Chapter One: Introduction
Cancer refers to a group of diseases that presents as abnormal cell growth with the possibility of the abnormal cells to spread or invade other parts of the body. Abnormal cell growth forms a subset of neoplasms or a tumor. A tumor is a cluster of cells that have gone through unfettered growth thus forming a lump. The most common types of cancer in the world among the male population are lung cancer, colorectal cancer, prostate cancer and stomach cancer. Among the female populations, breast cancer, lung cancer, colorectal cancer and cervical cancer are the most common types of cancers. In general, skin cancer accounts for approximately 40% of the total new cancer cases. Brain tumors and acute lymphoblastic leukemia are the most common types of cancers affecting children around the world. However, in Africa, non- Hodgkin lymphoma is the commonest type of cancer among children. Cancer occurs more frequently in developed countries than in developing countries. Furthermore, the chances of cancer diagnosis are exacerbated with age. The rates of cancer have been increasing in the recent past due to an improvement in the life expectancy of people (more people live to an old age) and a change in a people’s lifestyle (World Health Organization, 2014). This paper will review the epidemiology of cancer around the globe and trickle down to the United States of America.
Background Information
Cancer is non- communicable disease that is characterized by abnormal cell growth that has the possibility of invading other parts of the body. The over produced cells form a lump or a mass. The tumors formed can be malignant or benign; benign tumors are not cancerous and therefore do not spread to other body parts. Cancer can be caused by environmental factors or genetic factors. Since the largest percentage of cancer cases are caused by environmental factors, studies have proved that cancer can be prevented by adopting better lifestyle choices. However, other causes of cancer such as radiations or inherited genetics are unavoidable thereby reducing the chances of escaping the cancer. Globally, cancer cases have generally increased and as a result, the number of deaths caused by cancer has also increased. This increase in cancer diagnosis has been attributed to worldwide changes in lifestyle as well as an increase in lifespans.
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Reasoning For the Selection of the Topic
When browsing the internet one night, I found out that my all- time favorite actor had been diagnosed with basal cell carcinomas (a type of skin cancer). The actor revealed has undergone numerous surgeries over a span of five years to remove cancerous cells from his nose and shoulder. I was distraught by the news and therefore I decided to research about the disease. On further research of the disease, I found out that over 10 celebrities passed away in 2016 because of cancer with many more celebrities battling the disease. I was amazed to see how these renowned people spoke out against the disease and its effect on humanity. It is not common for prominent people to stand up and speak against the torment that is caused by a disease and therefore when I saw that scores of celebrities ranging from musicians to sportsman standing up to speak about how cancer takes a toll on not only the patient but on the general well- being of the family, I was curious to find out more about the disease. Further research showed that cancer was a disease that was causing millions of deaths of all over the world without any cure. The disease affects both children and adults together; it does not discriminate between races neither does it factor in the country. Cancer is a deadly disease with very low rates of cure. It is a disease that calls for further and immediate research to provide a much needed cure. The fascinating and devastating statistics about cancer made me select it for this paper.
Chapter Two: Principles of Epidemiology
Epidemiology is the study of the distribution and determinants of health related states or events in specified populations and the application of this study to the control of health problems. Several cancer registries have been put in place to trail trends in cancer diagnosis and treatment. In the United States of America, the surveillance epidemiology and end results (SEER) was established by the federal government for cancer trends tracking. The definition bears the main principles of the epidemiology: distribution, determinants, specified populations, and applications.
Distribution
T he principle of distribution entails the frequency of occurrence of the disease and its pattern in the population. This principle encompasses the rate and risks of the disease. Globally, in 2008 approximately 12.7 million people were diagnosed with cancer; these statistics exclude no- melanoma skin cancers and other non- invasive cancers). Consequently, in 2010 about 7.98 million people died as a result of cancer. According to statistics by World Health Organization, 2010, nearly 15 percent of total deaths globally are caused by cancers. The commonest types of cancer are lung cancer, which accounts for 1.4 million deaths annually; stomach cancer, it accounts for approximately 740,000 deaths; liver cancer follows closely with roughly 700,000 deaths; colorectal cancer is responsible for about 610, 000 cancers and finally breast cancer which accounts for approximately 460,000 global deaths annually. From the statistics, it is evident that invasive cancer is a leading cause of death in the world. In the developed countries, invasive cancer is the leading cause of death while in the third world countries; cancer is the second leading cause of deaths. However, over half the deaths occur in the third world countries (World Health Organization, 2010).
Cancer rates have been increasing steadily over the years. In 1990, cancer had caused approximately 5.8 million deaths worldwide. This number is relatively low when compared to the 2008 statistics whereby 7.98 million people died as a result of cancer. Studies have claimed that the increase in the number of newly diagnosed cancer cases and cancer deaths are attributable to lifestyle changes in the world (especially in the developing world) and longer lifespan. Although cancer is commonest in old age (over 65 years), a lot of children are also affected by cancer. The most common type of cancers in children includes brain tumors, leukemia and lymphomas. The rates of childhood cancers have increased slowly but steadily over time; between 1975 and 2002, cancer cases among children have increased by approximately 1 percent (WHO, 2010).
Cancer accounts for 25 percent of all deaths in the United States of America. The highest number of cancer deaths in the country is from lung cancer (30% of all cancer cases in the country). However, prostate cancer and breast cancers are the leading types of cancers among men and women respectively. In the country, cancer cases among children are significantly lower compared to the rates of adults; statistics shows out of a million cases of cancer, about 150 are found in children. The leading cancer among children in the country is leukemia. Among infants, cancer incidence is 230 cases per million; the most common type of cancer among infants is neuroblastoma. According to a 2004- 2008 report, the age adjusted incidence of cancer for men and women is 460 per 100,000 per year. Cancer is a public health menace in the country as well as in most parts of the world. According to the latest reports, an estimated 1.7 million new cancer cases were diagnosed in the country in 2016. Furthermore, it is projected that over half a million people will die from cancer in the year (National Cancer Institute, 2016).
Determinants
The principle of determinants involves searching for the causes and factors that influence the occurrence of a disease or health event. It entails factors that make the population susceptible to the disease, opportunity for exposure and environmental toxins. Cancer is a non- communicable disease that is caused by environmental factors and inherited genetics. Environmental factors account for approximately 95 percent of all cancer cases with the remaining 5 percent caused by genetic factors. Environmental factors encompass economic, lifestyle and behavioral factors. The main environmental causes of cancer include smoking tobacco, obesity and diet, radiations, infections, stress, environmental pollutants and physical activity. Smoking tobacco accounts for about 30 percent of the cases, obesity and diet represent almost 35 percent, radiations (constituting both non- ionizing and ionizing radiations) constitute 10 percent, with the remaining proportion accounting for stress, environmental pollutants and lack of physical activity. However, it is impossible to ascertain the specific cause of cancer in an individual. For example, it is not correct to establish that a lung cancer patient was predisposed to the disease by smoking; this is because, the patient might have contracted the disease from radiations or air pollution (National Cancer Institute, 2014).
Most cancers are caused by environmental factors and this makes them preventable. Cancer- causing environmental factors is in fact controllable lifestyle picks that can be meticulously controlled to prevent the occurrence of cancer. Over 30 percent of cancer cases can be prevented by eluding risk factors. Risk factors include alcoholism, smoking, physical inactivity, poor dietary choices, obesity and overweight, air pollution and sexually transmitted diseases ((Jayasekara, McInnis, Room and English, 2016). However, not all environmental factors are controllable such as radiation and therefore still predispose a person to cancer. Furthermore, cancer caused by hereditary genetic disorders cannot be avoided by altering personal behaviors. Some medications have been known to reduce the chances of cancers tremendously. For instance, non- steroidal anti- inflammatory drugs have proved to reduce the risks of colorectal cancer. NSAIDs are however discouraged for use since they cause general bodily harm including damage to the cardiovascular system (Anand, et al., 2008).
Currently, numerous researches have been conducted to reduce the occurrence of cancer and prevent mortality due to cancer; some of the studies have produced positive results. However, the prevalence of cancer continues to rise. In the United States of America, several recommendations have been put in place by the preventive services task force (USPSTF) for the screening and early treatment of cancers. These treatments have been set to reduce the risk of death because of the disease by undergoing early treatment. The survival rate of a cancer patient is predetermined by the stage the cancer is in and the type of cancer. Patients who receive treatment of cancer in early stages have higher chances of survival compare to patients who try to treat invasive cancer. Furthermore, cancer treatment is poorer in developing countries thus making the survival rate in these countries lower than in developed countries. With all the researches conducted, milestones made in cancer treatment and inventions in prevention of cancer, millions of people keep dying annually all over the world because of the disease (National Cancer Institute, 2012).
Specified Populations
The principle of specified populations involves the general health of the community affected but eh disease and how the disease has impacted them. Cancer is a disease that has been faced with stigmatization in many countries. A common phrase used to refer to cancer patients ‘after battling a long illness’ is a form of stigma. People believe that cancer is a difficult and deadly disease and cancer cases that are easily treated and cured (such as non- melanoma skin cancers) are left out of cancer statistics. People who are diagnosed with cancer are expected to make fast decisions since delaying or ignoring treatment exacerbates the effects of the disease. In the United States, some communities believe that cancer is caused by a bad attitude and therefore talk therapy was created. Accordingly, in these societies, the patients are blamed for causing the disease or for preventing its cure. This notion increases the patient’s anxiety thus reducing the efficiency of treatment.
Cancer is an expensive disease to maintain. In the USA, the overall costs of cancer were estimated in 2007 to be 226.8 million dollars. This costs encompassed treatment costs and indirect mortality expenses- these expenses include lost productivity in the workforce. In the country, many people lack health insurance and this negatively impacts their treatments. According to statistics, citizens without health insurance and those from ethnic minorities are most likely to be diagnosed in the late stages of cancer thus reducing the efficiency of the disease; the treatment is made more intensive and costly.
Applications
The principle of application provides that the data obtained from the other principles is used to direct public health action. The principle tries to recognize the usefulness of the information available in diagnosing the health of the community. Basically, the principle of application provides ways to control and prevent the spread of the disease in the affected community. Lead time bias and length time bias is a major concern in the study of the epidemiology of cancer. Lead time bias explains that earl diagnosis of cancer may affectedly pump up the survival statistics. As much as the chances of survival may be increased, the natural history of the disease will not be altered. On the other hand, length time bias provides that lethargic tumors can easily be diagnosed by screening tests. However, improvement in the diagnosis of indolent tumors does not necessarily translate to enhanced patient outcomes when interventions are implemented. Secondly, over- diagnosis is another major concern in the epidemiology of cancer. Over- diagnosis refers to the propensity of screening tests diagnosing patient with a disease that does not impact the longevity of the person. Over- diagnosis is mainly an issue with prostate cancer and prostate specific antigen screening tests (Brawley, 2004).
Conclusion
Cancer is a life threatening disease that has become a menace in the world. The disease affects both men and women alike without the exception of children. Although lung cancer is the most common cancer in both genders; female are mostly diagnosed with breast cancer while prostate cancer is commonest among men. However, the susceptibility of cancer is higher in old age than it is in the younger populations. Several researches have been conducted to establish better interventions for cancer management. Studies have proved that when discovered in its early stages, the success of cancer treatment is relatively higher than when it is diagnosed in later stages. Although some milestones have been made, the field still requires a great deal of studies to establish better preventions and treatments of the condition.
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Anand P., Kunnumakkara A. B. Sundaram C., Harikumar K. B., Tharakan S. T., Lai O. S., Sung B. and Aggarwal B. B. (2008). Cancer Is A Preventable Disease That Requires Major Lifestyle Changes. Pharmaceutical Research; 25 (9): 2097- 2116
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World health organization. (2010). Cancer. Print
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