Epidemiology

Question 1

Cancer epidemeology:

1. what is the most common cancer globally?
2. what are the other most common cancers globally?
3. what are the most common cancers in the UK
4. what are the most common cancers in men?
5. what are the most common cancers in women?

Answer 1

1. lung
2. breast, bowel, stomach, prostate
3. breast, prostate, lung, bowel, malignant melanoma
4. prostate, lung, bowel, bladder, kidney
5. breast, lung, bowel, uterus, malignant melanoma

Question 2

where do the following cancers have clusters?

1. cervical cancers
2. stomach cancer
3. colorectal cancer

Answer 2

1. south america and subsaharan africa
2. northeastern asia
3. North America, australasia and europe

Question 3

what are the most deadly cancers:

1. worldwide
2. in the UK

Answer 3

1. lung, stomach, liver, colorectal, breast

2. lung, bowel, breast, prostate, pancreatic

Question 4

1. What is the age range of childhood cancers

2. How do they differ from adult cancers?

Answer 4

1. <14 years
2. differ clinically, histopthologically and genetically
   comparatively responsive to treatment

Question 5

Name 6 general causes of cancer

Answer 5

1. infection
2. radiation exposure
3. lifestyle - smoking, obesity, die, alcohol
4. occupational exposures
5. hormones
6. genetics

Question 6

Describe the trend in childhood mortality

Answer 6

highest in infancy. dropping to very low in middle childhood, and rising again in adolescence

Question 7

1. What are the two major causes of infant mortality?

2. What risk factors for these causes?

Answer 7

1. low birth weight and prematurity

2. maternal age, smoking, Socioeconomic disadvantage

Question 8

1. What causes of mortality predominate in infancy?
2. What causes of mortality become more prominent in later childhood and adolescents?
3. what is the most common cause of death in adolescents?

Answer 8

1. perinatal and congenital causes
2. acquired natural causes
3. accidents

Question 9

How can child health be improved (3)

Answer 9

1. reduce risk of preterm birth and low birth weight, and promote maternal health
2. implement policies to prevent common causes of death from accidents and injuries
3. improve management of chronic diseases and mental health

Question 10

1. Name 4 non-modifiable risk factors for CHD

2. name modifiable risk factors for CHD

Answer 10

1. age; male; fam Hx; deletion polymorphism in the ACE gene (high prevalence of this in bangladeshi heritage)

2. hyperlipidaemia
   smoking
   hypertension
   diabetes mellitus
   lack of exercise
   blood coagulation factors
   obesity
   drugs
   heavy alcohol consumption
   social deprivation

Question 11

1. Define risk
2. what is risk difference?
3. What is risk ratio?

Answer 11

1. probability of an event in a given time period
2. risk exposed - risk unexposed
3. risk exposed / risk unexposed

Question 12

What is a better measure of the impact of an exposure in a population?

Answer 12

Attributable risk

Question 13

1. Define population attributable risk

2. Name the two things that are important when determining population attributable risk

Answer 13

1. the proportion of disease in the population that is attributable to a particular risk factor
2. the strength of the relationship (risk ratio)
   prevalence of the exposure

Question 14

What is the prevention paradox?

Answer 14

a preventative measure that brings large benefits to the community offers little to each participating individual

Question 15

Describe how the prevention paradox links to population attributable risk

Answer 15

majority of people affected by disease are in the moderately high risk group due to higher prevalence
to reduce prevalence of disease, we need to target people at lower risk because there is more of them.

Question 16

name problems with targeting people at low risk (prevention paradox)

Answer 16

poor motivation

low benefit:risk ratio