The best presentations of Epi of Cancer.ppt

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1. EPIDEMIOLOGY OF
CANCER

2. Outline
Introduction
Differentiatecategoriesofcancer
Describethemagnitudeofcancer
Outlinethecancermorbidity&Mortality-
worldwide
Highlightthecancermorbidity-Somalia
Incidenceofcancer
UnderstandtheriskfactorsforCancer
Preventionandcontrolofcancer

3. MYTH
Cancerisadiseaseofdeveloped
countries
FACT
Lowandmiddle-incomecountries
nowbearamajorityshareofthe
burdenofcancer

4. Introduction
Cancer(malignanttumoursorneoplasms)maybe
regardedasagroupofdiseasescharacterizedbyan
Abnormalgrowthofcells
Abilitytoinvadeadjacenttissuesandevendistant
organs,and
Theeventualdeathoftheaffectedpatientifthe
tumourhasprogressedbeyondthatstagewhenit
canbesuccessfullyremoved.
Canoccuratanysiteortissueofthebodyandmay
involveanytypeofcells.
Theinvasionofcancerisreferredtoasmetastasis.
Metastasesaretheprimarycauseofdeathfromcancer.

5. Categories of cancer
The major categories of cancer are :
a)Carcinomas
whicharisefromepithelialcellsliningtheinternal
surfacesofthevariousorgans(e.g.mouth,oesophagus,
intestines,uterus)andfromtheskinepithelium;
b)Sarcomas
Whicharisefrommesodermalcellsconstitutingthe
variousconnectivetissues(e.g.fibroustissue,fatand
bone);and
c)Lymphomas
Myelomaandleukaemiasarisingfromthecellsof
bonemarrowandimmunesystems.

6. Canceristhesecondleadingcauseofdeathglobally,andwasresponsible
for9.3milliondeathsin2015.Globally,nearly1in6deathsisdueto
cancer.
Approximately70%ofdeathsfromcanceroccurinlow-andmiddle-
incomecountries.
Theoverallagestandardizedcancerincidencerateisalmost25%higherin
menthaninwomen,withratesof205and165per100,000,respectively
Aroundonethirdofdeathsfromcancerareduetothe5leading
behavioralanddietaryrisks:highbodymassindex,lowfruitandvegetable
intake,lackofphysicalactivity,tobaccouse,andalcoholuse.
Tobaccouseisthemostimportantriskfactorforcancerandisresponsible
forapproximately22%ofcancerdeaths.
Magnitude of cancer

7. Cancer-causinginfections,suchashepatitisandhuman
papillomavirus(HPV),areresponsibleforapproximately30%of
cancercasesinlow-andlower-middle-incomecountries.
Late-stagepresentationandlackofaccesstodiagnosisand
treatmentarecommon,particularlyinlow-andmiddle-income
countries.
Comprehensivetreatmentisreportedlyavailableinmorethan
90%ofhigh-incomecountriesbutlessthan15%oflow-income
countries.
Theeconomicimpactofcancerissignificantandincreasing.
Thetotalannualeconomiccostofcancerin2010wasestimated
atUS$1.16trillion.
Magnitude of cancer

8. Magnitude of cancer
Globally,oneinfivemenandoneinsixwomendevelop
cancerintheirlifetime,whileoneineightmenandonein11
womendieofthisdisease.
InAfrica,itisestimatedthattherewere1,055,172new
cancercases(5.8%oftheglobaltotal)and693,487cancer
deaths(7.3%oftheglobaltotal)in2018.
SomaliaisincludedintheEastAfricanregion.

9. Themostcommonin2020(intermsofnewcasesofcancer)were:
breast(2.26millioncases);
lung(2.21millioncases);
colonandrectum(1.93millioncases);
prostate(1.41millioncases);
skin(non-melanoma)(1.20millioncases);and
stomach(1.09millioncases).
Themostcommoncausesofcancerdeathin2020were:
lung(1.80milliondeaths);
colonandrectum(935000deaths);
liver(830000deaths);
stomach(769000deaths);and
breast(685000deaths).
Cancer morbidity & Mortality-
worldwide

10. Cancer morbidity-Somalia
Theongoingglobaldemographicandepidemiologictransitionsmeanan
increasingcancerburden,especiallyinlowandmiddle-incomecountries
forthefollowingdecades.
Adefinitiveconclusionhasnotyetbeenmaderegardingtheincidenceof
allcancersintheregion.
Thepopulation-basedcancerincidenceisnotknown
ThereisnonationalcancerregistrysysteminSomalia
Itisevaluatedthatapproximatelyone-thirdofcancercasesinAfrica
occursintheEastAfricaregion.
Thedatawillbedisplayedisbasedonstudyofcancerincidencein
Somalia,especiallyinthecapitalMogadishuanditssurroundings
(Somalia Turkey Recep Tayyip Erdogan Education and Research Hospital)

11. Distribution of Cancer Cases in Somalia According to Gender and
Affected Organ from January 01, 2017 to December 31, 2019

13. The Most Common 10 Cancers Seen Among Men in East Africa Countries
and Somalia

14. The Most Common 10 Cancers Seen Among Women in East Africa
Countries and Somalia

15. Type and Frequency of Cancers in Pediatric Cases

16. What causes cancer?
Cancerarisesfromthetransformationofnormalcellsinto
tumourcellsinamulti-stageprocessthatgenerally
progressesfromapre-cancerouslesiontoamalignant
tumour.
Resultoftheinteractionbetweenaperson'sgeneticfactors
andthreecategoriesofexternalagents,including:
Physicalcarcinogens,suchasultravioletandionizingradiation;
Chemicalcarcinogens,suchasasbestos,componentsoftobacco
smoke,aflatoxin(afoodcontaminant),andarsenic(adrinking
watercontaminant);and
Biologicalcarcinogens,suchasinfectionsfromcertainviruses,
bacteria,orparasites.

17. Incidence of cancer
Theincidenceofcancerrisesdramaticallywithage,mostlikelyduetoa
build-upofrisksforspecificcancersthatincreasewithage.
Theoverallriskaccumulationiscombinedwiththetendencyforcellular
repairmechanismstobelesseffectiveasapersongrowsolder.
Approximately13%ofcancersdiagnosedin2018globallywereattributed
tocarcinogenicinfections,includingHelicobacterpylori,human
papillomavirus(HPV),hepatitisBvirus,hepatitisCvirus,andEpstein-Barr
virus.
HepatitisBandCvirusesandsometypesofHPVincreasetheriskforliver
andcervicalcancer,respectively.
InfectionwithHIVsubstantiallyincreasestheriskofcancerssuchas
cervicalcancer.

18. Modifyingoravoidingkeyriskfactorscansignificantlyreduce
theburdenofcancer.Theseriskfactorsinclude:
Tobaccouseincludingcigarettesandsmokelesstobacco
Beingoverweightorobese
Unhealthydietwithlowfruitandvegetableintake
Lackofphysicalactivity
Alcoholuse
SexuallytransmittedHPV-infection
Infectionbyhepatitisorothercarcinogenicinfections
Ionizingandultravioletradiation
Urbanairpollution
Indoorsmokefromhouseholduseofsolidfuels.
Tobaccouseisthesinglemostimportantriskfactorforcancerandis
responsibleforapproximately22%ofcancer-relateddeathsglobally
Somechronicinfectionsareriskfactorsforcancer;thisisa
particularissueinlow-andmiddle-incomecountries.
Risk factors for Cancer

19. Prevention of cancer
Cancerriskcanbereducedby:
Primaryprevention
Notusingtobacco;
Maintainingahealthybodyweight;
Eatingahealthydiet,includingfruitandvegetables;
Doingphysicalactivityonaregularbasis;
Avoidingharmfuluseofalcohol;
GettingvaccinatedagainstHPVandhepatitisBifyou
belongtoagroupforwhichvaccinationis
recommended;

20. Prevention of cancer
Cancerriskcanbereducedby:
Primaryprevention
Avoidingultravioletradiation(whichprimarilyresults
fromexposuretothesunandartificialtanningdevices);
Ensuringsafeandappropriateuseofradiationinhealth
care(fordiagnosticandtherapeuticpurposes);
Minimizingoccupationalexposuretoionizingradiation;
and
Reducingexposuretooutdoorairpollutionandindoor
airpollution,includingradon(aradioactivegas
producedfromthenaturaldecayofuranium,whichcan
accumulateinbuildings(homes,schoolsand
workplaces).

21. Prevention of cancer
Secondaryprevention
Cancermortalitycanbereducedifcasesaredetectedand
treatedearly.Therearetwocomponentsofearlydetection:
Earlydiagnosis
Ifidentifiedearly,cancerismorelikelytorespondto
treatment
Resultagreaterprobabilityofsurvivalandlessmorbidity
aswellaslessexpensivetreatment.
Consistsofthreecomponents:
Beingawareofthesymptomsofdifferentformsofcancer
andoftheimportanceofseekingmedicaladviceifyouare
concerned;
Accesstoclinicalevaluationanddiagnosticservices;and
Timelyreferraltotreatmentservices.

22. Prevention of cancer
Secondaryprevention
Screening
Screeningaimstoidentifyindividualswithfindingssuggestiveofa
specificcancerorpre-cancerbeforetheyhavedevelopedsymptoms.
Whenabnormalitiesareidentifiedduringscreening,furtherteststo
establish(ornot)adiagnosisshouldfollow,asshouldreferralfor
treatmentifneeded.
Screeningprogrammesareeffectiveforsomebutnotallcancertypes
andingeneralarefarmorecomplexandresource-intensivethanearly
diagnosisastheyrequirespecialequipmentanddedicatedpersonnel.

23. Prevention of cancer
Secondaryprevention
Screening
Patientselectionforscreeningprogrammesisbased
onageandriskfactorstoavoidexcessivefalse
positivestudies.
Examplesofscreeningmethodsare:
HPVtestingforcervicalcancer;
ThePAPcytologytestforcervicalcancer;
Visualinspectionwithaceticacid(VIA)forcervicalcancer;and
Mammographyscreeningforbreastcancerinsettingswithstrong
orrelativelystronghealthsystems.
Qualityassuranceisrequiredforbothscreeningand
earlydiagnosisprogrammes.

24. Prevention of cancer
Secondaryprevention
Treatment
Acorrectcancerdiagnosisisessentialforappropriateandeffective
treatment
Treatmentusuallyincludesradiotherapy,chemotherapyand/or
surgery.
Theprimarygoalisgenerallytocurecancerortoconsiderably
prolonglife.
Improvingthepatient'squalityoflifeisalsoanimportantgoal.
Someofthemostcommoncancertypes,suchasbreastcancer,
cervicalcancer,oralcancer,andcolorectalcancer,havehighcure
rateswhendetectedearlyandtreatedaccordingtobestpractices.
Somecancertypes,suchastesticularseminomaanddifferenttypes
ofleukaemiaandlymphomainchildren,alsohavehighcureratesif
appropriatetreatmentisprovided,evenwhencancerouscellsare
presentinotherareasofthebody.

25. Prevention of cancer
Tertiaryprevention
Palliativecare
Treatmenttorelieve,ratherthancure,symptomscausedbycancer
Improvethequalityoflifeofpatientsandtheirfamilies.
Palliativecarecanhelppeoplelivemorecomfortably.
Relieffromphysical,psychosocial,andspiritualproblemsthrough
palliativecareispossibleformorethan90%ofpatientswithadvanced
stagesofcancer.
Improvedaccesstooralmorphineisstronglyrecommendedforthe
treatmentofmoderatetoseverecancerpain,sufferedbyover80%of
peoplewithcancerintheterminalphase.