L2 - Epidemiology, clinical aspects, screening Flashcards
Why is liver cancer not that common in NZ?
Liver cancer is mostly caused by chronic inflammation
Hepatitis B - now has vaccination
Hepatitis C - now has antiviral treatment
Which cancer has the highest mortality rate globally?
Lung cancer
- Hard to diagnose early, & usually has already metastasised by that time
What is the most common cancer in males?
Lung cancer
What is the most common cancer in females?
Breast cancer
Lung is second highest cause of death
What is lung cancer like between males & females in NZ?
Quite even rates –> now less men are smoking but more women are smoking
Why is breast cancer diagnosis rate (94.2%) so high compared to mortality rate (12.6%)?
Screening programme –> more cases identified therefore diagnosis numbers increase
Why does prostate cancer have a low mortality rate?
Slow-progressing cancer
Patients are more likely to die of other comorbidities than of prostate cancer
What is the most common cancer in NZ & why?
Melanoma –> chronic sun exposure esp. with ozone hole
What are EIGHT risk factors for developing cancer?
FIVE TOAD
Family history Inactivity Virus Environmental Tobacco Obesity Alcohol Diet
Why is tobacco a risk factor?
Contains FOUR toxins
Benzene –> leukaemia
Polonium –> radiation
Cadmium –> overwhelms toxin-cleaning enzymes
Hydrogen cyanide & ammonia –> kill cilia
Why is diet a risk factor?
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
Why is obesity a risk factor?
Increased oestrogen production, reduce sex hormone binding globulin
Increased insulin production
Increased oesophageal reflux –> constant inflammation
Increased gallstone production
What cancer can hepatitis B & C cause?
Liver cancer
What cancer can human papillomavirus (HPV) cause?
Cervical cancer
Anal carcinoma
Mouth, tongue, oesophagus
What are THREE environmental factors that may contribute to cancer?
Sunlight
Asbestos
Radon –> not that common nowadays, but exposure to radiation common in war
Why is inactivity a risk factor?
Reduced levels of oestrogen
Reduced levels of insulin
Why is alcohol a risk factor?
Varied mechanisms
- Acetylaldehyde production
- Folate & vit B deficiency
- Increased sex hormone (oestrogen) production
What are the clinical presentations of lung cancer?
Dysphonia (change in voice)
Dyspnoea
Persistent cough
Haemoptysis
What is curative treatment?
Primary treatment modality
What is adjuvant treatment?
Given AFTER surgery to:
- Eliminate micrometastases
- Increase cure
- Reduce relapse
What is neoadjuvant treatment?
Given PRIOR to surgery to:
- Downstage/treat metastatic disease early –> may make surgery more successful
What is screening for cervical cancer?
Pap smear
What is screening for breast cancer?
Mammogram
What is screening for prostate cancer?
Serum prostate specific antigen
What is screening for bowel cancer?
Faecal occult blood testing
