data review risk factors and prevention secondary prevention
TRANSCRIPT
Cancer epidemiologyan introduction
Yi Ning, ScD, MD, MPHDept of Epidemiology and Community
Overview
Data review Risk factors and prevention Secondary prevention
Data review
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
Global NCD Death under 70
global status report on noncommunicable diseases 2010
Age-Adjusted Death Rates* for the 10 Leading Causes of Death
WWMR, December 9, 2011 / 60(48);1656-1656
global status report on noncommunicable diseases 2010
New cases and deaths
Death rates by site: Male
Death rates by site: Female
5 YEAR RELATIVE SURVIVAL
RATE
12 MILLION CANCER
SIVORVORS
Risk factors and prevention
CANCER, NON-COMMUNICABLE DISEASES AND LIFESTYLE
global status report on noncommunicable diseases 2010
Causes of Death
WWMR, December 9, 2011 / 60(48);1656-1656
Colon cancer paradigm
From AACR Cancer Progress Report 2011
Colon cancer
9/7/2004
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.
Major recommendation from World Cancer Research Fund and American Institute for Cancer Research
(All?)
Obesity Trends* Among U.S. Adults BRFSS, 1985
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
RESULTS:
RR for 5 kg/m2 BMI RR=1.18 (1.14, 1.21)
Ning Y. et al. Obesity Review, 200920
Obesity Trends* Among U.S. Adults BRFSS, 1987
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 1989
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 1991
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 1993
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 1995
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 1997
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 1999
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Obesity Trends* Among U.S. Adults BRFSS, 2001
Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10.
CDC Obesity Trends http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/
Source: Behavioral Risk Factor Surveillance System, CDC
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ? 25%
Obesity Trends* Among U.S. Adults BRFSS, 2002
Secondary Prevention
Natural History of CRC
Normal Epithelium
Hyperproliferating Epithelium
Early Adenoma Intermediate
Adenoma
Late Adenoma Carcinoma Metastasis
Screening
30-40 years
Secondary Prevention
Natural history of the disease Treatment is effective Reduce mortality
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
9/7/2004
9/7/2004