WEEK 3: Epidemiology of cancer Flashcards
What is Epidemiology?
A discipline which has evolved with changes taking place in the society and the emergence of new disease and discipline related to epidemiology.
Epidemiology is concerned with events that occur in the population.
*Epidemiology is a branch of public health that studies the distribution and determinants of health-related states among specified populations and the application of that study to the control of health problems.
Cancer Epidemiology- Branch of epidemiology concerned with disease cancer.
What differentiates epidemiology from clinical medicine?
Epidemiology is concerned with events that occur in population: primary unit of concern are group of people, not separate individuals. This is what differentiates epidemiology from clinical medicine.
What are the focus areas of epidemiology?
- Epidemiological studies are concerned not only with people who get the disease, but also with those who do not have and particularly how the two differs.
-Epidemiological studies not only concentrate on the disease, in terms of cancer they focus on precursors, they are not only concerned with the illness only or disability or death but also with health and prevention of the disease.
-Distribution of diseases in a population
*Which types of people are at a high risk?
*How does the disease frequency change over time?
*How much does it vary from place to place?
In Summary: who?, When?, Where?
Most epidemiological research involves the study of relationship of one type of events or characteristic to another.
They do this by measurement of exposure and outcome.
Define exposure and outcome with examples.
- Exposure- increased or decreased occurrence of disease or other specified health outcome.
Environment (e.g air pollution), lifestyle (smoking, diet) or inherited characteristics (blood group A, fair skin)
- Outcome- broad term for any defined disease, state of health, health related event or death
*The exposures and outcomes of interest are specific to study hypothesis.
identify exposure and outcome in the following statements.
1.Does alcohol intake increase the risk of lung cancer?
- Does hepatitis B vaccination protect against liver cancer?
-Alcohol: Exposure
-Lung cancer: Outcome
-Hepatitis B vaccine: Outcome
-Liver cancer: Exposure
Define the following terms:
1.Validity
2.Sensibility
3.Specificity
4.Predictive value of positive test
5.Predictive value of negative test
6.Reliability
Validity- the extent to which an instrument
(questionnaire, lab test) measures what it is intended to measure.
Sensibility - proportion of individuals classified as positive by the gold standard who are correctly identified by the study test.
Specificity- proportion of individuals classified as negatives by the gold standard who are correctly identifies by the test.
-Predictive value +ve test- the probability that someone with positive study test result really has characteristic of interest as determined by the gold standard
- Predictive value of –ve test- probability that someone with negative study test results does not have the characteristic of interest as determined by the gold standard
-Reliability (repeatability, reproducibility)- is a measure of the consistency of the performance of a test when used under similar circumstances.
What is the relationship between validity and reliability?
To be valid, a measurement must be reliable.
State the 5 key facts of WHO 2018.
Cancer is the second leading cause of death globally, about 1 in 6 deaths is due to cancer.
Approx. 70% of deaths from cancer occur in low-and middle – income countries.
About one third of deaths from cancer are due to behavioral and dietary risks (high BMI, low fruit & Veg intake, lack of physical activity, tobacco use, alcohol).
The economic impact of cancer is significant and is increasing.
Only 1 in 5 low-middle-income countries have the necessary data to drive cancer policy.
BURDEN OF CANCER IN BOTSWANA
How many % of all deaths in Botswana are due to cancer?
What is the major contributor to the cancer incidences by >40%?
_____ of cases reported and ____ of them at terminal stage.
An average of _____ cancers are registered annually.
7% of all deaths in Botswana are due to cancer.
High HIV prevalence increases cancer incidence >40% cancers HIV related.
25% of cases reported and 75% of them at terminal stage.
An average of 1,200 cancers are registered annually.
Vie stats on the slides.
State some of the social determinants of health contributing to cancer.
*Poor socio-economic status
*Lack of education
*Minority groups
Outline what clinicians need to recognize according to the scope of cancer prevention.
Clinicians need to recognize that cancer prevention:
*Is closely linked with wellbeing, empowerment and partnership [rather than a stand-alone principle]
*Should be an ongoing consideration and not something that happens only once.
*Entails knowing stopping cancer from developing or increasing is different from meeting eligible cancer care following diagnosis
*Should take a strengths-based approach and consider at every contact if their patient shows indications for a cancer screening or diagnosis.
Describe the 3 levels of cancer prevention.
- Primary prevention
*Manage the risk factors
*Prevent the onset of disease
2.Secondary prevention
*Early diagnosis
*Prompt treatment
- Tertiary prevention
*Reduce complication and disability.
Outline questions clinicians should answer as a preventative approach of cancer.
The clinician to establish what from the conversation?
-Which cancers may be prevented
-Which could be diagnosed early and treated?
-Which might progress?
-Which need support now?
-What does a good life look like for you and how can we work together to achieve it?
The conversation should enable the clinician to establish:
1. What is a problem now?
2. What may become a problem?
3. What can be done to prevent, reduce or delay the likelihood of those cancer related needs developing?
