Cancers of the Reproductive System

Review Session

November 19, 2012

Ashkan Afshin, MD, MPHScD Candidate, Department of Epidemiology

ScD Candidate, Department of Global Health & Population

Harvard School of Public Health

Kresge Building, Room 913

677 Huntington Avenue

Boston, Massachusetts 02115

Phone: (949) 235-6137

Email: aafshin@hsph.harvard.edu

Review Sessions

Format:

• Q & A (20 min)• Discussing the questions received by email (10 min)

Questions

Please send your questions or suggestions to:

Text Message:  (949) 235-6137 Email: aafshin@hsph.harvard.edu

Midterm Exam

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Stages of Tumor Development

Weinberg RA. How cancer arises. Sci Am. 1996 Sep;275(3):62-70.

AB C

E

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Stages of Tumor Development

Weinberg RA. How cancer arises. Sci Am. 1996 Sep;275(3):62-70.

Genetic Abnormalities in Cancer Cells

Genetic Abnormalities in Cancer Cells

A. Oncogenes

HER2 → Breast Cancer

B. Tumor Suppressor:

BRCA→ Breast Cancer

New cases of cancer in the US

American Cancer Society. Cancer Facts & Figures 2012. Atlanta: American Cancer Society.

New cases of cancer in the US

American Cancer Society. Cancer Facts & Figures 2012. Atlanta: American Cancer Society.

New cases of cancer in the US

American Cancer Society. Cancer Facts & Figures 2012. Atlanta: American Cancer Society.

True or False?

• Testicular cancer is the most common form of cancer in men 16-34

• Positive family history of the testicular cancer increases the risk of the cancer

• Testicular cancers is more common in African American males.

• Carcinoma in situ can sometimes progress to invasive cancer

• Obese men show highest risk of testicular cancer

True or False?

Testicular cancer is the most common form of cancer in men 16-34

Positive family history of the testicular cancer increases the risk of the cancer

Testicular cancers is more common in African American males.

Carcinoma in situ can sometimes progress to invasive cancer

Obese men show highest risk of testicular cancer

Race & Prostate Cancer

World J Urol (2012) 30:195–200

Mortality

Mortality

Incidence

Incidence

Race & Prostate Cancer

World J Urol (2012) 30:195–200

Mortality

Mortality

Incidence

Incidence

Diet & Prostate Cancer Risk

Dietary Factor Direction of Effect

Calcium

Processed Meat Intake

Fish Intake

Vitamin D

Tomatoes

Giovannucci et al. Int. J. Cancer: 121, 1571–1578 (2007)Wilson et al. J Natl Cancer Inst. 2011;103(11):876-84.Chan et al. J Clin Oncol 23:8152-8160

Diet & Prostate Cancer Risk

Dietary Factor Direction of Effect

Calcium (fatal & adv disease)

Processed Meat Intake

Fish intake (fatal disease)

Vitamin D

Tomatoes

Giovannucci et al. Int. J. Cancer: 121, 1571–1578 (2007)Wilson et al. J Natl Cancer Inst. 2011;103(11):876-84.Chan et al. J Clin Oncol 23:8152-8160

Other Risk Factors for Prostate Cancer

Risk Factor Direction of effect

Height

BMI

Other Risk Factors for Prostate Cancer

Risk Factor Direction of Effect

Height (fatal disease)

BMI (adv/fatal disease)

Breast Cancer Risk Factors

• True or False?– Nulliparity– Early menarche– Early menopause– Postmenopausal hormone use– Older forms of birth control pills – Premenopausal obesity – Alcohol use

Breast Cancer Risk Factors

• True or False?NulliparityEarly menarche

Early menopausePostmenopausal hormone useOlder forms of birth control pills

Premenopausal obesity Alcohol use

Race/Ethnicity and Breast Cancer

American Cancer Society. Breast Cancer Facts & Figures 2011-2012. Atlanta: American Cancer Society.

American Cancer Society. Breast Cancer Facts & Figures 2011-2012. Atlanta: American Cancer Society.

Race/Ethnicity and Breast Cancer

American Cancer Society. Global Cancer Facts & Figures 2nd Edition. Atlanta: American Cancer Society; 2011.

Endometrial Cancer Risk Factors• True or False:

– Nulliparity, – Early menarche– Late Menopause– Obesity– Prior breast cancer treatment with tamoxifen – Polycystic ovarian syndrome (PCOS)

Endometrial Cancer Risk Factors• True or False:

Nulliparity, Early menarche Late Menopause Obesity Prior breast cancer treatment with tamoxifen Polycystic ovarian syndrome (PCOS)

Obesity

• Obesity is not a risk factor for: – Breast Cancer – Ovarian Cancer – Testicular Cancer – Prostate Cancer

Obesity

• Obesity is not a risk factor for: – Breast Cancer – Ovarian Cancer – Testicular Cancer – Prostate Cancer