Escolar Documentos
Profissional Documentos
Cultura Documentos
Dharmais Cancer
Center
Penanggulangan Kanker
Di Indonesia
Malcolm A Moore, UICC-ARO and APJCP
Cancer Control Programs
Assessment of Burden (Hospital/Population-b)
Risk Factor Determination (Phys/Socioeco)
Interventions - Primary Prevention
(Awareness/Tobacco Control/Lifestyle)
Interventions - Secondary Prevention
(Screening/Monitoring/
Interventions - Therapeutic
(Surgical/Radio/Chemical/Hormonal)
Interventions - Palliative
(Physical/Psychological)
1) Disease
Diagnosis/Registration
Asian Network?
The Chinese National Center
for Cancer Registries
Gulf Center for Cancer
Registration
Australasian Association of
Cancer Registries
Korean Cancer
Registration
Thailand Registration Group
Asian Cancer Registries
CIV
Non-CIV IACR Voting
Non IACR Voting
Non IACR
APJCP Supplement 1,
22nd Annual IACR Meeting, Khon Kaen, Thailand, 2001
CANCER REGISTRATION IN ASIA IN THE YEAR 2000:
PAST, PRESENT AND FUTURE
Descriptive Epidemiology: Males
Mal e Burde n of Cancers in Major Organs - Incidence s/100,000
Registry China India Indonesia Iran Japan Korea Pakist an Philippines# Thailand Vietnam Ranking
Oral 1.3 (9)R 16.3 (1) ? 6.6 (4) 6.0 (9) 4.4 (8) 25.8 (1) 8.6 (6) 8.5 (4) 8.2 (5) 45 (6)
Oesophagus 14.8 (3) 7.4 (2) ? 39.4 (1) 10.0 (5) 10.1 (5) 6.2 (5) 3.1 (9) 3.7 (8) 3.7 (6) 46 (5)
Stomach 14.7 (4) 6.8 (3) ? 17.3 (2) 67.0 (1) 70.0 (1) 4.6 (8) 11.1 (5) 4.9 (6) 23.7 (2) 58 (4)
Colorect al 11.5 (5) 5.4 (4) 6.8 (2) 3.8 (7) 48.0 (2) 40.9 (4) 5.9 (6) 18.7 (3) 10.4 (3) 11.4 (4) 60 (3)
Liver 21.0 (2) ? 5.7 (3) 3.9 (6) 26.0 (4) 48.8 (2) 5.0 (7) 23.9 (2) 37.4 (1) 22.6 (3) 70 (2)
Pancreas 3.9 (6) 1.7 (8) ? 1.2 (9) 9.2 (7) 7.7 (7) ? 4.7 (8) ? 1.6 (9) 16 (9)
Lung 26.6 (1) 4.0 (6) 14.8 (1) 14.2 (3) 39.9 (3) 48.4 (3) 20.0 (2) 64.3 (1) 26.5 (2) 29.3 (1) 77 (1)
Pros tat e 2.1 (8) 5.2 (5) 5.6 (4) 2.0 (8) 10.0 (5) 4.2 (9) 7.6 (4) 17.6 (4) 4.4 (7) 2.2 (8) 28 (8)
Bladder 3.4 (7) 3.5 (7) ? 4.4 (5) 8.2 (8) 9.5 (6) 9.4 (3) 4.9 (7) 5.2 (5) 2.4 (7) 35 (7)
*Dat a f rom Sele cted Can cer Regist ries (see text f or ref ere nces)
#
Da ta fr om P arkin et al., 1997
R
, ra nk
Oral 0.8 (9)R 7.8 (3) ? 6.6 (4) 2.0 (8) 1.2 (8) 18.7 (2) 6.0 (8) 4.5 (7) 2.7 (8) 33 (6)
Oesop hagus 6.0 (6) 5.8 (5) ? 24.9 (1) 1.3 (9) 1.0 (9) 6.9 (5) 1.6 (9) 1.3 (9) 0.5 (9) 28 (9)
Sto mach 14.7 (1) 3.5 (7) ? 5.9 (5) 27.0 (2) 25.7 (1) 3.2 (8) 6.4 (7) 1.5 (8) 8.5 (3) 58 (3)
Colorect al 9.0 (4) 3.8 (6) 6.3 (3) 2.9 (6) 25.5 (3) 10.3 (6) 5.0 (6) 15.8 (3) 7.5 (5) 6.4 (5) 53 (4)
Liv er 8.0 (5) ? ? 1.8 (9) 7.7 (6) 11.6 (5) 3.4 (7) 8.0 (6) 15.5 (3) 4.6 (6) 33 (6)
Lung 10.2 (3) 3.1 (8) 4.8 (5) 2.5 (7) 11.2 (4) 12.7 (3) 2.8 (9) 17.7 (4) 11.1 (4) 7.9 (4) 49 (5)
Breast 12.7 (2) 22.6 (2) 14.8 (2) 12.3 (2) 31.0 (1) 12.5 (4) 56.6 (1) 47.7 (1) 16.3 (2) 13.8 (1) 80 (1)
Ovary 5.3 (7) 5.9 (4) 5.2 (4) 2.5 (7) 6.4 (7) 4.0 (7) 9.5 (3) 9.4 (5) 4.7 (6) 4.4 (7) 43 (8)
Cervix 1.2 (8) 25.3 (1) 21.7 (1) 7.0 (3) 8.5 (5) 15.3 (3) 7.3 (4) 21.6 (2) 20.9 (1) 13.1 (2) 70 (2)
*Data f rom Sele cted Canc er Regist ries (see text f or ref eren ces) # Da ta fr om P arkin et al., 1997
R
, ra nk
GENE
GENEACTIVATION
ACTIVATION ODC Inhibitors
DHEA
HMG-CoA Reductase
PRENEOPLASTIC/NEOPLASTIC CELL Inhibitors
Specific Cancer
Sites I
Rates Cervix
Breast
0-5 10-15 20-25
Oestrogen/ Menarche Breast Density Menopause High D ensity Dietary Factors Physical Exercise Hormonal Environment
Late Menarche/
Progesterone Early Menopause
Exposure Low Density Smoking Other STDs
Risk and Protective Factors
Environmental Persistent HPV High Risk Group Infection
Carcinogens
0 10 20 30 40 50 60 70 80 90
Age (years) Dietary Factors Physical Exercise Hormonal Environment
Screening: HPV Tes ting, Pap Smear (Self/Non-self Sampling), Direct Visual Acetic Acid
Site Specific Risk Factors I
Oral Cavity Oesophagus
/Pharynx Trauma, Smoking,
Betel, Smoking, Alcohol, Nutrition,
0-2.5 5.0-7.5 10.0-15.0
Alcohol, Sun 0-2.5 5.0-7.5 10.0-20.0
Obesity
2.5-5.0 7.5-10.0 >20.0
Stomach Colon/
Salt, Stress Rectum
H.pylori Diet, Hyper-
0-10 20-30 40-60
insulinemia 0-5 10-15 20-40
Liver Larynx
HBV/HCV Dusts
Opisthorchis
0-5 10-15 20-30
0-2 4-6 8-10
Lung Urinary
Smoking, Bladder
Fumes Smoking,
Nutrition Infection
0-10 20-30 40-50
CHK SM
Chinese Hong Hong SI Japanese 30 Chinese Hong Kong
JM Miyagi 30
SC
30
Indian Bombay IB Singapore
CHK
SI
SI JM
CS CS
JO
25
25 SI
Indian
Cervix
25 IB IB IB
Japanese Osaka Incidence CHK
SC SM
JM JO
(/100,000)
IB CS Indian Bombay
SM 20
IB IB
20 Chinese Shanghai 20
CS JO CHK
CS HH SC
JM SC
JO IB
Japanese Osaka Singapore Chinese
SC
15 SM 15
15 SC
JO CHK
JO
SI CHK
1982 1987 1992 1997 2003 JM HH SM
JM SM HH Hawaiin
Year of Publication 10
10 Hawaii
Singapore Malay JO SM
SC SI
SM SI
CS HH
Generally Increasing 5
5
JM
Chinese
Japanese
Miyagi
JO
JM
Shanghai
Paradoxical
Liver, Lung, Oesophageal
Health Problem Explosion?
Diabetes Prevalence
2025
2005
0-1.0 2.0-3.0 4.0-5.0 0-1 2-3 4-5 6-10
Regeneration/ Proliferation
Screening and Resection
Naked Eye/Palpation
Trauma/ Infectious Agents/ Metabolic Stimuli Occult Blood
Endoscopy
Ultrasound/CT
Medication Serum markers
Vaccination Hormonal
Milieu
Avoidance Manipulation
4) Clinical Intervention
Diet Cut-off Methodology Decision-mak ing Alleviation
Exercise Complications Number QOL QOL
Supplements Zone sizes Timing Salvage
Thank you!