Lec 08 Cancer Epidemiology Flashcards
Identify level of disease prevention:
Before disease occurs
Primary
Identify level of disease prevention:
Avoidance of smoking
Primary
Identify level of disease prevention:
Prior to its clinical manifestations
Secondary
Identify level of disease prevention:
Before clinical progression
Tertiary
How/when can a disease be considered a primary health concern?
When it is a top cause of mortality and morbidity
What is/are the differences between a public health
problem and a clinical health problem?
• Public health problem – community is concerned; for
instance, people’s lifestyle
• Clinical health problem – management of individual
patients
Incidence to mortality ratio (IMR) of cancer
2:1
For every 2 new cases, one of them will die
Type of CA with the worst prognosis.
Pancreatic CA.
IMR: 1.1:1
The number of new cases in a population at risk
Incidence
Top 10 cancers in the Philippines:
- Breast 6. Colon
- Lung 7. Thyroid*
- Liver 8. Stomach
- Cervix 9. Nasopharynx
- Leukemias* 10. Lymphoma*
Easiest way to prevent 85% of the top 10 cancers.
By NOT SMOKING
Virus associated with nasopharyngeal CA
EBV
Leading cancer in children
Leukemia
Proposed sequence of carcinogenic events?
Normal cell -> (Biologic effects->Genetic alterations) -> proliferation -> atypia -> in situ -> invasive cancer -> metastasis
What is the difference between a complication and disease progression?
A complication is any condition that arises which
complicates the primary disease. For example, a
symptom arises due to the treatment administered.
• Disease progression is the primary disease of
interest. The disease is just following its natural course.
What do you call the black spots of tar in a smoker’s lung?
Anthracosis
1 Cause of Liver CA
Hep B virus
Pre-cancerous lesion for Oral CA
leukoplakia
You should not be exposed to the sun during this time to avoid Skin cancer.
10am-2pm
Current lifestyle shows that the HPV vaccine is protective for how many years?
6-8 years
Essential vitamins for the prevention of CA of breast, stomach, and oropharynx
Vitamins A,C,E
What is the difference between a risk factor and a causative agent?
A risk factor adds to the probability of developing the
disease (cancer)
A causative agent causes the disease
Ex. Hep B is the causative agent for hepatitis. However, it
is only a risk factor for developing hepatocellular CA
How can pap smear be used as primary prevention for cervical CA
to see CIN 3 – cervical intraepithelial neoplasia - a precervical CA lesion
Denaturation of proteins coming from destroyed cells used in the community when no pap smear in available.
Aceto-whitening
cobblestone appearance that is pathognomonic of HPV infection
Mosaicism
Starting age for breast self examination
25
Best time to do BSE is:
after shower and before bed on the 5-7 days after the last menstrual day, since nodulations caused by hormones are at a minimum; or on first day of month if not menstruating
T/F Fibrocystic changes have higher probability of progressing to breast cancer than fibroadenoma
T
If polyp is beyond this size, a mandatory polypectomy should be done and tissue recovered should be subjected to biopsy
2cm
Population at risk for cervical CA
sexually active females
9 Danger Cancer Signs
CAUTION US
C hange in bowel or bladder habits
A sore that does not heal
U nusual bleeding and/or discharge
T hickening or lump in breast or elsewhere
I ndigestion or difficulty in swallowing
O bvious change in wart or mole
N agging cough or hoarseness
U nexplained anemia
S udden weight loss
Define CURE, CONTROL and PALLIATION
CURE – if treatment is given, survival of patient is the
same as any normal person, same age, sex, and
comorbidities (quantity of life)
CONTROL – if treatment is given, survival is longer
than that of a patient with same diagnosis, cancer stage,
age, and sex (quantity and quality of life)
PALLIATION – treated or untreated, survival is the
same (goal is quality of life)
