Week 5_Cancer Flashcards
What percentage of new cases of cancer are detected in men and women over 60yo?
How many new cases of cancer in men and women <85 ?
> 60yo:
men: 75% . women: 65%
<85yo
men: 1:2 . women 1:3
List 5 most common cancers for each gender:
List 5 cancers with highest mortality rates:
Most common cancers:
Men: Women:
- prostate 1. breast
- colorectal 2. colorectal
- melanoma 3. melanoma
- lung cancer 4. lung
- head and neck . 5. uterine
Highest # deaths: Men: Women: 1. lung 2. prostate 2. breast 3. colorectal 4. pancreatic 5. cancer of unknown primary source
Are incidence and mortality rates increasing or decreasing. Discuss trends and any reasons behind trends.
What is the age of average death from cancer?
Incidence:
Overall: increasing from 2002-2012.
Mortality: overall decreased
- better treatment
- better at finding
Exception: Acute Myeloid leukaemia in adults, oesophageal, melanoma and myeloma (platelets)
Av. age of death: 73yo.
Nb. Most common cancers are not leading cause of death.
- How much is spend per year in direct health costs on cancer?
- What % of all health research expenditure goes towards cancer?
- What percentage of cancers are preventable?
- $7.2 billion in direct health costs.
- 22%
note: nearly 1/4 of all cancer expenditure goes to cancers we already know a lot about or that we do well at.. Very little goes to the cancers that have poor survival rate. - 30% cancers preventable
List primary prevention strategies, what are they based on?
- primary prevention strategies are based around evidence.
Smoking (20-30% all cancers- acute and passive)
Alcohol> risk increases with consumption
Diet: processed and high fat
Obesity and inactivity: hard to separate them in order to get rid of one being confounder for other.
Occupational
Radiation : mostly occupational, can be iatrogenic, environmental
Secondary Prevention:
What features make a screening test effective/applicable?
- test must be sensitive: effectiveness in detecting cancer in those who hvae it.
- test must be specific: the extent to which test gives negative results in those who don’t have it.
- Positive predictive value: The extent to which subjects are free from disease in those with positive result.
- Negative predictive value: The extent to which subjects are free from disease in those who test negative.
- Acceptability: The extent to which those for whom test is designed agree to have test.
List basic screening principals:
- when should you screen for a disease?
- COMMON and SERIOUS: target disease should be common with high associated morbidity and mortality.
- TREATMENT MUST BE AVAILABLE: There must be an effective treatment, capable of reducing morbidity and mortality and it should be available.
- Test procedures should be acceptable, safe, relatively inexpensive.
What are the main differences between national screening programs vs opportunistic screening?
National screening programs:
- reach high proportion or at risk population
- AIMED AT ASYMPTOMATIC PEOPLE
Opportunistic screening:
- unlikely to realise full potential of screening.
AIMED AT PEOPLE WHO ALREADY HAVE THE DISEASE
BREAST CANCER
- Primary prevention
- secondary screening
- how to assess risk
- when to screen
- Types of screening
primary prevention strategies based around:
alcohol, processed meat/high fat diets, obesity and inactivity, radiation exposure
Secondary:
1. determine risk (use red book)
NORMAL RISK: age 50-75, mammogram every 2 years.
HIGH RISK: earlier screening or use diagnostic/individual monitoring strategies
ARe clinical breast examinations recommended to screen for breast cancer?
No. There is insufficient evidence that this is a sufficient screening method.
Describe what is meant by “recommend breast awareness”f
People should be aware of their breast. They should be familiar with the feel of them, in the hope that if any changes occur, they will be noticed.
What are the differences between a screening mammogram and a diagnostic mammogram:
Screening mammogram:
- breastScreen Australia program
- Free
- for asymptomatic women
- no referral required
- for risk group (50-75)
Diagnostic mammogram:
- more complex to evaluate abnormalities or suspected at prior screening mammogram.
- to evaluate abnormal changes/findings in breast.
- may incur a cost
- requires referral to private or public radiology practice.
Cervical Cancer
What risk factors are primary prevention strategies based on?
smoking
HPV
Cervical cancer screening changed in May 2017, what are the differences from how it used to be tested to how it is now tested?
What is the reason behind the change?
prior:
Every 2 years, women over 18 (or 2 years after first having sexual intercourse)-70 year. Tested for abnormal cells.
AFter may 2017
Women age 25-70(-74)- vaccinated and unvaccinated
Every 5 years.
Now test for HPV virus.
We now know more about the pathophysiology of the disease (ie HPV can show up but can clear spontaneously)
- we have lowest mortality rate in world, 2nd lowest incidence
- 85% who develop cervical cancer have never had pap smear OR have been inadequately screened in past 10 years.
Bowel Cancer/colorectal cancer:
Primary prevention strategies might involve:
- alcohol
- processed meats and fat
