Cancer Prevention and Screening of

Older Adults

Quratulain Tariq
DPTM-F15-075
*Project Summary*

This study is about the prevention of cancer and screening of older adults to prevent cancer. Cancer is a
term used for diseases in which abnormal cells divide without control and can invade other tissues.
Cancer cells can spread to the other parts of the body through the blood and lymph system. Advancing
age is most Important risk factor for cancer overall. One-quarter of new cancer cases are diagnosed in
people aged 65-74. As we age there is more time for damage in our cells to buildup and more chance
that some of this damage might lead to cancer. This doesn't mean that you will definitely get cancer. The
aim of the study is to prevent cancer in older adults. For this, the methods or the set of steps will be
taken in which prevention of cancer and screening of adults will be done and how they are facing the
difficulties. This study will provide an appropriate overview for further guidelines and precautions that
would be taken by cancer patients and older adults and will suggest that which factors should be
avoided in this regards.

*Introduction*

Cancer is uncontrolled growth of abnormal cells anywhere in the body. These abnormal cells are termed
cancer cells, malignant cells or tumor cells. These cells can infiltrate normal body tissues. Many cancer
and abnormal cells that compose the cancer tissues are further identified by the name of that the
abnormal cells originated from for example breast cancer, lung cancer, colorectal cancer. Cancer cells
can break away from there original mass of cells, travel through the blood and lymph systems, and lodge
in other organs where they can again repeat the uncontrolled growth cycle. This process of cancer cells
leaving and growing in another part of body is termed as metastatic spread or metastasis. Cancer is a
leading cause of death worldwide. It accounted for 8.2 million deaths. Deaths from cancer worldwide
are projected to continue raising, with an estimated 13.1 million deaths in 2030 (about a 70% increase)

*Signs and symptoms of cancer*

》Persistent cough or blood-tinged saliva

》A change in bowel or bladder habits

》Blood in the stool

》Hoarseness

》Unexplained anemia (low blood count)

》Breast lump or breast discharge

》lumps in testicles

》A change in urination

》Blood in the urine

》Persistent lumps or swollen glands

》obvious change in a wart or a mole

》Indigestion or difficulty in swallowing

》unusual vaginal bleeding or discharge

》unexpected weight loss, night sweats or fever

*causes of cancer*

*Smoking and tobacco

*diet and physical activity

*sun and other types of radiation

*viruses and other infections

*Risk factors of cancer*

*age

*habits

*family history

*health condition

*environment

*How to prevent cancer*

*don't use tobacco

*eat healthy diet

*maintain a healthy weight and be physically active

*protect your self from sun and radiations

*get vaccination

*avoide risky behaviour

*get regular medical care

*Cancer screening or Diagnosing*

Diagnosing cancer at its earliest stages often provides the best chance for a cure.
Doctor may diagnose cancer by:

*physical exam

*laboratory test

*imaging test

*biopsy

*Cancer treatments*

*surgery

*chemotherapy

*radiation therapy

*bone marrow transplant

*immunotherapy

*hormone therapy

*targeted drug therapy

*clinical trials

*Literature review*

Older adults often have multiple chronic conditions that may decrease additional life expetancy. The
benefits and harms of screening must include potentially increased harms of screening and patient
preferences. (E Eckstrom, DH Feny, LC Walter, LA perdue 2013)

Frail older adults don't always profit from screening. Older individuals usually have less physiological and
greater comorbidity. (AM Clarfield 2010)

Considerable uncertainty exists about the use of cancer screening tests in older adults. Individualized
cancer screening decision in older patients may be more useful. (LC Walter, KE Covinsky 2001)

There is general consensus that screening can reduce mortality from colorectal, breast, cervical cancer
among persons in their 50s and 60s. Few trials included person in their 70s. (LC Walter, CL Lewis, MB
Barton 2005)

A total of 1237 participants aged 50 and older who reported having made one or more cancer screening
decision in the past 2 years completed 1454 cancer screening modules for breast, prostate and
colorectal screening

Of all module respondents, 9.8% reported plans to stop screening, 12.6% for breast, 6.0% for prostate,
and 9.5% for colon cancer
(Carme L Lewis, Mick P Couper, A levin 2010)

*Objectives*

Prevent

Diagnose

Treat

Optimise

Our main objective is to bring forward the day when all cancers are cured.

*Hypothesis*

The null hypothesis for this study is that screening is part of standard medical care the risk of screening
are more common and cause more serious health issues in elderly people. While the Alternative
hypothesis for this study is that screening is important for prevention and treatment of cancer.

*Material and methods*

° *Study design*

The study design for this research is analytical cross sectional and this type of study is also called as
cohort study.

*Setting*

The data for this study is collected from older people living in Lahore.

*Study population*

Older adults of age 50 to 70.

*Duration*

This study will take about 3-5 months.

*Sample size*

Sample size for this study is 10 groups and in every group 5 persons are included.

*Sampling technique*

Convenient sample collecting technique will be used for this research.

*Eligibility criteria*

• Age more than 50.

*Data collection procedure*

Following are the steps that will be taken in the research:

1- Data retrieval from specific databases to get previous information.

2- Document all the questions in the questionnaires

3- Signature from the informed consent

4- Select different groups with different associated factors

5- Collection of data

6- Analysis through the gathered information

7- Statistical analysis through tools

8- Comparing the data with previous ones

9- Results elucidations

*stastical analysis*

SRP has developed new statistical methods and associated software tools for the analysis and

reporting of cancer statistics. Different methods and software are available for calculating

incidence, mortality, survival, prevalence, and spatial statistics. SEER*Stat contains a suite of

tools for the analysis of the Surveillance, Epidemiology, and End Results (SEER) and other

cancer-related databases. Methods associated with the reporting of basic cancer statistics are

added directly to SEER*Stat. Methods involving complex modeling are developed as separate

applications, and several can read data generated from SEER*Stat.

SEER*Stat software has various session types, each designed for specific calculations:

1. Frequency session: Generates the number of records stratified by any variable in a

database;

2. Rate session: Calculates disease incidence and mortality rates;

3. Survival session;

4. Prevalence session;

5. MP-SIR statistics session;

6. Case listing session: Allows users to view the values of variables for individual cases
(records).

*References*

. American Cancer Society. Cancer facts and figures

2015. http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf.
Accessed February, 2015.

 Walter LC, et al. Relationship between health status and use of screening mammography and
Papanicolaou smears among women older than 70 years of age. Ann Intern Med. 2004;140(9):681–688.

Walter LC, Lindquist K, Nugent S, et al. Impact of age and comorbidity on colorectal cancer screening
among older veterans. Ann Intern Med. 2009;150(7):465–473.

Schonberg MA, McCarthy EP, Davis RB, Phillips RS, Hamel MB. Breast cancer screening in women aged
80 and older: results from a national survey. J Am Geriatr Soc. 2004;52(10):1688–1695.

Mehta KM, Fung KZ, Kistler CE, Chang A, Walter LC. Impact of cognitive impairment on screening
mammography use in older US women. Am J Public Health. 2010;100(10):1917–1923.

Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision
making. JAMA. 2001;285(21):2750–2756.

Lee SJ, Leipzig RM, Walter LC. Incorporating lag time to benefit into prevention decisions for older
adults. JAMA. 2013;310(24):2609–2610.

Lee SJ, Boscardin WJ, Stijacic-Cenzer I, Conell-Price J, O'Brien S, Walter LC. Time lag to benefit after
screening for breast and colorectal cancer: meta-analysis of survival data from the United States,
Sweden, United Kingdom, and Denmark. BMJ. 2013;346:e8441.