By

sukumar.s

‘09 althean

One of the ten most common cancers in the world.

High frequency: in central and south east asiancountries like bangladesh,India,Sri lanka and Thailand.

In India, incidence is 12.48/lakh of males and 5.52/lakh of females.

Mortality: 3.48/lakh in males and 1.34/lakh in females.

1. Tobacco: approx. 90% cases in south east asia - linked to usage of tobacco.

During 1966-77, a epidemiological survey studied 30,000 individuals over 3 districts of ernakulam(kerala), srikulam(andhra) and bhavnagar(gujarat). Risk – 36 times higher.

2.Alcohol: high concentrations – increased incidence.

3.Pre cancerous stage: like erythroplakia, leukoplakia etc. which can be detected 15 yrs prior it changes to an invasive carcinoma.

4. High risk groups: include Tobacco chewers, bidi smokers, using tobacco in the form of betal quid and those sleep with tobacco quid in the mouth.

5. Cultural patterns: Indigenous forms of smoking are bidi, chutta(cigar), chilum, hookah(hubble,bubble).

In India, tobacco is chewed as betal quid – consists of betal leaf, arecanut, lime and tobacco.

Another type of cancer - in eastern coastal regions of Andhra pradesh – is epidermoid carcinoma of hard palate - Associated with reverse smoking of cigar.

2nd most common cancer among women.

5,24,000 cases all over the world in 1995 – In India, 80% of cases.

Higher incidence in Latin America, Sub-saharanAfrica and South east asia.

a. the disease :

b. causative agent : human papilloma virus. found in > 95 % of cases.

Age : in women 25 to 45 yrs. Genital warts : present or past occurrence. Marital status : in those who are single, more likely

widowed,divorced or separated and having multiple sexual partners.

Early marriage, early child bearing and repeated child birth – inc. the risk.

OCPs : inc. duration of use and high dose of estrogen.

Socio – economic status : in lower economic groups due to poor genital hygiene.