Fudan University Shanghai cancer Center Etiology of Cancer Zhen hu m.d Department of Breast Surgery Fudan University Cancer Center Arrrr 复旦大学上海医学院肿瘤学糸
复旦大学上海医学院肿瘤学系 Fudan University Shanghai Cancer Center Etiology of Cancer Zhen Hu M.D. Department of Breast Surgery Fudan University Cancer Center
The estimated amount of cancer cases attributed to specific risk factors Risk Factors Cases(% Diet 35 Tobacco use 25~30 Hereditary factors 5~10 Occupational exposures 5 Radiation 2 Viruses 15 Miscellaneous 16~23 OffitK. 1998 Abeloff's Clinical Oncology, 2008
Risk Factors Cases (%) Diet 35 Tobacco use 25~30 Hereditary factors 5~10 Occupational exposures 5 Radiation 1~2 Viruses 15 Miscellaneous 16~23 The estimated amount of cancer cases attributed to specific risk factors Offit K, 1998 Abeloff‘s Clinical Oncology, 2008
Major modifiable and nonmodifiable cancer risk factors Nonmodifiable factors Modifiable factors Aging Tobacco use Ethnicity or race Alcohol use Hereditary Unhealthy diet Gender Obesity Chronic medical conditions Physical inactivity Chromosomal anomalies Infectious agents Ultraviolet radiation lonizing radiation Occupational exposures Environmental pollution Medical drugs Food contaminations Mackay et al, American Cancer Society, The Cancer Atlas, 2006
Nonmodifiable Factors Modifiable Factors Aging Tobacco use Ethnicity or race Alcohol use Hereditary Unhealthy diet Gender Obesity Chronic medical conditions Physical inactivity Chromosomal anomalies Infectious agents Ultraviolet radiation Ionizing radiation Occupational exposures Environmental pollution Medical drugs Food contaminations Major modifiable and nonmodifiable cancer risk factors Mackay et al, American Cancer Society, The Cancer Atlas, 2006
Etiology of Cancer Extrinsic factors Intrinsic facors Chemical carcinogens Hereditary factors . Chemotherapeutic Agents .Radiation Metal fibers and dust . Dietary .virus
Etiology of Cancer Extrinsic factors •Chemical carcinogens •Chemotherapeutic Agents •Radiation •Metal •Fibers and Dust •Dietary •Virus Intrinsic facors •Hereditary factors
Etiology of Cancer Extrinsic factors Intrinsic facors Chemical carcinogens Hereditary factors o Chemotherapeutic Agents .Radiation Metal Fibers and dust .Dietary evirus
Etiology of Cancer Extrinsic factors •Chemical carcinogens •Chemotherapeutic Agents •Radiation •Metal •Fibers and Dust •Dietary •Virus Intrinsic facors •Hereditary factors
History of Identification of Human Carcinogens ramazzini 1700 nuns breast cancer pott 1775 chimney sweeps scrotal cancer . Rehn 1895 dye industry workers bladder cancer Unna 1894 sunlight exposure skin cancer .Yamagiwa 1915 animal model skin tumors
History of Identification of Human Carcinogens •Ramazzini 1700 nuns breast cancer •Pott 1775 chimney sweeps scrotal cancer •Rehn 1895 dye industry workers bladder cancer •Unna 1894 sunlight exposure skin cancer •Yamagiwa 1915 animal model skin tumors
History of Identification of Human carcinogens .The carcinogenic effects were first described in humans .In the 20th century experimental animals has preceded evidence from epidemiologic or case studies in humans The majority of human cancers probably result from the interaction of carcinogen along with intrinsic factors
•The carcinogenic effects were first described in humans. •In the 20th century, experimental animals has preceded evidence from epidemiologic or case studies in humans. •The majority of human cancers probably result from the interaction of carcinogen along with intrinsic factors. History of Identification of Human Carcinogens
The opinion that environmental agents are the principal causes of human cancers Although the overall incidence of all cancers is reasonably constant among countries, incidences of specific cancer types can vary up to several hundred fold. There are large differences in tumor incidence within populations of a single country Migrant populations assume the cancer incidence of their new environment within one to two generations Cancer rates within a population can change rapidly
•Although the overall incidence of all cancers is reasonably constant among countries, incidences of specific cancer types can vary up to several hundred fold. •There are large differences in tumor incidence within populations of a single country. •Migrant populations assume the cancer incidence of their new environment within one to two generations. •Cancer rates within a population can change rapidly. The opinion that environmental agents are the principal causes of human cancers
Polycyclic Aromatic Hydrocarbons(PAH) .Pott, 1775, chim ney sweeps, scrotal cancer . Carcinogens in soot and coal tar were PAhs ° Benzopyrene occupation smoking diet and air cutaneous occupational exposure skin cancer .Inhalation exposure: lung, bladder, pancreas and upper Gl
•Pott, 1775, chimney sweeps, scrotal cancer •Carcinogens in soot and coal tar were PAHs •Benzopyrene •Occupation, smoking, diet, and air •Cutaneous occupational exposure: skin cancer •Inhalation exposure: lung, bladder, pancreas and upper GI Polycyclic Aromatic Hydrocarbons (PAH)
Tobacco Smoke Carcinogens Recognized by the International Agency for Research on Cancer Chemical Class No. of Carcinogens Representative Carcinogens Polycyclic aromatic hydrocarbons Benzo[a]pyrene(BaP) (PAH)and their heterocyclic analogs Dibenz a, h]anthracene N-Nitrosamines 8 4-MethyInitrosamino)-1-(3-pyridyl)-1- utanone(NNK N-Nitrosonornicotine(NNN) Aromatic amines 12 4-Aminobiphenyl 2-Naphthy lal Aldehydes 2 Formaldehyde Acetaldehyd Phenols Catechol Caffeic acid Volatile hydrocarbons 3 Benzene 1.3-Butadiene isoprene Other organics Ethylene oxide Acrylonitrile Inorganic compounds Cadmium Polonium-210 Holland-Frei cancer Medicine. 2010
Tobacco Smoke Carcinogens Recognized by the International Agency for Research on Cancer Holland-Frei Cancer Medicine, 2010
