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Fortis Hospital, Shalimar Bagh Dr. Ajay Mehta MBBS, MD, DTCD, DPMR Sr. Consultant & HOD Department of Medical Oncology FORTIS HEALTHCARE CANCER SCREENING.

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Presentation on theme: "Fortis Hospital, Shalimar Bagh Dr. Ajay Mehta MBBS, MD, DTCD, DPMR Sr. Consultant & HOD Department of Medical Oncology FORTIS HEALTHCARE CANCER SCREENING."— Presentation transcript:

1 Fortis Hospital, Shalimar Bagh Dr. Ajay Mehta MBBS, MD, DTCD, DPMR Sr. Consultant & HOD Department of Medical Oncology FORTIS HEALTHCARE CANCER SCREENING AND PREVENTION

2

3 HEADINGS CANCER FACTS CANCER GLOBAL BURDEN CAUSES OF CANCER 7 DANGER SIGNALS SCREENING DEFINITION SCREENING BASICS PRINCIPLES OF SCREENING COMMONLY SCREENED DIAGNOSIS CANCER SCREENING AND PREVENTION

4 CANCER PREVENTION DEFINITION LEVELS OF PREVENTION PRIMARY PREVENTION SECONDARY PREVENTION TERTIARY PREVENTION FUTURE TRENDS CANCER SCREENING AND PREVENTION

5 CANCER FACTS

6 FACTS ABOUT CANCER 70 – 80 % CANCER CASES ARE DETECTED AT LATE STAGE WHEN TREATMENT IS NOT POSSIBLE EARLY DETECTION OF CANCER HELPS IN COMPLETE CURE OF SOME CANCER PREVENTION BY TAKING SOME PRECAUTIONARY MEASURES IS THE BEST WAY TO PREVENT CANCER

7 CANCER GLOBAL BURDEN

8 By 2015, 66 % of all cancers will be in the developing world !

9 GLOBAL SCENARIO MALES FEMALES

10 INDIA: SCENARIO Males Females Globocan database

11 DELHI: SCENARIO

12 CANCER DEFINITION

13 What Is Cancer? Cancer is a large group of diseases (over 200) characterized by uncontrolled growth and spread of abnormal cells.* * American Cancer Society, Cancer Facts and Figures 2005

14 Normal cell vs cancer cell

15 NORMAL CELL CHARACTERISTICS: Metabolism. Strictly controlled & predictable Maturation & Specialisation. Occurrs before dividing. Strictly controlled. Reproduction = Cell death Contact Inhibition. Mechanism for switching off division when in contact with different cells Recognition. Like cells stay together.

16 Cancer Cell Characteristics: Unchecked & Uncontrolled Growth Loss of contact inhibition Loss of capacity to differentiate Increased growth fraction Chromosomal Instability Capacity to metastasise Altered biochemical properties

17 Normal Cells Vs. Cancer Cells Cancer cells: Lose control over growth and multiplication Do not self-destruct when they become worn out or damaged Crowd out healthy cells

18 GROWTH OF CANCER CELLS Size of cancer cells: One million cancer cells = head of a pin One billion cancer cells = a small grape 2 30 = 1,073,741,824 = 1 billion cells 2-6 weeks Cancer cells reproduce every 2-6 weeks. 2-6 weeks

19 CAUSES OF CANCER

20 CAUSES - TOBACCO CIGARETTE SMOKING IS A MAJOR CAUSE OF CANCER SMOKING MAY BE – ACTIVE OR PASSIVE – BOTH ARE HARMFUL CONSUMPTION OF TOBACCO IN FORM OF KHAINI, ZARDA AND GHUTKA ALSO CAUSES CANCER TOBACCO NOT ONLY CAUSES CANCER BUT ALSO OTHER DISEASES

21 CAUSES – BETELNUT BETELNUT CONTAINS CARCINOGENS THE NUTS KEPT BURRIED IN THE GROUND FOR LOND PERIOD LEADS TO THE GROWTH OF FUNGUS WHICH IS CARCINOGENIC PEOPLE CONSUMING BETELNUT ALSO HAVE THE HABIT OF CONSUMING TOBACCO

22 CAUSES - ALCOHOL ALCOHOL CONSUMPTION LEADS TO CANCER OF ORAL CAVITY, PHARYNX, LARYNX, ESOPHAGUS, STOMACH, LIVER PEOPLE WHO DRINK ALSO SMOKES FURTHER INCREASING THE RISK OF DEVELOPING CANCER

23 CAUSES – FAT/FIBRE HIGH INTAKE OF FAT (ANIMAL) INCREASES THE RISK OF DEVELOPING CANCER (BREAST AND COLON) DIETARY FIBRE OF PLANT ORIGIN HAS A PROTECTIVE ROLE AGAINST CANCER

24 CAUSES – BARBEQUED FOOD HIGH FAT AND HIGH PROTEIN FOOD WHEN GRILLED AT HIGH TEMPARATURE PRODUCES A CHEMICAL KNOWN TO BE HAVING CARCINOGENIC EFFECT HIGHLY BROWN AND CHARRED FOOD HAS CANCER CAUSING COMPOUNDS

25 CAUSES - POLLUTION AIR POLLUTION – MAY ALSO CAUSE CANCER (ASBESTOS) INDUSTRIAL WORKERS ARE EXPOSED TO VARIOUS CHEMICALS WHICH ARE KNOWN TO BE CARCINOGEN

26 CAUSES – WATER POLLUTION WATER MAY CONTAIN A NUMBER OF CANCER CAUSING SUBSTANCE AS THE INDUSTRIES DUMP CHEMICAL DIRECTLY INTO WATER OR BURRY THEM IN THE GROUND

27 CAUSES – X-RAY X-RAYS MAY STIMULATE THE DEVELOPMENT OF CANCER REPEATED X-RAYS SHOULD BE AVOIDED X-RAY DONE ON PREGNANT WOMEN MAY INCREASE THE FREQUENCY OF CHILDHOOD CANCER

28 CAUSES - VIRUS CERTAIN VIRUSES MAY CAUSE CANCER THESE VIRUSES ARE – HEPATITIS –B & C, EPSTEIN BARR VIRUS, HUMAN PAPILLOMA VIRUS, CMV. Etc. THESE VIRUSES CAN BE TRANSMITTED BY BLOOD TRANSFUSION, USE OF CONTAMINATED NEEDLES, FROM MOTHER TO CHILD DURING PREGNANCY OR BREAST FEEDING AND THROUGH SEXUAL INTERCOURSE

29 CAUSES - HEREDITY FEW CANCER LIKE RETINOBLASTOMA (EYE), COLON CANCER ARISING FROM GENETICALLY CAUSED POLYPS EVEN BREAST CANCER AND ESOPHAGEAL CANCER

30 HOW TO DETECT DISEASE EARLY SEVEN DANGER SIGNALS CHANGE IN BLADDER & BOWEL HABITS SORE THROAT NOT HEALING UNUSUAL BLEEDING OR DISCHARGE THICKENING OR LUMP IN BREAST OR ANYWHERE INDIGESTION AND DIFFICULTY IN SWALLOWING OBVIOUS CHANGE IN WART OR MOLE NAGGING COUGH OR HOARSENESS OF VOICE

31 SCREENING DEFINITION

32 CANCER SCREENING Screening is the process whereby Asymptomatic Individuals are Tested to Detect a disease that is YET to be Symptomatic. CRITERIA laid down for - Disease in question - Screening test - Screening problem.

33 CANCER SCREENING Disease natural history is well understood. has a recognizable early stage. Treatment at early stage is more successful than at late stage. it is sufficiently common in target population to warrant screening.

34 CANCER SCREENING Test Sensitive and specific. Acceptable. Safe. inexpensive.

35 CANCER SCREENING Programme adequate facilities for diagnosis in those with a positive test. high quality of Treatment for screen detected disease. benefit outweighs physical and psychological harm. benefit must justify financial cost.

36 SCREENING BASICS

37 SCREENING TESTS Universal screening Screening all individuals of a certain category (e.g. PKU screening in kids) Case finding Screening a small group of individuals based on the presence of risk factors (e.g cancer clusters, family members diagnosed with hereditary disease)

38 SCREENING TESTS Biases Lead time bias Length time bias Selection bias Overdiagnosis bias Avoid bias by using Randomized Control Trials (RCTs)

39 THE PRINCIPLES OF SCREENING

40 The disease must be an important health problem. There should be a recognizable latent or early symptomatic stage. The natural history of the disease, including latent to declared disease, should be adequately understood

41 SCREENING TESTS Universal screening Screening all individuals of a certain category (e.g. PKU screening in kids) Case finding Screening a small group of individuals based on the presence of risk factors (e.g cancer clusters, family members diagnosed with hereditary disease

42 SCREENING TESTS Adverse effects Stress and anxiety caused by false positive results Unnecessary radiation/chemical exposure and test discomfort Prolonged knowledge of a disease with no treatment False sense of security over false negative results Overuse of medical resources

43 ADVERSE EFFECTS

44 SCREENING TESTS Adverse effects Stress and anxiety caused by false positive results Unnecessary radiation/chemical exposure and test discomfort Prolonged knowledge of a disease with no treatment False sense of security over false negative results Overuse of medical resources

45 PITFALLS OR BIASES

46 SCREENING TESTS Biases Lead time bias Length time bias Selection bias Overdiagnosis bias Avoid bias by using Randomized Control Trials (RCTs)

47 COMMONLY SCREENED DIAGNOSIS

48 COMMONLY SCREENED DIAGNOSES Cancer (Breast, lung, colorectal, prostate, pancreatic, cervical, ovarian, skin, testicular, thyroid) Cardiovascular (AAA, Blood pressure, Lipid disorders, carotid artery stenosis, PAD) Infectious disease (HIV, Hep B/C, STDs, Tuberculosis) Injury and violence (domestic violence, Youth violence/gang activity, seatbelt use) Mental health/substance abuse (Etoh, illicit drugs, tobacco, depression, suicide risk) Endocrine/Metabolism (Diabetes, IDA, obesity, physical activity) MSK –osteoporosis OB/Gyn (Pre-eclampsia, Rh incompatibility, neural tube defects, asymptomatic bacteruria, Downs syndrome) Pediatrics (PKU, sickle cell disease, visual impairment, lead intoxication, hearing loss, dental caries)

49 CANCER PREVENTION DEFINITION

50 INTRODUCTION CANCER IS PREVENTABLE 80 – 90% CANCER ARE DUE TO OUR HABITS AND ACTIVITIES CANCER INVOLVES ALMOST EVERY PARTS OF THE BODY CANCER CELLS MULTIPLY IN AN UNCONTROLLABLE & HAPAZARD MANNER

51 SCENARIO CANCER IS THE CAUSE OF 12% OF ALL DEATHS IN INDIA 1.5 – 2 MILLION ESTIMATED CANCER CASES AT ANY POINT OF TIME EVERY YEAR 8 LAKHS NEW CASES ARE DETECTED IN INDIA EVERY YEAR 5.5 LAKHS CANCER PATIENTS DIE IN OUR COUNTRY

52 LEVELS OF PREVENTION

53 CANCER PREVENTION LEVELS OF PREVENTION 1 PRIMARY PREVENTION. 2 SECONDARY PREVENTION. 3 TERTIARY PREVENTION.

54 PRIMARY PREVENTION

55 CANCER PREVENTION PRIMARY PREVENTION Is when there is NO ABNORMALITY OBJECTIVES - Strengthening Healthy Lifestyle. - Decreasing Weakness. - Preventing and Minimizing Risk Factors of CARCINOGENESIS Exposure.

56 SECONDARY PREVENTION

57 CANCER PREVENTION SECONDARY PREVENTION Is when Abnormality is found. OBJECTIVES - Early Diagnosis // Investigations for Abnormality. - Assessment of Risk Groups. - CANCER SCREENINGS. - Early Detection.

58 TERTIARY PREVENTION

59 CANCER PREVENTION TERTIARY PREVENTION EXAMPLES : Use of Vit. A in prevention of Lung Ca/Leukemias, Tamoxifen in Breast Ca/Uterine Ca.

60 Visionarys Dream

61 Our Values

62 Presentation Overview Land Area7.50 acre Built-Up Area 3.50 Lac sq.ft. No. of Floors7 floors ICUs5

63 THANK YOU


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