University of Al-Ameed

College of Medicine
Department of Community medicine

Cancer Epidemiology
Lecture 2
Dr. Ahmed AL Ibraheemi
Radiation Oncologist
Objectives of the lecture
1.To understand cancer epidemiology and the global and national
burden of cancer.
2.To explore the various risk factors contributing to cancer occurrence
3.To highlight preventive strategies and interventions for cancer control
 Awareness
and
prevention

Registration Screening
and and early
research Cancer detection

control
program

Diagnosis
Palliative
and
care
treatment
 Primary control (prevention)

• A. Health education: National policies and programmes

should be implemented to:

1. Raise awareness and reduce exposure to cancer risk factors.

2. To ensure that people are provided with the information and

support they need to adopt healthy lifestyles.
Primary Control
• B. Lifestyle and behaviour change:
1) Avoiding using tobacco: reducing the epidemic of tobacco smoking
is currently the most effective means for cancer prevention.
2) Regular physical activity and the maintenance of a healthy body
weight, along with a healthy diet, will considerably reduce cancer
risk.
3) Encourage eating a healthy diet, including fruit and vegetables.
4) Avoiding or reducing consumption of alcohol
Primary prevention
C. Vaccination against human papilloma virus (HPV) and
hepatitis B virus (HBV).
D. Avoiding ultraviolet radiation exposure.
E. Reduce exposure to ionizing radiation.
F. Reducing exposure to outdoor air pollution and indoor air pollution.
G. Chemoprevention may be helpful in high-risk patients,
II. Secondary control
• A. Early diagnosis which is composed of 3 components :

1) Being aware of the symptoms of different forms of cancer and of the

importance of seeking medical advice when abnormal findings are
observed;

2) Access to clinical evaluation and diagnostic services;

3) Timely referral to treatment services.

II. Secondary control
• B. Screening
Aims to identify individuals with findings suggestive of a specific cancer or pre-cancer
before they have developed symptoms.

cancers Screening programs :

Breast
Cervix
Colon and Rectum
Lung,
Ovary
Prostate
Endometrium
Tongue
Skin
III. Tertiary control
1. Cancer diagnosis
• Invasive Vs Non invasive
• Labs Vs Radiology

2. Cancer treatment
• Surgery
• Chemotherapy
• Radiotherapy
 III. Tertiary control
3. Palliative care and pain relief
• Palliative care for physical, psychosocial, and spiritual problems
• Survivorship care
• Pain management
 ‫قصة فوزية‬
‫امرأة عمرها ‪ 52‬سنة‬
‫وزنها ‪ 94‬كغم‬
‫تعليم ابتدائي‬
‫متزوجة و لديها ‪ 6‬اوالد و بنات‬
‫تعمل ربة بيت‬
‫خالتها اصيبت و هي في عمر ‪ 35‬و ماتت بالسرطان قبل ‪ 10‬سنوات‬
‫شعرت بوجود كتلة في منطقة الثدي‬
‫ترددت كثيرا في مراجعة الطبيب‬
‫زاد حجم الكتلة‬
‫راجعت طبيب جراح و نصحها بعمل رفع للكتلة‬
‫تم تشخيصها على انها سرطان ثدي و بعدها تم نصيحتها بعمل عملية تنظيف االبط‬
‫اجرت العملية و كانت الحالة من المرحلة الثالثة‬
‫اخذت العالج الكيمياوي في كربالء‬
‫من بعده العالج االشعاعي في النجف‬
‫و من بعده العالج الهرموني‬
‫بعد فترة شعرت بالم بالكتف‬
‫عملت فحص عظام‬
‫تم اكتشاف انتشار في منطقة الكتف باالضافة الى انتشار في الرئة و الكبد‬
‫بدأت تعاني من الم شديد مع فقدان شهية و كأبة حادة و تدهور في حالتها الصحية‬
‫توفيت فوزية بعد رحلة عالجية استمرت حوالي ‪ 3‬سنوات‬
References (5, 6)
• 1. WHO. Cancer. 2023.
• 2. WHO. Cancer, keyfacts % overview. 2023.
• 3. WHO. EMRO _ Noncommunicable diseases _ Priority areas _ Iraq
site.
• 4. Wikipedia. X-ray - Wikipedia.
• 5. Adetokunbo O. Lucas HMG. Short Textbook of Public Health
Medicine for the Tropics. 4th ed: Hodder Arnold; 2003.
• 6. Wallace/Maxcy-Rosenau-Last. Public Health and Preventive
Medicine. fifteenth ed2008.