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DEFINING CANCER
Cancer is a term used for diseases in which abnormal cells divide
without control and are able to invade other tissues. Cancer cells
can spread to other parts of the body through the blood and lymph
systems.

EPIDEMIOLOGY OF CANCER

The epidemiology of cancer is the study of the factors affecting

cancer, as a way to infer possible trends and causes. The study of
cancer epidemiology uses epidemiological methods to find the
cause of cancer and to identify and develop improved treatments.

The burden of cancer is still increasing worldwide despite advances

for diagnosis and treatment. Epidemiological studies have shown
that many cancers may be avoidable. It is widely held that 80–90%
of human cancers may be attributable to environmental and
lifestyle factors such as tobacco, alcohol and dietary habits1.
Cancer prevention includes primary, secondary and prevention
methods. Primary prevention refers to avoiding cancer-causing
substances in the environment or dietary elements associated with
increased risk; dietary supplementation with putative protective
agents. Secondary prevention aims at early detection and removal
of benign tumours of oral, cervical and breast cancers2. It was
estimated that in the year 2000, worldwide over 10 million new
cases of cancer occurred (approximately 5.3 million men and 4.7
million women) and over 6 million people died from cancers3. The
 most frequently affected organs are lung, breast, colon, rectum,
stomach and liver. Epidemiology of cancer, its control and
prevention measures as applicable to Indian population have been
discussed here.

WHAT ARE THE CAUSES AND RISK FACTORS FOR

CANCER?

 Physical Activity

Exercising at least 30 minutes a day, 5 days a week greatly

reduces your cancer risk. Exercise like yoga, aerobics, walking
and running is great activities to lower your cancer risk factor.
Not only is physical activity important to preventing other
diseases, it reduces the chances of becoming obese. Obesity is a
major cause for many cancers. Exercising on a regular basis can
prevent prostate, colon, breast, endometrial and lung cancer.

 Genetics

Genetics can play a big role in cancer development. If you have

a family history of cancer, such as breast cancer, taking extra
precautions is vital. When cancer is genetic, a mutated gene has
been passed down. Genetic tests are available for many
hereditary cancers. Keep in mind that if you have a family
history of cancer, it does not mean you will develop it. You only
 have a greater chance of developing it.

 Environmental Factors

The environment you are in can cause cancer.

Exposure to asbestos, a group of minerals found in housing
and industrial building materials can cause a variety of medical
problems, such as mesothelioma.
Studies have shown that people who are exposed to high
amount of benzene are at risk for cancer. Benzene is a chemical
found in gasoline, smoking, and pollution.

 Unsafe Sex

Practicing unsafe sex can increase your risk of developing a

virus called HPV. HPV is a group of over 100 viruses, medically
known as human papillioma virus. HPV increases your risk
factor for cervical, anal, vulvar and vaginal cancer. Further
studies are being conducted in HPV's role in the development of
other cancers.

There is a test available to see if you have contracted HPV. It

involves scraping of cervical cells and then the sample is sent to
a lab. The lab test can even identify the strain of the virus, also.
 Sun Exposure

Skin cancer is caused by exposure to the UV rays of the sun. A

sunburn, or a tan is actually the result of cell damage caused by
the sun. Skin cancer can be prevented in most cases. Wearing
sunscreen when outdoors and staying out of the sun between the
hours of 10 a.m. and 2 p.m., when the sun's rays are strongest is
your best defense.

 Industrial environment

It is important as aniline dye industry workers are prone to develop

bladder cancer and nickel refining plant workers are at greater risk
of developing cancer of nasal sinuses.

Drugs:

e.g. Immunosuppressive drugs like steroids suppress the

immunity of host and increases risk.

Viruses:

One of notorious virus of today is Hepatitis B which affects

liver and ultimately results in hepatocellular carcinoma.

Parasite:
 Schistosoma haematobium if infects, causes bladder cancer.

 Hormones:

One of the commonest causes of breast and uterine endometrial

cancer in females is increased levels of estrogen, and, increased
levels of dihydrotestosterone (metabolite of testosterone) in males
can result in prostate cancer.

Carcinogenic chemicals and food

Chemical carcinogens such as asbestos, benzene, arsenic and

diesel exhaust and certain carcinogenic foods such as salted,
pickled, smoked and charred foods can cause cancer. Taking
Vitamin C supplements and Vitamin C rich foods may protect
against the effects carcinogenic foods causing cancer.

 Overexposure to estrogen

Too much estrogen in a woman's blood system puts her at

increased risk for some gynecological cancers such as breast &
uterine cancer. Estrogen level enhances during the first period,
pregnancy and age at pregnancy, age at menopause, weight,
physical activity, and diet. The ways to reduce the estrogen
level are doing regular aerobic exercise, minimizing alcohol,
eating a low-fat diet and having a baby before 35 years of age.

 Ultraviolet radiation
 Ultraviolet rays of the sun damages DNA of cells. Over
exposure to these rays cause skin cancers. Covering well and
using a sunscreen lotion with a high SPF can prevent the onset
of cancer.

 Ionizing radiation

Overexposure to radiation, such as X rays and nuclear radiation,

can cause DNA injury that may lead to cancer. Avoiding X-rays
unless absolutely necessary or not living near a nuclear power
plant or nuclear waste disposal site

 Smoking and Alcohol

Smoking can be a causative factor for different cancers such as

cancer of the lungs, the upper respiratory tract, esophagus,
bladder, pancreas, stomach, liver, kidney, colon, and rectum.
Passive smoking can also cause lung cancer among
nonsmokers. Intake of alcohol also may lead to several cancers
like mouth, throat, esophagus, stomach, liver cancer etc. So quit
smoking and drinking alcohol to avoid cancers.

 Diet
Avoid animal fats especially red meat which is associated with
 several different types of cancer, including the colon, rectum,
stomach prostate etc. Eating more soy-based foods, fiber, fruits,
and vegetables, can offer some protection against cancer. A diet
high in dark yellow and orange fruits and vegetables, will block
the formation of chemical compounds known as 'free radicals'
that can damage DNA in cells leading to cancer.

 Others

Most cancers can be kept at bay by following proper lifestyle

habits. Along with taking care of the above mentioned factors,
maintaining ideal weight with exercise or physical activity for a
minimum of 30 minutes per day is beneficial to prevent the
onset of cancer. Regular checkups at the recommended age
should be done. Women must maintain regular gynecological
examinations including Pap smear and Mammograms and must
perform monthly breast self- examination. Men must perform
monthly testicular self exam and routine check ups like PSA
and Digital rectal Exam is recommended.

 The immune system

 People who have problems with their immune systems are more
likely to get some types of cancer. This group includes people
who

Have had organ transplants and take drugs to suppress their

immune systems to stop organ rejection
Have HIV or AIDS
Are born with rare medical syndromes which affect their
immunity
The types of cancers that affect these groups of people fall into
two, overlapping groups

Cancers that are caused by viruses, such as cervical cancer and

other cancers of the genital or anal area, some lymphomas, liver
cancer and stomach cancer

 Bacterial infection

Bacterial infections have not been thought of as cancer causing

agents in the past. But studies have shown that people who have
helicobacter pylori infection of their stomach develop
inflammation of the stomach lining, which increases the risk of
stomach cancer. Helicobacter pylori infection can be treated
with a combination of antibiotics.

Research is also looking at whether substances produced by

 particular types of bacteria in the digestive system can increase
the risk of bowel cancer or stomach lymphomas. Some
researchers think that particular bacteria may produce cancer
causing substances in some people. But research into this issue
is at an early stage.
If bacteria do play a part in causing cancer this could be
important in cancer prevention. Bacterial infections can often be
cured with antibiotics, so getting rid of the infection could be a
way to reduce the risk of these types of cancer.

CONCLUSION

Till now we discussed about etiology and epidemiology of

cancer.

BIBILIOGRAPHY

1. Brunner and Sudharth, Medical surgical Nursing, 10th

edition, Lippincott publishers.
2. Lewis, Medical surgical Nursing, 6th edition, Mosby
publishers.
3. Basavanthappa, Text book of Medical surgical Nursing, 4 th
edition, Jaypee publishers.
4. Betsy A. Finkelmeier , Cardiothoracic Surgical Nursing, JB.
Lippincott company, Philadelphia.
5. Susan L. woods, Cardiac Nursing, 5 th edition,lippincott
Williams and Wilkins publication.

WEB REFERENCE
1. WWW. WIKEPEDIA.COM
2. WWW.GOOGLE.COM