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REFERENCES 1. Leitch AM (1999) Breast cancer screening: success amid conflict. Surg Oncol Clin N Am, 8: 657-672, vi. 2. Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J, eds (1997) Cancer Incidence in Five Continents, Vol. VII (IARC Scientific Publications No. 143 and IARC Cancerbase No. 2), Lyon, IARCPress. 3. Waterhouse J, Muir C, Shanmugaratnam K, Powell J, Peacham D, Whelan S, eds (1982) Cancer Incidence in Five Continents, Vol. IV (IARC Scientific Publications No. 42), Lyon, IARCPress. 4. Adams-Cameron M, Gilliland FD, Hunt WC, Key CR (1999) Trends in incidence and treatment for ductal carcinoma in situ in Hispanic, American Indian, and non- Hispanic white women in New Mexico, 1973-1994. Cancer, 85: 1084-1090. 5. Barchielli A, Paci E, Giorgi D (1999) Recent trends of in situ carcinoma of the breast and mammographic screening in the Florence area, Italy. Cancer Causes Control, 10: 313- 317. 6. Quinn M, Allen E (1995) Changes in incidence of and mortality from breast cancer in England and Wales since introduction of screening. United Kingdom Association of Cancer Registries. BMJ, 311: 1391-1395. 7. Chu KC, Tarone RE, Kessler LG, Ries LA, Hankey BF, Miller BA, Edwards BK (1996) Recent trends in U.S. breast cancer incidence, survival, and mortality rates. J Natl Cancer Inst , 88: 1571-1579. 8. Ballard-Barbash R, Klabunde C, Paci E, Broeders M, Coleman EA, Fracheboud J, Bouchard F, Rennert G, Shapiro S (1999) Breast cancer screening in 21 countries: delivery of services, notification of results and outcomes ascertainment. Eur J Cancer Prev, 8: 417-426. 9. Whitman GJ (1999) The role of mammography in breast cancer prevention. Curr Opin Oncol, 11: 414-418. 10. Monsees BS (2000) The Mammography Quality Standards Act. An overview of the regulations and guidance. Radiol Clin North Am, 38: 759-772. 11. Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, White E (2000) Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst, 92: 1081-1087. 12. Andersson I, Aspegren K, Janzon L, Landberg T, Lindholm K, Linell F, Ljungberg O, Ranstam J, Sigfusson B (1988) Mammographic screening and mortality from breast cancer: the Malmo mammographic screening trial. BMJ, 297: 943-948. 13. Miller AB, Baines CJ, To T, Wall C (1992) Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years. CMAJ, 147: 1459-1476. 14. Tabar L, Fagerberg G, Duffy SW, Day NE, Gad A, Grontoft O (1992) Update of the Swedish two-county program of mammographic screening for breast cancer. Radiol Clin North Am, 30: 187-210. 15. Moss S (1999) Breast cancer, In: Kramer BS, Gohagan JK, Prorok PC, eds, Cancer Screening: Theory and Practice, Marcel Dekker. 16. Primic-Zakelj M (1999) Screening mammography for early detection of breast cancer. Ann Oncol, 10 Suppl 6: 121-127. 17. Kerlikowske K, Barclay J (1997) Outcomes of modern screening mammography. J Natl Cancer Inst Monogr, 105- 111. 18. De Koning HJ (2000) Breast cancer screening: costeffective in practice? Eur J Radiol, 33: 32-37. 19. Olsen O, Gotzsche PC (2001) Cochrane review on screening for breast cancer with mammography. Lancet, 358: 1340-1342. 20. IARC (2002) Breast Cancer Screening (IARC Handbooks of Cancer Prevention, Vol. 7), Lyon, IARCPress. 21. Ernster VL, Barclay J (1997) Increases in ductal carcinoma in situ (DCIS) of the breast in relation to mammography: a dilemma. J Natl Cancer Inst Monogr, 151-156. WEBSITES Information from the US NCI on testing for various cancers, including breast: http://www.cancer.gov/cancerinfo/screening NCI’s Division of Cancer Prevention: http://cancer.gov/prevention/ FDA's Mammography Programme: http://www.fda.gov/cdrh/mammography/mqsa-rev.html Screening for breast cancer 159
SCREENING FOR PROSTATE CANCER SUMMARY > Prostate-specific antigen (PSA) testing is widely used for the early detection of prostate cancer. > Elevated levels of PSA are closely, but not definitively, associated with prostate cancer; false positive results may lead to unnecessary treatment. > Assessment of population-based PSA screening suggests a reduction in mortality in countries with access to urological follow-up and treatment. Secondary prevention of prostate cancer is feasible, but is subject to controversy, since the capacity to detect early disease must inevitably result in overtreatment for the individual patient, with substantial costs to society, in exchange for decreased mortality [1]. The lack of effective, appropriate markers of disease and any reasonable consensus on subsequent treatment necessitates extensive patient counselling as an important prerequisite, with some degree of prudence until the outcomes of the ongoing randomized trials in Europe and North America have been evaluated and audited [2]. Biological basis of secondary prevention Prostate-specific antigen (PSA), a glycoprotein, is a proteinase that is responsible for the liquefaction of semen. PSA analysis has replaced prostatic acid phosphatase as the preferred serum marker of prostate cancer. The fact that PSA is highly tissue-specific and the consideration that few prostatic conditions result in a sustained, elevated level of serum PSA have made it the most efficacious marker currently available for the detection of prostate cancer. A serum “cut-off level” of 4 ng/ml for normality was used to demon- 160 Prevention and screening Fig. 4.37 A physician in discussion with a patient: informed consent is a prerequisite for PSA testing. strate the efficacy of PSA as a diagnostic tool [3]. Unfortunately, 25% of patients diagnosed with prostate cancer have levels of serum PSA that are less than 4 ng/ml. Of men with PSA levels between 4- 10 ng/ml, 25% have cancer, and 60% have cancer when PSA levels are greater than 10 ng/ml. PSA analysis should be combined with a digital rectal examination, the latter providing an assessment of the volume of the gland, since PSA is also released into the bloodstream of patients with benign prostate hyperplasia and other prostatic diseases. To improve the sensitivity of the PSA analysis, a number of parameters Advantages Disadvantages may be assessed, most of which relate to concomitant benign prostate hyperplasia and also include age-specific reference ranges [4], typical values being: 40-49 years,
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WORLD HEALTH ORGANIZATION WHO OMS I
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WORLD CANCER REPORT Editors Bernard
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CONTENTS Foreword 9 1 The global bu
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The global burden of cancer Cancer
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Fig. 1.2 Incidence and mortality of
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Central and Southern Europe differ
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Incidence of cancer in South Centra
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from documentation of disease to a
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TOBACCO SUMMARY >In addition to lun
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Fig. 2.3 Smoking by children is inc
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Cancers positively Sex Standardized
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PHARMACOLOGICAL APPROACHES TO SMOKI
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level the dose—response relations
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lipoprotein-associated cholesterol,
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Agent Cancer site/cancer Main indus
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Industry, occupation Cancer site/ca
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to occupational exposures in develo
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Air pollutant WHO Air Quality Guide
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der cancer of the order of 50% is p
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AFLATOXIN B 1 HEPATITIS VIRUS (chro
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Fig. 2.30 Correlation between regio
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MEDICINAL DRUGS SUMMARY > Certain d
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Drug or drug combination Cancer IAR
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Agent or substance Cancer site/canc
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sources of electromagnetic fields [
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CHRONIC INFECTIONS SUMMARY > Infect
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Infection Subclinical Mutagenic fac
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TUMOURS ASSOCIATED WITH HIV/AIDS Ap
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DIET AND NUTRITION SUMMARY > Up to
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Fig. 2.54 The age-adjusted mortalit
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OVERWEIGHT, OBESITY AND PHYSICAL AC
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IMMUNOSUPPRESSION SUMMARY >Persiste
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Fig. 2.64 Cancer following immunosu
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Syndrome Gene Location Cancer site/
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viduals, confirmation of a gene def
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REPRODUCTIVE FACTORS AND HORMONES S
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PHYTO-ESTROGENS AND CANCER PEVENTIO
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Indicator Number of oral contracept
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Mechanisms of tumour development Th
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The stages in tumorigenesis have be
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PRECURSOR LESIONS IN CHEMOPREVENTIO
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CARCINOGEN ACTIVATION AND DNA REPAI
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adducts, a few weeks or months for
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I Reactive oxygen species Methylati
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which remove the mismatched bases,
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Common human oncogenes Many common
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product of the RB1 gene (pRb) and a
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ates a molecular bridge between p53
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potential cancer genes altered thro
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One of the earliest genes to be ide
Page 103 and 104: Regulation of the cell cycle and co
Page 105 and 106: CELL-CELL COMMUNICATION SUMMARY > C
Page 107 and 108: Connexin genes and tumour suppressi
Page 109 and 110: APOPTOSIS SUMMARY > The term apopto
Page 111 and 112: Caspase-8 Caspase-3 c-FLIP Procaspa
Page 113 and 114: ways. Several options are under inv
Page 115 and 116: INVASION AND METASTASIS SUMMARY > T
Page 117 and 118: laminin, entactin and also heparan
Page 119 and 120: Target Example of agent Comments Ad
Page 121 and 122: organs, and to respond to local gro
Page 123 and 124: TOBACCO CONTROL SUMMARY > Tobacco-i
Page 125 and 126: Region Deaths due to % of total dea
Page 127 and 128: ipated, is primarily attributable t
Page 129 and 130: smoke. This may be achieved in part
Page 131 and 132: there is no evidence for the effica
Page 133 and 134: industries, processes and occupatio
Page 135 and 136: stoves arises in rural areas of dev
Page 137 and 138: Climbing plants on trellis at end r
Page 139 and 140: HEPATITIS B VACCINATION SUMMARY > P
Page 141 and 142: Fig. 4.17 Chronic active HBV-associ
Page 143 and 144: HUMAN PAPILLOMAVIRUS VACCINATION SU
Page 145 and 146: Vaccine Site of trial Number of pat
Page 147 and 148: prolonged use. Similar drugs, that
Page 149 and 150: aspirin and other non-steroidal ant
Page 151 and 152: SCREENING FOR BREAST CANCER SUMMARY
Page 153: Fig. 4.35 Cumulative mortality from
Page 157 and 158: Fig. 4.39 Poster designed for an an
Page 159 and 160: is around 10% for cancer (out of ev
Page 161 and 162: 45 with one positive rehydrated FOB
Page 163 and 164: eing based on (i) time trends in th
Page 165 and 166: Fig. 4.48 Women at a clinic in Indi
Page 167 and 168: SCREENING FOR ORAL CANCER SUMMARY >
Page 169 and 170: India will provide useful informati
Page 171 and 172: cer incidence following cure of inf
Page 173 and 174: 100 50 25 10 5 2.5 1 Japan Males Fe
Page 175 and 176: Human cancers by organ site Maligna
Page 177 and 178: tobacco smoking: age at start, aver
Page 179 and 180: diagnosis is usually confirmed by h
Page 181 and 182: is frequent and survival rates are
Page 183 and 184: Fig. 5.14 Physician reading digital
Page 185 and 186: Markers of prognosis in breast canc
Page 187 and 188: cer in the contralateral breast (Ch
Page 189 and 190: 100 50 25 10 5 2.5 1 Japan Chile Po
Page 191 and 192: depends on staging. Small intramuco
Page 193 and 194: Fig. 5.30 A diet rich in fresh frui
Page 195 and 196: ane protein involved in cell adhesi
Page 197 and 198: LIVER CANCER SUMMARY > About 560,00
Page 199 and 200: Fig. 5.39 A woman in the Gambia pre
Page 201 and 202: REFERENCES 1. Ferlay J, Bray F, Par
Page 203 and 204: Certain Possible Uncertain Age Andr
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Management The dramatic division be
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TUMOUR NORMAL Gastrula PGC 2n Impri
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CANCERS OF THE FEMALE REPRODUCTIVE
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Fig. 5.62 Five-year relative surviv
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Inheritance of high-penetrance gene
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invasive malignant. Malignant germ
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OESOPHAGEAL CANCER SUMMARY >Cancer
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Fig. 5.76 A radiographic view of an
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with a stent; laser recannulation,
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Fig. 5.82 Risk of bladder cancer am
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Partial cystectomy is appropriate f
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poorly known since hypopharyngeal c
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Fig. 5.92 Oral leukoplakia with mil
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LYMPHOMA SUMMARY > Malignant lympho
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T Fig. 5.101 Nuclear magnetic reson
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Fig. 5.106 Five-year relative survi
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Fig. 5.109 The immediate aftermath
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A B Fig. 5.113 Acute myeloid leukae
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Fig. 5.118 Five-year relative survi
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Fig. 5.120 Age-specific incidence a
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Hereditary condition Mode of inheri
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MELANOMA SUMMARY > Approximately 13
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Fig. 5.131 Primary melanoma with a
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THYROID CANCER SUMMARY > Cancer of
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Papillary carcinoma RET/PTC TRK BRA
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KIDNEY CANCER SUMMARY > Cancer of t
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Stage Clear cell carcinoma Papillar
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TUMOURS OF THE NERVOUS SYSTEM SUMMA
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ing the optic tract, brain stem and
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mut = mutant p53 wt = wildtype p53
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SURGICAL ONCOLOGY SUMMARY > Surgica
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Year Radical mastectomy (%) Modifie
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TELEMEDICINE The prospects for tele
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Equipment Energy 50% depth dose App
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CANCER EDUCATION IN MEDICAL COURSES
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Fig. 6.10 Crystals of cisplatin: mo
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Responsiveness Cancer (in decreasin
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Most of the world’s most common c
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treatment of cancer. The problems l
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duction. It is clear that tumour ce
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REHABILITATION SUMMARY > Rehabilita
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cer and its associated disability.
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REFERENCES 1. Garden FH, Gillis TA
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Cancer pain relief varies and in so
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EMERGING ISSUES IN PALLIATIVE CARE
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Cancer control The negative impact
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priority to cancer control activiti
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Prevention of cancer Every country
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- Assessing the magnitude of the ca
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high-risk women. Further details on
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ecords departments are either rudim
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THE INTERNATIONAL AGENCY FOR RESEAR
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in the capitals/urban areas of four
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in the overall cancer strategy. WHO
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68% 1955 1975 1995 2025 32% 40% by
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Fig. 7.15 A grandfather at work in
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Fig. 7.17 Main causes of death in d
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Contributors and Reviewers Sources
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Dr Vera Luiz da Costa e Silva Tobac
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Georgia Moore Centers for Disease C
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REVIEWERS Dr Sandra E. Brooks 405 W
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2.53 T. Norat and E. Riboli, IARC 2
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Gastroenterology, 118(2 Suppl 1): S
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5.106 & 5.107 IARC/SEER/Osaka Cance
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4.17 R. Lambert, IARC/Adapted from
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Brain cancer, see nervous system tu
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Fibroblast growth factor (FGF), 117
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Microarray, 240 Micronutrients, 65,
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S Saccharin, 64, 85 Salicin, 153 Sa
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