CANCER RISK FACTORS

Risk Factor

A risk factor is anything that increases a

person's chance of getting a disease.

Some risk factors can be changed, and others

cannot.

Different cancers have different risk factors

 RISK FACTOR
Many factors contribute to the changes in cells that result
in cancer.

These risk factors may be intrinsic to an individual, such

as sex, age, or genes.

But most are external, in the individus general

environment

The interplay between the intrinsic and external factors is

the major determinant of an individual cancer risk
 Heredity? Behaviors? Other Factors?

Colon Cancer Stomach Cancer

(Number of new cases (Number of new cases
per 100,000 people) per 100,000 people)
100 100

70

50

5 7
0 0
Japan Japanese U.S. Japan Japanese U.S.
families families
in U.S. in U.S.

This suggests that the risk of developing the two kinds of cancer is not determined
primarily by heredity. The change in risk for cancer for Japanese families could
involve cultural, behavioral, or environmental factors predominant in one location and
not in the other.
 What Causes Cancer?

Some viruses or bacteria

Some chemicals Radiation

Heredity
Diet
Hormones
 CANCER RISK FACTORS

MAJOR MODIFIABLE RISK FACTORS

OTHER MODIFIABLE RISK FACTORS

CANCER RISK FACTORS

NON - M0DIFIABLE RISK FACTORS

OTHER RISK FACTORS

 MAJOR MODIFIABLE RISK FACTORS

TOBACCO USE

UNHEALTHY DIET

INFECTIOUS AGENTS

ULTRAVIOLET RADIATION

PHYSICAL INACTIVITY
 TOBACCO USE
Tobacco use is the main cause of cancers of the lung,
larynx, oral cavity, and esophagus, and a major cause of
bladder and pancreas cancers.

UNHEALTHY DIET
Up to 30% of cancers in developed countries may be
related to poor nutrition. Diets high in saturated fats and
low in fruits and vegetables increase the risk of cancers
of the breast, colon, prostate and esophagus
 Tobacco
3000 chemicals are present in tobacco smoke, 60 of which
recognize as carcinogen : nitrosamines and polycyclic
aromatic hydrocarbons either in initiation or promotion

Become carcinogen when activated by specific enzymes

found in many tissues in the body

The compounds can become part of DNA

(deoxyribonucleic acid) molecules and possible interfere
with the normal growth of cells
 Diseases associated
with cigarette smoking
 Tobacco Use and Cancer
Some Cancer-Causing Chemicals in Tobacco Smoke
 Lag Time

20-Year Lag Time Between

Smoking and Lung Cancer
Cigarette
consumption (men)

4000
150
Lung
Cigarettes 3000 cancer
Smoked (men) Lung Cancer
100 Deaths (per
per Person
per Year 2000 100,000 people)
50
1000

1900 1920 1940 1960 1980

Year
 Tobacco
Tobacco use is the environmental exposure
most widely known to be associated with an
increase risk of cancer as well as several
nonmalignant diseases.
The associated cancer :
Lung Pancreas
Larynx Kidney
Pharynx Cervix ( uterine )
Esophagus Breast
Bladder
 Avoid Tobacco

Lung Cancer Risk Increases with

Cigarette Consumption
15x

10x
Lung
Cancer
Risk
5x

0 15 30
Non-smoker
Cigarettes Smoked per Day
Limit Alcohol and Tobacco
Combination of Alcohol and Cigarettes
Increases Risk for Cancer of the Esophagus
40x

30x
Risk
Increase
20x

10x

Alcoholic Drinks
Consumed per Day
AND
Packs of Cigarettes
Consumed per Day
CANCER AND TOBACCO
CANCER AND TOBACCO
Diet: Consume Fruits and Vegetables
Dicrease Cancer Risk
 Diet: Limit Fats and Calories
Correlation Between Meat Consumption and Colon
Cancer Rates in Different Countries

40

30
Number of Cases
(per 100,000
people)
20

10

0 80 100 200 300

Grams (per person per day)
 INFECTIOUS AGENTS
Infectious agents account for 18% of cancers worldwide.
Human papilloma virus, hepatitis B virus, and the Helicobacter
Pylori bacterium account for the largest number of cancers
due to infections.

ULTRAVIOLET RADIATION
Sunlight is the major source of UV radiation, which causes
several types of skin cancers, the most common malignancy
in humans

PHYSICAL INACTIVITY
A sedentary lifestyle increases the risk of colon cancers,
and may increase the risk for other types of cancer. Its
effects are closely related to an individuals nutrition
 Viruses

Virus inserts
and changes
genes for
cell growth
Cancer-linked virus
Examples of Human Cancer Viruses
Some Viruses Associated with Human Cancers
AIDS and Kaposis Sarcoma

Without
disease

HIV infection
Depressed
immune
system

KSHV infection
Kaposis
sarcoma
 Avoid Cancer Viruses

HPV Infection Increases

Risk for Cervical Cancer
High

Cervical
Cancer
Risk

Low
Noninfected Women
women infected
with HPV
Bacteria and Stomach Cancer

Patients H. pylori
tissue sample
INFECTION AS A CAUSE OF CANCER
WORLD CANCER BURDEN CAUSED BY INFECTION
WORLD CANCER BURDEN CAUSED BY INFECTION
ULTRA VIOLET RADIATION
ULTRAVIOLET RADIATION
Protect Yourself From Excessive Sunlight
Physical Inactivity
STRENGTH OF EVIDENCE ON PHYSICAL ACTIVITY
AND DIETARY FACTORS
 PROPORTION OF CANCERS
CAUSED BY MAJOR RISK FACTORS
 OTHER MODIFIABLE RISK FACTORS

ALCOHOL USE

OCCUPATIONAL EXPOSURES

SOCIOECONOMIC STATUS

ENVIRONMENTAL POLLUTION

OBESITY

FOOD CONTAMINANTS

IONIZING RADIATION
 ALCOHOL USE
Heavy alcohol use causes cancers of the oral cavity,
esophagus, liver and upper respiratory tract. The cancer risk is
greatly increased by concurrent smoking. Alcohol use also
increases the risk of breast cancer.

OCCUPATIONAL EXPOSURES
Certain substances encountered of work are carcinogens,
including asbestos, arsenic, benzene, silica and second-hand
tobacco smoke. Lung cancer is the most common occupational
cancer.

SOCIOECONOMIC STATUS
Some cancers occur more often in people with a higher socio-
economic status ( SES ); others are more common in lower-SES
populations. SES is most likely a marker for lifestyle and other
risk factors described in this section.
Alcohol
 Alcohols Link to Cancer

Epidemiologic research has shown a dose-respondent

association between alcohol consumption and certain types
of cancer
Study on the mechanism by which alcohol contribute to
cancer development
The strongest link between alcohol and cancer : cancer of
the upper digestive tract (esophagus, mouth, pharynx,
larynx )
Less consistent with cancer of the liver, breast and colon
 Upper digestive tract
cancer- alcohol
Chronic heavy drinkers have a higher incidence of
esophageal cancer, 75 % of esophageal cancers
in US are attributable to chronic, excessive alcohol
consumption
Nearly 50 % of cancer of the mouth, pharynx, and
larynx are associated with heavy drinking
People who drink large quantities of alcohol
overtime have increases risk of this cancers
If they drink and smoke the increase risk is even
more dramatic
 Liver cancer - alcohol
Prolonged, heavy drinking has been associated
in many cases with primary liver cancer

Liver cirrhosis, hepatitis B and C virus infections

often confound data

Studies of the interactions between alcohol,

hepatitis viruses, and cirrhosis essential to
perform
 Breast cancer - alcohol
Inconsistency and weakness of epidemiology findings
suggest that a third confounding factor, such as nutrition
and fat
Alcohol increases estrogen levels in premenopausal
women, which may promote breast cancer.
Other risk factor for breast cancer :
- age of menarche : < 10 years old
- age of menopause > 50 years old
- childless
- the first labour : > 35 years old age
- has operation for either benign or malignant tumours
- has family / relative suffered from breast cancer
 Colon cancer alcohol
Small and but consistent dose-dependent association
between alcohol consumption and colorectal
cancer,even controlling for fiber and other dietary factors.

Causality cannot be determined from the available data

with cancer of the stomach, pancreas, and lungs
The association is consistency weak and the majority of
studies have found no association
 Mechanisms of
Alcohol-Related Cancers
Oncogenes
Preliminary studies show that alcohol may affect cancer
development at the genetic level by affecting oncogenes at
the initiation and promotion stages of cancer

Acetaldehyde, a product of alcohol metabolism, impairs a

cells natural ability to repair its DNA resulting in a greater
likelihood that mutations causing cancer initiation will occur
 Avoid Carcinogens at Work
Some Carcinogens in the Workplace
carcinogen Occupation Type of cancer
Occupational Exposures
 CULTURAL AND SOCIOECONOMIC FACTORS
AFFECTING CANCER SCREENING, EARLY DETECTION AND CARE
 ENVIRONMENTAL POLLUTION
Pollution of air, water and soil account for between 1% and
4% of all cancers in developed nations.

OBESITY
Obesity is an important risk factor for endometrial, kidney,
gallbladder and breast cancers.

FOOD CONTAMINANTS
Certain food contaminants are carcinogenic, including those
that occur naturally ( eg aflatoxins ) and those that are
manufactured ( eg pesticides )

IONIZING RADIATION
For most, the greatest exposure to ionizing radiation comes
from medical X rays. But we are all exposed to small
amounts of naturally occurring radiation.
 Industrial Pollution

Incidence of
Most Cancers

1930 1950 1970 1990

Year
obesity
BMI Category
 Aflatoxins
FOOD
CONTAMINANT
Nitrosamine

benzopyrine

Corn
Peanuts
Cottonseed
 IONIZING
RADIATION

cancer
 NON MODIFIABLE RISK FACTORS

AGEING

ETHNICITY OR RACE

HEREDITY

SEX
 AGEING
The risk of most types of cancer increases with age. The
highest cancer rates occur among the elderly.

ETHNICITY OR RACE
The risk of many types of cancer varies between racial
and ethnic populations. Some of these differences are
attributable to genetic differences, but most are due to
differences in lifestyle and exposures to cancer causing
agents.

HEREDITY
Inherited cancer genes may cause 4% of all cancers.
Other genes affect our susceptibility to cancer risk factors.

SEX
Certain cancers occur in only one sex due to different
anatomy, eg prostate, uterus. Others occur in both sexes,
but at markedly different rates, eg bladder, breast.
 Cancer Risk and Aging

Cancer Risk and Aging

400
Colon

3000
Breast
Number of
Cancer Cases 2000
(per 100,000
people))
1000

0 20 40 60 80
Age of Person (in years)
Ethnicity
 Heredity and Cancer
All Breast Cancer Patients

Inherited factor(s)
Other 5-10% Breast ca are familial cancer
factor(s)
Heredity Can Affect Many Types of Cancer
Inherited Conditions That Increase Risk for Cancer

Name of condition Type of cancer

 Genetic makeup
Children with primary immunodeficiency
disorders have an extremely high rate of
cancer lymphoid malignancies.
The incidence of acute leukemia is
4 30 times higher in person with Down
Syndrome> normal.
Translocation of chromosomes 8 and 14 is
associated with Burkitts lymphoma.
Genetic Testing
Sex
SEX DIFFERENCES
New cancers cases by sex
2002
REPRODUCTIVE AND HORMONAL FACTORS
 Sexual activity
Possible carcinogen or co-carcinogens
(e.g. certain viruses ) may be
venereal transmitted
In the female reproductive tract, the uterine cervix has the
highest association with malignant diseases and its
precursor.
The cervix shows an increased vulnerability to
neoplasia after exposure to infection, particularly
H(uman) P(apilloma) V(irus) infection
Since squamous cervical neoplasia begins in the
squamocolumnar junction, hyperplasia in this area
that results from the irritation of infection may be one
cause.
 Risk factor for cervical uterine
cancer
Inter sexual course beginning at the (too)
young age
Changing sexual partners (quite often)
Venereal infection disease (quite often)
Multiparous
Smoking habit
 OTHER RISK FACTORS

REPRODUCTIVE FACTORS

IMMUNOSUPPRESSION

MEDICINAL DRUGS
 REPRODUCTIVE FACTORS
Female hormones, menstrual history, and childbearing
affect the risks of breast, endometrial and ovarian cancers.

IMMUNOSUPPRESSION
Certain viruses that suppress the immune system increase
the risk of lymphoma and kaposi sarcoma.

MEDICINAL DRUGS
Some hormonal drugs can cause cancers, while others
reduce the risk. Rarely, anti cancer drugs have caused
another cancer years later.
Reproductive system
REPRODUCTIVE AND HORMONAL FACTORS
Immunosuppresion
AIDS and Kaposis Sarcoma
IMMUNOSUPRESSION
Without
disease

HIV infection
Depressed
immune
system

KSHV infection
Kaposis
sarcoma
??? Medicinal drugs
Risk Factors of Cancer
 Risk Factor/ Cancer Type

Cancer Type Risk Factor

Lung Cancer Tobacco smoke
Radon
Asbestos and other substances
Air pollution
Breast Radiation
Genetic changes (Inherited mutation)
Colorectal Cancer polyp
Genetic alteration
Diet
Cigarette smoking
Ulcerative colitis or chon's disease
Prostate Diet
Certain prostate changes
Race Africans Americans
 Risk Factor/ Cancer Type

Cancer Type Risk Factor

Liver Hepatitis viruses (HCV.HBV)
Pancreas Smoking
Diabetes
Being male
Chronic pancreatitis
Kidney Tobacco smoking
High blood pressure
Von-Hippel-Lindau syndrome (VHL)
Leukemia Radiation
Chemotherapy
Certain disease (Down syndrome)
Human T cell leukemia virus
Myelodysplatic syndrome
 Risk Factor/ Cancer Type

Cancer Type Risk Factor

Bladder Occupation
Certain infection
Tobacco smoking
Race Twice as often as Africans Americans
Treatment with cyclophosphamide or arsenic
Uterine Endometrial hyperplasia
Race Africans Americans
Hormonal replacement therapy
Obesity
Melanoma Dysplastic nevi
Fai skin
Weakened immune system
Sever blistering/Sunburn
UV irradiation
Source:http://ishwaryatechnosolutions.com/cancer.aspx
Certain viruses or bacteria may increase the risk of developing cancer

Microorganism Cancer
Human papilloma virus Cervical cancer
Helicobacter pylori Stomach cancer
Hepatitis B and hepatitis C viruses Liver cancer
Human T-cell leukemia/lymphoma Lymphoma and leukemia
virus
Human immunodeficiency virus Lymphoma and a rare cancer called
Kaposi's sarcoma
Epstein-Barr virus Lymphoma
Human herpes virus 8 Kaposi's sarcoma
Risk Factors for Breast Cancer
Risk Factors for Prostate Cancer
THANK YOU