cancer - a public health issue. epidemiology the study of the patterns, causes, and effects of...

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CANCER - a public health issue

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Page 1: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

CANCER

- a public health issue

Page 2: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

epidemiology

• the study of the patterns, causes, and effects of health and disease conditions in defined populations

• informs policy decisions and evidence-based medicine – identifies risk factors for disease– targets for prevention

Page 3: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• Epidemiologists help with study design, collection and analysis of data, and interpretation and distribution of results

Page 4: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Canadian Cancer Statistics 2013

Page 5: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Canadian Cancer Statistics 2013

Page 6: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Canadian Cancer Statistics 2013

Page 7: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Canadian Cancer Statistics 2013

Page 8: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Cancer in Canada

Page 9: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Cancer Risk FactorsThere are many known risk factors for cancer:

• Tobacco Use (30%)• almost 30% of all fatal cancers in Canada

• major cause of lung cancer

Page 10: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• Poor Diet/Obesity/ Lack of Exercise (30%)• one with a high proportion of dietary fat, about 20% of

fatal cancers

• Colon and prostate cancers are associated with diets high in fat

http://www.youtube.com/watch?v=aUaInS6HIGo&feature=c4-overview-vl&list=PL4TcyUrQ3YhJ4X5kajWcx9myxoLfx_zt-

Page 11: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• Other Risks (30%)• workplace hazards

• family history

• alcohol use

• reproductive factors

• sexual activity

• sunlight/ ionizing radiation

• drugs

Page 12: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Reducing your risk• Live well. Make healthy choices.

• Be a non-smoker and avoid second-hand smoke.

• Keep a healthy body weight. Be active and eat well.

• Know the risks of alcohol.

• Protect your skin.

Page 13: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

But…What’s causing cancer?

• A look inside the nucleus

Page 14: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• Multi cellular organisms = billions of cells• cells need to divide and copy themselves for a variety of

reasons.

For example:

– cells wear out and need to be replaced

– new cells allow the body to repair damaged tissue

– new cells allow the body to grow

Page 15: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Cell Division

- The most common form of cell division is mitosis

- Occurs in all body cells and is used for growth and repair

- cell makes an exact copy of itself and splits into two new cells

- Each cell contains an exact copy of the original cell’s DNA: this is the reason why all the cells in an organism are genetically identical

Page 16: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• Cell division occurs through a copying of its genetic information

Page 17: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs
Page 18: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs
Page 19: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• At the end of mitosis you end up with two identical (daughter) cells, each carrying the same DNA

http://www.youtube.com/watch?v=Q6ucKWIIFmg

Page 20: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

But…what’s so important about DNA?

• In a cell all functions are carried out by proteins: control of cell reproduction, production of energy, production of hormones, production of digestive enzymes, etc.

• DNA contains genes: the blueprints for those proteins

• Each gene is an assembly guide (think IKEA) on how to put the protein together

Page 21: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

DNA RNA protein

Page 22: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Central Dogma of Molecular Biology

DNA RNA protein

Page 23: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• If there is a mistake (mutation) in the blueprint, in the DNA, there will be a mistake in the protein

• Most times the cell will detect the mistake and die:

Page 24: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Figure 9.21 Apoptosis: Programmed Cell Death

Page 25: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

When cell division goes wrong

• Cell division is tightly controlled by genes inside the nucleus.

• Special genes, called oncogenes, stimulate cell division

• If through a mutation an oncogene is irreversibly switched “on” it can cause uncontrolled cell division

Page 26: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

CANCER = uncontrolled cell division

• Cells divide, divide, and divide…

www.microscopyu.com/moviegallery/livecellimaging/3t3/index.html

http://www.youtube.com/watch?v=IeUANxFVXKc

Page 27: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

tumour

Page 28: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• The uncontrolled growth of cells forms a lump called a tumour.

– Some tumours are benign and may not cause any problems.

– Others are malignant. They can invade into other body tissues and cause severe damage. It is these malignant tumours that we call cancer.

• There are over 200 different types of cancer and they can occur anywhere in the body.

Page 29: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs
Page 30: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

Cancer Treatments

1. Surgery- Effective for tumours in a defined area, often the first

treatment

1. Chemotherapy- Medication used to target and kill quickly-dividing

cancer cells: some prevent new cells from splitting apart, while others stop the production of new DNA

2. Radiation therapy- high-energy radiation is aimed at the growing tumour

to damage its DNA

3. Some combination

Page 31: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

• http://www.hhmi.org/biointeractive/cancer/angiogenesis.html

Page 32: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

What do you think?

A new genetic screening test for some cancers could allow for the identification of people who are at higher risk. Even if the test is positive, the person may never develop cancer. Do you think such a test should be available and if so, should it be publicly funded?

Page 33: CANCER - a public health issue. epidemiology the study of the patterns, causes, and effects of health and disease conditions in defined populations informs

What do you think?

Certain cancer are linked to lifestyle choices (i.e. smoking), some people think that public health care dollars should not support the treatment of these types of cancers (at least not 100%) and that there is a certain degree of personal choice and responsibility.