Studies may reflect geographical differences rather than specifically ethnicity
Why is the incidence of breast cancer lower in South Asian & Black women than White?
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
What are some disease-control priorities to help prevent cancer worldwide?
- 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
Overall, how come lung cancer has decreased in incidence in Uk & US, but prostate has increased?
Coal mining and tobacco smoking have decreased, so lung cancer incidence has decreased.
Older age & increased life span increases incidence of prostate
What is the estimate change in number of cancer cases from 2020 -> 2040?
2020: 19.3 million
2040:30.2 million predicted
What does HDI stand for?
Human Development Index
How much are each HDI groups predicted to increase by between 2020-2040?
Explain the differences
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
