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CANCEREPIDEMIOLOGYBidasari Lubis

Dept.I.Kesehatan Anak FK-USU Medan

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Epidemiology

The study of distribution and determinants of

disease in human population ; why different

population or group different risks , diferrentdisease

Patterns of incidence and death rates of

malignant disease : sex,age,race,geography

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Concept epidemiology

1.Disease is not randomlydistributed

2.Disease causation is multifactorial

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General approach

What

Who

Where

When

Descriptive epidemiology

Analytic epidemiology Why

How

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Types of epidemilogical

Occupational epidemiology:

effects of workplace exposures on workers

Clinical epidemiology: outcome the patients

Genetic epidemiology: focus on familes or high

risk individual, concerned with determinants of

disease in families and on inherited causes of

cancer in population Nutritional or environmental epidemiology

Molecular epidemiology

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Application epidemiology

Planning

Evaluation of cancer control

Primary prevention Early detection

Scope of cancer epidemiology: broad

concern causes of canceridentification of population where risk

reducedprevention

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Leading cancer types in Indonesia

1.Cervix cancer

2.Breast cancer

3.Colorectal cancer 4.Lung cancer

5.Nasopharyng cancer

( POI=Perhimpunan Onkologi Indonesia)

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Leading cancer types among African

American

Male Prostate

Lung and bronchus

Colon and rectum NHL

Oral cavity

Kidney

Urinary bladder Pancreas

Stomach

liver

Female Breast

Lung and bronchus

Colon and rectum Uterine corpus

Pancreas

Ovary

NHL Kidney

Multiple Myeloma

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Etiology

Chemical carcinogens

Environmental and industrial carcinogens

Drug induced cancers

Radiation carcinogenesis

Viral and immunologic mechanisms

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Etiology

A.Chemical

carcinogens

1.Indus tr ial exposure

2-Naphthylamine

Benzidine

Bis(chloromethyl)ethe

rBis(2-

chloroethyl)sulfide

(mustard gas)

Vinyl chloride

Chromium

compounds

Nickel compounds

Asbestos

Benzene

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2.Med ical exposure

N,N-bis(2-

chloroethyl)-2-

naphthylamine(Chlornaphazin)

Diethylstilbestrol

Inorganic arseniccomp.

Mephalan,cyclophos

phamide

Azathio rine Phen t

3.Soc ietal exposu re

Cigarette smoke

Betel nut and

tobacco quid

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2.Radiation carcinogenesis:medical x-

rays,atomic weapon,radon in house

3.Viral and immunologic mechanisms

-Epstein-Barr virus

-Hepatitis-B

-HIV

4.Environmental: ultraviolet

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Cancers 7 warning signals

1.Change in bowel or bladder habits

2.A sore that does not heal

3.Unusual bleeding or discharge

4.Thickening or lump in breast or elsewhere5.Indigestionor difficulty in swallowing

6.Obvious change in wart or mole

7.Nagging cough or hoarseness

If you have a warning signal ,see your doctor

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Role of infection

Epstein-Barr virus (EBV)

Underdeveloped country rate infection in

infancy , high the age of onset HD

-EBV is present in 40 60% of cases

-chronic viral infection activation of

cellular oncogenes, loss of tumour

suppressor genes and deregulation of

several cytin

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