Lec 08 Cancer Epidemiology

Question 1

Identify level of disease prevention:

Before disease occurs

Answer 1

Primary

Question 2

Identify level of disease prevention:

Avoidance of smoking

Answer 2

Primary

Question 3

Identify level of disease prevention:

Prior to its clinical manifestations

Answer 3

Secondary

Question 4

Identify level of disease prevention:

Before clinical progression

Answer 4

Tertiary

Question 5

How/when can a disease be considered a primary health concern?

Answer 5

When it is a top cause of mortality and morbidity

Question 6

What is/are the differences between a public health

problem and a clinical health problem?

Answer 6

• Public health problem – community is concerned; for
instance, people’s lifestyle

• Clinical health problem – management of individual
patients

Question 7

Incidence to mortality ratio (IMR) of cancer

Answer 7

2:1

For every 2 new cases, one of them will die

Question 8

Type of CA with the worst prognosis.

Answer 8

Pancreatic CA.

IMR: 1.1:1

Question 9

The number of new cases in a population at risk

Answer 9

Incidence

Question 10

Top 10 cancers in the Philippines:

Answer 10

1. Breast 6. Colon
2. Lung 7. Thyroid*
3. Liver 8. Stomach
4. Cervix 9. Nasopharynx
5. Leukemias* 10. Lymphoma*

Question 11

Easiest way to prevent 85% of the top 10 cancers.

Answer 11

By NOT SMOKING

Question 12

Virus associated with nasopharyngeal CA

Answer 12

EBV

Question 13

Leading cancer in children

Answer 13

Leukemia

Question 14

Proposed sequence of carcinogenic events?

Answer 14

Normal cell -> (Biologic effects->Genetic alterations) -> proliferation -> atypia -> in situ -> invasive cancer -> metastasis

Question 15

What is the difference between a complication and disease progression?

Answer 15

A complication is any condition that arises which
complicates the primary disease. For example, a
symptom arises due to the treatment administered.

• Disease progression is the primary disease of
interest. The disease is just following its natural course.

Question 16

What do you call the black spots of tar in a smoker’s lung?

Answer 16

Anthracosis

Question 17

1 Cause of Liver CA

Answer 17

Hep B virus

Question 18

Pre-cancerous lesion for Oral CA

Answer 18

leukoplakia

Question 19

You should not be exposed to the sun during this time to avoid Skin cancer.

Answer 19

10am-2pm

Question 20

Current lifestyle shows that the HPV vaccine is protective for how many years?

Answer 20

6-8 years

Question 21

Essential vitamins for the prevention of CA of breast, stomach, and oropharynx

Answer 21

Vitamins A,C,E

Question 22

What is the difference between a risk factor and a causative agent?

Answer 22

A risk factor adds to the probability of developing the
disease (cancer)

A causative agent causes the disease

Ex. Hep B is the causative agent for hepatitis. However, it
is only a risk factor for developing hepatocellular CA

Question 23

How can pap smear be used as primary prevention for cervical CA

Answer 23

to see CIN 3 – cervical intraepithelial neoplasia - a precervical CA lesion

Question 24

Denaturation of proteins coming from destroyed cells used in the community when no pap smear in available.

Answer 24

Aceto-whitening

Question 25

cobblestone appearance that is pathognomonic of HPV infection

Answer 25

Mosaicism

Question 26

Starting age for breast self examination

Answer 26

25

Question 27

Best time to do BSE is:

Answer 27

after shower and before bed on the 5-7 days after the last menstrual day, since nodulations caused by hormones are at a minimum; or on first day of month if not menstruating

Question 28

T/F Fibrocystic changes have higher probability of progressing to breast cancer than fibroadenoma

Answer 28

T

Question 29

If polyp is beyond this size, a mandatory polypectomy should be done and tissue recovered should be subjected to biopsy

Answer 29

2cm

Question 30

Population at risk for cervical CA

Answer 30

sexually active females

Question 31

9 Danger Cancer Signs

Answer 31

CAUTION US C hange in bowel or bladder habits A sore that does not heal U nusual bleeding and/or discharge T hickening or lump in breast or elsewhere I ndigestion or difficulty in swallowing O bvious change in wart or mole N agging cough or hoarseness U nexplained anemia S udden weight loss

Question 32

Define CURE, CONTROL and PALLIATION

Answer 32

CURE – if treatment is given, survival of patient is the same as any normal person, same age, sex, and comorbidities (quantity of life) CONTROL – if treatment is given, survival is longer than that of a patient with same diagnosis, cancer stage, age, and sex (quantity and quality of life) PALLIATION – treated or untreated, survival is the same (goal is quality of life)