17. Epidemiology and prevention of liver-, pancreas- and gastric cancer

From greek.doctor


Gastric

  • Epidemiology
    • Was most common cancer in 1970s, but now much less common
      • Perhaps due to decreased prevalence of H. pylori
    • Male > female
    • Strong geographical differences in incidence
      • High incidence in Korea and Japan
      • Declining incidence in Western countries
  • Etiology
    • Male gender
    • Old age
    • Diet
      • Salt
      • Smoked food
      • Nitrites, nitrates
    • Smoking
    • Obesity
    • Chronic gastritis
      • H. pylori
  • Prognosis
    • 5 year survival: 15%
  • Prevention
    • Treat H. pylori
    • Improve diet
    • Stop smoking
    • Treat gastritis
    • Prevent obesity

Pancreas

  • Epidemiology
    • Rare but fatal cancer
    • Male > female
    • Age of onset: 60 – 80
    • Accounts for only 3% of cancers in US
  • Etiology
    • Old age
    • Men
    • Blacks
    • Smoking
    • Obesity
    • Chronic pancreatitis
    • Cirrhosis
    • Binge drinking
    • Family history
  • Prognosis
    • 5 year survival: 5%
    • Highest lethality of all cancers
  • Prevention
    • Avoid avoidable risk factors

Liver

  • Epidemiology
    • Male > female
    • Age of onset in Western countries: 70 years
    • Highest incidence in Asia, Africa
      • Due to endemic HBV, HCV
  • Etiology
    • In developing countries
      • HBV
      • HCV
      • Aflatoxin
    • In developed countries
      • HCV
      • Promiscuity
      • Chronic alcoholism
      • Non-alcoholic fatty liver disease
      • Low socioeconomic status
  • Prognosis
    • 5-year survival < 50%
  • Prevention
    • Avoid alcohol
    • Avoid obesity
    • Safe sex
    • Screening
      • In high-risk patients (cirrhosis, chronic hepatitis)
      • HBV, HCV serology
      • AFP