Topics 1-2 Etiology and Epidemiology Flashcards
Topic 1. Etiology:
- About what % of these etiological factors is important in carcinogenesis?*
- -Environmental (chemical, physical)*
- -Infections (viruses, bacteria, worms)*
- -Hereditary/genetic*
- Environmental: 80-90%
- Infections: 5-10%
- Genetic: 5%
Topic 1. Etiology:
About what percentage of tumors are acquired/sporadic, meaning they’re caused by mutations resulting from the accumulation of environmental damages in somatic cells?
Over 95%
Topic 1. Etiology:
- What does IARC stand for?*
- What is it?*
International Agency for Research on Cancer
A division of the WHO that classifies carcinogens based on scientific evidence (Category 1, 2/A, 2/B, 3, 4)
Topic 1. Etiology:
- What is category 1 of the IARC?*
- What are some examples?*
Proven carcinogens:
tobacco smoke, asbestos,
alcohol, UV, ionising radiation, air
pollution, contraceptives, processed
meat products
Topic 1. Etiology:
- What is category 2/A of the IARC?*
- What are some examples?*
probable carcinogens
bitumen (tar), DDT, anabolic steroids, red meat
Topic 1. Etiology:
- What is category 2/B of the IARC?*
- What are some examples?*
possible carcinogens:
phenobarbital, chloroform, fiberglass, gasoline, diesel oil, carbon black, lead, chrome, nickel
Topic 1. Etiology:
- What is category 3 of the IARC?*
- What are some examples?*
not classifiable as to carcinogenicity
caffeine, tea, PVC, printing inks, magnetic and electric fields, paracetamol, diazepam)
Topic 1. Etiology:
- What is category 4 of the IARC?*
- What are some examples?*
probably not carcinogenic
caprolactam (prob not important to know, something used in fibers/plastics)
Topic 1. Etiology:
What is the increased risk of cancer in organ transplant recipients?
Double the risk, due to immunosuppression
HIV/AIDS patients have increased risk for the same reason
Topic 1. Etiology:
How does familial inheritance of a tumor work?
Mutations occur in the gametes of a parent that predispose their offspring to a cancer after further mutations are acquired. Every cell of the offspring is affected.
The combination of the acquired mutation + new somatic mutation makes it likely to develop a tumor at a young age.
Topic 1. Etiology:
- What types of tumors are typically caused by HPV?*
- (5 listed)*
Cervical, penile, anal, bladder, head/neck
Topic 1. Etiology:
What types of HPV typically cause cancer?
[I’m focusing on maximum 7 of them, but a lot are listed]
About 70% of cervical cancers are from HPV 16 and 18
6, 11: important in laryngeal cancer
31, 33, 45 also important for genital cancers
The e-book also includes: 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82… but I don’t think anyone expects you to remember all that
Topic 1. Etiology:
- What types of neoplasia are associated with hepatitis C?*
- Which neoplasia is hepatitis B associated with?*
Lymphoma
Aplastic anemia
Hepatocellular carcinoma (also for hepatitis B)
Topic 1. Etiology:
What type of neoplasia is human polyomavirus associated with?
Childhood neuroblastoma
Related to BK and JC virus
[Just gonna put a note in here to remember that HTLV-1 virus causes T cell leukemia/lymphoma, but that’s in the name of the virus so it shouldn’t require its own card]
Topic 1. Etiology:
Which herpes viruses can cause neoplasia?
EBV
CMV
HHV-8 (aka Kaposi-sarcoma associated virus)
Topic 1. Etiology:
What 3 main types of neoplasia are associated with Epstein-Barr Virus / EBV?
Burkitt lymphoma
Hodgkin lymphoma
Nasopharyngeal carcinoma
(+ some others not mentioned in e-book.. primary CNS lymphomas, some stomach cancers..)
Topic 1. Etiology:
What type of neoplasias can occur from Helicobacter pylori infection?
Stomach cancer:
gastric adenocarcinoma + MALT lymphoma
Topic 1. Etiology:
What type of neoplasias can result from either Schistosoma haematobium or S. japonicum infection?
Squamous cell bladder carcinoma, colorectal carcinoma, stomach carcinoma
Liver carcinoma
Topic 1. Etiology:
- Which genes are involved in hereditary breast and ovarian cancer syndromes?*
- Which other tumors can occur as a result?*
BRCA1, BRCA2
Besides breast and ovarian cancers, prostate, and pancreatic tumors
Topic 1. Etiology:
- What gene is responsible for hereditary retinoblastoma?*
- What other tumor often arises in people with the mutation?*
RB1
Osteosarcoma
Topic 1. Etiology:
What gene is responsible for Wilms tumor (nephroblastoma)?
WT-1
(transcription factor that regulates urogenital development)
Topic 1. Etiology:
- What gene is mutated in familial adenomatous polyposis (FAP)?*
- What tumors can arise as a result of this mutation?*
APC
Gastrointestinal (especially colorectal),
e-book says also brain, thyroid, retina
Topic 1. Etiology:
What types of tumors often arise in Lynch syndrome?
Colorectal cancer (Lynch syndrome is also known as hereditary non-polyposis colorectal cancer)
Risk of endometrial, ovarian, stomach and several others
Topic 1. Etiology:
What types of cancers are more likely in Peutz-Jegher syndrome?
PJS is associated with hamartomatous polyps throughout the GI, but these only a small risk of malignant transformation
PJS has an increased risk of cancer all over the body (GI, breast, ovary, uterus, testicles, pancreas)
Topic 1. Etiology:
What types of cancers are more likely in Ataxia telangiectasia?
lymphoma, leukaemia, breast, adrenal gland
ATM mutation -> inability to fix double stranded breaks. Neurodegeneration occurs (hence ataxia) + dilated vessels (telangiectasia)
Topic 1. Etiology:
- Which gene is mutated with Li-Fraumeni syndrome**?*
- What cancers are likely to occur?*
TP53
Many cancers can occur as p53 is often the last mutation to make a cell neoplastic. E-book says sarcomas, breast, brain, leukemia
Topic 1. Etiology:
What types of cancers are likely to occur with Multiple Endocrine Neoplasia / MEN1 mutation?
Insulinoma
Gastrinoma
Hypophyseal tumors
Parathyroid tumors
(3 Ps: pituitary adenoma, primary hyperparathyroidism, and pancreatic endocrine tumors)
Topic 1. Etiology:
What types of cancers are likely to occur with Xeroderma pigmentosum?
Basal cell carcinoma
Melanoma
(XPA mutation > nucleotide excision repair is faulty as a result, and UV light becomes much more dangerous)
Topic 1. Etiology:
What type of cancers are more likely to occur in Von Hippel-Lindau Syndrome / VHL mutation?
Clear cell renal carcinoma (most important)
+ Pheochromocytoma, Retinal angioma
Topic 2. Epidemiology:
- For the most common causes of mortality, where does cancer rank in developed or medium-devloped countries?*
- In Hungary, how often is cancer typically a cause of death? How does it compare to the rest of Europe?*
Ranks 2nd as a cause of mortality
(1st is cardiovascular disease)
As of 2014, about 1 in 4 (technically 28.7%) of people in Hungary die from cancer. Hungary has the highest standardized death rate in Europe, and Eastern Europe in general has higher rates than the rest of Europe
Topic 2. Epidemiology:
- By incidence, what are the top 3 types of cancer in Hungary in general?*
- (not including non-melanoma skin cancers)*
- How is cancer incidence different for just men or just women?*
General: 1. Lung 2. Colorectal 3. Breast/prostate
(These three make up approx 40% of new cancer cases)
Men: 1. lung, 2. colorectal, 3. prostate (the same)
Women: 1. breast, 2. lung, 3. colorectal
(women are less likely to smoke and more likely to have breast cancer than men are to have prostate cancer; E-book text says breast > lung > colorectal, but the graph they used said B > C > L)
Topic 2. Epidemiology:
By mortality, what are the top 3 types of cancer in Hungary for men vs women?
Men: lung, colorectal, prostate
(the same as incidence.. male lung cancer is almost always deadly)
Women: lung, breast, colorectal
(different than incidence, which is breast, colorectal, lung.. lung cancer is more deadly than breast cancer, which has been improving in mortality rates)
Topic 2. Epidemiology:
- What are some of the general principles of the European Code against Cancer?*
- [this is mostly standard stuff to avoid cancer so just be familiar rather than memorize the whole thing]*
- Don’t smoke, don’t use tobacco products
- Be a healthy body weight, physically active, eat healthy
- Eat vegetables/fruits, high fiber, low calorie
- Avoid processed meat, limit red meat and salt
- Limit alcohol intake
- Avoid too much sun, use sunscreen
- Avoid work-related exposures, follow safety protocols
- Reduce potential radon exposure in homes
- Breastfeeding reduces breast cancer risk for mother, so breastfeed if possible
- Get hepatitis B and HPV vaccines
- Undergo standard screening procedures (e.g. colonoscopies, breast exams, cervical exams)
