Global Health- Non-infectious diseases (Cancer and CVD) Flashcards by Joshua Killilea

Describe what is meant by an epidemiological transition

Epidemiological transition – this is the changes in levels and causes of mortality, which is commonly summarized as a decline in total mortality, and a significant reduction in infectious and deficiency diseases, which increase the relative role of chronic non-communicable diseases like cancers, cardiovascular and chronic respiratory disease, and diabetes.

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Describe the factors that play a role in epidemiological transitions

It accompanies socio-demographic and health system changes among the poorer countries but continues in more industrialized nations. With advances in clinical medicine and epidemiology, it has become apparent that this transition is complex and dynamic: the health and disease patterns of a society evolve in diverse ways as a result of demographic, socioeconomic, technological, cultural, environmental and biological changes. It is rather a continuous transformation process, with some diseases disappearing and others appearing or re-emerging. There are some outstanding examples, such as the emergence of new infectious diseases like AIDS, the increase in infections that were previously controlled, such as tuberculosis and dengue fever, the decline
in stomach cancer and the rise and fall of lung cancer, and the shift from stroke to heart disease.

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What were the top 10 leading causes of deaths in 2000

Ischaemic heart disease
Stroke
Lower Respiratory Infections
COPD
Diarrhoeal diseases
HIV/AIDS
TB
Preterm Birth Complications
Trachea, Bronchus, Lung Cancers
Diabetes mellitus

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What were the top 10 leading causes of deaths in 2012

Ischaemic Heart Disease
Stroke
COPD
Lower Respiratory Infections
Trachea, Bronchus, Lung Cancers
HIV/AIDS
Diarrhoeal diseases
Diabetes mellitus
Road injury
Hypertensive heart disease

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What type of conditions are becoming more common in developed countries

Chronic Conditions and cancers

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How do chronic conditions and cancer change as you age

More common as you age

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What is a consequence of people living longer

High prevalence of chronic conditions and cancers

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What are the 5 leading cancers in the world for females in terms of incidence

Breast
Colorectum
Lung
Cervix uteri
Thyroid

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What are the 5 leading causes of cancers in the world for females in terms of mortality

Breast
Lung
Colorectum
Cervix uteri
Stomach

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What are the 5 leading causes of cancers in the world for females in terms of prevalence

Breast
Colorectum
Thyroid
Cervix uteri
Corpus uteri

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What are the 5 leading causes of cancers in the world for males in terms of incidence

Lung
Prostate
Colorectum
Liver

Stomach

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What are the 5 leading causes of cancer in the world for males in terms of mortality

Lung
Liver
Stomach

Colorectum
Prostate

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What are the 5 leading causes of cancers in the world for males in terms of prevalence

Prostate
Colorectum
Lung
Bladder
Stomach

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In very high HDI countries, what are the 5 most commonly diagnosed cancers for both sexes

Breast
Colorectum
Lung
Prostate 
Bladder

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In very high HDI countries, what are the 5 most deadly cancers for both sexes

Lung
Colorectum
Pancreas
Breast
Stomach

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In very high HDI countries, what are the most prevalent cancers for both sexes

Breast
Prostate
Colorectum
Bladder
Lung

In low HDI countries what are the most diagnosed cancers for both sexes

Breast
Cervix uteri
Prostate
Colorectum
Liver

In low HDI countries what are the most deadly cancers for both sexes

Cervix uteri
Breast
Liver
Prostate
Colorectum

In low HDI countries what are the most prevalent cancers for both sexes

Breast
Cervix uteri
Prostate
Colorectum
Non-Hodgkin Lymphoma

Describe the cancer transition in Japan post 1951

Before (infectious disease)
Stomach (H.Pylori)
Cervix (HPV)
Liver (HBV and HVC)
After (Non-infectious disease)
Lung, Pancreas (smoking)
Colorectum (development)
Breast (diet and fertility)

Describe the epidemiological transition in Japan post 1951

Before (infectious disease)
TB
Malaria
Smallpox
After (non-infectious disease)
Cancer
Heart Disease
Stroke

What is generally seen in Age-standardized cancer mortality trends in selected countries

Mortality rates decrease

What is generally seen in Age-standardized lung cancer mortality trends in selected countries

Men- decreasing

Women- increasing

What is generally seen in Age-standardized stomach cancer mortality trends in selected countries

Mortality rate decreases

What is generally seen in Age-standardized breast cancer mortality trends in selected countries

Mortality rate decreases in some countries, increases in others

List the 9 major environmental and behavioural risks for cancer deaths in 2001

1. Smoking 2. Low intake of fruit and vegetables 3. Alcohol use 4. Unsafe sex 5. Obesity 6. Physical inactivity 7. Contaminated injections in health care 8. Urban air pollution 9. Indoor smoke from household solid fuel use

What cancers can H.Pylori cause

Stomach and lymphoma

What cancers can EBV cause

NPC Hodgkin L BL

What cancers can HPV cause

Cervix, ano-genital sites, oral and pharyngeal

developed countries in 2002

8.1%

What percentage of cancer deaths were attributable to infection in underdeveloped countries in 2002

26.9%

Describe how we can prevent cancer deaths

Many cancer deaths preventable through policies/actions that reduce smoking and alcohol use, increase access to healthier food options, and prevent/treat infections

What happens after deaths caused by child infectious diseases declines

Over time relatively large declines in child infectious diseases have led to more people dying at older ages and an increase in the number of deaths from cancers and other non-communicable diseases (NCDs) However, after accounting for population growth and ageing, NCD rates also tend to decline

How do we know that viruses can cause cancer

Microscopy allowed us to follow the virus, and see how it changes human DNA.

How is cancer burden shifting

Cancer burden is shifting to less developed countries, in which 60% of these cases are likely to occur.

How many deaths is cancer responsible for worldwide

Cancer accounted for about 15.1% of the deaths worldwide in 2010

Describe the distribution of cancers in the world

Many types of cancer vary in incidence between different populations and every type of cancer is rare in some parts of the world. Lung, breast and colorectal cancer are currently the most commonly diagnosed cancers, whereas lung cancer, liver, and stomach cancers are the most common causes of cancer death. Cancer rates in migrants tend to converge towards local cancer rates over time, pointing to a role for modifiable risk factors. At least a third of all cancers are likely to be preventable through a small number of lifestyle and environmental approaches, with an additional burden due to infections. Smoking is currently the largest preventable cause of cancer in the world.

Describe the changes in age-specific cancers and mortality rates

Age-specific cancer incidence and mortality rates have fallen for some cancer sites, while other cancers have become more common, reflecting changes in relevant exposures, diagnosis, treatment, and screening. Because cancer can take 20 years to appear, current cancer rates are affected by changes and exposures that took place in the past. Rates of smokingrelated cancers in women, for example, will continue to increase in most countries; as will the number of cases attributable to asbestos exposure. Smoking and overweight may become more important contributors to cancer rates than infections in some countries.