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TOBACCO AND CANCERS OF THE DIGESTIVE TRACT

TOBACCO AND CANCERS OF THE DIGESTIVE TRACT. Mini Lecture 3 Module : Tobacco Effects and Neoplasia. Objectives of the Mini Lecture. GOAL OF MINI LECTURE: Increase students’ knowledge of the risks of developing cancer associated with tobacco use. LEARNING OBJECTIVES:

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TOBACCO AND CANCERS OF THE DIGESTIVE TRACT

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  1. TOBACCO AND CANCERS OF THE DIGESTIVE TRACT Mini Lecture 3 Module: Tobacco Effects and Neoplasia

  2. Objectives of the Mini Lecture GOAL OF MINI LECTURE: Increase students’ knowledge of the risks of developing cancer associated with tobacco use. LEARNING OBJECTIVES: Students will be able to: • Identify carcinogens in cigarette smoke and mechanisms of carcinogenesis • Understand how tobacco is a risk factor for digestive cancers, lung cancer, and urogenital cancer • Appreciate the adverse effects of smoking on cancer management and the need for smoking cessation

  3. Contents Core Slides • Tobacco and Digestive Cancers • Tobacco and Digestive Cancer Risk (1) • Tobacco and Digestive Cancer Risk (2) • Smokeless Tobacco and GI Cancers • Alcohol and Smoking: Combined Effects • Alcohol and Smoking: Combined Rehabilitation

  4. CORE SLIDES Tobacco and GastrointestinalCancers Mini Lecture 2 Module: Tobacco Effects and Neoplasia

  5. Tobacco and Digestive Cancers Types of digestive cancers caused by tobacco use are: • Oral cancers • Pharynx • Larynx • Oesophagus • Liver • Pancreas • Stomach • Large intestine • Rectum 1. Polesel et al. 2008

  6. Tobacco and Digestive Cancer Risk (1) • Smoking is a strong risk factor for oesophageal squamous-cell carcinoma and cardia adenocarcinoma.1 • Individuals who smoke 25 or more cigarettes per day have a seven-fold increased risk of oral and pharyngeal cancer compared with nonsmokers.2 • There is a direct association between smoking and the risk of hepatocellular carcinoma.2 www.stjohn.org/MacombIR/Chemoemb/ 1. Lagergren et al. 2000; 2. Pelucchi et al. 2006

  7. Tobacco and Digestive Cancer Risk (2) • Smoking greatly increases the risk of dying from stomach cancer.1 • Even smoking just 2 cigarettes per day increases the risk of oral, pharyngeal and oesophageal in smokers.2 • Those who stopped smoking remained at increased risk of colon cancer even if they stopped over 10 years ago.3 http://www.elements4health.com/images/stories/conditions/digestive-system.jpg 1. American Cancer Society 2002; 2. Polesel et al. 2008; 3. Slattery et al.1997

  8. India Smokeless Tobacco andGI Cancers in India • Over 90% of oral cancer in India is attributable to tobacco use.1 • Chewers are also at risk for stomach cancer.2 www.drugsandpoisons.com/2006_11_01_archive.html 1. Dikshit and Kanhere 2000; 2. Phukan et al. 2005

  9. Alcohol and Smoking:Combined Effects • Alcohol is a cancer promoter via one or more of the following mechanisms: • Increased permeability of mucosal cells to tobacco smoke carcinogens due to solubilization by alcohol; • Presence of low levels of carcinogenic substances in alcoholic beverages; or • Cellular injury produced by ethanol metabolites. • Alcohol, when combined with cigarette smoke, significantly increases the risk of cancer in the upper aero-digestive tract. 1. Schlecht et al.1999

  10. Alcohol and Smoking:Combined Rehabilitation • The dramatic added cancer morbidity and subsequent mortality associated with smoking and drinking provides a strong argument for targeting public health campaigns to curb the effect of both exposures simultaneously. 1. Schlecht et al.1999

  11. The most important health message a doctor can give to patients is to quit smoking.

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