Cancer
SHIVANI S P
ROLL NO : 76
BATCH : 2023
DEPARTMENT OF COMMUNITY MEDICINE
GOVERNMENT SIVANAGAI MEDICAL COLLEGE
Introduction
Cancer is group of diseases characterised by
Abnormal growth of cells
Ability to invade adjacent tissues and even distant organs
Eventual death of the affected patient if the tumour has
progressed beyond that stage when it can be successfully
removed.
Causes of cancer
[Link] FACTORS[ 80-90%]
Tobacco-causes cancer of lung,larynx,mouth, pharynx,esophagus,bladder and probably
kidney
Alcohol - esophageal and liver cancer
Dietary factors
occupational exposure - exposure to benzene,asbestos,cadmium and vinylchloride
BIOLOGICAL FACTORS
Viruses - Hepatitis b and c viruses causes carcinoma liver , Kaposi’s sarcoma in AIDS , Epstein-
Bar virus in Burkit’s lymphoma and nasopharyngeal carcinoma,HPV in cervical cancer ,HTLV in
T-cell leukaemia/lymphoma
Parasites - schistosomiasis in bladder cancer
[Link] FACTORS
Retinoblastoma in children
Mongols are likely to develop leukemia
Epidemiology of selected cancers
[Link] CANCER
One of the ten most common cause of cancer
major problem in India which caused 8.7deaths per 100,000 population
EPIDEMIOLOGICAL FEATURES
Tobacco and alcohol consumption
Precancerous stage
High risk groups
Cultural patterns
Epidermoid carcinoma of hard palate - seen in eastern coast of Andhra Pradesh
PREVENTION
1. PRIMARY PREVENTION
control of tobacco and alcohol consumption by health education and legislative measures
2. SECONDARY PREVENTION
Early detection of precancerous lesions
[Link] cancer
4th most frequent cancer in woman
EPIDEMIOLOGICAL FEATURES -RISK FACTORS
Age - 25 to 40 years
Genital warts- past/present occurrence
Marital status - mostly associated with sexual intercourse
Early marriage - early coitus , early child bearing and repeated child birth
Oral contraceptive pills
Socioeconomic class - common in low socioeconomic class
woman living with HIV
PREVENTION
Primary prevention
HPV vaccination
[Link] cancer
2nd leasing cause of global cancer incidence in 2022
5th leasing cause of cancer mortality worldwide
In India CA breast is the top most common cancer with incidence rate about 26.6 per 1,00,000 population
EPIDEMIOLOGICAL FEATURES - RISK FACTORS
Age : Bimodal trend - increasing incidence between ages 35 to 50 and after 65 years
Family history : Risk increases with first degree relatives
Parity : CA breast is directly related with age at which the woman bore her first child
Age at menarche and menopause
Prior breast biopsy
Diet
Socioeconomic status
Radiation exposure , OC pills
PREVENTION
Behavioural choices like - prolonged breast feeding , regular physical activity weight reduction , avoidance of alcohol and
tobacco and avoidance of radiation and prolonged hormonal use
GLOBAL BREAST CANCER INITIATIVE
Objective: Reduce global breast cancer mortality by 2.5% per year thereby averting 2.5 million deaths globally by 2020 -
2040
The three pillars toward achieving these objectives are: health promotion earlydetection; timely diagnosis; and
comprehensive breast cancer management.
[Link] cancer
EPIDEMIOLOGICAL FEATURES
Age and sex : 1/3rd of cancer death occurs below 65 years
Risk factors : Smoking , air pollution , occupational exposure [ asbestos exposure] , radiation exposure
PREVENTION
PRIMARY PREVENTION
80-90% of lung cancer death is due to smoking
Methods of controlling the smoking epidemic have been described by the WHO expert committees in their eports. Broadly
these methods include:
a. Public information and education
b. Legislative and restrictive measures
C. Smoking cessation activities
d. National and international coordination
SECONDARY PREVENTION
Early case detection - chest X-ray and sputum cytology
[Link] cancer
Epidemiological features
Twice fold increase in men more than female
Two types - non cardio gastric carcinoma [ declined over 50 years ] and gastric cardia
carcinoma [ epidemiological features similar to oesophageal adenocarcinoma and GERD ]
Infection by Helicobacter pylori
Constant decrease in CA stomach is seen in industrialused countries because of better
food preservation practices and better nutritional food intake
clinical presentation
1. Lump or hard area in the breast
2. Persistent change in digestive and bowel habits
3. Persistent cough or hoarseness
4. Excessive loss of blood at the monthly period or loss
of blood outside the usual dates
5. Blood loss from any natural orifice
6. A swelling or sore that does not get better
7. Unexplained loss of weight
8. A sore that doesn't heal.
9. Coughing up blood;
10. Blood in urine
Diagnosis - cancer screening
Search of unrecognised malignancies by means of rapidly applied tests
[Link] FOR CERVIVAL CANCER
pap smear
VIA - Visual Inspection with 5% acetic acid
VIAM - VIA with magnification
VILI - Visual Inspection with Lugol’s Iodine
[Link] FOR BREAST CANCER
BSE - Breast Self Examination
Palpation by physician
Thermography
Mammography
[Link] FOR LUNG CANCER
Chest radiogram
sputum cytology
Prevention and control measures
PRIMARY PREVENTION
Control of tobacco and alcohol consumption
Personal hygiene
Radiation
Occupational exposure
Immunisation
Testing of food , drugs and cosmetics
Air pollution
Treatment of precancerous lesions
Legislation
Cancer education
SECONDARY PREVENTION
CANCER REGISTRATION
Base for assessing the magnitude of problem and for planning necessary measures
Two types - Hospital based registries and Population based registries
EARLY DETECTION OF CASES
Cancer screening
TREATMENT
Certain cancers are amendable by surgical measures while others respond favourably to radiation, chemotherapy or both
For patients beyond curable stage pain relief should be the goal
Cancer Control Programmes in India
NPNCD
National Tobacco Control Programme
Universal immunisation programme