9681

Information about 9681

Published on August 2, 2007

Author: Techy_Guy

Source: authorstream.com

Content

A ‘pandemic’ of adenocarcinomas in the new millennium: a common causal pathway?:  A ‘pandemic’ of adenocarcinomas in the new millennium: a common causal pathway? Zubair Kabir MD MSc University of Dublin (Trinity College) CResT Directorate St. James’s Hospital, Dublin-8, Ireland Email: [email protected] Introduction:  Recent studies on cancers of lung, 1 oesophagus, 2 stomach, 3 kidney, 4 prostate, 5 breast, 6 colon, 7 uterine cervix 8 and endometrium 9 show an increasing trend in a particular histologic sub-type, namely, adenocarcinoma, especially among the relatively young cohorts. The biological implication of this distinct epidemiologic and potentially etiologic entity is poorly understood. Introduction Importance of cancer trends by histologic sub-types:  Long-term trends in cancer incidence provide significant leads to an underlying causal pathway of cancers. More importantly, cancer trends by histologic sub-types identify the possible role of any putative risk factors, which may not be apparent in studies looking at cancer trends in general. Importance of cancer trends by histologic sub-types Examples of cancer trends by histologic sub-types:  Lung cancer is one of the commonest cancers worldwide, especially among male populations. Younger females are experiencing a relatively sharp increase in the development of lung adenocarcinoma worldwide, while the remaining histologic sub-types of lung cancer have stabilised across both sexes, particularly in the West.1 Examples of cancer trends by histologic sub-types Diagnostic technologies or histopathologic critieria as contributing factors?:  The reasons for this emerging pattern in adenocarcinomas are unclear. Variations in the coding, classification and diagnostic technology may contribute partially to the observed trends. The consistent upward trends observed worldwide argue against any of these, as they may be expected to demonstrate distinct regional variations. Diagnostic technologies or histopathologic critieria as contributing factors? Slide6:  The increasing trends in regions of relatively low socio-economic development suggest that better or improved medical imaging and diagnostic technologies are unlikely to have resulted in these global trends. The survival rates of the majority of these adenocarcinomas have not improved significantly over this period worldwide, suggesting the less likely effect of treatment changes on the observed variations. These observations also suggest that genetic or early life environmental factors may contribute to the recent trends. Potential risk factors?:  The contribution of some of the potential risk factors to the development of these specific cancers may be an alternative explanation. In general, changes in smoking prevalence, alcohol use, drug intake, dietary habits (fats, fruits, vegetables, salted pickles, vitamins, etc) and infections, such as Human papillomavirus (HPV) and Helicobacter pylori, may contribute to such observed patterns across these cancers. Potential risk factors? Observed trends in the potential risk factors:  A declining trend in smoking prevalence may partly explain the decreasing trend in the development of lung squamous-cell carcinoma, 10 as well as squamous-cell carcinoma of oesophagus. Introduction of filter cigarettes, including the so-called ‘low-yield’ cigarettes, may contribute to the rising incidence of lung adenocarcinoma, especially among female smokers, 10 consistent with a recent finding.11 Observed trends in the potential risk factors Slide9:  The common sub-types of HPV infection are frequently associated with squamous-cell carcinoma of cervix. An observed declining trend in the seroprevalence of H. pylori 13 that is more commonly associated with non-cardia gastric adenocarcinoma, 12 as opposed to a recent increase in gastric cardia adenocarcinoma3. Alcohol use has the strongest association, particularly with oesophageal carcinoma. Possible role of dietary factors and obesity?:  Regarding dietary factors, a common food hypothesis shows inconsistent findings for the majority of these cancers. Total energy intake, as assessed by obesity, seems more biologically plausible. Obesity being differentially associated with the development of histologic sub-types of lung cancer in females may be a possibility.14 Possible role of dietary factors and obesity? Influence of hormones or any underlying interactions?:  The historic findings of linking in-utero diethylstilboesterol (DES) exposure to vaginal adenocarcinoma, as well as hormone replacement therapy (HRT) have long been issues of debate. There is speculation that females are more likely to develop lung adenocarcinoma, possibly due to interactions between genetic factors and endocrine status, 15 suggesting additional investigation in gene-environment interactions. Influence of hormones or any underlying interactions? Global obesity trend: a likely factor?:  Taken together, the only consistent observation in any of these known risk factors is a simultaneous rising prevalence in obesity worldwide since 1980, not only in the older cohorts13 but also among the adolescents.18 Recently, WHO termed this phenomenon ‘globesity’, which may be a ticking time bomb. Global obesity trend: a likely factor? Observed conclusion:  These apparent observations raise the possibility of linking the development of these adenocarcinomas to body weight, which may be modified by endogenous hormone metabolism, such as sex steroids, insulin and insulin-like growth factors, throughout the life course. This hypothesis thus generated provides a unique opportunity for further investigations. Observed conclusion Early life experiences on cancer risk development?:  Until the cause-effect relation of obesity on cancer is clear, it would seem reasonable to consider whether environmental changes in later life modify the effects of early life experiences. Foetal experience may influence adult obesity with potential consequences for risk of several major cancers.20 Early life experiences on cancer risk development? Burden of obesity:  In addition to total health-care costs,23 the overall impact of obesity on population health is becoming clear across the globe, such as diabetes, coronary artery diseases, etc. (http://cdc.gov/nccdphp/dnpa/obesity/index.htm) An estimated 72,000 new cases of obesity and overweight-related cancer occurring each year in the European Union alone is no less worrisome.24 Burden of obesity Implications of this epidemiologic review:  These observations may provide a new framework for large controlled trials in cancer chemoprevention. If true, these observations also have the potential for primary prevention of an underlying adenocarcinoma pandemic in the new millennium. Implications of this epidemiologic review Future directions:  Governmental and non-governmental organisations, the food industry, media, worksites, schools, health professionals, educators, as well as families should have a common responsibility to produce an environment less conducive to weight gain, particularly for young people, recently recognised as the ‘common sense’ approach. 25 Future directions References:  References 1.  Kabir Z, Manning PJ, Clancy L. Epidemiologic patterns of lung cancer incidence in the Republic of Ireland by major histologic types: 1994-1997. Am J Epidemiol 2002; 155 (Suppl): 19. 2.   Powell J, McConkey CC, Gillison EW, Spychal RT. Continuing rising trend in oesophageal adeonocarcinoma. Int J Cancer 2002; 102: 422-7. Slide19:  6.  Prehn A, Clarke C, Topol B, Glaser S, West D. Increase in breast cancer incidence in middle-aged women during the 1990s. Ann Epidemiol 2002; 12: 476-81. 7. Kim DW, Bang YJ, Heo DS, Kim NK. Colorectal cancer in Korea: characteristics and trends. Tumori 2002; 88: 262-5. 8. Krishnamurthy S, Yecole BB, Jussawalla DJ. Uterine cervical adenocarcinomas and squamous carcinomas in Bombay: 1965-1990. J Obstet Gynaecol Res 1997; 23: 521-7. Slide20:  11. Yang P, Cerhan JR, Vierkant RA et al. Adenocarcinoma of the lung is strongly associated with cigarette smoking: further evidence from a prospective study of women. Am J Epidemiol 2002; 156: 1114-22. 12. Schottenfeld D, Fraumeni JF Jr (Ed). In: Cancer Epidemiology and Prevention (Second Edition). New York: Oxford University Press, 1996. 13.  Swerdlow A, Silva I, Doll R (ed). In: Cancer incidence and mortality in England and Wales: trends and risk factors. New York: OUP, 2001. Slide21:  16. Nelson R. Steroidal oestrogens added to list of known human carcinogens. Lancet 2002; 360: 2053. 17. Batty D, Thune I. Does physical activity prevent cancer? BMJ 2000; 321: 1424-5. 18. Wang Y, Monteiro C, Popkin BM. Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China and Russia. Am J Clin Nutr 2002; 75: 971-7. 19. Okasha M, McCarron P, McEwen J, Smith GD. Body mass index in young adulthood and cancer mortality: retrospective cohort study. J Epidemiol Community Health 2002; 56: 780-4. Slide22:  21.Dietz WH. ‘Adiposity rebound’: reality or epiphenomenon? Lancet 2000; 356: 2027. 22. Youssef AA, Valdez R, Elkasabany A, Srinivasan SR, Berenson GS. Time-course of adiposity and fasting insulin from childhood to young adulthood in offspring of parents with coronary artery disease. Ann Epidemiol 2002; 12: 553-9. 23.Thompson D, Brown JB, Nichols GA, Elmer PJ, Oster G. Body mass index and future healthcare costs: a retrospective cohort study. Obes Res 2001; 9: 210-18. Acknowledgements:  Acknowledgements Dr Zubair Kabir is a Research Fellow in Cancer Epidemiology at the University of Dublin (Ireland) funded by the Royal City of Dublin Hospital Trust. Professor Luke Clancy is supervising Dr Kabir based at St. James’s University Teaching Hospital (Dublin) in the Department of Respiratory Medicine. Useful resources:  Useful resources Globocan 2000- Cancer Incidence, Mortality, and Prevalence worldwide. (http://www-dep.iarc.fr/globocan/globocan.html) Surgeon’s General Report. ( ttp://www.surgeongeneral.gov/topics/obesity) International Obesity Task Force. (http://www.iotf.org).

Related presentations


Other presentations created by Techy_Guy

Character Analysis
04. 01. 2008
0 views

Character Analysis

Roosevelt and Latin America
22. 10. 2007
0 views

Roosevelt and Latin America

S10 Processor Performance
17. 09. 2007
0 views

S10 Processor Performance

Hawaiian Humpback Whale
17. 09. 2007
0 views

Hawaiian Humpback Whale

rainforest
02. 10. 2007
0 views

rainforest

Comvalid BGPsentinel
07. 10. 2007
0 views

Comvalid BGPsentinel

PETERPAN
10. 10. 2007
0 views

PETERPAN

across crocodile lake
11. 10. 2007
0 views

across crocodile lake

MLM basic info
12. 10. 2007
0 views

MLM basic info

VortragRichter
15. 10. 2007
0 views

VortragRichter

azerbaijan
15. 10. 2007
0 views

azerbaijan

ch02jjm
19. 10. 2007
0 views

ch02jjm

PRNAV Eurocontrol presentation
19. 10. 2007
0 views

PRNAV Eurocontrol presentation

Hakkarainen 091104
17. 09. 2007
0 views

Hakkarainen 091104

Extreme Ostrich2
17. 09. 2007
0 views

Extreme Ostrich2

Soy Protein in Baking
04. 10. 2007
0 views

Soy Protein in Baking

McMurrenTidbits
23. 10. 2007
0 views

McMurrenTidbits

Larijani stemcell ABA2007 Final
24. 10. 2007
0 views

Larijani stemcell ABA2007 Final

F Gauze
24. 10. 2007
0 views

F Gauze

TornadoSafetyAMS
07. 10. 2007
0 views

TornadoSafetyAMS

nii report
09. 10. 2007
0 views

nii report

NS102 3a S07 Fighting Sail
21. 10. 2007
0 views

NS102 3a S07 Fighting Sail

am0845 Khanna
16. 11. 2007
0 views

am0845 Khanna

culturechange
10. 12. 2007
0 views

culturechange

Jeopardy
29. 10. 2007
0 views

Jeopardy

masstheory
02. 11. 2007
0 views

masstheory

Finnish Chemicals information
21. 08. 2007
0 views

Finnish Chemicals information

zodiac
21. 08. 2007
0 views

zodiac

ICT Expo Presentation
21. 08. 2007
0 views

ICT Expo Presentation

words alive notes
21. 08. 2007
0 views

words alive notes

notes 13
21. 08. 2007
0 views

notes 13

200612011440150 ser mama
01. 10. 2007
0 views

200612011440150 ser mama

t5f2
07. 11. 2007
0 views

t5f2

PHYS 124 lt 2
13. 11. 2007
0 views

PHYS 124 lt 2

Localization days1 2
14. 11. 2007
0 views

Localization days1 2

Barlow
15. 11. 2007
0 views

Barlow

CEO breakfast Mar
16. 11. 2007
0 views

CEO breakfast Mar

SEVESO II 28 04 2003 d jansen
23. 11. 2007
0 views

SEVESO II 28 04 2003 d jansen

farawayplaces quiz
31. 10. 2007
0 views

farawayplaces quiz

lino hospitalstay 2005
28. 12. 2007
0 views

lino hospitalstay 2005

eno
05. 10. 2007
0 views

eno

Destinos Tradicionale
22. 10. 2007
0 views

Destinos Tradicionale

El Karib Hagmann 2001 HEKS ACORD
23. 10. 2007
0 views

El Karib Hagmann 2001 HEKS ACORD

Bioceramics
05. 01. 2008
0 views

Bioceramics

dennis
07. 01. 2008
0 views

dennis

DNR wetland benefits
07. 01. 2008
0 views

DNR wetland benefits

Norm Wright Presentation06
17. 09. 2007
0 views

Norm Wright Presentation06

Tudor Sports
21. 08. 2007
0 views

Tudor Sports

watson 2006
21. 08. 2007
0 views

watson 2006

IBM Presentation Roel Spee
24. 10. 2007
0 views

IBM Presentation Roel Spee

david simek
17. 09. 2007
0 views

david simek

75thWinter Silver
02. 08. 2007
0 views

75thWinter Silver

Revay Presentation
17. 09. 2007
0 views

Revay Presentation

week12 f03
17. 09. 2007
0 views

week12 f03

Ch12 ResolutionTheoremPro ving
17. 09. 2007
0 views

Ch12 ResolutionTheoremPro ving

INFOCOM99
05. 10. 2007
0 views

INFOCOM99

RoHS Presentation3 May
12. 10. 2007
0 views

RoHS Presentation3 May

Botany
07. 12. 2007
0 views

Botany

Week6February20 07
20. 02. 2008
0 views

Week6February20 07

Microcosmo Parte II
12. 10. 2007
0 views

Microcosmo Parte II

TSW
29. 02. 2008
0 views

TSW

HazMat Flow Study
26. 02. 2008
0 views

HazMat Flow Study

Vegetarian Nutrition 101
04. 03. 2008
0 views

Vegetarian Nutrition 101

White 10th Inter mountain
21. 08. 2007
0 views

White 10th Inter mountain

hondaimobil
02. 01. 2008
0 views

hondaimobil

Cfi
10. 03. 2008
0 views

Cfi

Timber Bridge Presentation
01. 01. 2008
0 views

Timber Bridge Presentation

carstenschymik
29. 12. 2007
0 views

carstenschymik

Ch 22 WB
07. 04. 2008
0 views

Ch 22 WB

Macroclean
10. 04. 2008
0 views

Macroclean

agingandwork
13. 04. 2008
0 views

agingandwork

nyBrazeau
14. 04. 2008
0 views

nyBrazeau

presentation total
16. 04. 2008
0 views

presentation total

3 Tufano2002
17. 04. 2008
0 views

3 Tufano2002

Chapter 18
18. 04. 2008
0 views

Chapter 18

Baltic states and Russia
12. 10. 2007
0 views

Baltic states and Russia

quotes
03. 10. 2007
0 views

quotes

WDR 2008
29. 11. 2007
0 views

WDR 2008

CHLA PSRS Overview
30. 04. 2008
0 views

CHLA PSRS Overview

15 UKernel
02. 05. 2008
0 views

15 UKernel

Mr Logan OCCAR
06. 03. 2008
0 views

Mr Logan OCCAR

shen
15. 10. 2007
0 views

shen

Industry Brief
22. 10. 2007
0 views

Industry Brief

sess 4 solano
18. 06. 2007
0 views

sess 4 solano

sess 2 vollmer
18. 06. 2007
0 views

sess 2 vollmer

NSDI05 poster
18. 06. 2007
0 views

NSDI05 poster

NLC talk
18. 06. 2007
0 views

NLC talk

My Proxy GW06
18. 06. 2007
0 views

My Proxy GW06

my Master 4
18. 06. 2007
0 views

my Master 4

More Mosaics
18. 06. 2007
0 views

More Mosaics

MEM SPI Jan00
18. 06. 2007
0 views

MEM SPI Jan00

VCA Org Charts
11. 12. 2007
0 views

VCA Org Charts

cjdim com Boudchiche
23. 10. 2007
0 views

cjdim com Boudchiche

GA Conf06China1
25. 03. 2008
0 views

GA Conf06China1

lecture 7 deadlock
17. 09. 2007
0 views

lecture 7 deadlock

Neptune Presentation
15. 06. 2007
0 views

Neptune Presentation

neptune
15. 06. 2007
0 views

neptune

Mehregan
18. 06. 2007
0 views

Mehregan

Plants are very useful
15. 06. 2007
0 views

Plants are very useful

Learning Phonics
15. 06. 2007
0 views

Learning Phonics

Learning Percent III
15. 06. 2007
0 views

Learning Percent III

Learning Percent I
15. 06. 2007
0 views

Learning Percent I

Physical Education Procedures
15. 06. 2007
0 views

Physical Education Procedures

Penguins
15. 06. 2007
0 views

Penguins

Olympic Wax Museum
15. 06. 2007
0 views

Olympic Wax Museum

howe9
17. 09. 2007
0 views

howe9

GSantin Siena 2 SpaceTools
03. 01. 2008
0 views

GSantin Siena 2 SpaceTools

gunderia powerpointlab
26. 11. 2007
0 views

gunderia powerpointlab

MySQL UC solid DB xact
18. 06. 2007
0 views

MySQL UC solid DB xact

Civics Lecture
31. 12. 2007
0 views

Civics Lecture

Physics and psycho2
14. 02. 2008
0 views

Physics and psycho2

TOUREDIT
12. 03. 2008
0 views

TOUREDIT

harvard deas
03. 01. 2008
0 views

harvard deas

Angelology
01. 10. 2007
0 views

Angelology

HenryVIII wwtbam
21. 08. 2007
0 views

HenryVIII wwtbam

AGU 2002
03. 10. 2007
0 views

AGU 2002

RubÃn Blades
22. 10. 2007
0 views

RubÃn Blades

tran present
21. 08. 2007
0 views

tran present

BU01
17. 09. 2007
0 views

BU01

Thode
17. 09. 2007
0 views

Thode

PP R CAJAR
22. 10. 2007
0 views

PP R CAJAR

moore lightning uw05
17. 09. 2007
0 views

moore lightning uw05

Space- The Outside World
15. 06. 2007
0 views

Space- The Outside World

arts and humanities applications
22. 11. 2007
0 views

arts and humanities applications

Session9 CATHALAC UNDP
25. 10. 2007
0 views

Session9 CATHALAC UNDP

use sunscreen
17. 09. 2007
0 views

use sunscreen

aatom
20. 11. 2007
0 views

aatom

HHDL
15. 10. 2007
0 views

HHDL