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CANCER RISK FACTORS

Risk Factor

A risk factor is anything that increases a


person's chance of getting a disease.

Some risk factors can be changed, and others


cannot.

Different cancers have different risk factors

RISK FACTOR
Many factors contribute to the changes in cells that result
in cancer.
These risk factors may be intrinsic to an individual, such
as sex, age, or genes.
But most are external, in the individus general
environment
The interplay between the intrinsic and external factors is
the major determinant of an individual cancer risk

Heredity? Behaviors? Other Factors?


Colon Cancer

Stomach Cancer

(Number of new cases


per 100,000 people)

(Number of new cases


per 100,000 people)

100

100
70

50

5
0

7
0
Japan

Japanese
families
in U.S.

U.S.

Japan

Japanese
families
in U.S.

U.S.

This suggests that the risk of developing the two kinds of cancer is not determined
primarily by heredity. The change in risk for cancer for Japanese families could
involve cultural, behavioral, or environmental factors predominant in one location and
not in the other.

What Causes Cancer?


Some viruses or bacteria

Some chemicals

Radiation

Heredity
Diet
Hormones

CANCER RISK FACTORS

MAJOR MODIFIABLE RISK FACTORS

OTHER MODIFIABLE RISK FACTORS

CANCER RISK FACTORS

NON - M0DIFIABLE RISK FACTORS

OTHER RISK FACTORS

MAJOR MODIFIABLE RISK FACTORS

TOBACCO USE

UNHEALTHY DIET

INFECTIOUS AGENTS

ULTRAVIOLET RADIATION

PHYSICAL INACTIVITY

TOBACCO USE
Tobacco use is the main cause of cancers of the lung,
larynx, oral cavity, and esophagus, and a major cause of
bladder and pancreas cancers.

UNHEALTHY DIET

Up to 30% of cancers in developed countries may be


related to poor nutrition. Diets high in saturated fats and
low in fruits and vegetables increase the risk of cancers
of the breast, colon, prostate and esophagus

Tobacco
3000 chemicals are present in tobacco smoke, 60 of which
recognize as carcinogen : nitrosamines and polycyclic
aromatic hydrocarbons either in initiation or promotion
Become carcinogen when activated by specific enzymes
found in many tissues in the body
The
compounds
can
become
part
of
DNA
(deoxyribonucleic acid) molecules and possible interfere
with the normal growth of cells

Diseases associated
with cigarette smoking

Tobacco Use and Cancer


Some Cancer-Causing Chemicals in Tobacco Smoke

Lag Time
20-Year Lag Time Between
Smoking and Lung Cancer
Cigarette
consumption (men)

4000
Cigarettes
Smoked
per Person
per Year

3000

Lung
cancer
(men)

150
100

2000
50

1000
1900 1920 1940 1960 1980
Year

Lung Cancer
Deaths (per
100,000 people)

Tobacco

Tobacco use is the environmental exposure


most widely known to be associated with an
increase risk of cancer as well as several
nonmalignant diseases.

The associated cancer :


Lung
Larynx
Pharynx
Esophagus
Bladder

Pancreas
Kidney
Cervix ( uterine )
Breast

Avoid Tobacco
Lung Cancer Risk Increases with
Cigarette Consumption

15x

10x
Lung
Cancer
Risk

5x

Non-smoker

15
Cigarettes Smoked per Day

30

Limit Alcohol and Tobacco


Combination of Alcohol and Cigarettes
Increases Risk for Cancer of the Esophagus
40x
30x
Risk
Increase
20x
10x

Alcoholic Drinks
Consumed per Day

AND
Packs of Cigarettes
Consumed per Day

CANCER AND TOBACCO

CANCER AND TOBACCO

Diet: Consume Fruits and Vegetables


Dicrease Cancer Risk

Diet: Limit Fats and Calories


Correlation Between Meat Consumption and Colon
Cancer Rates in Different Countries
40

Number of Cases
(per 100,000
people)

30

20

10

80

100

200

300

Grams (per person per day)

INFECTIOUS AGENTS
Infectious agents account for 18% of cancers worldwide.
Human papilloma virus, hepatitis B virus, and the Helicobacter
Pylori bacterium account for the largest number of cancers
due to infections.

ULTRAVIOLET RADIATION
Sunlight is the major source of UV radiation, which causes
several types of skin cancers, the most common malignancy
in humans

PHYSICAL INACTIVITY
A sedentary lifestyle increases the risk of colon cancers,
and may increase the risk for other types of cancer. Its
effects are closely related to an individuals nutrition

Viruses

Virus inserts
and changes
genes for
cell growth
Cancer-linked virus

Examples of Human Cancer Viruses


Some Viruses Associated with Human Cancers

AIDS and Kaposis Sarcoma


Without
disease

HIV infection
Depressed
immune
system

KSHV infection
Kaposis
sarcoma

Avoid Cancer Viruses


High

HPV Infection Increases


Risk for Cervical Cancer

Cervical
Cancer
Risk

Low

Noninfected
women

Women
infected
with HPV

Bacteria and Stomach Cancer

Patients
tissue sample

H. pylori

INFECTION AS A CAUSE OF CANCER

WORLD CANCER BURDEN CAUSED BY INFECTION

WORLD CANCER BURDEN CAUSED BY INFECTION

ULTRA VIOLET RADIATION

ULTRAVIOLET RADIATION

Protect Yourself From Excessive Sunlight

Physical Inactivity

STRENGTH OF EVIDENCE ON PHYSICAL ACTIVITY


AND DIETARY FACTORS

PROPORTION OF CANCERS
CAUSED BY MAJOR RISK FACTORS

OTHER MODIFIABLE RISK FACTORS

ALCOHOL USE

OCCUPATIONAL EXPOSURES

SOCIOECONOMIC STATUS

ENVIRONMENTAL POLLUTION

OBESITY

FOOD CONTAMINANTS

IONIZING RADIATION

ALCOHOL USE

Heavy alcohol use causes cancers of the oral cavity,


esophagus, liver and upper respiratory tract. The cancer risk is
greatly increased by concurrent smoking. Alcohol use also
increases the risk of breast cancer.

OCCUPATIONAL EXPOSURES

Certain substances encountered of work are carcinogens,


including asbestos, arsenic, benzene, silica and second-hand
tobacco smoke. Lung cancer is the most common occupational
cancer.

SOCIOECONOMIC STATUS

Some cancers occur more often in people with a higher socioeconomic status ( SES ); others are more common in lower-SES
populations. SES is most likely a marker for lifestyle and other
risk factors described in this section.

Alcohol

Alcohols Link to Cancer


Epidemiologic research has shown a dose-respondent
association between alcohol consumption and certain types
of cancer
Study on the mechanism by which alcohol contribute to
cancer development
The strongest link between alcohol and cancer : cancer of
the upper digestive tract (esophagus, mouth, pharynx,
larynx )
Less consistent with cancer of the liver, breast and colon

Upper digestive tract


cancer- alcohol
Chronic heavy drinkers have a higher incidence of
esophageal cancer, 75 % of esophageal cancers
in US are attributable to chronic, excessive alcohol
consumption
Nearly 50 % of cancer of the mouth, pharynx, and
larynx are associated with heavy drinking

People who drink large quantities of alcohol


overtime have increases risk of this cancers
If they drink and smoke the increase risk is even
more dramatic

Liver cancer - alcohol


Prolonged, heavy drinking has been associated
in many cases with primary liver cancer
Liver cirrhosis, hepatitis B and C virus infections
often confound data
Studies of the interactions between alcohol,
hepatitis viruses, and cirrhosis essential to
perform

Breast cancer - alcohol


Inconsistency and weakness of epidemiology findings
suggest that a third confounding factor, such as nutrition
and fat
Alcohol increases estrogen levels in premenopausal
women, which may promote breast cancer.

Other risk factor for breast cancer :


- age of menarche : < 10 years old
- age of menopause > 50 years old
- childless
- the first labour : > 35 years old age
- has operation for either benign or malignant tumours
- has family / relative suffered from breast cancer

Colon cancer alcohol


Small and but consistent dose-dependent association
between alcohol consumption and
colorectal
cancer,even controlling for fiber and other dietary factors.

Causality cannot be determined from the available data


with cancer of the stomach, pancreas, and lungs
The association is consistency weak and the majority of
studies have found no association

Mechanisms of
Alcohol-Related Cancers
Oncogenes
Preliminary studies show that alcohol may affect cancer
development at the genetic level by affecting oncogenes at
the initiation and promotion stages of cancer
Acetaldehyde, a product of alcohol metabolism, impairs a
cells natural ability to repair its DNA resulting in a greater
likelihood that mutations causing cancer initiation will occur

Avoid Carcinogens at Work


Some Carcinogens in the Workplace
carcinogen

Occupation

Type of cancer

Occupational Exposures

CULTURAL AND SOCIOECONOMIC FACTORS


AFFECTING CANCER SCREENING, EARLY DETECTION AND CARE

ENVIRONMENTAL POLLUTION

Pollution of air, water and soil account for between 1% and


4% of all cancers in developed nations.

OBESITY
Obesity is an important risk factor for endometrial, kidney,
gallbladder and breast cancers.

FOOD CONTAMINANTS

Certain food contaminants are carcinogenic, including those


that occur naturally ( eg aflatoxins ) and those that are
manufactured ( eg pesticides )

IONIZING RADIATION

For most, the greatest exposure to ionizing radiation comes


from medical X rays. But we are all exposed to small
amounts of naturally occurring radiation.

Industrial Pollution

Incidence of
Most Cancers

1930

1970

1950
Year

1990

obesity

BMI Category

Aflatoxins

FOOD
CONTAMINANT

Nitrosamine

benzopyrine

Corn
Peanuts
Cottonseed

IONIZING
RADIATION

cancer

NON MODIFIABLE RISK FACTORS

AGEING

ETHNICITY OR RACE

HEREDITY

SEX

AGEING
The risk of most types of cancer increases with age. The
highest cancer rates occur among the elderly.

ETHNICITY OR RACE
The risk of many types of cancer varies between racial
and ethnic populations. Some of these differences are
attributable to genetic differences, but most are due to
differences in lifestyle and exposures to cancer causing
agents.

HEREDITY
Inherited cancer genes may cause 4% of all cancers.
Other genes affect our susceptibility to cancer risk factors.

SEX
Certain cancers occur in only one sex due to different
anatomy, eg prostate, uterus. Others occur in both sexes,
but at markedly different rates, eg bladder, breast.

Cancer Risk and Aging

400

Cancer Risk and Aging


Colon

3000

Breast
Number of
Cancer Cases
(per 100,000
people))

2000

1000

20
40
60
Age of Person (in years)

80

Ethnicity

Heredity and Cancer


All Breast Cancer Patients

Inherited factor(s)
Other
factor(s)

5-10% Breast ca are familial cancer

Heredity Can Affect Many Types of Cancer


Inherited Conditions That Increase Risk for Cancer

Name of condition

Type of cancer

Genetic makeup

Children with primary immunodeficiency


disorders have an extremely high rate of
cancer lymphoid malignancies.

The incidence of acute leukemia is


4 30 times higher in person with Down
Syndrome> normal.

Translocation of chromosomes 8 and 14 is


associated with Burkitts lymphoma.

Genetic Testing

Sex

SEX DIFFERENCES
New cancers cases by sex
2002

REPRODUCTIVE AND HORMONAL FACTORS

Sexual activity
Possible carcinogen or co-carcinogens
(e.g. certain viruses ) may be
venereal transmitted
In the female reproductive tract, the uterine cervix has the
highest association with malignant diseases and its
precursor.
The cervix shows an increased vulnerability to
neoplasia after exposure to infection, particularly
H(uman) P(apilloma) V(irus) infection
Since squamous cervical neoplasia begins in the
squamocolumnar junction, hyperplasia in this area
that results from the irritation of infection may be one
cause.

Risk factor for cervical uterine


cancer

Inter sexual course beginning at the (too)


young age
Changing sexual partners (quite often)
Venereal infection disease (quite often)
Multiparous
Smoking habit

OTHER RISK FACTORS

REPRODUCTIVE FACTORS

IMMUNOSUPPRESSION

MEDICINAL DRUGS

REPRODUCTIVE FACTORS
Female hormones, menstrual history, and childbearing
affect the risks of breast, endometrial and ovarian cancers.

IMMUNOSUPPRESSION
Certain viruses that suppress the immune system increase
the risk of lymphoma and kaposi sarcoma.

MEDICINAL DRUGS
Some hormonal drugs can cause cancers, while others
reduce the risk. Rarely, anti cancer drugs have caused
another cancer years later.

Reproductive system

REPRODUCTIVE AND HORMONAL FACTORS

Immunosuppresion

AIDS and Kaposis Sarcoma


IMMUNOSUPRESSION
Without
disease

HIV infection
Depressed
immune
system

KSHV infection
Kaposis
sarcoma

??? Medicinal drugs

Risk Factors of Cancer

Risk Factor/ Cancer Type


Cancer Type

Risk Factor

Lung Cancer

Tobacco smoke
Radon
Asbestos and other substances
Air pollution

Breast

Radiation
Genetic changes (Inherited mutation)

Colorectal

Cancer polyp
Genetic alteration
Diet
Cigarette smoking
Ulcerative colitis or chon's disease

Prostate

Diet
Certain prostate changes
Race Africans Americans

Risk Factor/ Cancer Type


Cancer Type

Risk Factor

Liver

Hepatitis viruses (HCV.HBV)

Pancreas

Smoking
Diabetes
Being male
Chronic pancreatitis

Kidney

Tobacco smoking
High blood pressure
Von-Hippel-Lindau syndrome (VHL)

Leukemia

Radiation
Chemotherapy
Certain disease (Down syndrome)
Human T cell leukemia virus
Myelodysplatic syndrome

Risk Factor/ Cancer Type


Cancer Type

Risk Factor

Bladder

Occupation
Certain infection
Tobacco smoking
Race Twice as often as Africans Americans
Treatment with cyclophosphamide or arsenic

Uterine

Endometrial hyperplasia
Race Africans Americans
Hormonal replacement therapy
Obesity

Melanoma

Dysplastic nevi
Fai skin
Weakened immune system
Sever blistering/Sunburn
UV irradiation
Source:http://ishwaryatechnosolutions.com/cancer.aspx

Certain viruses or bacteria may increase the risk of developing cancer

Microorganism

Cancer

Human papilloma virus

Cervical cancer

Helicobacter pylori

Stomach cancer

Hepatitis B and hepatitis C viruses

Liver cancer

Human T-cell leukemia/lymphoma


virus

Lymphoma and leukemia

Human immunodeficiency virus

Lymphoma and a rare cancer called


Kaposi's sarcoma

Epstein-Barr virus

Lymphoma

Human herpes virus 8

Kaposi's sarcoma

Risk Factors for Breast Cancer

Risk Factors for Prostate Cancer

THANK YOU