L5: Epidemiological transition

Question 1

What is ET?

Answer 1

Long term shift in mortality + disease patterns whereby pandemics of infection and neonatal disease are replaced by degenerative and man-made diseases.

Question 2

Describe ET in Canada

Answer 2

From 1930-50 heart disease rate doubled.

Cancer was the second cause of death. Infectious diseases: influenza, bronchitis, pneumonia, TB decreased from 1930-60

Question 3

What factors lead to ET?

Answer 3

Better lifestyle, living conditions and standards, more research

Question 4

Describe ET effect in UK

Answer 4

Heart disease epidemic. Men of working age were dying which has economic and social impact.

Question 5

Describe CVD rate in UK

Answer 5

Declining from 1950 to 2010 from 50-33%

Question 6

Explain disparity between Mediterranean and rest of Europe for CHD mortality

Answer 6

Better diet, better genes and environment = less mortality

Question 7

Describe difference between male and female CHD mortality

Answer 7

approx. double in males

Question 8

Describe relationship between US and UK CVD deaths

Answer 8

Decline in deaths, US precedes CVD decline

Question 9

When did smoking epidemics occur

Answer 9

Males: 1950-60
Females: 1970s

Question 10

What are the effects of smoking

Answer 10

10 year loss in longevity

Question 11

How is epidemiological transition set to change in future?

Answer 11

Low income countries will have higher BP and other risk factors for man-made disease. Degenerative disease will put considerable burden on LICs.

Question 12

What are the downward trends in serum cholesterol from 1980-2008 due to?

Answer 12

Statins and lifestyle change

Question 13

What do low cancer mortality prevalence ratios tell you?

Answer 13

Standard and quality of health care is high

Question 14

Compare cancer mortality prevalence ratios

Answer 14

UK, America, Europe have low cancer mortality prevalence ratios
Asia has a high mortality prevalence ratio (more people work with coal)
Africa has a very high mortality prevalence ratio

Question 15

Describe breast cancer trends

Answer 15

Incidence high across all income categories, but mortality higher in low income countries

Question 16

Describe liver cancer trends

Answer 16

Present in middle/low income groups

Question 17

Describe cervical cancer trends

Answer 17

High mortality in low income countries

Question 18

What is the most frequent cause of premature cancer death in men?

Answer 18

Lung cancer

Question 19

What are the most frequent causes of death by cancer in women?

Answer 19

Poor countries: cervical
UK, N. America: Lung
Other parts of world: breast

Question 20

Describe lung cancer trends

Answer 20

High income associated with smoking increases lung cancer trends

Question 21

Explain lower mortality in stomach cancer patients

Answer 21

H. pylori research, changes to treatment, refrigeration of food

Question 22

State preventable cancer risk factors

Answer 22

Low fruit + veg, alcohol, overweight, low physical activity, unsafe sex, iatrogenic needle, smoking (TOBACCO)

Question 23

State infection leading to liver cancer

Answer 23

Hep B, C

Question 24

State infection leading to cervical cancer

Answer 24

HPV

Question 25

State infection leading to Hodgkin cancer

Answer 25

EBV

Question 26

State infection leading to Kaposi’s sarcoma

Answer 26

HIV

Question 27

State the big four cancer types

Answer 27

Lung, large bowl, prostate, breast