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Epidemiology%20242:%20Cancer%20Epidemiology

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Title: Epidemiology 242: Cancer Epidemiology Author: Zuo-Feng Zhang Last modified by: zzhang Created Date: 9/30/2002 3:11:32 AM Document presentation format – PowerPoint PPT presentation

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Title: Epidemiology%20242:%20Cancer%20Epidemiology


1
Epidemiology 242 Cancer Epidemiology
  • Zuo-Feng Zhang, MD, PhD
  • Fall Quarter, 2009

2
Overall Objectives of the Course
  • The overall objectives are to introduce basic
    concept in cancer epidemiology, including
    concepts of carcinogenesis, multistage models,
    pre-malignant lesion, international patterns of
    cancer.

3
Overall Objectives of the Course
  • To discuss major etiologic issues for a variety
    of cancers including smoking, alcohol drinking,
    virus, radiation, nutrition, occupational and
    environmental exposures.
  • To review epidemiological data on major cancers
    including prostate, breast, lung, and other
    cancers.
  • To lecture on the basic concepts of molecular and
    genetic epidemiology.

4
Introduction to Cancer Epidemiology
  • (1) To overview the cancer magnitude
  • (2) To familiarize students with basic concepts
    of tumor and its classification
  • (3) To introduce basic concept of carcinogenesis
    and cancer epidemiology

5
Why Cancer is a Major Public Health Problem?
  • Improved medical care and public health have lead
    to
  • Decrease and control of common diseases of
    childhood and infectious disease, the major
    causes of death in the past
  • the increase of life expectation
  • the increase of the proportion of aging
    population, since cancer is generally considered
    as an aging disease, cancer becomes a major
    public health problem.

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Number of deaths for leading causes of death
  • Heart disease 631,636
  • Cancer 559,888
  • Stroke (cerebrovascular diseases) 137,119
  • Chronic lower respiratory diseases 124,583
  • Accidents (unintentional injuries) 121,599
  • Diabetes 72,449
  • Alzheimer's disease 72,432
  • Influenza and Pneumonia 56,326
  • Nephritis, nephrotic syndrome, and nephrosis
    45,344
  • Septicemia 34,234

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Incidence by sex and cancer site, World 2002
Source Table 1 Parkin DM, et al. CA Cancer J
Clin 2005 55 74-108
14
Mortality by sex and cancer site, World
Source Table 1 Parkin DM, et al. CA Cancer J
Clin 2005 55 74-108
15
The Major Cancers
  • Lung (ICD-10 C33 and C34)
  • Breast (female, C50)
  • Colon/rectum (C18-C20)
  • Stomach (C16)
  • Prostate (C61)
  • Liver (C22)
  • Cervix uteri (C53)
  • Esophagus (C15)

16
What is Cancer Epidemiology?
17
Definition
  • Cancer epidemiology is the study of the pattern
    of cancer in populations.
  • Its essential aim is to identify causes of
    cancer, including preventable (avoidable) causes
    and inherited tumor susceptibility.
  • It is also play an critical role in many other
    areas of cancer research including evaluation of
    screening effects, cancer prevention and control
  • Current studies directions includes molecular and
    genetic epidemiology of cancer.

18
Types of Epidemiologic Studies
  • Descriptive Epidemiologic study To describe the
    difference in occurrence of a particular cancer
    between different groups (age, gender, race,
    country, a period of time for time trend) and to
    generate the hypothesis for increased/decreased
    for the specific tumor type.

19
Types of Epidemiological Studies
  • Analytic Epidemiology To study risk factors or
    potential causes of cancer by a particular study
    design, e.g., case-control study or cohort study.

20
Types of Epidemiological Studies
  • Intervention studies Applying the knowledge
    (risk/protective factors) obtained from analytic
    epidemiological studies to specific population in
    order to reduce the risk of cancer.

21
Risk factors for Cancer
22
Percentage of Cancer Deaths Attributed to Various
Factors (Doll R and Peto R, JNCI, 1981)
  • Tobacco Use 30 (25-40)
  • Diet35 (10-70)
  • Infection 10? (1-?)
  • Reproductive Sexual Behavior 7 (1-13)
  • Occupation 4 (lt2-8)
  • Alcohol 3 (2-4)
  • Geophysical factors (natural radiation) 3
    (2-4)
  • Pollution 2 (lt1 5)
  • Food additive lt1 (-5 2)
  • Medicines and Medical Procedures 1 (0.5-3)
  • Industrial consumer products lt1 (lt1-2)
  • Unknown ?, ?

23
Harvard Center for Cancer Prevention
(www.hsph.harvard.edu/cancer)
  • Tobacco 30
  • Diet in adult life, including obesity 30
  • Sedentary lifestyle 5
  • Infectious agents 5
  • Defects in single genes that run in family 5-10

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Chemical/environmental carcinogens
  • Smoking and lung cancer
  • Sun exposure and squamous cell carcinoma of skin
  • Asbestos exposure and lung cancer
  • Smoke food risk with nitrosamines and
    adenocarcinoma of the stomach
  • Alcohol drinking and squamous cell carcinoma of
    esophagus
  • Aflatoxin B1 and liver cancer

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Radiation
  • Exposure to ultraviolet radiation (in the form of
    sunlight) and squamous cell carcinoma of skin
  • Ionizing radiation is related to skin cancer and
    leukemia in radiologist
  •  

29
Viral factors
  • HPV (human papilloma virus) and Cervix cancer
  • EBV(Epstein-Barr virus) and Nasopharyngeal
    cancer, Burkitts lymphoma
  • HBV (hepatitis B virus) and hepatocellular
    carcinoma
  • HIV (human immunodeficiency virus) and Kaposis
    sarcoma

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http//www.yourdiseaserisk.wustl.edu/hccpquiz.pl?l
angenglishfunchomepagecancer_index
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