Cancer is a leading cause of death worldwide, with an estimated 9.6 million deaths in 2018. The document discusses the major categories of cancer and their risk factors. It states that tobacco use is the most important risk factor, responsible for 22% of cancer deaths. The prevention and control of cancer involves primary prevention through reducing risk factors like tobacco and improving hygiene, as well as secondary prevention including cancer screening and early detection/treatment of precancerous lesions.
2. INTRODUCTION
Cancer may regarded as a group of diseases characterized by an:
• Abnormal growth of cells
• Ability to invade tissue and even distant organs
• The eventually death of the affected patient if the tumor has
Progressed beyond the stage when it can be successful
removed
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3. MAJOR CATEGORIES OF CANCER
CARCINOMA:
• Arises from the epithelial cells lining the internal surface of various
organs (e.g. mouth, esophagus, uterus)
SARCOMA:
• Arises from the mesodermal cells constituting the various
connective tissues (e.g. fibrous tissue, bone)
LYMPHOMA, MYELOMA AND LEUKEMIA:
• Arising from the cells of the bone marrow and immune system
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4. Global Burden
Second leading cause of death globally
Estimated 9.6 million deaths in 2018
About 1 in 6 deaths is due to cancer
Approximately 70% of deaths from cancer occur in low- and
middle-income countries.
Tobacco use is the most important risk factor for cancer and is
responsible for approximately 22% of cancer deaths
The total annual economic cost of cancer in 2010 was
estimated at approximately US$ 1.16 trillion.
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5. The Problem
Cancer is a leading cause of death worldwide, an estimated
9.6 million deaths in 2018.
I. Lung (2.09 million cases)
II. Breast (2.09 million cases)
III. Colorectal (1.80 million cases)
IV. Prostate (1.28 million cases)
V. Skin cancer (non-melanoma) (1.04 million cases)
VI. Stomach (1.03 million cases)
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6. Burden in Pakistan
Breast 19.6%
Lip, oral cavity 10.9 %
Lungs 5.6%
Esophagus 4.6%
Leukemia 4.1%
Other cancers 53.3%
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7. Number of new cases 2018,females all ages
Breast 36.8%
Lip, Oral cavity 6.4%
Cervix, Uterus 6%
Ovary 4.9 %
Esophagus 3.5 %
Other cancers 42.4%
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8. Number of new cases 2018,Males all ages
Lip, oral Cavity 15.9%
Lungs 9.8%
Esophagus 5.8%
Prostate 5.6%
Leukemia 5.2 %
Other cancers 57.77 %
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10. CAUSES OF CANCER
There are lot of international variations in the pattern of cancer
which are attributed to a number of factors divided such as:
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A.Environmental Factors
B.Genetic Factors
C. Life Style
D. Food Habits
E. Inadequacy in detection and reporting of cases
11. A. ENVIRONMENTAL FACTORS
TOBACCO
Tobacco in various forms of usage can cause cancer of lungs,
larynx, mouth, pharynx, esophagus, bladder, pancreas and
probably kidney
Cigarette smoking is now responsible for more than 1 million
death each year
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12. A. ENVIRONMENTAL FACTORS
ALCOHOL
Excess intake of alcohol can cause esophageal and liver
cancer
Beer consumption may be associated with rectal cancer
Alcohol contributes about 3 % of all cancer deaths
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13. A. ENVIRONMENTAL FACTORS
DIETARY FACTOR
Smoked fish is related to stomach cancer
Dietary fiber to intestinal cancer
Beef consumption to bowel cancer
High fat diet to breast cancer
Food additives and contaminants have fallen under suspicion
as causative agents
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14. A. ENVIRONMENTAL FACTORS
OCCUPATIONAL EXPOSURES
These includes exposure to benzene, cadmium, arsenic,
chromium, vinyl chloride, asbestos, polycyclic hydrocarbons, etc.
The risk of occupational exposure is said to be increased if the
individual also smokes cigarette
Occupational exposure is usually reported 1-5% of human
cancer
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15. A. ENVIRONMENTAL FACTORS
VIRUS
Hepatitis B & C - hepatocarcinoma
HIV infection – Kaposi's carcinoma
AIDS – non Hodgkin’s lymphoma
Epstein – bar virus – Burkett's lymphoma and naso –
pharyngeal carcinoma
Cytomegalovirus – Kaposi’s Sarcoma
Papilloma virus – cervix cancer
Human T cell leukemia virus – T cell leukemia
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16. A. ENVIRONMENTAL FACTORS
PARASITE
May be a cause of cancer
Schistosomiasis can produce Ca of bladder
CUSTOMS, HABITS AND LIFE STYLE
May be associated with an increased risk of cancer
Smoking and lung cancer
Tobacco and beetle chewing and oral cancer
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17. B. GENETIC FACTORS
Genetic influences have long been suspected
Retinoblastoma occurs in children of the same
parent
Mongols are more likely to develop leukemia
There is probably a complex relationship between
hereditary susceptibility and environmental
carcinogenic stimuli in the causation of cancer
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19. PREVENTION AND CONTROL
It consists of
Prevention, detection, diagnosis, treatment, after care and
rehabilitation, reducing incidence and prevalence.
It can achieved by:
A.PRIMARY PREVENTION
B.SECONDARY PREVENTION
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20. PRIMARY PREVENTION
Control of Tabaco and alcohol consumption
Control of these two will reduce the total burden of cancer
by 1 million cases per year
Personal hygiene:
Improvement in hygiene may decline the incidence of
certain types of cancers
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21. PRIMARY PREVENTION
Radiation
Effort should be made to reduce the amount of radiation
received by each individuals to a minimum without
reducing the benefits
Occupational Exposure
Should protect worker s from exposure to industrial
carcinogens.
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22. PRIMARY PREVENTION
Food, drugs, and cosmetics
Should be tested for carcinogens
Air pollutions
Control of air pollution is a preventive measure
Treatment of pre cancerous lesions
Early detection and prompt treatment of precancerous
lesions
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23. PRIMARY PREVENTION
Cancer Education
Should be directed in high risk groups
To motivate people for early diagnosis and treatment
A lump or hard area in the breast
A change in a wart or mole
A persistent change in digestive and bowel habits
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24. PRIMARY PREVENTION
To motivate people for early diagnosis and treatment
A persistent cough or hoarseness
Excessive loss of blood at the monthly period or loss of
blood
outside the usual dates
Blood loss from any natural orifice
A swelling or sore that does not get better
Unexplained loss of weight
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25. SECONDARY PREVENTION
Cancer registration
Hospital-based registries
Population based registries
Early detection of cases
By screening for pre-malignant conditions in high risk
groups.
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27. CANCER SCREENING
FOR CERVICAL CANCER
Pap Smear
Periodic Pelvic Examination
FOR LUNG CANCER
Chest x-rays
Sputum cytology.
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28. CANCER SCREENING
FOR BREAST CANCER
Breast self examination (BSE) by the patient
Palpation by physician
Thermography mammography
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