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Chromosome 9p loss 3p, 17p loss survival rate than males. There has been very little improvement in five-year survival from this cancer, or other head and neck cancers, over the last four decades [18]. Early-stage head and neck cancers have a good cure rate, but over 60% of patients present with advanced disease. Moreover, a significant percentage of patients with squamous cell carcinoma go 11q, 13q, 14q loss p53 mutation (21-75% of cases) NORMAL MUCOSA PRECURSOR LESION DYSPLASIA CARCINOMA in situ INVASION on to develop a second primary tumour although initially cured. Patients may also face serious reductions in quality of life after definitive surgical therapy; despite improving rehabilitation and reconstructive surgery, residual cosmetic and functional debilities may be significant. The overall relative survival of laryngeal cancer patients varies between 60 and 6p, 8, 4q loss Fig. 5.96 Genetic alterations in squamous cell carcinoma of the head and neck. The accumulation and not necessarily the order of these genetic changes determines progression. REFERENCES 1. IARC (1985) Tobacco habits other than smoking; betelquid and areca-nut chewing; and some related nitrosamines (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 37), Lyon, IARCPress. 2. IARC (1986) Tobacco Smoking (IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans, Vol. 38), Lyon, IARCPress. 3. IARC (1988) Alcohol drinking (IARC Monographs on the Evaluation of Carcinogenic risks to Humans, Vol. 44), Lyon, IARCPress. 4. Merchant A, Husain SS, Hosain M, Fikree FF, Pitiphat W, Siddiqui AR, Hayder SJ, Haider SM, Ikram M, Chuang SK, Saeed SA (2000) Paan without tobacco: an independent risk factor for oral cancer. Int J Cancer, 86: 128-131. 5. Steinmetz KA, Potter JD (1991) Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control, 2: 325- 357. 6. Gillison ML, Koch WM, Shah KV (1999) Human papillomavirus in head and neck squamous cell carcinoma: are some head and neck cancers a sexually transmitted disease? Curr Opin Oncol, 11: 191-199. 7. IARC (1997) Epstein-Barr Virus and Kaposi's Sarcoma Herpesvirus / Human Herpesvirus 8 (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 70), Lyon, IARCPress. 8. Fernandez-Garrote L, Sankaranarayanan R, Lence anta JJ, Rodriguez-Salva A, Parkin DM (1995) An evaluation of the oral cancer control programme in Cuba. Epidemiology, 6: 428-431. 9. Sankaranarayanan R, Mathew B, Jacob Bj, Thomas G, Somanathan T, Pisani P, Pandey M, Ramadas K, Najeeb K, Abraham E (2000) Early findings from a community-based, cluster randomized, controlled oral cancer screening trial in Kerala, India. The Trivandrum Oral Cancer Screening Study Group. Cancer, 88: 664-673. 236 Human cancers by organ site 10. Schantz SP, Harrison LB, Forastiere AA (1997) Tumours of the nasal cavity and paranasal sinuses, nasopharynx, oral cavity and oropharynx. In: DeVita VTJ, Hellman S, Rosenberg SA eds, Cancer: Principles and Practice of Oncology, Philadelphia-New York, Lippincott-Raven, 741- 799. 11. Chan AT, Teo PM, Johnson PJ (1998) Controversies in the management of locoregionally advanced nasopharyngeal carcinoma. Curr Opin Oncol, 10: 219-225. 12. Oh Y, Mao L (1997) Biomarkers in head and neck carcinoma. Curr Opin Oncol, 9: 247-256. 13. Schwartz JL (2000) Biomarkers and molecular epidemiology and chemoprevention of oral cancer. Crit Rev Oral Biol Med, 11: 92-122. 14. Norman JE de B (1998) Cancers of the head and neck. In: Morris D, Kearsley J, Williams C eds, Cancer: a comprehensive clinical guide, Harwood Academic Publishers, 15. Adelstein DJ (1998) Recent randomized trials of chemoradiation in the management of locally advanced head and neck cancer. Curr Opin Oncol, 10: 213-218. 16. Khuri FR, Nemunaitis J, Ganly I, Arseneau J, Tannock IF, Romel L, Gore M, Ironside J, MacDougall RH, Heise C, Randlev B, Gillenwater AM, Bruso P, Kaye SB, Hong WK, Kirn DH (2000) a controlled trial of intratumoral ONYX-015, a selectively-replicating adenovirus, in combination with cisplatin and 5-fluorouracil in patients with recurrent head and neck cancer. Nat Med, 6: 879-885. 17. Berrino F, Capocaccia J, Estève J, Gatta G, Hakulinen T, Micheli A, Sant M, Verdecchia A, eds (1999) Survival of Cancer Patients in Europe: The EUROCARE-2 Study (IARC Scientific Publications, No. 151), Lyon, IARCPress. 18. Clayman GL, Lippma SM, Laramore GE, Hong WK (1997) Head and neck cancer. In: Holland JF, Bast RC, Morton DL, Frei E, Kufe DW, Weichselbaum RR eds, Cancer Medicine, Williams and Wilkins. 70% in Europe and North America, but is lower in developing countries. It is highly dependent on the sub-site of the disease which itself is dependent on the etiological factors involved. In countries with elevated alcohol consumption the prognosis is poorer because there are more tumours of the upper part of the larynx, which have a lower survival. WEBSITE NCI Head and Neck Cancer Homepage: http://www.cancer.gov/cancer_information/cancer_type/ head_and_neck/
LYMPHOMA SUMMARY > Malignant lymphomas are classified as either Hodgkin disease or non-Hodgkin lymphoma. > Hodgkin disease afflicts mainly children and the elderly in developing countries and young adults in more developed countries; 62,000 new cases are diagnosed annually. > The incidence of malignant non-Hodgkin lymphomas is increasing worldwide; more than 280,000 new cases occur annually, predominantly in more developed countries. > Burkitt lymphoma is a subtype of malignant B-cell lymphoma common in Africa in regions with endemic malaria. B-cell lymphomas may also be caused by immunosuppression. Both are commonly associated with the Epstein-Barr virus. > Advances in chemotherapy have led to a five-year survival rate for Hodgkin disease of more than 70% and that for non- Hodgkin lymphomas has increased to 60-70%. Definition The term lymphoma covers a heterogeneous group of neoplasms of lymphoid tissue. Traditionally, lymphomas are categorized as either Hodgkin disease or non- Hodgkin lymphoma, these distinct entities having different patterns of behaviour and response to treatment. Within each of these two entities there is a range of diverse subtypes. Epidemiology Non-Hodgkin lymphomas are a very varied group of neoplasms. Excluding the types that generally manifest as leukaemias rather than single or multiple aggregates of cells, there are around 287,000 cases of non-Hodgkin lymphoma in the world < 3.7 < 5.0 Fig. 5.97 Global incidence of non-Hodgkin lymphoma in men. The disease is most common in developed countries, although there are areas of moderate to high incidence in some Middle-Eastern countries and in parts of sub-Saharan Africa. per year. More males than females are affected (17.1 cases per 100,000 males compared to 11.2 cases per 100,000 females in the USA) and incidence increases with age. Geographically, non- Hodgkin lymphoma is most common in developed countries (52% of the world total cases, and the seventh most common cancer in more developed countries), although in the developing world there are areas of moderate to high incidence in some Middle-Eastern countries (Saudi Arabia, Israel) and in parts of sub-Saharan Africa (Fig. 5.97). The latter is due to the high incidence of Burkitt lymphoma, an aggressive subtype of non-Hodgkin lymphoma, particularly in children in tropical Africa. Papua New Guinea also has high rates of Burkitt lymphoma. The incidence rates of non-Hodgkin lymphoma have risen dramatically in the last 20 years, particularly in developed countries, including Western Europe, North America and Australia (Fig. 5.99). This may in part reflect better diagnosis, or < 6.8 < 8.9 Age-standardized incidence/100,000 population < 16.1 changing classification systems. However, these considerations together do not account for the extent of increase. Likewise, the fact that non-Hodgkin lymphoma is a complication of AIDS (occurring in up to 5-10% of AIDS cases in developed countries) does not completely account for the increasing trend. In contrast to incidence, mortality rates have, in general, been declining as a consequence of improvement in therapy. Hodgkin disease comprises about 23% of malignant lymphomas worldwide (about 62,000 annual cases). There is a male predominance (sex ratio 1.6:1). In developing countries, Hodgkin disease (predominantly the mixed cellularity subtype) occurs mainly in children and in the elderly, while in developed countries there is a peak in young adults (mainly the nodular sclerosing subtype). The disease is rare in Eastern and South-Eastern Asian populations at any age (Fig. 5.100). The pattern of Hodgkin disease in black Americans more closely resembles that of white Lymphoma 237
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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
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Regulation of the cell cycle and co
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CELL-CELL COMMUNICATION SUMMARY > C
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Connexin genes and tumour suppressi
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APOPTOSIS SUMMARY > The term apopto
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Caspase-8 Caspase-3 c-FLIP Procaspa
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ways. Several options are under inv
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INVASION AND METASTASIS SUMMARY > T
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laminin, entactin and also heparan
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Target Example of agent Comments Ad
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organs, and to respond to local gro
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TOBACCO CONTROL SUMMARY > Tobacco-i
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Region Deaths due to % of total dea
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ipated, is primarily attributable t
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smoke. This may be achieved in part
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there is no evidence for the effica
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industries, processes and occupatio
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stoves arises in rural areas of dev
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Climbing plants on trellis at end r
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HEPATITIS B VACCINATION SUMMARY > P
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Fig. 4.17 Chronic active HBV-associ
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HUMAN PAPILLOMAVIRUS VACCINATION SU
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Vaccine Site of trial Number of pat
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prolonged use. Similar drugs, that
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aspirin and other non-steroidal ant
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SCREENING FOR BREAST CANCER SUMMARY
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Fig. 4.35 Cumulative mortality from
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SCREENING FOR PROSTATE CANCER SUMMA
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Fig. 4.39 Poster designed for an an
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is around 10% for cancer (out of ev
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45 with one positive rehydrated FOB
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eing based on (i) time trends in th
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Fig. 4.48 Women at a clinic in Indi
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SCREENING FOR ORAL CANCER SUMMARY >
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India will provide useful informati
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cer incidence following cure of inf
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100 50 25 10 5 2.5 1 Japan Males Fe
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Human cancers by organ site Maligna
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tobacco smoking: age at start, aver
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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
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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
Page 205 and 206: Management The dramatic division be
Page 207 and 208: TUMOUR NORMAL Gastrula PGC 2n Impri
Page 209 and 210: CANCERS OF THE FEMALE REPRODUCTIVE
Page 211 and 212: Fig. 5.62 Five-year relative surviv
Page 213 and 214: Inheritance of high-penetrance gene
Page 215 and 216: invasive malignant. Malignant germ
Page 217 and 218: OESOPHAGEAL CANCER SUMMARY >Cancer
Page 219 and 220: Fig. 5.76 A radiographic view of an
Page 221 and 222: with a stent; laser recannulation,
Page 223 and 224: Fig. 5.82 Risk of bladder cancer am
Page 225 and 226: Partial cystectomy is appropriate f
Page 227 and 228: poorly known since hypopharyngeal c
Page 229: Fig. 5.92 Oral leukoplakia with mil
Page 233 and 234: T Fig. 5.101 Nuclear magnetic reson
Page 235 and 236: Fig. 5.106 Five-year relative survi
Page 237 and 238: Fig. 5.109 The immediate aftermath
Page 239 and 240: A B Fig. 5.113 Acute myeloid leukae
Page 241 and 242: Fig. 5.118 Five-year relative survi
Page 243 and 244: Fig. 5.120 Age-specific incidence a
Page 245 and 246: Hereditary condition Mode of inheri
Page 247 and 248: MELANOMA SUMMARY > Approximately 13
Page 249 and 250: Fig. 5.131 Primary melanoma with a
Page 251 and 252: THYROID CANCER SUMMARY > Cancer of
Page 253 and 254: Papillary carcinoma RET/PTC TRK BRA
Page 255 and 256: KIDNEY CANCER SUMMARY > Cancer of t
Page 257 and 258: Stage Clear cell carcinoma Papillar
Page 259 and 260: TUMOURS OF THE NERVOUS SYSTEM SUMMA
Page 261 and 262: ing the optic tract, brain stem and
Page 263 and 264: mut = mutant p53 wt = wildtype p53
Page 265 and 266: SURGICAL ONCOLOGY SUMMARY > Surgica
Page 267 and 268: Year Radical mastectomy (%) Modifie
Page 269 and 270: TELEMEDICINE The prospects for tele
Page 271 and 272: Equipment Energy 50% depth dose App
Page 273 and 274: CANCER EDUCATION IN MEDICAL COURSES
Page 275 and 276: Fig. 6.10 Crystals of cisplatin: mo
Page 277 and 278: Responsiveness Cancer (in decreasin
Page 279 and 280: 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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