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[ONCG2005] Epidemiology Of Cancer & Population Genetics > 2. Risk Factors & Incidence > Flashcards

2. Risk Factors & Incidence Flashcards

1
Q

What is a ‘cause’ of cancer?

A

A factor that directly changes something in the biology to result in cancer
Eg environmental exposure/ genetic susceptibility

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2
Q

T or F:
1. If you are exposed to a cause of cancer, you will always get the disease
2. Few cancers arise from a single cause
3. Exposures can only cause 1 cancer

A
  1. F: it is not an all or nothing relationship you can be exposed but not develop the disease.
  2. T
  3. F: some exposures can cause more than 1 cancer
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3
Q

What is a risk factor

A

An exposure than increases the risk of disease

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4
Q

What are some examples of:
- exposures
- outcomes

A

Exposures: environment, lifestyle, infections, genetics
Outcomes: defined disease, health-related event, death

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5
Q

What is a confounding factor? With an example

A

A factor associated with an exposure that is wrongly linked to an outcome
EG: alcohol (exposure), lung cancer (outcome), smoking (confounding factor)

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6
Q

What are the IARC carcinogenic hazards to human calissifcations

A

1: carcinogenic
2A: probably carcinogenic
2B: possibly carcinogenic

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7
Q

When measuring exposures, what may affect the type of data collection method used?

A
  • study type
  • detail of data required
  • availability of existing records
  • lack of/ poor recall of exposure
  • sensitivity of topic
  • variability of exposure over time
  • availability of measurement tools
  • cost
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8
Q

What are some examples of sources of exposure data?

A
  • questionnaires
  • diaries
  • records
  • biological methods
  • environmental methods
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9
Q

What are the 2 types of questionnaires used to collect data on exposure, and what are their benefits/ drawbacks?

A
  • self administered: + Cheap, - no quality control
  • interviewer: + improve participation & completeness, - expensive, must be fair
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10
Q

What are some examples of data collection commonly used in cancer epidemiology?

A

Records/ routine data eg:
Medical records
Cancer registrations
Specialized surveillance
Death certificates

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11
Q

Why is population-based cancer registries often deemed superior to hospital-based?

A
  • data is comparable between countries as many countries have a population-based registry
  • you cannot calculate rates, risk, and incidence from hospital-based registries as it is more difficult to know underlying factors
  • as people move around the country, hospital-based registries are less respective of the population of the area
  • population- based used well defined populations
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12
Q

To measure cancer occurrence, what must be defined?

A
  • case: standardized definition of disease
  • population: eg region/ whole country?
  • Time period
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13
Q

How do you calculate prevalence

A

No. Of cases in defined population at one time
/
No. Of people in defined population at the same point in time

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14
Q

What is prevalence and what is it dependent on?

A

It is a ‘snapshot’ of disease frequency (a proportion)
It is dependent on: incidence (new cases), survival/mortality, recurrence, recovery/cure

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15
Q

Using the bath tub analogy, describe incidence, prevalence, cure, mortality, and recurrence

A

Prevalence is how full the bath tub is at one time
Incidence is the flow of water into the bath tub, the new cases
Cure/mortality is the leak of water from the bath tub
Reccurance is the water returning to the tub

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16
Q

What is incidence and what are its 3 measures

A
  • number of new cases in a defined population at risk during a specified time period
  • 3 measures: risk, odds of disease, incidence rate
17
Q

How do you calculate incidence risk

A

No of new cases in a population over time
/
Population initially at risk

18
Q

How do you calculate odds of disease

A

No. Of new cases in a population over time
/
No. Of people who remain disease- free

19
Q

How do you calculate incidence rate

A

No. Of new cases in population over time
/
Total person-time at risk

20
Q

T or F:
- incidence rate is measures in person-years
- incidence risk is calculated by dividing the no of new cases by the no of people who remain disease free
- odds of disease is not a measure of incidence

A
  • T
  • F: that is the calculation for odds, incidence risk is divided by population initially at risk
  • F: it is a measure of incidence
21
Q

What is a good way of estimating person-time at risk and when is it appropriate ?

A
  • by using population at mid point of calender period x length of period (an average of the calendar period)

Appropriate when:
- population is stable throughout period
- disease is rare

22
Q

What are the 3 measures of relative risk?

A
  • risk ratio (risk in exposed/risk in unexposed)
  • odds ratio (odds in exposed / odds in unexposed)
  • rate ratio (incidence rate in exposed/ incidence rate in unexposed)
23
Q

T or F:
- 1: rate ratio is rate in exposed / rate in unexposed
- 2: a relative risk of >1 is a decreased risk among exposed
- 3: measures of exposure effect is how much more likely the exposed group is to develop cancer (than unexposed group)

A
  • 1: F, incidence rate in exposed/ incidence rate in unexposed
  • 2: F, RR of >1 is a positive association, increased risk among exposed
  • 3: T
24
Q

How do you calculate:
- Risk difference (excess risk)
- Population attributable risk

A
  • Risk difference (excess risk): risk in exposed - risk in unexposed
  • Population attributable risk: excess risk x proportion of population exposed to risk factor
25
Q

T or F:
- 1: the change in incidence 2004 onwards in BC in women aged 65-69 was due to introduction of BC screening program
- 2: a decrease in incidence of malignant cancer may be due to change of ICD classification from in situ to malignant
- 3: a decrease in incidence of malignant cancer may be due to genetics

A
  • 1: T
  • 2: F, from malignant to in situ (less angers classified as malignant)
  • 3: F, genetic changes cannot be seen over just a few decades
26
Q

List 3 hereditary cancer syndromes and the gene mutated

A
  • BRCA 1 & 2 in breast & ovarian cancer syndrome
  • TP53 in Li-Fraumeni syndrome
  • MLH1, MSH2, MSH6, PMS2 (MMR genes) in Lynch syndrome / non-polyposis colon cancer
  • APC in familial adenomatous polyposis
27
Q

What % of bowel cancer is accounted for by mutations in the MMR pathway?

A

~3% (Lynch syndrome/ HNPCC)

28
Q

5% of ovarian and breast cancers are caused by mutations in what genes?

A

BRCA 1 & 2

29
Q

What is the lifetime risk of developing breast cancer for someone with mutations in the BRCA1&2 genes compared to the general population?

A

50-85% (compared to 12% in general population)

30
Q

Describe the familial and non familial cases of retinoblastoma

A
  • bilateral: 40%, familial, occurs within the first year or 2 of birth.
  • unilateral: 60%, no familial (sporadic mutation), occurs throughout early childhood, build up of environmental exposure
31
Q

What is concordance

A

The probability that a pair of individuals will both have the disease, given that one has it

[ONCG2005] Epidemiology Of Cancer & Population Genetics (10 decks)

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