1 / 40

Cancer Prevention

Dr Brenda Wilson Department of Epidemiology & Community Medicine. Cancer Prevention. Global burden of cancer. IARC estimates of new cancer patients in 2000: All countries ≈ 5,300,000 Developed ≈ 2,500,000 Less developed ≈ 2,800,000. Cancer is a disease of rich countries.

pekelo
Download Presentation

Cancer Prevention

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Dr Brenda Wilson Department of Epidemiology & Community Medicine Cancer Prevention

  2. Global burden of cancer • IARC estimates of new cancer patients in 2000: • All countries ≈ 5,300,000 • Developed ≈2,500,000 • Less developed ≈2,800,000

  3. Cancer is a disease of rich countries

  4. But cancer is not necessarily a disease of rich people

  5. Burden of cancer: Canada • 134,000 new cases per year • 65,000 deaths per year • Lifetime risk of developing cancer • males 40% • females 35%

  6. Time trends – all cancers in Canada Standardized incidence rate per 100,000 500 400 300 200 100 0 1975 1980 1985 1990 1995 2000 Year Females Males

  7. Geographical variation in Canada Fewestcases Most

  8. Canada: commonest male cancers Standardized rate per 100,000 (1998)

  9. Time trends: male cancers Standardized incidence rate per 100,000

  10. Canada: commonest female cancers Standardized rate per 100,000 (1998)

  11. Time trends: female cancers Standardized rate per 100,000

  12. 100 80 60 40 20 0 1975 1980 1985 1990 1995 2000 Year Males Females Time trends: lung cancer Standardized incidence rate per 100,000

  13. Lung cancer - men Fewest Most

  14. Lung cancer - women Fewest Most

  15. Lung cancer risk factors • Tobacco • Occupational exposures – asbestos, arsenic, polycyclic aromatic hydrocarbons, chromium, silica, nickel • Radon, radon daughters (occupational, domestic) • Protective effect of fruit & vegetables? • Genetic predisposition

  16. 70 60 50 40 30 20 10 0 1975 1980 1985 1990 1995 2000 Year Males Females Time trends: colorectal cancer Standardized incidence rate per 100,000

  17. Colorectal cancer – men & women

  18. Colorectal cancer risk factors • Family history • Diet • Ulcerative colitis & Crohn’s disease • Obesity • Lack of exercise (colon)

  19. 15 10 5 0 1975 1980 1985 1990 1995 2000 Year Males Females Time trends: melanoma Standardized rate per 100,000

  20. Melanoma – men & women

  21. Melanoma risk factors • Gender • Fair skin • UV exposure patterns • Tanning predisposition • Number of naevi • Dysplastic naevi • Family history

  22. Time trends: breast cancer Standardized rate per 100,000

  23. Breast

  24. Breast risk factors • Age • Family history • Obesity • Hormonal effects • nulliparity • age of first pregnancy • early menarche • late menopause • Socioeconomic status • Benign breast disease (some) • Radiation to chest

  25. Time trends: cervix cancer Standardized rate per 100,000

  26. Cervix

  27. Cervical cancer risk factors • Age at first intercourse • Number of sexual partners • Age • Smoking habit • Socioeconomic status • Oral contraceptive use • Nutritional deficiencies?

  28. 140 120 100 80 60 40 20 0 1975 1980 1985 1990 1995 2000 Year Time trends: prostate cancer Standardized rate per 100,000

  29. Prostate

  30. Prostate risk factors • Fat consumption • Androgens • Ethnic group • Family history • ?role of vitamins

  31. Estimated preventable cancer deaths • Smoking 30% • Diet 20-50% • Infections 10-20% • Reproductive hormones 10-20% • Alcohol 5% • EM radiation 6% • Occupational exposures 3% • Pollution up to 5%

  32. Risk factors • Tobacco • Diet & exercise • UV exposure • Viral infection • Genetic susceptibility

  33. Tobacco in Canada • 29% of adults smoke (>6m) • 1.4 million children exposed to tobacco smoke at home • Complete elimination of smoking could prevent >38,000 cancer cases, 18,000 cancer-associated deaths annually

  34. Available interventions • Individual • smoking prevention • smoking cessation • healthier diet • Societal level • Restrict availability • Restrict advertising • increase cost • smoking bans

  35. Diet & exercise in Canada • Most Canadians not meeting even minimum recommendations for fruit & vegetable consumption, most unaware of recommendations • 57% inactive during leisure time • Daily diets high in vegetables and fruit decrease cancer incidence by 20% • Healthy diet, physical activity, body mass reduces cancer incidence by 30-40% • Improve nutrition, reduce obesity – could prevent >161,000 cancer cases, 12,000 deaths

  36. Available interventions • Individual • Healthy eating campaigns, initiatives • Food preparation tips • Shopping skills • Physical activity in school curricula • Societal • Food fortification • Increase access to healthier foods • Increase nutritional information • Increase accessibility of places for physical activity

  37. UV radiation in Canada • Repeated exposure to the sun related to risk of melanoma – 66 000 new cases in 1999 in Canada • Half of adults do not adequately protect themselves against the sun. About 45% parents report that at least one of their children was sunburned at least once in the past summer • Reduction of over-exposure to sun – prevents ?13,800 melanoma cases

  38. Available interventions • Individual • Education • Societal • School policies • Occupational protection • Availability of protection

  39. Viral infections – available interventions • Cervical cancer • Education • Barrier methods of contraception • Vaccines?

  40. Environmental carcinogens • Tobacco smoke, pesticides, radon, chlorinated disinfection by-products in drinking water • Overall exposure 3-9% • Few studies • Exposure to carcinogens – we don’t know

More Related