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CANCER EPIDEMIOLOGY
Bidasari Lubis Dept.I.Kesehatan Anak FK-USU Medan
Epidemiology
The study of distribution and determinants of disease in human population ; why different population or group different risks , diferrent disease Patterns of incidence and death rates of malignant disease : sex,age,race,geography
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Concept epidemiology
General approach
What Who Where When
Descriptive epidemiology
Analytic epidemiology
Why How
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Types of epidemilogical
Occupational epidemiology : effects of workplace exposures on workers Clinical epidemiology : outcome the patients Genetic epidemiology: focus on familes or high risk individual, concerned with determinants of disease in families and on inherited causes of cancer in population Nutritional or environmental epidemiology Molecular epidemiology
Application epidemiology Planning Evaluation of cancer control Primary prevention Early detection Scope of cancer epidemiology: broad concern causes of cancer identification of population where risk reduced prevention
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Leading cancer types in Indonesia 1.Cervix cancer 2.Breast cancer 3.Colorectal cancer 4.Lung cancer 5.Nasopharyng cancer
( POI=Perhimpunan Onkologi Indonesia)
Male
Prostate Lung and bronchus Colon and rectum NHL Oral cavity Kidney Urinary bladder Pancreas Stomach liver
Female
Breast Lung and bronchus Colon and rectum Uterine corpus Pancreas Ovary NHL Kidney Multiple Myeloma
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Etiology
Chemical carcinogens Environmental and industrial carcinogens Drug induced cancers Radiation carcinogenesis Viral and immunologic mechanisms
Etiology
A.Chemical carcinogens 1.Industrial exposure 2-Naphthylamine Benzidine Bis(chloromethyl)ether Bis(2-chloroethyl)sulfide (mustard gas) Vinyl chloride Certain tars,soots,oils Chromium compounds Nickel compounds Asbestos Benzene
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2.Medical exposure N,N-bis(2-chloroethyl)2-naphthylamine (Chlornaphazin) Diethylstilbestrol Inorganic arsenic comp. Mephalan,cyclophosph amide Azathioprine,Phenytoin
2.Radiation carcinogenesis:medical x-rays,atomic weapon,radon in house 3.Viral and immunologic mechanisms -Epstein-Barr virus -Hepatitis-B -HIV 4.Environmental: ultraviolet
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Role of infection
Epstein-Barr virus (EBV) Underdeveloped country rate infection in infancy , high the age of onset HD -EBV is present in 40 60% of cases -chronic viral infection activation of cellular oncogenes, loss of tumour suppressor genes and deregulation of several cytin
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