1. Prevensi Kanker secara Komperhensif
Fatwa ST. Dewi
Public Health Dept.
Faculty of Medicine, GMU

2. References
Mackay J., Jemal A., Lee N.C., Parkin, D.M., 2006, The Cancer Atlas, Atlanta, Georgia, USA
CDC, 2007, Cancer Prevention & Early Detection, Facts and Figures

3. Type of Prevention Primary prevention Disease or injury Impairment
Secondary prevention
Disability
Tertiary prevention
Dependency

4. Prevensi Kanker Sesi I: Sesi II:
Primary prevention: sebelum terkena kanker  promotif dan protektif
Sesi II:
Secondary prevention: setelah terkena kanker, untuk meminimalisasi keterbatasan, kecacatan  kuratif
Tertiary prevention: setelah mendapatkan kecacatan untuk minimalisasi ketergantungan  rehabilitatif

5. Prevensi Kanker Prevensi kanker adalah tindakan antisipatif untuk:
Menghilangkan atau meminimalisasi paparan penyebab kanker
Mengurangi kerentanan terkena kanker

6. Prevensi Primer = Promosi Kesehatan
Enabling people to control their own health  manipulate unhealthy lifestyle become healthy
Kanker dikaitkan dengan perilaku tidak sehat sebagai penyebabnya
Faktor risiko: meningkatkan resiko terserang penyakit
Faktor proteksi: Menurunkan resiko terserang penyakit

7. Faktor-faktor Risiko Kanker
Keturunan: retinoblastoma, kanker payudara
Faktor lingkungan:
Kimiawi:
Tar (rokok) Kanker paru
Radiasi iodinasi leukemia
Alkohol  kanker mulur
Fisika: papara UV  kanker kulit
Biologis: Hepatitis B  hepatoma

8. Major Risk Factors of Cancer
Smoking: Lung cancer, oral cavity, larynx, oesophagus, stomach
Overweight and obesity: Oral, oesophagus, gastric, colorectal high fiber diet and physical acitivity
Occupational and environmental exposure: Lung Ca (asbestos), Bladder (aniline dyes), leukaemia (benzene)
Infection and infestation: Liver (Hepatitis B and C), Cervix (HPV), stomach (Helicobacter pilory), Bladder (schistosomiasis)
UV radiation: Skin cancer

9. NCD and its risk factors (Dans et al., 2011)
Controlling NCD: From disease specific to major shared risk factors
D. Environmental Factors
C. Behavioral Factors
B. Biological Factors
A. Diseases
Globalization
Urbanization
Poverty
Low education
Stress
Unhealthy diet
Physical inactivity
Smoking
Alcoholic drinking
Hipertension
High blood glucose
High cholesterol
Obesity
Heart disease
Stroke
Diabetes
Cancer
COPD
NCD and its risk factors (Dans et al., 2011)

10. Secondary prevention: risk assessment
Figure 20-1: Ten-Year Risk of Fatal CVD in High-Risk Regions of Europe by Sex, Age, Systolic Blood Pressure, Total Cholesterol, and Smoking Status. Source: Reprinted with permission from IM Graham, Current Opinion in Cardiology, Vol. 20, © 2005 Lippincott Williams and Wilkins, p. 434.
Taken from:
Labarthe, 2011

12. Facts on Cancer Prevention
One third of Ca are preventable:
Smoking: responsible for 80-90% Lung Ca and 30% of all Ca death in developing countries: oral cavity, larynx, oesophagus, stomach
Diet: obesity related with Ca oesophagus, colorectum, breast, endometrium, kidney
High fiber diet, physical activity and normal body weight  protective factors of Ca
Physical exercise- gastric and colon cancer
Healthy lifestyle for other type of cancer

13. Primary Prevention: Cancer Health Promotion
Determinants + unknown factors  Cancer
There is a dose response relationships between : exposure of agent and Cancer
Exposure  not totally avoid Cancer
Eliminate the carcinogen will be the best:
Remove carcinogen
Replacement carcinogen
Impeding contact with carcinogen
Vaccination (Hepatitis B)

14. Primary Prevention: Cancer Health Promotion
General habit to avoid cancer:
Do not smoke
High fiber intake (fresh fruit, vegetables and cereals)
Limit the fat intake
Avoid becoming overweight
Moderate the consumption of alcoholic drinks
Avoid excessive exposure to the sun
Using health working protection  substances that may cause cancer

15. How to do primary prevention of cancer
Identify readiness to change behavior among target
Decide level of behavior changing and needed strategies

16. Table 2. Stages of readiness to change and action that appropriate
Not interested (Precontemplation stage)
Give information
Uncertain about prospect (Contemplation stage)
Give opportunity to weigh up pros and cons of changing
Ready to change (Preparation)
Discuss how to proceed with behavior
Reinforcement
Maintenance

17. Level of Target Behavior Change and Health Promotion Objectives
Individual
Knowledge, Attitude, Behaviors, Physiology
Organizational
Policies, Practices, Programs, Facilities, Resources
Community
Government
Policies, Programs, Facilities, Resources, Legislations/ordinances, Regulation, Enforcement

18. Prevention is much
better than treatment