cancer prevention Flashcards
what are the most common Dx of cancer for males and females?
males
- prostate cancer
- Colorectal cancer
- melanoma of the skin
- lung cancer
- Head and neck
females
- breast cancer
- Colorectal cancer
- melanoma
- lung cancer
- uterine cancer
what are the main death causing cancers in males and females?
men
- lung cancer
- prostate cancer
- colorectal cancer
- pancreatic cancer
- cancer of unknown primary site
females
- lung cancer
- breast cancer
- colorectal cancer
- pancreatic cancer
- cancer of unknown primary site
what are the cancer statistics?
i.t.o mortality and cost
- age standardised mortality decreased by 20% in the last 30years
- 67% cancer pt will survive 5+ years after Dx
- direct costs $3.8 billion
- $378 mil spent on research
approximately 30% cancer is preventable
what are primary prevention strategies for cancer?
address some of the modifiable risk factors
- tobacco,
- alcohol,
- diet,
- obesity and physical activity,
- infections,
- environmental exposure,
- genetics,
- occupational,
- radiation,
- iatrogenic,
- reproductive,
- sunlight
outline smoking as a risk factor for cancer
smoking accounts for 20-30% of cancer (active and passive)
- increases risk for bladder, cervical, kidney, larynx, liver, lung, myeloid leukaemia, nasal and oral, oesophagus, pancreas, pharynx, stomach
outline alcohol as a risk factor for cancer
- increasing risk with increasing consumption
- increases risk for colorectal, breast, larynx, liver, oral, pharynx and oesophageal cancer
outline diet as a risk factor for cancer
- risk attributed to processed meat and high fat foods
- increases risk of colorectal, breast, kidney, oesophagus, pancreas, prostate, stomach and uterine cancer
outline obesity and inactivity as a risk factor for cancer
- increased risk of bowel, breast, colon, endometrial, gallbladder, oesophagus, kidney, ovarian and pancreatic cancer
outline chronic infections as a risk factor for cancer
- EG. HBV, HCV, HPV
- increased risk for bladder, cervical, gallbladder, leukaemia, liver, lung, lymphoma, oral and oropharynx and stomach cancer
outline occupational exposure as a risk factor for cancer
- EG. asbestos, vinyl chloride
- increased risk for bladder, kidney, leukaemia, liver, oesophagus, mesothelioma, lung, lymphoma, oral and oropharynx, nasopharynx, stomach and skin cancer
outline radiation exposure as a risk factor for cancer
- can be occupational, environmental, iatrogenic
- increased risk for breast, lung and thyroid cancer + leukaemia
what are the principles for successful screening programme according to the WHO?
- target disease is a common cancer with high associated morbidity/ mortality
- effective treatment capable of reducing morbidity/mortality should be available
- test procedures should be acceptable, safe + relatively inexpensive
what is the WHO view on national programme vs opportunistic screening?
- organised screening more likely to be successful as a means of reaching a high proportion of the at risk pop
- if you only focus on high risk you will miss cases
outline the screening process for breast cancer
1) determine risk
2) screen for normal risk =
mammogram every 2 years from age 50-75
(high risk = start earlier/ use diagnostic/individual monitoring strategies)
3) insufficient evidence for clinical exam (recommend breast awareness as opposed to breast self examination)
4) screening mammogram vs diagnostic mammogram
- SCREENING MAMMOGRAM = preformed in BreastScreen Australia program, free, asymptomatic women, don’t require referral and aimed at risk group
- DIAGNOSTIC = complex, to evaluate abnormalities seen/suspected on prior screening mammogram/ evaluate other breast abnormalities, may incur cost, requires referral
outline the screening process for cervical cancer
- HPV tent (vaginal swab) every 5 years from 25yo OR 2 years after first sexual intercourse whichever is later
why?
1) detect HPV exposure
2) if next test is neg= cleared up; if pos = treat earlier
(test changed because we have better knowledge of pathophysiology, lots of women exposed to HPV will spontaneously clear it up)
