implementation of cancer control programs, cancer prevention research

8/8/2019 Implementation of Cancer Control Programs, Cancer Prevention Research

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Implementation of Cancer

Control Programs

Education Epidemiology

Screening and Intervention

Toxicology Pathology

Clinical Treatment Palliation

asian cancer control

Cancer Prevention

Research

Malcolm A MooreHead UICC-ARO,Chief Editor APJCP,Coordinator Asian Pacific Organization for Cancer Prevention


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Asian-Pacific Players

AsianPacific

APJCP

APFOCC

EMRO

SEARO

WPRO

APOCP

APIAHF

ANCR?

ERO

IARC-Asia?IARC

WHO UICC

4040

IACR

UICC-Asia

IAEA?QuickTime and a

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C

Research CancerRegistration

&Research

TechnicalHelp

Advocacy

Collaborating

Centres

Meetings


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Cancer Control ProgramsAssessment of Burden (Hospital/Population-based)

Risk Factor Determination (Physical/Socioeconomic)

Interventions - Primary Prevention(Awareness/Tobacco Control/Lifestyle)

Interventions - Secondary Prevention(Risk Group Identity/Screening/Monitoring)

Interventions - Therapeutic(Surgical/Radio/Chemical/Hormonal)

Interventions - Palliative(Physical/Psychological)

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are needed to see this picture.



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The Chinese National Centerfor Cancer Registries

Gulf Center for CancerRegistration

Indian Association of

Cancer Registries

Korean CancerRegistration

Asian Network?

Thailand Registration Group

Diagnosis/Registration





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IACR VotingCIV

IACR VotingNon-CIV

IACRNon-Voting

Non IACR

Cancer Registriesin the

Asian PacificAustralia and New Zealand





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Registration Promotion

Cancer Epidemiology in Asia and the PacificIslands - Past, Present and Future

The authors thank the Japanese Foundation forCancer Research and the Japanese NationalCommittee of the Union International AgainstCancer for generous financial support

NW & Central12

SW 13South 13

SE Main12

GuamGuam

SolomonIslands

New Caledonia

New Zealand

Hawaii

Fiji Samoa

TahitiTonga

French Polynesia

Polynesia

Micronesia

Marshall Islands

PNG

Cook Islands

Niue

Vanuatu

NW 13

Pacific 10

SE Island 15

QuickTime and a




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Males Females

Malaysia*

Penang

Sarawak

Singapore Malay

Brunei**

Singapore Chinese

Singapore Indian

Brunei*

Philippines*

Manila

Hawaii

Indonesia*

Singapore All*

Malaysia*

Penang

Sarawak

Singapore Malay

Brunei**

Singapore Chinese

Singapore Indian

Brunei*

Philippines*

Manila

Hawaii

Indonesia*

Singapore All*

Stomach Colon Rectum Liver Pharynx Lung Prostate Breast Ovary Corpus Cervix NHL Other

Peninsular and Island South-East AsiaQuickTime and a




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0-10 20-30 40-50

10-20 30-40 >50

0-5 10-15 20-25

5-10 15-20 >25

Incidence/Mortality Rates

Breast

Cervix

Specific Cancer

Sites




0-10 20-30 40-50

10-20 30-40 >50

Lung


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15

20

25

30

35

40

45

SC

SC

SC

Singapore Chinese

SC

SM

SM

SM

SM

Singapore Malay

SISI

Singapore Indian

SI

SI

IB

IB IB

Indian Bombay IB

CS

CS

Chinese Shanghai

CS CS

Chinese Hong Hong

CHK

CHK

CHKCHK

JM

JM

JM

JMJapaneseMiyagi

JO

JO

JO

Japanese Osaka

JO

1982 1987 1992 1997 2003

Year of Publication

Incidence(/100,000)

0

5

10

15

20

25

30

SC

SC

SC

Singapore Chinese

SC

SM

SM

Singapore Malay

SM

SM

SI

SingaporeIndian

SI

SI SI

IB

IB Indian Bombay IB

IB

CS

CS

ChineseShanghai

CS CS

Chinese Hong Kong

CHK

CHK

CHK

CHKJM

JM

JMJapanese

Miyagi

JM

JOJapanese Osaka

JO

JO

JO

HH

HH

HH

HH

HawaiinHawaii

1982 1987 1992 1997 2003

Year of Publication

0

5

10

15

20

25

30

Incidence(/100,000)

GenerallyIncreasing

Breast, Colorectal,Prostate, Thyroid

Generally DecreasingCervical, Buccal

Paradoxical

Liver, Lung, Oesophageal, Gastric

Breast

Cervix

Specific Cancer Sites




AgespecificCancerIncidenceper100000population

Age group

Female:Pen insu la rMalays ia Female:S ingaporeFemale:South Australia

0 - 5 - 1 0- 1 5- 2 0- 2 5- 3 0- 3 5- 4 0- 4 5- 5 0- 5 5- 6 0- 6 5- 7 0- 7 5- 8 0- 8 5+

0

317.3

Male Female

SCC AC Ratio SCC AC Ratio

Shanghai 7.6 8.0 1.0:1 2.9 14.2 0.2:1

Busan 54.8 28.0 2.0:1 17.9 57.9 0.3:1

Aichi 27.2 49.1 0.6:1 8.2 80.6 0.1:1

Curado et al., 2007

Misdiagnosis


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Age 10 15 20 25 30 35 40 45 50 55 60 65 70 75

Vaccination Screening: Pap smear/HPV/VIA/VILI

Virginal Exposure starts Transient/Persistent Infection

India (30) 4.4 (7.8) 12.4 (22) 18.6 (33) 14.9 (27) 6.1 (7.8)

Thailand (20) 2.7 (7.9) 7.2 (25) 10.2 (36) 7.2 (25) 1.1 (2.3)

Japan (8) 1.5 (6.7) 4.8 (21) 5.8 (26) 5.5 (24) 4.9 (22)

PersuasionSet upVaccineStaff

Location

PersuasionSet upTest costsStaff

Location

ColposcopyTreatment

SurgeryChemotherapy

Radiotherapy

IncidenceMortalityHPV Types

ComplianceSensitivitySpecificityPredictivepotential

Cervical

Vaccination/Screening -Factors to ConsiderNormal CIN 1 C IN 2- 3 Adenocarcinoma

in situ

Treatifpersists Treatimmediately

Cryotherapy/LEEP/Conization

N or ma l P er si st en t D is ea se

Normal Re-treatmentRe-enter Screening





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0-1.0 2.0-3.0 4.0-5.0

1.0-2.0 3.0-4.0 >5.0

Co-Factors: Diabetes

Mellitus

0-1 2-3 4-5 6-10

1-2 3-4 5-6 >10




2005 2030


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NORMALCELLS

PRENEOPLASIA/DYSPLASIA

Dietary Supplementation/Detoxification

Smoking, Endogenous and Dietary Carcinogens

Avoidance

MedicationVaccination

Trauma/ Infectious Agents/ Metabolic Stimuli

Regeneration/ Proliferation

Avoidance

HormonalMilieuManipulation

Initiation Growth

Naked Eye/PalpationOccult BloodEndoscopyUltrasound/CTSerum markers

Screening and Resection

Progression

Chemoprevention

CANCER

Primary and Secondary

Prevention





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PSA/PSAD/DREFree PSA/RatiosAdjunct Therapy

HGPINASAPPCa

Stage

Grade

Risk Screening Biopsy Treatment Outcome

IncontinenceImpotenceErectileDysfunction

Psychological

HormonalSurgeryRadiotherapyChemotherapy

Cut-offComplicationsZone sizes

MethodologyNumber

Decision-makingQOLTiming

AlleviationQOLSalvage

Body SizeHormonesMorphology

DietExerciseSupplements

Intl Hospital-based Case-control Studies

Clinical Intervention

and Palliation





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25th IACR Annual Meeting,

Hawaii

Cancer Registration and

SurveillanceAround the

Globe

APOCP ASIATOX Satellite Symposium, Bangkok

In Vivo Models for Assessment of Carcinogenicity and

Chemopreventive Potential of Food Components

ASIATOX III,

Bangkok/Chiang Mai

International Toxicology

Harmonization : The Challenge

of Asia

1st Regional APOCP Conference -

Western Asia, Izmir

New Strategies for Cancer Control

2nd Regional APOCP Con-

ference -

South East Asia, Khon Kaen

Customs, Environment and

Cancer

ISSN 1513-7368

APOCP Groups

Australasia

Central Asia

China

Japan

Korea

South Asia

South-East Asia

Western Asia

http://www.apocp.org

Education Epidemiology

Screening and Intervention Toxicological Pathology

Clinical Therapy Palliation

Vol 10 2009

ASIAN PACIFIC JOURNALof

CANCER PREVENTIONOfficial Publication of the APOCPC/UICC-ARO

An Official Journal of the International Association of Cancer Registries




and CONTROL

PubMed/SCI Expanded


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Local Cancer Control



asian cancer

control

Political Pressure

Research

Journals

Policy -making

Government

Politicians

The Media

Local Populace

Local Registration/Research Centre

PublicationInformation

Training

FundingFinancialSupport

Research Organizations

IARC

UICC-AROAPOCPC

WHO RO/CC

Information

RO, regional office; CC, collaborating centre


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International Cancer/NCD

Control Programs?People Power

Thank you!


UICC-ARO/APOCPC

implementation of cancer control programs, cancer prevention research

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