Chronic Disease - Cancer Flashcards

(33 cards)

1
Q

what are the most common cancers

A

breast, lung, prostate, bowel
recent increase in incidence of cancers linked to lifestyle - kidney, liver, skin, oral

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2
Q

what age is cancer most common in

A

1/3 of cancers are in those aged 75+

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3
Q

incidence of cancer on SES

A

higher incidence in those living in more deprived areas - especially smoking-related cancers

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4
Q

outline geographical variation of cancer

A

due to ethnic differences - genetic factors
environmental exposures - infections
lifestyle - diet, smoking, alcohol
demographic factors - age, sex, SES

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5
Q

what is cancer?

A

clonal disease with ability to metastasize
solid tumours or leukemias

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6
Q

why is cancer screening important

A

breast, colon, prostate and cervical cancer screening
for public health, detectability, early intervention

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7
Q

what is the risk of cancer at age 14 and 24

A

14 = 1 in 600
24 = 1 in 300

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8
Q

what are the main cancers in childhood

A

leukemia/lymphoma
brain

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9
Q

what are the main cancers in men

A

big groups are lung cancer, prostate and colorectal

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10
Q

does childhood cancer affect more boys or girls

A

more boys

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11
Q

what % of childhood cancer can be attributed to genetic factors

A

5%

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12
Q

what are congenital conditions associated with childhood cancer

A

downs syndrome
neurofibromatosis
fanconis anaemia

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13
Q

what does the greater incidence of childhood cancer suggest

A

something to do with better detection but there is still an increase, so suggests a change in environment

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14
Q

what is an example for an environmental cause of leukemia

A

clustering in seascale village and new towns on leukemia and brain tumours

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15
Q

what were aetiological candidates of the seascale environment in causing leukemia

A

it is located near a nuclear plant so radiation, population mobility, occupation exposures and EMF (power lines)

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16
Q

outline how X rays affect pregnancy

A

increased risk of leukaemia and solid tumours by 30%
X ray therapy increases risk of malignancy - 4 fold increase

17
Q

what case control study tried to get to the bottom of the seascale cluster

A

Gardner et al - paternal preconceptional occupational radiation
107 cases but the case study was flawed - did not select controls well
court case found no sufficient evidence for the association and there was no biological plausibility given the amount of radiation

18
Q

what was other evidence for paternal exposure in the seascale cluster

A

consistent findings of increased risk for leukeamias in children of men employed in radiation industry and petrochemical industry

19
Q

what did the exposure of fathers not explain in seascale?

A

commuters
evacuees
which all were shown to have high rates of leukemia
special population movements

20
Q

what was the population mixing hypothesis for the seascale cluster and leukeamia

A

linekd increased risk with population movement
more incomers = more risk

21
Q

what was Kinlens hypothesis in regard to population mixing for seascale cluster

A

when populations mix for first time there is an exchange of infectious agents for which the previously isolated (susceptible) populations do not have herd immunity
results in childhood infection which can manifest as leukeamia

22
Q

what was Kinlens hypothesis based on and why is this problematic

A

communities where mixing occurred like new towns, commuter towns and places used for war time evacuation
but ww2 evacuation was based on mortality data not incidence data so not a good measure BUT there was less treatments at the time so maybe mortality was best analyses back then

23
Q

outline population mixing and childhood leukemia in Cumbria

A

evidence shows higher rates of childhood leukaemia for children of non-Cumbrian parents, especially in early childhood, age 1-6
demonstrated population mixing could explain the higher rates

24
Q

what did the study conclude about population mixing in Cumbria

A

it increases risk of childhood leukaemia by a factor of 2.5 in children of non-Cumbrian parents and accounts for 58% of cases

25
what did the Cumbria leukaemia study summarise
children of radiation workers have higher rate of leukeamia - 2/3 due to population mixing and 1/3 due to fathers radiation exposure there is a dose-response relationship not accounted for by population risk is higher for seascale children but dose response not the same
26
what was the Greaves hypothesis of infection and childhood leukaemia
it is normal for children to encounter many infections in early first year - but this is for immune protection or dose limitation from mothers antibodies/breast milk so said it was due to a reduction in breastfeeding
27
Greaves : in what 3 ways do lifestyles compromise evolutionary adaptation of the immune system?
pregnant mothers not being exposed reduction in breastfeeding reduction and delay of infection
28
what infections did evidence show in solid tumours
space-time clustering of brain tumours EBV, measles and influenza but this is not consistent
29
what are some dietary requirements factors of potentially greater risk to childhood leukaemia
flavonoids - fruits and veg catechins - tea, cocoa, wine
30
what does evidence show about alcohol consumption and leukaemia
higher number of drinks in pregnancy conferred greater risk of AML leukaemia
31
outline herbicides/pesticides as risk for leukaemia
gene-environment interaction indoor use of insectisides and pesticide use in garden is a risk mothers with CYP1A1m1 mutation during pregnancy or child exposed -> risk
32
outline prenatal exposure to EMF causing leukaemia
maternal occupational exposure to extremely low frequency magnetic fields during pregnancy increased risk of leukaemia MODERATELY highest odds ratio was 1.2-5.0
33
how could we minimise childhood ALL leukaemia?
encourage protracted breastfeeding avoid known leukemogens in pregnancy encourage early social contact - play groups identify at-risk individuals