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Cancer epidemiology an introduction

Cancer epidemiology an introduction. Yi Ning, ScD, MD, MPH Dept of Epidemiology and Community Health yning2@vcu.edu. Overview. Data review Risk factors and prevention Secondary prevention. Data review. Cancer.

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Cancer epidemiology an introduction

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  1. Cancer epidemiologyan introduction Yi Ning, ScD, MD, MPH Dept of Epidemiology and Community Health yning2@vcu.edu

  2. Overview • Data review • Risk factors and prevention • Secondary prevention

  3. Data review

  4. Cancer • 1st described by Hippocrates to describe radiating appendage-like projections observed in breast tumors • In Greek, cancer = crab • Def.: malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis

  5. Global NCD Death under 70 global status report on noncommunicable diseases 2010

  6. Age-Adjusted Death Rates* for the 10 Leading Causes of Death WWMR, December 9, 2011 / 60(48);1656-1656

  7. global status report on noncommunicable diseases 2010

  8. New cases and deaths

  9. Death rates by site: Male

  10. Death rates by site: Female

  11. 5 year relative survival rate12 million cancer sivorvors

  12. Risk factors and prevention

  13. Cancer, non-communicable diseases and lifestyle global status report on noncommunicable diseases 2010

  14. Causes of Death WWMR, December 9, 2011 / 60(48);1656-1656

  15. Colon cancer paradigm Colon cancer From AACR Cancer Progress Report 2011

  16. Actual Causes of Death in the United States McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA 1993; 270(18):2207-12.

  17. Major recommendation from World Cancer Research Fund and American Institute for Cancer Research (All?)

  18. Obesity Trends* Among U.S. Adults BRFSS, 1985 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  19. RESULTS: RR for 5 kg/m2 BMI RR=1.18 (1.14, 1.21) Ning Y. et al. Obesity Review, 2009

  20. Obesity Trends* Among U.S. Adults BRFSS, 1987 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  21. Obesity Trends* Among U.S. Adults BRFSS, 1989 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  22. Obesity Trends* Among U.S. Adults BRFSS, 1991 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  23. Obesity Trends* Among U.S. Adults BRFSS, 1993 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  24. Obesity Trends* Among U.S. Adults BRFSS, 1995 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  25. Obesity Trends* Among U.S. Adults BRFSS, 1997 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  26. Obesity Trends* Among U.S. Adults BRFSS, 1999 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  27. Obesity Trends* Among U.S. Adults BRFSS, 2001 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10. CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/

  28. Secondary Prevention

  29. Natural History of CRC 30-40 years Normal Epithelium Hyperproliferating Epithelium Early Adenoma Intermediate Adenoma Late Adenoma Metastasis Carcinoma Screening

  30. Secondary Prevention • Natural history of the disease • Treatment is effective • Reduce mortality

  31. Cancer prevention • 1981 Doll and Peto compared incidence in countries or regions with the highest and lowest rates • Estimated majority of cancer due to preventable causes • ACS challenge goals (1996) to reduce mortality by 50% through 2015

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