Question

Describe the secular and demographic trends of any cancer (breast, lung etc.) in Saudi Arabia from 2000 to 2019. (200 words).

Compare it with any other developed country. (200 words)

Give two suggestions to control the cancer with appropriate reason. (100 words)

Answer 1

Saudi Arabia faces a rapid growth in cancer cases and deaths despite the rapid development and expansion of its healthcare system. No applied national strategies exist, limiting cancer control efforts. Saudi Cancer Registry data lacks cancer specific mortality rates and available data to project the future cancer burden is inadequate.

The SCR collects data from healthcare facilities throughout the Kingdom of Saudi Arabia. All newly diagnosed cases of cancer are recorded, with information on site and histology. For the present report, age-standardised and age-specific incidence rates (ASR, AIR, respectively) were calculated, with attention to gender-specific and regional differences. cancer incidence in Saudi Arabia demonstrated significant differences according to gender, age, and region of the Kingdom. The data should help ensure the most appropriate allocation of resources, with the aim of minimising the healthcare burden associated with cancer. Incidence rate was defined as the rate at which new event occur in a population. It was calculated as the number of new cases of disease arising in a population over a defined time period, divided by the population at risk of developing that disease. Crude incidence rate for a cancer site is the total number of cases registered as a proportion of the total population. It denotes the approximate number of cases occurring in each 100,000 individuals. All rates are thus, expressed as per 100,000 population. Relative frequency was defined as the number of specific cancer cases registered relative to the total number of all cancer. It was expressed as a percentage. Cancer rank measure reflected the importance of a specific cancer site relative to other sites, in terms of the number of registrations. Ranking illustrates the most and least frequent cancer sites in a population according to their frequency. Average age-specific incidence rate (AIR) was defined as the number of cancer cases occurring during a specific period in a population of a specific age and sex group, divided by the number of mid-year population of that age and sex group. Age-standardized rate (ASR) was defined as the summary measure of a rate that a population would have if it had a standard age structure. The most frequently used standard population is the World Standard Population. The calculated incidence is known as the World Standardized Incidence Rate. The rate is expressed per 100,000 populations.

Cancer has a major impact on society in the United States and across the world. Cancer statistics describe what happens in large groups of people and provide a picture in time of the burden of cancer on society. Statistics tell us things such as how many people are diagnosed with and die from cancer each year, the number of people who are currently living after a cancer diagnosis, the average age at diagnosis, and the numbers of people who are still alive at a given time after diagnosis. They also tell us about differences among groups defined by age, sex, racial/ethnic group, geographic location, and other categories.

• Cancer is among the leading causes of death worldwide. In 2012, there were 14.1 million new cases and 8.2 million cancer-related deaths worldwide.
• 57% of new cancer cases in 2012 occurred in less developed regions of the world that include Central America and parts of Africa and Asia; 65% of cancer deaths also occurred in these regions.
• The number of new cancer cases per year is expected to rise to 23.6 million by 2030.

The International Agency for Research on CancerExit Disclaimer has more information about cancer statistics across the world.

cancer-prevention tips.

1. Don't use tobacco

Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, mouth, throat, larynx, pancreas, bladder, cervix and kidney. Chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don't use tobacco, exposure to secondhand smoke might increase your risk of lung cancer.

Avoiding tobacco — or deciding to stop using it — is an important part of cancer prevention. If you need help quitting tobacco, ask your doctor about stop-smoking products and other strategies for quitting.

2. Eat a healthy diet

Although making healthy selections at the grocery store and at mealtime can't guarantee cancer prevention, it might reduce your risk. Consider these guidelines:

• Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
• Avoid obesity. Eat lighter and leaner by choosing fewer high-calorie foods, including refined sugars and fat from animal sources.
• If you choose to drink alcohol, do so only in moderation The risk of various types of cancer — including cancer of the breast, colon, lung, kidney and liver — increases with the amount of alcohol you drink and the length of time you've been drinking regularly.
• Limit processed meats. A report from the International Agency for Research on Cancer, the cancer agency of the World Health Organization, concluded that eating large amounts of processed meat can slightly increase the risk of certain types of cancer.

In addition, women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet choose healthy fats, such as olive oil, over butter and fish instead of red meat.

3. Maintain a healthy weight and be physically active

Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney.

Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer.

Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity. You can also do a combination of moderate and vigorous activity. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better.

4. Protect yourself from the sun

Skin cancer is one of the most common kinds of cancer — and one of the most preventable. Try these tips:

• Avoid midday sun. Stay out of the sun between 10 a.m. and 4 p.m., when the sun's rays are strongest.
• Stay in the shade. When you're outdoors, stay in the shade as much as possible. Sunglasses and a broad-brimmed hat help, too.
• Cover exposed areas. Wear tightly woven, loose fitting clothing that covers as much of your skin as possible. Opt for bright or dark colors, which reflect more ultraviolet radiation than do pastels or bleached cotton.
• Don't skimp on sunscreen. Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days. Apply sunscreen generously, and reapply every two hours — or more often if you're swimming or perspiring.
• Avoid tanning beds and sunlamps. These are just as damaging as natural sunlight.

5. Get vaccinated

Cancer prevention includes protection from certain viral infections. Talk to your doctor about vaccination against:

• Hepatitis B. Hepatitis B can increase the risk of developing liver cancer. The hepatitis B vaccine is recommended for certain adults at high risk — such as adults who are sexually active but not in a mutually monogamous relationship, people with sexually transmitted infections, people who use intravenous drugs, men who have sex with men, and health care or public safety workers who might be exposed to infected blood or body fluids.
• Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical and other genital cancers as well as squamous cell cancers of the head and neck. The HPV vaccine is recommended for girls and boys ages 11 and 12. The U.S. Food and Drug Administration recently approved the use of vaccine Gardasil 9 for males and females ages 9 to 45.

6. Avoid risky behaviors

Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, might increase the risk of cancer. For example:

• Practice safe sex. Limit your number of sexual partners and use a condom when you have sex. The more sexual partners you have in your lifetime, the more likely you are to contract a sexually transmitted infection — such as HIV or HPV. People who have HIV or AIDS have a higher risk of cancer of the anus, liver and lung. HPV is most often associated with cervical cancer, but it might also increase the risk of cancer of the anus, penis, throat, vulva and vagina.
• Don't share needles. Sharing needles with people who use intravenous drugs can lead to HIV, as well as hepatitis B and hepatitis C — which can increase the risk of liver cancer. If you're concerned about drug misuse or addiction, seek professional help

Answer 2

A- Lung cancer accounts for 4% of all newly diagnosed cancers in saudi arabia .Lung cancer is becoming a leading cause of death in saudi arabia.The prevalence of lung cancer has increased significantly in the recent years . In 2004 the National Cancer Register insaudi arabia reported that lung cancer ranked fifth in males and seventeenth in females .In total lung cancer patients were studied 78% males with minimum age of 42 years and maximum age of 80 years.

In saudi arabia only 14% of lung cancers are diagnosed at early stages and researches on survival and its predictors are lacking This overview analysis was conducted on predictors of lung cancer .Mortality according to the 2 major cancer types small-cell lung cancer and non-small-cell lung cancer in saudi arabia.

B- Lung cancer incidence rates and mortalities are still low in the saudi arabia as compared to u.s.a.

While lung cancer has been the leading cause of cancer-related deaths for many years in the u.s.a.

In the united states lung cancer was responsible for 35 %of cancer deaths among men.In the united states during 2006 an estimated 170000were diagnosed with and over 160000 died from lung cancer.

C- Improvement of tobacco controlregistration and treatment are all necessary to decrease the burden of lung cancer in the saudi arabia. The primary and secondary prevention approaches in lung cancer including tobacco control early diagnosis and lung cancer screening . In tobacco control the recommendations encourage all the health professionals in all practice settings to screen their patientsfor smoking and to provide councelling and if needed referral to smoking cessation programm. Mass screening of patients at high risk for developing lunģ cancer. Early diagnosis of patients with symptoms suspicions of lung cancer.  In industrialized nations evolving social and cultural smoking patterns have lead to rising the rates of lung cancer in women and lagging the long -declining smoking in men . Harbor risks from environmental exposures , particularly widespread air pollution.

Answer 3

Describe the secular and demographic trends of any cancer (breast, lung etc.) in Saudi Arabia from 2000 to 2019.

Lung cancer is the most lethal cause of death among the cancer cases globally. The epidemiology, trends, challenges of the disease or the management is fundamental to consider. According to Saudi Cancer Registry, Lung cancer is the fifth most and fifteenth most typical cancer among Saudi men and Saudi women respectively. In 2011, it was reported that the mortality rate of newly diagnosed lung cancer was 1.6 million out of 1.8 million. Thus, lung cancer was the common cause of death among men and women in Saudi Arabia. It is also identifies that the common cause of death related to lung cancer is because of long term smoking which is about 85% of the total cases of lung cancer (Ministry of health, 2020). The incidence of lung cancer rates appeared to be comparatively low from 2012- 2013 (Bazarbashi, S. et al, 2017). In 2013, the death mortality rate due to lung cancer plummeted and reported that lung cancer ranked the seventh most common cancer among men and women (Ministry of health, 2020). Saudi Arabia adopted tobacco control as a global strategy to reduce cancer rates in the nation. Implementing this strategy from World Health Organization helped to reduce the cancer rates in the country (Bazarbashi, S. et al, 2017).

Compare it with any other developed country.

Although the incidence rate of cancer in Saudi Arabia is significantly lower compared to any other developed countries, the rate was increased over the past two decades from 2000 to 2019. There is a similarity of this trend of lung cancer in comparison to Canada. The prevalence rate of lung cancer in Canada is higher in males than in females. Even though the mortality rate due to lung cancer was increasing until 2006, the incidence rate of lung cancer in women began to decrease in the year 2011. However, the death rate due to lung cancer is still high in men compared to women. It is also reported that the cause of lung cancer is due to the excessive use of tobacco and smoking habits (Canadian Cancer Society, 2020). In America, the common cause of death of all the cancers is lung cancer which accounts for 60% of all the diagnosed cancer cases. It is reported that 1 in 16 Americans are diagnosed with lung cancer. However, it is surprising that 60 to 65% of all the newly diagnosed cases are former smokers or non-smokers. 10 to 15 % of the cases are non-smokers. Moreover, lung cancer is affected in both genders regardless of their ethnicity (Lungevity, 2020).

Give two suggestions to control cancer with an appropriate reason.

Health promotion and prevention is the best strategy to control cancer similar to any other morbidity. Some of the prevention methods to control cancer and its prevalence rate is discussed below:

· Avoid sedentary lifestyles: Healthy lifestyle practices such as maintaining a healthy weight and physical activities help to reduce the risk for cancer. It is very important to maintain equilibrium in life such as healthy habits and dietary habits, work-life balance, good sleeping pattern, regular exercises and physical activities to be healthy (Mayo clinic, 2018).

· Regular medical checkups: Timely and proper self-examinations and screening exams for various types of carcinomas will help in early detection of the disease and successful treatment modalities (Mayo clinic, 2018).

Answer 4

Breast cancer is a most dangerous and frequently affected disease in womens of Saudi Arabia. According to the data analysis of breast cancer mortality in Saudi Arabia has been conducted in Faisal Hospital and research centre, 13.08% deaths occur due to the breast cancer in women. The studies are conducted in chi-squared test and cox regression model on 2018 year. Prevelance of breast cancer in men is lower than that of women but even man have higher risk of death. The studies conducted around the region of makkah shows that the efects are socioeconomic factors, health related characteristics and menstrual history of the individual.

Belgium has found to be higher rate of breast cancer in women followed by Luxembourge. Age standardised rate per 100000 in Belgium is 113.2 and Luxembourge is 109.3. So the study when compared to Saudi Arabia the rate is quite higher in these 2 countries. WHO conducted a database by International Agency for Research on cancer and listed American cancer rate as the top with 229.84 where the Saudi Arabia has found no place in top list.

Lack of knowledge and awareness regarding the breast cancer was actually the risk of prevelance of breast cancer. Awareness programs are conducted in Saudi Arabia every year on breast cancer awareness day. Life style  of an individual is another factor that contribute as risk factor for breast cancer. Obesity and lack of excersice is one of such. Risk of smoking in the devolopment of tumour has been tested for various types of cancers. Life style modification and minimal use of hormonal contraceptives can help to prevent the incidence of cancer. A antioxidants rich food intake in a daily basis is a recommended solution.

Answer 5

Introduction of epidemiology:-

Epi= on, upon

Demos= people

Logos= to study or knowledge

-The study of the distribution and determiment of health related state or event in specialised population and the application of this study to the control of helath problem

-Focused on the health and disease status of a population

-The study of how disease is distributed in a population and the factor that influence and determine this distribution

Objectives of epidemiology:= - to identify the etiology of disease and the relevant risk factor

-To determine the extent of disease found in the community

-To study the natural history and prognosis of the disease

Use of epidemiology:-

- discribe the distribution of disease

- discribe the natural history of disease

- identify the factor in decrease risk predict trend

- consider mechenism of transmission

- test efficacy and evaluate intervention

- identify health need

Goal of veterinary feild epidemiology:-

-prevention and control disease agents

- health of animal, human, environment

- concept and method of epidemiology

- practical and information

1. Secular and demographic trend:-

The data set contain information on 8312 patient with cancer ,including 8172 female (98 percent) 140 males (1.68 percent) who were diagnose and advance breast cancer with some coveriates .the data were collected for 9.year from 2004-2013. Information include servival time ,censoring indicator ,sex ,age, merital status, demographic (address nationality) and tumor detail (intrrlity, site, behaviour, stage ,grade ,topography

The primary site , histology of the melignencies and identified ate coded.

According to the international classfication for oncology 3rd adition (WHO 2000)

The data were entered the computer using can rag 4(IACR) software cencer incident report (2010) participent who did not provide responded fpr all study variable were deleted, elemination 2901 patient record . Remaining 5411 patient records were used the data analysis

Breast cancer screening in develope contories :-

Breast cancer is globel problem and 1.7 million new cases are diagnosed per year , approximately 60 percent of case due to breast cancer accure in developing contories .where is in the united states as estimated 249,260 new cases of breast cancer are diagnose each year and mortality due to this disease is decreasing in contrast breast cancer in DCS represent one of breast cancer cases and 62 percent of the death, in brazil it is expected that the incidence of breast cancer will be about one fourth that of us , but this increase incident with associated in motality

3. Control of breast cancer:-

Dont use tobbaco ,using any type of tobbaco put your on a collision with cancer

Eat a healthy diet...

Maintain a helathy weight and be physically active

Protect yourself from sun

Get vaccination

Avoid risky behaviour

Get regular medication care

Carrier prevention and control:-

This include observation , method to identify new approaches, to early detection and better stategeis to reduce cancer incidence, recurrence, progression of death.

Answer 6

The cancer disease have been increasing day by day in Saudi Arabia .in between 2000 to 2019 the rate increase 66.9 percentage than olden days. The reasons behind this disease is

1.obesity and overweight

2 tobacco and alcohol use habits

3.physical inactivity and life style changes

Comparing the Saudi with other developed countries we can see the ratio is slight lesser in developing countries because of their healthy life style modification. In my opinion the people will follow healthy life style pattern like non fatty foods and healthy tips. Exercise and follow ups will help to avoid cancer disease. Instead of using alcohol and tobacco use healthy drinks like natural water and vegetables and leafs in cooking will reduce risks