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World
Every year- 10 million diagnosed
6 million die
Males - mouth/oropharynx
oesophagus
stomach
Lower respiratory tract
Females - Cervix
Breast
mouth/oropharynx
oesophagus
Cancer Yearly Morbidity & Mortality by Sex
& Site
LEADING SITES OF CANCER ARE ORAL CAVITY,
prostate, LUNGS, OSEOPHAGUS AND STOMACH
AMONG MEN AND CERVIX ,BREAST AND ORAL
CAVITY AMONG WOMEN
initiation
promotion
malignant conversion
progression
METASTASIS
others Leiomyomas
surgery
chemotherapy
radiation therapy
immunotherapy
monoclonal antibody therapy-anti- HERZ
used in breast cancer.
hormonal therapy
complimentary & alternative therapies
CANCER CONTROL
Premodial prevention:
inhibit the establishment factors
(environmental, economic, social,
behavioural, cultural) known to increase the
risk of disease.
establishing healthy communities,
promoting a healthy lifestyle in childhood (for
example, through prenatal nutrition
programs and supporting early childhood
development programmes),
CANCER CONTROL
Cancer Education
screening
Cancer Screening
Methods
Mass Screening by comprehensive cancer detection
examination
Mass Screening at single sites
Results: The significant risk factors were (odds ratios with 95% CI)
previous history of biopsy for benign breast lesion 10.4 (1.3-86.3),
nulliparity 2.4 (1.14-5.08),
consumption of fats more than 30 g/day 2.4 (1.14-5.45) and
consumption of oils containing more of saturated fat 2.0 (1.03-4.52).
Conclusions: Nulliparity, past history of benign breast lesion, high fat diet and
consumption of oils with more saturated fats were the risk factors
Screening - Cervical Cancer
Chest radiograph
Sputum Cytology
Screening- Colon and Rectal Cancer
BRCA1 and BRCA2 genes that cause hereditary breast and ovarian
cancer, and
now offers the most accurate clinical tests available to determine
predisposition to cancer:
STARTED IN 1975-76
49
Evolution of NCCP
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PRIMARY
PREVENTION-
HEALTH EDUCATION
SECONDARY
PREVENTION- EARLY
DETECTION
STRENGTHENING OF
EXISTING CANCER
TREATMENT
FACILITIES
PALLIATIVE CARE IN
TERMINAL STAGE
CANCER
53
STRATEGIES
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ONCOLOGY WINGS IN
MEDICAL COLLEGES
link between the regional centres on one
hand, and the more peripheral health
infrastructure on the other hand
Financial assistance has been released for
medical colleges / hospitals for installation of
cobalt therapy facilities. For that Rs. 2 crore
per institution has been provided under this
scheme
DISTRICT CANCER CONROL
PROGRAM
LAUNCHED IN 1990-91
Cobalt therapy installation and mamography
has been strengthened
Morphine tablets, and pap smear kits RCC
12 training prog were held for medical officer
at PHC/CHC in 1999
MODIFIED DISTRICT CANCER
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CONROL PROGRAM
LAUNCHED IN 1990-91
15 LAKHS ONE TIME ASSISTANCE AMOUNT
90 LAKHS FOR 5YRS
FIVE ELEMENTS:
1. PRIMARY PREVENTION-HEALTH EDUCATION
2. SECONDARY PREVENTION-EARLY DETECTION
3. TRAINING OF MEDICAL & PARAMEDICAL
PERSONNELS
4. PALLIATIVE TREATMENT AND PAIN RELIEF
5. COORDINATION AND MONITORING
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Other members
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Implementation
NEW INITIATIVES:
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TWO LEVELS:CENTRAL GOVT. AND
STATE GOVT. LINKAGE THROUGH
THE CENTRAL GOVT
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NATIONAL CANCER REGISTRY
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PROGRAM
OBJECTIVES:
1.To generate authentic data on the magnitude of
cancer problem in india
2.undertake epidemiology investigation and
advice control measures
3.promote human resource development in cancer
epidemiology 67
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Population Based Cancer Registry
Hospital Based Cancer Registries
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Population based registries:
There are six in number ; 5 in urban areas ( delhi
, Bhopal, Mumbai, Bangalore,Chennai) and
one in rural areas ( barshi in Maharashtra).
Hospital based registries:
69
CANCER ATLAS