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Riyadh Qaseem Northern Al-jouf Hail Tabouk Medina Makkah Baha Aseer Jazan Eastern Najran

Control and Prevention of Neoplasm of Neoplasm

ObjectivesObjectives ä You should be capable to point out the most common neoplasm in different age groups classifying them by geographical areas. ä You will be capable to identify risk factors associated with the most common types of neoplasm and applying prevention strategy.

Categories of Cancer Causation Environment - + Genes + -

International Variation in Cancer Incidence

Cancer in KSA ä In general, in KSA almost all known cancers have been seen to occur, though with some variations. ä Most of the previous epidemiological studies on cancer in the kingdom had been based on reports from different regions. ä It is only recently during the past 8 years that a National Tumor Registry has taken over this task of collecting information from all over Saudi Arabia.

Ten Most Common Cancers in Saudi Arabia ä Breast 8.8% ä liver7.5% ä Leukemia7.5% ä NHL7.3% ä Colorectal5.5% ä Thyroid 5.2% ä Lung4.7% ä CNS 3.9% ä Stomach3.8% ä Bladder3.5% National Cancer Registry, 1999

Cancer in KSA: Source: KSA National Cancer Registry For the total Saudi population, the most common ten cancers are( ): ä Female breast cancer (8.8%), ä Liver cancer (7.5%), ä Leukemia (7.5%), ä Non-Hodgkin's lymphoma (7.3%) ä Colorectal cancer (5.5%). ä Thyroid cancer (5.2%), ä Lung cancer (4.7%) ä Nervous system cancer (3.9%) ä Stomach cancer (3.8%) and ä Urinary bladder cancer (3.5%)

MALES (8791) 1) 1)Liver (10.3%) 2) 2)NHL (8.5%) 3) 3)Leukemia (8.1%) 4) 4)Lung (7%) 5) 5)Colorectal (5.8%) 6) 6)Stomach (5.5%) 7) 7)Bladder (5.4%) 8) 8)Prostate (5.3%) 9) 9)CNS (4.6%) 10) 10)Hodgkin’s Disease (3.9%) FEMALES (7503 ) 1) 1)Breast (19.1%) 2) 2)Thyroid (8.8%) 3) 3)Leukemia (6.7%) 4) 4)NHL (5.9%) 5) 5)Colorectal (5.4%) 6) 6)Ovary (4.3%) 7) 7)Liver (4.1%)) 8) 8)Carvix (3.8%) 9) 9)CNS (3.5%) 10) 10)Stomach (3.5%) The ten most common cancers for Saudis by sex, National Cancer Registry, 1999

Riyadh Qaseem Northern Al-jouf Hail Tabouk Medina Makkah Baha Aseer Jazan Eastern Najran Alhsa only 41.2 % 7.6 % 8.4 % 18.2 % 9.6 %

Thyroid Cancer in Saudi Arabia ä 883 cases (3.5/ population) ä 5.4% of all newly diagnosed cancers ä 2nd most common in females,14th in males ä Male: female ratio 1:2.9 ä Mean age 49.8 yrs in Males, 40.8 yrs in females ä Most common in: u Hail7/ u Riyadh5.8/ u Qassim3.8/ National Cancer Registry, 1999

HOW TO CONTROL CANCER Putting Science into Practice

THE AIM OF CANCER CONTROL Reduction of Cancer Incidence, Morbidity & Mortality by: ä Prevention ä Early Diagnosis ä Treatment ä Palliative Care

THE W.H.O. PUBLIC HEALTH MODEL FOR CANCER CONTROL MODEL THE W.H.O. PUBLIC HEALTH MODEL FOR CANCER CONTROL MODEL ä Assess the magnitude of the cancer problem ä Evaluate possible strategies for cancer control ä Choose priorities for initial cancer control activities of prevention, screening, therapy and palliative care ä Set measurable cancer control objectives

PRIMARY PREVENTION OF CANCER ä Tobacco Control ä Diet ä Control of Alcohol Consumption ä Occupation and Environment ä Infections (viruses and parasites) ä Reducing Sunlight Exposure ä Sexual and Reproductive Factors

PRIMARY PREVENTION Tobacco Control Tobacco Control Tobacco Control PRIMARY PREVENTION Tobacco Control Tobacco Control Tobacco Control ä Education ä Legislation ä National Leadership

PRIMARY PREVENTION DIET DIET PRIMARY PREVENTION DIET DIET ä Education ä Legislation ä National Leadership

PRIMARY PREVENTION Alcohol Alcohol PRIMARY PREVENTION Alcohol Alcohol ä Education ä Legislation ä National Leadership

PRIMARY PREVENTION Occupational Hazards Occupational Hazards Occupational Hazards PRIMARY PREVENTION Occupational Hazards Occupational Hazards Occupational Hazards ä Education ä Legislation ä National Leadership

PRIMARY PREVENTION Viral Hepatitis B Viral Hepatitis B Viral Hepatitis B PRIMARY PREVENTION Viral Hepatitis B Viral Hepatitis B Viral Hepatitis B ä Education ä Legislation (HBV vaccination)) ä National Leadership

PRIMARY PREVENTION Overexposure to Sunlight Overexposure to Sunlight Overexposure to Sunlight PRIMARY PREVENTION Overexposure to Sunlight Overexposure to Sunlight Overexposure to Sunlight ä Education ä Legislation ä National Leadership

Primary Prevention Sexual and Reproductive Factors ä Hormonal influences ä Sexually transmitted diseases

EARLY DETECTION Education

EARLY DETECTION Downstaging

Downstaging for Cervical Cancer Cervical Cancer Cervical Cancer

EARLY DETECTION Downstaging for Oral Cancer Oral CancerOral Cancer

EARLY DETECTION Screening

Screening for Cervical Cancer Cervical Cancer Cervical Cancer

EARLY DETECTION Screening for Breast Cancer Breast CancerBreast Cancer

EARLY DETECTION ä Stomach ä Colon and rectum ä Liver ä Lung ä Ovary ä Bladder ä Prostate ä Esophagus

TREATMENTTREATMENT ä Surgery ä Radiotherapy ä Chemotherapy and hormonal treatment

TREATMENTTREATMENT The Role of Surgery Surgery

TREATMENTTREATMENT The Role of Radiation Therapy Radiation Therapy

TREATMENTTREATMENT The Role of Chemotherapy Chemotherapy

TREATMENTTREATMENT The Role of Hormonal Therapy Hormonal TherapyHormonal Therapy

TREATMENTTREATMENT The Role of Biological Therapy Biological TherapyBiological Therapy

TREATMENTTREATMENT How Effective is Cancer Treatment ? Effective

TREATMENTTREATMENT ä Policies Policies u Treatment Policies u Referral Policies

PALLIATIVE CARE ä Palliative Medicine is the study and management of patients with active, progressive, far-advanced disease for whom the prognosis is limited and the focus of care is the quality of life. ” Doyle et al (Eds). Oxford Textbook of Palliative Medicine. P3. Oxford University Press, Oxford, Palliative Medicine Palliative Medicine

Cancer Prevention and Control e.g.: GOALS Health authorities may consider 1. Cancer Registry 2. Public education 3. Surgical Courses

SUMMARY SUMMARY ä Cancer is a Disease of Lifestyle With Both Host Resistance and Genetic Components ä 60-80% of the Risk factors for Cancer are Avoidable ä Putting Science Into Practice Leads to a Public Health Approach for Cancer Control Which Integrates Prevention, Screening, Treatment and Palliation at the National Level

ObjectivesObjectives ä You should be capable to point out the most common neoplasm in different age groups classifying them by geographical areas. ä You will be capable to identify risk factors associated with the most common types of neoplasm and applying prevention strategy.