L2 - Epidemiology, clinical aspects, screening Flashcards

1
Q

Why is liver cancer not that common in NZ?

A

Liver cancer is mostly caused by chronic inflammation

Hepatitis B - now has vaccination
Hepatitis C - now has antiviral treatment

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2
Q

Which cancer has the highest mortality rate globally?

A

Lung cancer

  • Hard to diagnose early, & usually has already metastasised by that time
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3
Q

What is the most common cancer in males?

A

Lung cancer

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4
Q

What is the most common cancer in females?

A

Breast cancer

Lung is second highest cause of death

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5
Q

What is lung cancer like between males & females in NZ?

A

Quite even rates –> now less men are smoking but more women are smoking

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6
Q

Why is breast cancer diagnosis rate (94.2%) so high compared to mortality rate (12.6%)?

A

Screening programme –> more cases identified therefore diagnosis numbers increase

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7
Q

Why does prostate cancer have a low mortality rate?

A

Slow-progressing cancer

Patients are more likely to die of other comorbidities than of prostate cancer

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8
Q

What is the most common cancer in NZ & why?

A

Melanoma –> chronic sun exposure esp. with ozone hole

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9
Q

What are EIGHT risk factors for developing cancer?

FIVE TOAD

A
Family history
Inactivity
Virus
Environmental
Tobacco
Obesity
Alcohol
Diet
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10
Q

Why is tobacco a risk factor?

A

Contains FOUR toxins

Benzene –> leukaemia
Polonium –> radiation
Cadmium –> overwhelms toxin-cleaning enzymes
Hydrogen cyanide & ammonia –> kill cilia

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11
Q

Why is diet a risk factor?

A

Low fibre

  • Less butyrate produced by gut bacteria –> less inhibition of cancer development
  • Decreased stool weight –> increases transit time & therefore contact time of toxins with colon

Low fruits & vegetables
- Decreased fibre, vitamin E, folate

Red/processed meats

  • Less will decrease haem –> anaemia
  • Fried/BBQed

Salty
- Interaction with H. pylori

Saturated fats
- Increased risk of breast cancer

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12
Q

Why is obesity a risk factor?

A

Increased oestrogen production, reduce sex hormone binding globulin

Increased insulin production

Increased oesophageal reflux –> constant inflammation

Increased gallstone production

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13
Q

What cancer can hepatitis B & C cause?

A

Liver cancer

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14
Q

What cancer can human papillomavirus (HPV) cause?

A

Cervical cancer

Anal carcinoma

Mouth, tongue, oesophagus

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15
Q

What are THREE environmental factors that may contribute to cancer?

A

Sunlight
Asbestos
Radon –> not that common nowadays, but exposure to radiation common in war

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16
Q

Why is inactivity a risk factor?

A

Reduced levels of oestrogen

Reduced levels of insulin

17
Q

Why is alcohol a risk factor?

A

Varied mechanisms

  • Acetylaldehyde production
  • Folate & vit B deficiency
  • Increased sex hormone (oestrogen) production
18
Q

What are the clinical presentations of lung cancer?

A

Dysphonia (change in voice)
Dyspnoea
Persistent cough
Haemoptysis

19
Q

What is curative treatment?

A

Primary treatment modality

20
Q

What is adjuvant treatment?

A

Given AFTER surgery to:

  • Eliminate micrometastases
  • Increase cure
  • Reduce relapse
21
Q

What is neoadjuvant treatment?

A

Given PRIOR to surgery to:

- Downstage/treat metastatic disease early –> may make surgery more successful

22
Q

What is screening for cervical cancer?

A

Pap smear

23
Q

What is screening for breast cancer?

A

Mammogram

24
Q

What is screening for prostate cancer?

A

Serum prostate specific antigen

25
Q

What is screening for bowel cancer?

A

Faecal occult blood testing