Noeplasia II Epidemiology of Cancer

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Noeplasia IIEpidemiology of Cancer

• Husni Maqboul, M.D

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Epidemiology Of Cancer

• Cancer A significant health problem, second only
  to heart disease with regard to morbidity and
  mortality
• Responsible for 564,000 deaths in 1998
• Accounted for 23 of all deaths
• Residents of U.S.A. have a one in five chance of
  dying of cancer
• Over 1,000,000 new cases each year (excluding 1
  mln. cases of non-melanoma skin cancer )

• EVERY BODY HAS HIS CANCER, HE JUST HAS TO LIVE
  LONG ENOUGH TO GET IT

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Cancer, Endogenous Exogenous factors
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Cancer, Exogenous endogenous factors

• The only certain way of avoiding cancer is
  not to be born !!!!!

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Environmental Carcinogens

• Drugs antineoplastic, immune suppressing etc..
• Organic chemicals Insecticides, herbicides,
  aromatic hydrocarbons, etc..
• Cigarette Smoke
• Ethanol
• Heavy Metals
• Sexually transmitted viruses HTLV-I, Herpes
  simplex, Human papilloma virus
• Radiation Ultraviolet light

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Age and Cancer

• Cancer Mortality by Age for Males

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Cancer Mortality by Age for Females
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Heredity and Cancer

• Hereditary predisposition
• Clustering of environmentally induced cancers in
  families.
• Close relatives of cancer patients have three
  times greater risk of developing the same
  neoplasm.
• Close relatives of patients with breast, colon,
  or endocrine cancers have greater than three
  times risk for developing the same neoplasm.
• Increased cancer risk with inherited mutations of
  cancer suppressor genes such as Rb and p53.

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Heredity and Cancer

• Inherited Cancer Syndromes
• Specific sites and tissue involved in each
  syndrome
• Tumors often associated with specific marker
  phenotype ( benign tumors, café-au-lait spots )
• Incomplete penetrance and variable expressivity

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Heredity and Cancer

• Familial Cancers
• Early age of onset
• Tumors arise in two or more close relatives
• Some times multiple and bilateral
• No specific marker phenotype
• ? Inherited or mutant genes e.g BRCA-1 BRCA-2

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Heredity and Cancer
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Acquired Preneoplastic Syndromes

• Proliferative lesions
• Regenerative cell replication
• Hyperplastic proliferation
• Neoplastic - Villous and tubular adenomas
• Dysplastic lesions
• Clinically correlated
• Atrophic gastritis
• U.C and Crohns disease
• Leukoplakia