Cancer Epidemiology

Question 1

what are leading causes of death globally?

Answer 1

Ischaemic heart disease and stroke

Question 2

what are the changes in death rate in CVS and cancer over the years?

Answer 2

o Death rates from CVS disease have dropped over the years.

o Death rates from cancer have remained stable/increased-slightly over the years.

Question 3

what are the most common cancers among men?

Answer 3

prostate and lung cancers

Question 4

what are the most common cancers among women?

Answer 4

breast and cervix uteri cancers

Question 5

examples of cancer incidence differing dependent on geographical location

Answer 5

Melanoma is most common in AUS/NZ and colorectal cancer is most common in Japan.

Question 6

how are migrant studies useful

Answer 6

the rate of change following migration can indicate to what level a cancer is genetic or environmentally influenced

Question 7

what does rapid change in cancer incidence after migration indicate?

Answer 7

environmental factors and lifestyle act late in carcinogenesis

Question 8

what does a slow change in cancer incidence after migration indicate?

Answer 8

exposures early in life are more relevant i.e. genetic

Question 9

what does persistence in rates in cancer incidence indicate?

Answer 9

genetic susceptibility is important in determining risk.

Question 10

why may cancer incidence be increasing in both high and low income countries?

Answer 10

effects of earlier diagnosis, screening and changes in risk factors.
the introductions of official screening procedures

Question 11

what is the effect on the incidence of cancer in high income countries after the introduction of screening programmes?

Answer 11

High income countries tend to show an increasing and then rapid increase followed by a plateau of cancer incidence

Question 12

how is mortality changing in high and low income countries?

Answer 12

decreasing in HI countries

not decreasing in LI countries as the total burden of cancer increases

Question 13

what percentage of cancers are of hereditary inclination?

Answer 13

5-10% of cases

Question 14

what are the attributable risks of cancers in order of highest to lowest?

Answer 14

Smoking
diet
infection
reproductive hormone
alcohol
occupation

Question 15

how much of an impact do modifiable risks have on the cancer burden?

Answer 15

o 45% (men) and 40% (women) of cancers could have been prevented by reducing risk.

Smoking – 30% of cancer death, increases risk for >15 cancers, 90% (men) and 80% (women) of lung cancer causes.

Question 16

what modifiable risk factor increases chances of colorectal cancer?

Answer 16

diet:

risk increases with a low fibre diet

Question 17

what cancers are associated with alcohol?

Answer 17

liver
oral cavity
pharynx
larynx
oesophageal cancer

even though it has a CHD preventative effect

Question 18

what are the dietary prevention guidelines for cancer prevention?

Answer 18

o Be lean without being underweight.
o Be physically active for at least 30 minutes a day.
o Avoid sugary drinks.
o Eat a variety of fruit/veg.
o Limit consumption of red meat (<500g/week) and avoid processed meat.
o Limit alcoholic drinks.
o Limit consumption of salty foods.

Question 19

what do increased sex steroids increase the risk of?

Answer 19

breast cancer

Question 20

what are some causes of cancer of viral origin?

Answer 20

HPV (cervix cancer)
EBV (Hodgkin’s/Burkett’s Lymphoma),
HCV/HBV (liver cancer)
H. pylori (stomach cancer).

Question 21

what are the 5 major cancers contributing to worldwide mortality?

Answer 21

lung
stomach
liver
colorectal
breast

lung has seen little therapeutic progress

Question 22

describe the current prevalence and incidence of cancer

Answer 22

There are approximately 14 million new cases of cancer every year
these diseases kill approximately 8 million people worldwide every year.
Approximately 33 million people worldwide are living with cancer (within 5 years of diagnosis).
It is estimated that there will be at least 16 million new cases per year by 2020, and the number of new cases is expected to rise by 70% over the next 20 years.

Question 23

Cases per year
Deaths per year
Living (within 5 years of diagnosis)

Answer 23

• 14 milllion
• 8 million
• 33 million

Question 24

what is the reason for increasing cancer prevalence?

Answer 24

increasing life span and unhealthy lifestyles

Question 25

which cancers are common in young boys?

Answer 25

lymphomas

Question 26

common cancer types in children (0-14)

Answer 26

• Leukaemia
• Brain/CNS tumours (claim the most lives)
• lymphomas

cancers are a leading cause of death of children

Question 27

what are common cancer of children under 5?

Answer 27

• embryonal solid tumours such as neuroblastoma, retinoblastoma and Wilms’ tumour
• acute lymphoblastic leukaemia (ALL)

Question 28

what are the causes of avoidable death due to childhood cancer?

Answer 28

• lack of diagnosis
• misdiagnosis or delayed diagnosis
• obstacles to accessing care
• abandonment of treatment
• death from toxicity
• higher rates of relapse.