Cancer - Etiology, Epidemology and Prevention

CANCER-
Etiology- Epidemology- Prevention
DR. RAM TAKTODE-PATIL

CONSULTANT HEAD AND NECK SURGEON
KOLHAPUR
w w w. ko l h a p u rca n c e rc e nt re . co m
At a Glance
Cancer - an overview
Cancer Burden- World wide
Cancer Burden- India
Etiology / Risk factors for the cancer
Prevention
Early detection
WHAT IS CANCER ?
Uncontrolled cell division that leads to abnormal tissue

growth.
Hallmarks of cancer
Self Sufficiency in Growth Signal

Insensitivity to AntigrowthSignal
Tissue Invasion and Metastasis
Prof.Douglas Hanahan
Limitless Replicative Potential
SustainedAngiogenesis
EvadingApoptosis
Prof. Robert
Weinberg
Cancer Burden- World

wide
Prevention
Early detection
Caner Burden- World wideBy 2030
TODAY 2030
New Cases 14 M 21.7M
Cancer 13 M
8.8 M
Deaths
www.cancer.org
Caner Burden- World Wide By 2030
Number of new cancer cases

will increase by 54%
Number of cancer related

deaths will increase by 59%
Cancer Burden-
India
Prevention
Early detection
People living with 2.5Million

Cancer
New Cancer Cases
7 Lakh
Registered
Cancer Related
5.56 Lakh
Deaths
cancerindia.org.in
Top 5 cancer incidence in India
Both Male Female

Breast Oral Breast
Cervix Lung Cervix
Oral Cavity Stomach Colorectal
Lung Colon Ovary
Colon Pharynx Oral cavity
Cancer Facts in India
Only 12.5 % of patients One in eight Indian is

come for treatment in likely to develop cancer
early stages of the in their lifetime.
disease. wIndian Council for Medical Research
w w. ko l h a p u rca n c e rc e nt re . co m
Reality In India
NDTV News Desk February 6,2017
Indians consult doctor when Patient dies in first year due to late
recovery is difficult detection
80% 70%
Prevention
Early detection
Risk factors for cancers
Modifiable
Non-modifiable
Combined
Modifiable Risk Factors
• Tobacco
• Alcohol
• Diet
• Exercise
• Obesity
• Occupational Exposure
• Infections
• Sexual Activity
Risk factors Cancer
smoking
Cigarette is smoking smokers

Tobacco
Tobacco
Alcohol
Alcohol
Obesity
Being overweight or obese INCREASES the
risk of 11 cancers:
COLON
BREAST (post-menopause)
GALLBLADDER
KIDNEY
LIVER
OESOPHAGUS (oesophageal adenocarcinoma)
OVARY
PACAREAS
PROSTATE (advanced)
STOMACH (cardia)
UTERUS (ENDOMETRIUM)
Diet
Diet
Occupation Exposure
Virus
HBV/ HCV
HPV
Sexual Activity
• HPV and carcinoma of cervix
Non-modifiable risk factors
• Genetic mutation
• Familial Syndrome
Non-modifiable risk factors
• Genetic mutation
• Familial Syndrome
• Hereditory nonpolyposis colon cancer

• Hereditory breast and ovarian cancer
• NF
• FAP
• MEN
• Lynch
At a Glance
Prevention
Early detection
Primary Prevention
Secondary Prevention
Tertiary Prevention
Primary Prevention Prevention before disease occurs
Secondary Prevention Detection of early disease
Tertiary Prevention Prevention of complications and progression
Prevention
Healthy food
Exercise
Meditation
KNOWING FAMILY HISTORY
VACCINATION
Prevention
Early detection
Understand that early detection saves lives
Cancer Screening
• Breast
• Cervix
• Colorectal
• Lung
• Prostate
CA . BREAST
2018 Screening Recommendations for Breast Cancer
Test or Procedure American Cancer Society U.S. Preventive Services Task

Force
Breast self No recommendation “D”
examination
Clinical examination No recommendation Women ≥40 years: “I”
INSUFFICIENT EVIDENCE
Mammography Women 40-44 years: Should Women 40–49 years: The decision
be able to start screening if they should be an individual one, and
want to take patient context/values into
account (“C”)
Women ≥45 years: Screen
annually for as long as the woman is
Women 50–74 years:
in good health and is expected to Every 2 years (“B”)
live for 10 years or more
“B”: The USPSTF recommends the service, because there is high certainty that the net benefit is moderate or moderate Women ≥75 years: “I”
Women ≥55 years: Can
certainty that the net benefit is moderate to substantial.
“C”: The USPSTF recommends selectively offering this service to individual patients based on professional judgment. There is
at least moderate certainty that the net benefit iscontinue
small. yearly or every 2 years
“D”: The USPSTF recommends against the service, because there is moderate or high certainty that the service has no net
benefit or that the harms outweigh the benefits.
“I”: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and
w w wharms
. k o lofh the
a pservice.
urcancercentre.com
Simplified Cervical Cancer Screening
Woman’s Age How often should a woman have a
Pap Test?
<21 years old No testing needed
21-30 years old Pap test every 3 years
30-65 years old Pap test every 3 years, or
Pap test and HPV cotesting every 5 years
>65 years old No testing needed if no abnormal

results for the past 10 years
2018 Screening Recommendations for Lung Cancer
Test or Procedure American Cancer Society U.S. Preventive Services Task Force
Low dose helical CT Current or former smokers Adults aged 55-80 years with a
scan aged 55-74 years in history of smoking: Screen every
good health: Screen every year, “B”
year
• Screening should be discontinued once:
• a person has not smoked for 15 years, or
• develops a health problem that substantially limits life expectancy or the ability or willingness
to have curative lung surgery
“A”: The USPSTF recommends the service, because there is high certainty that the net benefit is substantial.
“B”: The USPSTF recommends the service, because there is high certainty that the net benefit is
moderate or moderate certainty that the net benefit is moderate to substantial.
“C”: The USPSTF recommends selectively offering this service to individual patients based on professional judgment. There is
at least moderate certainty that the net benefit is small.
“D”: The USPSTF recommends against the service, because there is moderate or high certainty that the service has no net
benefit or that the harms outweigh the benefits.
“I”: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the
service.
Colorectal cancer screening
• Stool test
• Endoscopy
• Imaging – CT, barium enema
Prostate Cancer Screening

Serum PSA
Ovarian Cancer Screening

CA125
Most common causes of cancer are
Tobacco(25-30%), Diet and Physical Activity
related Factors (30-35%).
 60-65% cancers can be prevented just by

Lifestyle modification.
 Vaccines which can prevent malignancies

should be emphasized and counseled to parents.
Genetically related malignancies like Breast

and Colon Cancer should have screening and
Genetic Counseling.
Just as cancer affects everyone in different ways, everyone has
the power to take action to reduce the impact that cancer has.
So Let’s Educate Ourselves- Educate the Public.
THANK YOU

Cancer - Etiology, Epidemology and Prevention

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CANCER-

Etiology- Epidemology- Prevention

DR. RAM TAKTODE-PATIL

Cancer Burden- World wide

Cancer Burden- India

Etiology / Risk factors for the cancer

Uncontrolled cell division that leads to abnormal tissue

Self Sufficiency in Growth Signal

Cancer Burden- World

Cancer Burden- India

Etiology / Risk factors for the cancer

New Cases 14 M 21.7M

Number of new cancer cases

Number of cancer related

Cancer Burden- World wide

People living with 2.5Million

Both Male Female

Only 12.5 % of patients One in eight Indian is

Cancer Burden- World wide

Cancer Burden- India

Etiology / Risk factors for the cancer

Cigarette is smoking smokers

• HPV and carcinoma of cervix

• Hereditory nonpolyposis colon cancer

Cancer Burden- World wide

Cancer Burden- India

Etiology / Risk factors for the cancer

Secondary Prevention Detection of early disease

Tertiary Prevention Prevention of complications and progression

Cancer Burden- World wide

Cancer Burden- India

Etiology / Risk factors for the cancer

Test or Procedure American Cancer Society U.S. Preventive Services Task

>65 years old No testing needed if no abnormal

Prostate Cancer Screening

Ovarian Cancer Screening

 60-65% cancers can be prevented just by

 Vaccines which can prevent malignancies

Genetically related malignancies like Breast

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