Non infectious disease - cancer and cardiovascular disease

Question 1

Explain the concept of epidemiological transition

Answer 1

This is the changes in levels and causes of mortality, which is commonly summarised as: a decline in total mortality, and a significant reduction in infectious diseases, which increase the relative role of chronic non-communicable diseases

Question 2

why is the epidemiological transition complex and dynamic

Answer 2

It is as a result of: demographic, socioeconomic, technological, cultural, environmental and biological changes
Some diseases disappear (small pox) and others appear(AIDS) or re-emerge (TB,Dengue). There is a decline in stomach cancer, rise and fall of lung cancer and a shift from stroke to heart disease

Question 3

what are the most commonly diagnosed cancer

Answer 3

Lung, breast and colorectal cancer

Question 4

what is the most common cause of cancer death

Answer 4

Lung, liver and stomach cancers

Question 5

how could most cancers be prevented

Answer 5

one third of cancers are likely to bepreventablethrough a small number of lifestyle and environmental approaches

Question 6

what percentage of deaths are due to cancer worldwide

Answer 6

Causes more than 25% of deaths worldwide

Question 7

what is the cancer burden shifting to

Answer 7

Burden is shifting to less developed countries. Incidence varies between populations

Question 8

what is the largest preventable cause of cancer

Answer 8

smoking

Question 9

what are current cancer rates affected by

Answer 9

changes and exposures that took place in the past because cancer can take up to 20 years to appear

Question 10

what are the 9 major risks that cancer deaths are attributable to

Answer 10

Smoking
Low intake of fruit and veg
alcohol use
Unsafe sex
Overweight and obesity
physical inactivity
contaminated injections in healthcare
Urban air pollution
Indoor smoke from household solid fuel use

Question 11

what infections can cancer deaths be due to

Answer 11

Hepatitis, H.pylori (gastric cancer), HPV (cervical cancer) , EBV (stomach cancer) , HIV, Schistosomes

Question 12

what do changes in mortality and incidence over time reflect changes in

Answer 12

exposure, diagnosis, screening and treatment

Question 13

what are the risk factors for CVD

Answer 13

Raised Blood pressure - 62% of all strokes and 49% of all HD attributable to raised BP. Tobacco - Smoking curtails life by 10 years, but prevalence of smoking has decreased, i.e. though smoking ban etc. High cholesterol. Obesity. Underweight and Unsafe sex - These are mainly applicable in developing countries

Question 14

what are the first and second cause specific mortality

Answer 14

CHD and stroke

Question 15

where are there low rates of CHD

Answer 15

japan

Question 16

where are there high rates of CHD

Answer 16

in formerly socialist economies of Europe and in the Middle East

Question 17

three main risk factors of CVD

Answer 17

High blood pressure, Tobacco smoking, Serum Cholesterol level

Question 18

what do these patterns (rising and declining rates within countries, large differences across countries which lessen or disappear with migration) indicate

Answer 18

indicate that environmental rather than genetic factors underlie much of the CVD risk worldwide

Question 19

What will worldwide trends of trend in overweight and obesity lead to

Answer 19

an increase in the burden of Non-communicable disease including metabolic disorders and diabetes.

Question 20

list the commonest non-infectious causes of world mortality

Answer 20

ischaemic heart diease, cerebrovascular disease

Question 21

trends to know

Answer 21

health decreases with socioeconomic class. Smoking is more prevalent among manual laborers. Smoking generally decreases with age though in some socioeconomic classes there is a peak around 45-54 years. Alcohol consumption decreases with socioeconomic class. Obesity increases as deprivation increases