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Oncology (Dustin, Fredrik) > Topics 1-2 Etiology and Epidemiology > Flashcards

Topics 1-2 Etiology and Epidemiology Flashcards

1
Q

Topic 1. Etiology:

  • About what % of these etiological factors is important in carcinogenesis?*
  • -Environmental (chemical, physical)*
  • -Infections (viruses, bacteria, worms)*
  • -Hereditary/genetic*
A
  • Environmental: 80-90%
  • Infections: 5-10%
  • Genetic: 5%
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2
Q

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?

A

Over 95%

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3
Q

Topic 1. Etiology:

  • What does IARC stand for?*
  • What is it?*
A

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)

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4
Q

Topic 1. Etiology:

  • What is category 1 of the IARC?*
  • What are some examples?*
A

Proven carcinogens:

tobacco smoke, asbestos,
alcohol, UV, ionising radiation, air
pollution, contraceptives, processed
meat products

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5
Q

Topic 1. Etiology:

  • What is category 2/A of the IARC?*
  • What are some examples?*
A

probable carcinogens
bitumen (tar), DDT, anabolic steroids, red meat

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6
Q

Topic 1. Etiology:

  • What is category 2/B of the IARC?*
  • What are some examples?*
A

possible carcinogens:
phenobarbital, chloroform, fiberglass, gasoline, diesel oil, carbon black, lead, chrome, nickel

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7
Q

Topic 1. Etiology:

  • What is category 3 of the IARC?*
  • What are some examples?*
A

not classifiable as to carcinogenicity

caffeine, tea, PVC, printing inks, magnetic and electric fields, paracetamol, diazepam)

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8
Q

Topic 1. Etiology:

  • What is category 4 of the IARC?*
  • What are some examples?*
A

probably not carcinogenic

caprolactam (prob not important to know, something used in fibers/plastics)

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9
Q

Topic 1. Etiology:

What is the increased risk of cancer in organ transplant recipients?

A

Double the risk, due to immunosuppression

HIV/AIDS patients have increased risk for the same reason

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10
Q

Topic 1. Etiology:

How does familial inheritance of a tumor work?

A

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.

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11
Q

Topic 1. Etiology:

  • What types of tumors are typically caused by HPV?*
  • (5 listed)*
A

Cervical, penile, anal, bladder, head/neck

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12
Q

Topic 1. Etiology:

What types of HPV typically cause cancer?

[I’m focusing on maximum 7 of them, but a lot are listed]

A

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

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13
Q

Topic 1. Etiology:

  • What types of neoplasia are associated with hepatitis C?*
  • Which neoplasia is hepatitis B associated with?*
A

Lymphoma

Aplastic anemia

Hepatocellular carcinoma (also for hepatitis B)

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14
Q

Topic 1. Etiology:

What type of neoplasia is human polyomavirus associated with?

A

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]

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15
Q

Topic 1. Etiology:

Which herpes viruses can cause neoplasia?

A

EBV

CMV

HHV-8 (aka Kaposi-sarcoma associated virus)

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16
Q

Topic 1. Etiology:

What 3 main types of neoplasia are associated with Epstein-Barr Virus / EBV?

A

Burkitt lymphoma

Hodgkin lymphoma

Nasopharyngeal carcinoma

(+ some others not mentioned in e-book.. primary CNS lymphomas, some stomach cancers..)

17
Q

Topic 1. Etiology:

What type of neoplasias can occur from Helicobacter pylori infection?

A

Stomach cancer:

gastric adenocarcinoma + MALT lymphoma

18
Q

Topic 1. Etiology:

What type of neoplasias can result from either Schistosoma haematobium or S. japonicum infection?

A

Squamous cell bladder carcinoma, colorectal carcinoma, stomach carcinoma

Liver carcinoma

19
Q

Topic 1. Etiology:

  • Which genes are involved in hereditary breast and ovarian cancer syndromes?*
  • Which other tumors can occur as a result?*
A

BRCA1, BRCA2

Besides breast and ovarian cancers, prostate, and pancreatic tumors

20
Q

Topic 1. Etiology:

  • What gene is responsible for hereditary retinoblastoma?*
  • What other tumor often arises in people with the mutation?*
A

RB1

Osteosarcoma

21
Q

Topic 1. Etiology:

What gene is responsible for Wilms tumor (nephroblastoma)?

A

WT-1

(transcription factor that regulates urogenital development)

22
Q

Topic 1. Etiology:

  • What gene is mutated in familial adenomatous polyposis (FAP)?*
  • What tumors can arise as a result of this mutation?*
A

APC

Gastrointestinal (especially colorectal),

e-book says also brain, thyroid, retina

23
Q

Topic 1. Etiology:

What types of tumors often arise in Lynch syndrome?

A

Colorectal cancer (Lynch syndrome is also known as hereditary non-polyposis colorectal cancer)

Risk of endometrial, ovarian, stomach and several others

24
Q

Topic 1. Etiology:

What types of cancers are more likely in Peutz-Jegher syndrome?

A

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)

25
Q

Topic 1. Etiology:

What types of cancers are more likely in Ataxia telangiectasia?

A

lymphoma, leukaemia, breast, adrenal gland

ATM mutation -> inability to fix double stranded breaks. Neurodegeneration occurs (hence ataxia) + dilated vessels (telangiectasia)

26
Q

Topic 1. Etiology:

  • Which gene is mutated with Li-Fraumeni syndrome**?*
  • What cancers are likely to occur?*
A

TP53

Many cancers can occur as p53 is often the last mutation to make a cell neoplastic. E-book says sarcomas, breast, brain, leukemia

27
Q

Topic 1. Etiology:

What types of cancers are likely to occur with Multiple Endocrine Neoplasia / MEN1 mutation?

A

Insulinoma

Gastrinoma

Hypophyseal tumors

Parathyroid tumors

(3 Ps: pituitary adenoma, primary hyperparathyroidism, and pancreatic endocrine tumors)

28
Q

Topic 1. Etiology:

What types of cancers are likely to occur with Xeroderma pigmentosum?

A

Basal cell carcinoma

Melanoma

(XPA mutation > nucleotide excision repair is faulty as a result, and UV light becomes much more dangerous)

29
Q

Topic 1. Etiology:

What type of cancers are more likely to occur in Von Hippel-Lindau Syndrome / VHL mutation?

A

Clear cell renal carcinoma (most important)

+ Pheochromocytoma, Retinal angioma

30
Q

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?*
A

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

31
Q

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?*
A

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)

32
Q

Topic 2. Epidemiology:

By mortality, what are the top 3 types of cancer in Hungary for men vs women?

A

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)

33
Q

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]*
A
  • 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)

Oncology (Dustin, Fredrik) (5 decks)

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