Biological Markers for Exposures Epidemiology 243 Molecular Epidemiology of Cancer.
Cancer epidemiology an introduction
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Transcript of Cancer epidemiology an introduction
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Cancer epidemiologyan introduction
Yi Ning, ScD, MD, MPHDept of Epidemiology and Community Health
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Overview Data review Risk factors and prevention Secondary prevention
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Data review
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Cancer 1st described by Hippocrates to
describe radiating appendage-like projections observed in breast tumors› In Greek, cancer = crab
Def.: malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis
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Global NCD Death under 70
global status report on noncommunicable diseases 2010
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Age-Adjusted Death Rates* for the 10 Leading Causes of Death
WWMR, December 9, 2011 / 60(48);1656-1656
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global status report on noncommunicable diseases 2010
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New cases and deaths
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Death rates by site: Male
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Death rates by site: Female
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5 YEAR RELATIVE SURVIVAL
RATE
12 MILLION CANCER
SIVORVORS
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Risk factors and prevention
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CANCER, NON-COMMUNICABLE DISEASES AND LIFESTYLE
global status report on noncommunicable diseases 2010
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Causes of Death
WWMR, December 9, 2011 / 60(48);1656-1656
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Colon cancer paradigm
From AACR Cancer Progress Report 2011Colon cancer
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Actual Causes of Death in the United States
McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA 1993; 270(18):2207-12.
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Major recommendation from World Cancer Research Fund and American Institute for Cancer Research
(All?)
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Obesity Trends* Among U.S. Adults BRFSS, 1985
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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RESULTS:
RR for 5 kg/m2 BMI RR=1.18 (1.14, 1.21)
Ning Y. et al. Obesity Review, 200920
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Obesity Trends* Among U.S. Adults BRFSS, 1987
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 1989
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 1991
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 1993
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 1995
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 1997
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 1999
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Obesity Trends* Among U.S. Adults BRFSS, 2001
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
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Source: Behavioral Risk Factor Surveillance System, CDC
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
No Data <10% 10% –14% 15%–19% 20%–24% ? 25%
Obesity Trends* Among U.S. Adults BRFSS, 2002
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Secondary Prevention
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Natural History of CRC
Normal Epithelium
Hyperproliferating Epithelium Early
Adenoma Intermediate Adenoma
Late Adenoma Carcinoma Metastasis
Screening
30-40 years
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Secondary Prevention Natural history of the disease Treatment is effective Reduce mortality
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Cancer prevention 1981 Doll and Peto compared incidence in
countries or regions with the highest and lowest rates› Estimated majority of cancer due to
preventable causes ACS challenge goals (1996) to reduce
mortality by 50% through 2015
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