K - 2 Cancer Epidemiology (IKA)

CANCER EPIDEMIOLOGY

Hematology Oncology DivisionChild Health Departement Universty of Sumatera Utara

*Basic science of Oncology 2011

Basic science of Oncology 2011

Epidemiology

The study of distribution and determinants of disease in human population ; why different population or group are at different risks for diferrent diseasePatterns of incidence and death rates of malignant disease : sex,age,race,geography*Basic science of Oncology 2011


Childhood cancer

Is rare less than 1 % of all cancer in industrialized countriesSeveral types of cancer are virtually unique to childhood, whereas the carcinomas most frequently seen in adultsSome of the most striking progress in cancer treatment has been made in paediatric oncologyInvestigation of childhood tumours has led to major advances in the understanding of the genetic*Basic science of Oncology 2011


Concept epidemiology

1.Disease is not randomly distributed2.Disease causation is multifactorial*Basic science of Oncology 2011


The scope of EpidemiologyConcerned with population healthConcern to cliniciansClinical researchers Laboratory scientiest*Basic science of Oncology 2011


General approach

WhatWhoWhereWhenDescriptive epidemiology

Analytic epidemiologyWhyHow



Types of epidemilogical

Occupational epidemiology : effects of workplace exposures on workersClinical epidemiology : outcome the patients Genetic epidemiology: focus on familes or high risk individual, concerned with determinants of disease in families and on inherited causes of cancer in populationNutritional or environmental epidemiologyMolecular epidemiology*Basic science of Oncology 2011


Application epidemiologyPlanningEvaluation of cancer control Primary preventionEarly detectionScope of cancer epidemiology: broad concern causes of cancer identification of population where risk reduced prevention*Basic science of Oncology 2011


Cancer statisticWhen a patient is diagnosed with cancer one of the first questions an oncologist will be asked: how long do I have Survival based statistics : observational studies : 1.relative 5-year survival rates 2.Overall survival 3.Median survival



Cancer trendsRelatifve 5-year survival rate for all cancer: 1975 - 1977 : 51% 1996 - 2002 : 66%The reason: Multifactorial:Increasing:1. diagnostic test:mammogram,Pap smears,prostate specific antigen 2.immunosupression 3.the aging of population



Leading cancer types in Indonesia1.Cervix cancer2.Breast cancer3.Colorectal cancer4.Lung cancer5.Nasopharyng cancer

( POI=Perhimpunan Onkologi Indonesia)*Basic science of Oncology 2011


Leading cancer types among African AmericanMaleProstateLung and bronchusColon and rectumNHLOral cavityKidneyUrinary bladderPancreasStomachliverFemaleBreastLung and bronchusColon and rectumUterine corpusPancreasOvaryNHLKidneyMultiple Myeloma*Basic science of Oncology 2011


Leading cancer in children

LeukemiaLymphoma and Reticuloendothelial neoplasmsCNS tumoursRetinoblastomaRenal TumoursHepatic Tumours



.cancer in childrenMalignant Bone tumoursSoft Tissue sarcomasGerm Cell, trophoblastic and other gonadal neoplasmsCarcinomas and other malignant epithelial neoplasmsOther and unspecified malignant neoplasms



EtiologyChemical carcinogensEnvironmental and industrial carcinogensDrug induced cancersRadiation carcinogenesisViral and immunologic mechanisms*Basic science of Oncology 2011


EtiologyA.Chemical carcinogens1.Industrial exposure2-NaphthylamineBenzidineBis(chloromethyl)etherBis(2-chloroethyl)sulfide (mustard gas)Vinyl chlorideCertain tars,soots,oilsChromium compoundsNickel compoundsAsbestosBenzene*Basic science of Oncology 2011


Chemicals

Pesticides (CNS tumors)Solvents (eg, CNS tumors, leukemia, neuroblastoma, hepatoblastoma)Metals (hepatoblastoma)Petroleum products (eg, wilms tumor, leukemia, hepatoblastoma)Lead (wilms tumor)Boron (wilms tumor)Furnaces (lymphoma)Chemotherapy (leukemia)*Basic science of Oncology 2011


2.Medical exposureN,N-bis(2-chloroethyl)-2-naphthylamine (Chlornaphazin)DiethylstilbestrolInorganic arsenic comp.Mephalan,cyclophosphamideAzathioprine,Phenytoin

3.Societal exposureCigarette smokeBetel nut and tobacco quid*Basic science of Oncology 2011


2.Radiation carcinogenesis:medical x-rays,atomic weapon,radon in house

3.Viral and immunologic mechanisms-Epstein-Barr virus-Hepatitis-B-HIV4.Environmental: ultraviolet*Basic science of Oncology 2011


Environmental FactorsIonizing radiationData derived from the atomic bomb exposures at Hiroshima and Nagasaki Leukemia

Electromagnetic fieldsPublished reports have suggested that electromagnetic fields have some potential effect on the promotion of leukemia



Cancers 7 warning signals1.Change in bowel or bladder habits2.A sore that does not heal3.Unusual bleeding or discharge4.Thickening or lump in breast or elsewhere5.Indigestionor difficulty in swallowing6.Obvious change in wart or mole7.Nagging cough or hoarseness

If you have a warning signal ,see your doctor*Basic science of Oncology 2011


Role of infectionEpstein-Barr virus (EBV)Underdeveloped country rate infection in infancy , high the age of onset HD-EBV is present in 40 60% of cases-chronic viral infection activation of cellular oncogenes, loss of tumour suppressor genes and deregulation of several cytin



Epstein-Barr virus (EBV) African Burkitt lymphoma Hodgkin lymphoma Nasopharyngeal carcinomaHIV-induced immunosuppressionCNS lymphoma Leiomyosarcoma



Thank You*Basic science of Oncology 2011


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K - 2 Cancer Epidemiology (IKA)