Firly Azra Ghassanie

6411422230

Cancer Epidemiology
Overview
Any disease that can affect any region of the body is referred to as cancer. Neoplasms and
malignant tumors are other words that are used. One characteristic of cancer is the quick
development of aberrant cells that expand outside of their normal borders, infiltrate other body
components, and eventually move to other organs. This process is known as metastasis. The
main reason why cancer patients die is because of widespread metastases.
The problem
Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020.
The most common in 2020 (in terms of new cases of cancer) were:
 breast (2.26 million cases);
 lung (2.21 million cases);
 colon and rectum (1.93 million cases);
 prostate (1.41 million cases);
 skin (non-melanoma) (1.20 million cases); and
 stomach (1.09 million cases).
The most common causes of cancer death in 2020 were:
 lung (1.80 million deaths);
 colon and rectum (916 000 deaths);
 liver (830 000 deaths);
 stomach (769 000 deaths); and
 breast (685 000 deaths).
Each year, approximately 400 000 children develop cancer. The most common cancers vary
between countries. Cervical cancer is the most common in 23 countries.
Causes
In a multi-stage process that often goes from a pre-cancerous lesion to a malignant tumor, cancer
develops when normal cells undergo a transition into tumor cells. These modifications are the
outcome of interactions between a person's genetic factors and three different types of outside
forces, such as:physical carcinogens, such as ultraviolet and ionizing radiation;
  chemical carcinogens, such as asbestos, components of tobacco smoke, alcohol, aflatoxin
(a food contaminant), and arsenic (a drinking water contaminant); and
 biological carcinogens, such as infections from certain viruses, bacteria, or parasites.
WHO, through its cancer research agency, the International Agency for Research on Cancer
(IARC), maintains a classification of cancer-causing agents.
The incidence of cancer rises dramatically with age, most likely due to a build-up of risks for
specific cancers that increase with age. The overall risk accumulation is combined with the
tendency for cellular repair mechanisms to be less effective as a person grows older.
Risk factors
Cancer and other noncommunicable illnesses are at risk from tobacco use, alcohol usage, poor
diet, physical inactivity, and air pollution.
Cancer risk factors can include some chronic infections; low- and middle-income nations are
particularly affected by this. Globally, carcinogenic diseases such as Helicobacter pylori, human
papillomavirus (HPV), hepatitis B, hepatitis C, and Epstein-Barr virus were linked to 13% of
cancer diagnoses in 2018.
Some strains of HPV, as well as the hepatitis B and C viruses, raise the chance of developing
liver and cervical cancer, respectively. HIV infection significantly raises the risk of some
cancers, including Kaposi sarcoma, and increases the risk of acquiring cervical cancer by six
times.
Reducing the burden
By avoiding risk factors and using currently available evidence-based prevention measures,
between 30 and 50% of malignancies can now be avoided. Early cancer identification and
adequate cancer treatment and patient care can both lessen the burden of the disease. If detected
early and treated effectively, many cancers have a high chance of recovery.
Prevention
Cancer risk can be reduced by:
 not using tobacco;
 maintaining a healthy body weight;
 eating a healthy diet, including fruit and vegetables;
 doing physical activity on a regular basis;
 avoiding or reducing consumption of alcohol;
 getting vaccinated against HPV and hepatitis B if you belong to a group for which
vaccination is recommended;
  avoiding ultraviolet radiation exposure (which primarily results from exposure to the sun
and artificial tanning devices) and/or using sun protection measures;
 ensuring safe and appropriate use of radiation in health care (for diagnostic and
therapeutic purposes);
 minimizing occupational exposure to ionizing radiation; and
 reducing exposure to outdoor air pollution and indoor air pollution, including radon (a
radioactive gas produced from the natural decay of uranium, which can accumulate in
buildings — homes, schools and workplaces).
Early detection
Cancer mortality is reduced when cases are detected and treated early. There are two components
of early detection: early diagnosis and screening.
Early diagnosis
Early detection of cancer increases the likelihood that it will react to treatment, increasing the
likelihood of survival with less morbidity and requiring less expensive treatment. Early cancer
detection and avoiding care delays can significantly enhance the lives of cancer patients.
Early diagnosis consists of three components:
 being aware of the symptoms of different forms of cancer and of the importance of
seeking medical advice when abnormal findings are observed;
 access to clinical evaluation and diagnostic services; and
 timely referral to treatment services.
Early diagnosis of symptomatic cancers is relevant in all settings and the majority of cancers.
Cancer programmes should be designed to reduce delays in, and barriers to, diagnosis, treatment
and supportive care.
Screening
Prior to the onset of symptoms, screening tries to identify people with evidence suggestive of a
particular malignancy or pre-cancer. If abnormalities are found during screening, additional tests
to confirm the diagnosis should be performed, as well as a referral for treatment if cancer is
confirmed to be present.
Screening programs are generally much more complicated and resource-intensive than early
diagnosis since they call for specialized equipment and devoted workers. They are useful for
some types of cancer, but not all. Early diagnosis programs are still required to detect cancer
diagnoses in those who do not fulfill the age or risk factor requirements for screening even after
screening programs have been established.Patient selection for screening programmes is based
on age and risk factors to avoid excessive false positive studies. Examples of screening methods
are:
  HPV test (including HPV DNA and mRNA test), as preferred modality for cervical
cancer screening; and
 mammography screening for breast cancer for women aged 50–69 residing in settings
with strong or relatively strong health systems.
Quality assurance is required for both screening and early diagnosis programmes.
Treatment
Every cancer kind calls for a different treatment plan, so a precise cancer diagnosis is crucial for
the right kind of treatment. Surgery, radiotherapy, and/or systemic therapy (chemotherapy,
hormonal treatments, and targeted biological therapies) are frequently used as therapeutic
options. When choosing a treatment plan, it is important to take into account both the cancer and
the patient. To obtain the anticipated therapeutic outcome, it is critical to complete the treatment
procedure within the allotted time frame.
Setting treatment objectives is a crucial first step. Typically, the main objective is to eradicate
cancer or significantly extend life. A key objective is enhancing the patient's quality of life.
Support for the patient's physical, emotional, and spiritual well-being as well as palliative care
throughout the latter stages of cancer might help achieve this.
When discovered early and treated in accordance with best standards, some of the most prevalent
cancer types, including breast cancer, cervical cancer, oral cancer, and colorectal cancer, have
high cure prospects.
Even when cancerous cells are present in other parts of the body, several cancer forms, such as
testicular seminoma and other types of leukemia and lymphoma in children, have high cure rates
if adequate treatment is given.
However, the availability of treatment varies significantly among nations with different income
levels; according to reports, comprehensive treatment is accessible in more than 90% of high-
income nations but only in less than 15% of low-income nations.
Palliative care
Palliative care is a form of medical care that helps patients and their families live better lives by
treating their symptoms and suffering rather than curing them. People can live more comfortably
with the aid of palliative care. It is especially necessary in areas with a large percentage of cancer
patients who are in advanced stages and have little prospect of recovery.
For more than 90% of patients with advanced stages of cancer, palliative care can provide relief
from physical, emotional, and spiritual issues.
Palliative care and pain management for patients and their families require effective public health
policies that include community- and home-based treatment.
For the management of moderate to severe cancer pain, experienced by more than 80% of those
with the disease in its terminal stage, better access to oral morphine is strongly advised.
Mention the difference between benign and malignant type
Malignant (cancerous) tumors and benign (non-cancerous) tumors are the two main categories of
tumors. Although it may continue to develop abnormally in size, a benign tumor is made up of
cells that will not infect other associated tissues or organs of the body. Cells that breach the
basement membrane and expand to other areas of the body make up a malignant tumor. This can
happen directly by spreading to nearby organs and/or tissues, or it can happen indirectly by
spreading to distant areas via the lyphatic system, the circulatory system, or by implanting or
seeding cancer cells in body cavities.
The margins of a benign tumor are distinct, uniform, and smooth. A benign tumor grows more
slowly than a malignant tumor, which has wavy boundaries. A cancerous tumor may potentially
metastasize to different regions of your body. A benign tumor can grow quite large, but it won't
migrate to other areas of your body or invade neighboring tissue.
Reference
https://www.who.int/news-room/fact-sheets/detail/cancer
https://my.clevelandclinic.org/health/diseases/22121-benign-tumor
https://training.seer.cancer.gov/disease/cancer/terms.html