Epidemiology of cancer

Last updated
The age-adjusted death rate from cancer per 100,000 inhabitants in 2004. .mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column} .mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{} no data less than 55 55-80 80-105 105-130 130-155 155-180 180-205 205-230 230-255 255-280 280-305 more than 305 Malignant neoplasms world map - Death - WHO2004.svg
The age-adjusted death rate from cancer per 100,000 inhabitants in 2004.
  no data
  less than 55
  55–80
  80–105
  105–130
  130–155
  155–180
  180–205
  205–230
  230–255
  255–280
  280–305
  more than 305
Age adjusted, new cases of cancer in 2017 Cancer incidence, OWID.svg
Age adjusted, new cases of cancer in 2017
Percent of new cancer cases by age Cancer by age SEER 22.png
Percent of new cancer cases by age

The epidemiology of cancer is the study of the factors affecting cancer, as a way to infer possible trends and causes. The study of cancer epidemiology uses epidemiological methods to find the cause of cancer and to identify and develop improved treatments.

Contents

This area of study must contend with problems of lead time bias and length time bias. Lead time bias is the concept that early diagnosis may artificially inflate the survival statistics of a cancer, without really improving the natural history of the disease. Length bias is the concept that slower growing, more indolent tumors are more likely to be diagnosed by screening tests, but improvements in diagnosing more cases of indolent cancer may not translate into better patient outcomes after the implementation of screening programs. A related concern is overdiagnosis, the tendency of screening tests to diagnose diseases that may not actually impact the patient's longevity. This problem especially applies to prostate cancer and PSA screening. [3]

Some cancer researchers have argued that negative cancer clinical trials lack sufficient statistical power to discover a benefit to treatment. This may be due to fewer patients enrolled in the study than originally planned. [4]

Organizations

State and regional cancer registries are organizations that abstract clinical data about cancer from patient medical records. These institutions provide information to state and national public health groups to help track trends in cancer diagnosis and treatment. One of the largest and most important cancer registries is Surveillance Epidemiology and End Results (SEER), administered by the US Federal government. [5]

Health information privacy concerns have led to the restricted use of cancer registry data in the United States Department of Veterans Affairs [6] [7] [8] and other institutions. [9] The American Cancer Society predicts that approximately 1,690,000 new cancer cases will be diagnosed and 577,000 Americans will ultimately die of cancer in 2012. [10]

Studies

Observational epidemiological studies that show associations between risk factors and specific cancers mostly serve to generate hypotheses about potential interventions that could reduce cancer incidence or morbidity. Randomized controlled trials then test whether hypotheses generated by epidemiological studies and laboratory research actually result in reduced cancer incidence and mortality. In many cases, findings from observational epidemiological studies are not confirmed by randomized controlled trials.[ citation needed ]

Risk factors

The approximate relative levels of the preventable causes of cancer in the United States, taken from the article Cancer prevention. Preventable Causes of Cancer in US.png
The approximate relative levels of the preventable causes of cancer in the United States, taken from the article Cancer prevention.

The most significant risk factor is age. According to cancer researcher Robert A. Weinberg, "If we lived long enough, sooner or later we all would get cancer." [11] Essentially all of the increase in cancer rates between prehistoric times and people who died in England between 1901 and 1905 is due to increased lifespans. [11]

Although the age-related increase in cancer risk is well-documented, the age-related patterns of cancer are complex. Some types of cancer, like testicular cancer, have early-life incidence peaks, for reasons unknown. Besides, the rate of age-related increase in cancer incidence varies between cancer types with, for instance, prostate cancer incidence accelerating much faster than brain cancer. [12] It has been proposed that the age distribution of cancer incidence can be viewed as the distribution of probability to accumulate the required number of driver events by the given age. [13] [14]

Over a third of cancer deaths worldwide (and about 75-80% of cancers in the United States [15] ) are due to potentially modifiable risk factors. The leading modifiable risk factors worldwide are:[ citation needed ]

Men with cancer are twice as likely as women to have a modifiable risk factor for their disease. [16]

Other lifestyle and environmental factors known to affect cancer risk (either beneficially or detrimentally) include the use of exogenous hormones (e.g., hormone replacement therapy causes breast cancer), exposure to ionizing radiation and ultraviolet radiation, and certain occupational and chemical exposures.[ citation needed ] A Western diet is associated with increased exposure of the gastrointestinal tract to bile acids that are produced by the body to digest fatty foods. Bile acids are likely endogenous etiologic agents in gastrointestinal cancer. [17]

Every year, at least 200,000 people die worldwide from cancer related to their workplace. [18] Millions of workers run the risk of developing cancers such as pleural and peritoneal mesothelioma from inhaling asbestos fibers, or leukemia from exposure to benzene at their workplaces. [18] Currently, most cancer deaths caused by occupational risk factors occur in the developed world. [18] It is estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year in the U.S. are attributable to occupation. [19]

Rates and mortality

New cancer diagnosis in England in 2012 10 most common cancers (cropped).png
New cancer diagnosis in England in 2012

In the U.S. cancer is second only to cardiovascular disease as the leading cause of death; [20] in the UK it is the leading cause of death. [21] In many developing countries cancer incidence (insofar as this can be measured) appears much lower, most likely because of the higher death rates due to infectious disease or injury. With the increased control over malaria and tuberculosis in some Third World countries, incidence of cancer is expected to rise; in the Eastern Mediterranean region, for example, cancer incidence is expected to increase by 100% to 180% in the next 15 years due to increases in life expectancy, an increasing proportion of elderly people, and the successful control of childhood disease. [22] This is termed the epidemiologic transition in epidemiological terminology.[ citation needed ]

Cancer epidemiology closely mirrors risk factor spread in various countries. Hepatocellular carcinoma (liver cancer) is rare in the West but is the main cancer in China and neighbouring countries, most likely due to the endemic presence of hepatitis B and aflatoxin in that population. Similarly, with tobacco smoking becoming more common in various Third World countries, lung cancer incidence has increased in a parallel fashion.[ citation needed ]

India

According to the National Cancer Registry Programme of the India Council of Medical Research (ICMR), more than 1300 Indians die every day due to cancer. Between 2012 and 2014, the mortality rate due to cancer increased by approximately 6%. In 2012, there were 478,180 deaths out of 2,934,314 cases reported. In 2013 there were 465,169 deaths out of 3,016,628 cases. In 2014, 491,598 people died in out of 2,820,179 cases. [23] According to the Population Cancer Registry of Indian Council of Medical Research, the incidence and mortality of cancer is highest in the north-eastern region of the country. [24] Breast cancer is the most common, and stomach cancer is the leading cause of death by cancer for the population as a whole. Breast cancer and lung cancer kill the most women and men respectively. [25]

Canada

In Canada, as of 2007, cancer is the number one cause of death, contributing to 29.6% of all deaths in the country. The second highest cause of death is cardiovascular diseases resulting in 21.5% of deaths. As of 2011, prostate cancer was the most common form of cancer among males (about 28% of all new cases) and breast cancer the most common in females (also about 28% of all new cases).[ citation needed ]

The leading cause of death in both males and females is lung cancer, which contributes to 26.8% of all cancer deaths. Statistics indicate that between the ages of 20 and 50 years, the incidence rate of cancer is higher amongst women whereas after 50 years of age, the incidence rate increases in men. Predictions by the Canadian Cancer Society indicate that with time, there will be an increase in the rates of incidence of cancer for both males and females. Cancer will thus continue to be a persistent issue in years to come.[ citation needed ]

United States

In the United States, cancer is responsible for 25% of all deaths with 30% of these from lung cancer. The most commonly occurring cancer in men is prostate cancer (about 25% of new cases) and in women is breast cancer (also about 25%). Cancer can occur in children and adolescents, but it is uncommon (about 150 cases per million in the U.S.), with leukemia the most common. [20] In the first year of life the incidence is about 230 cases per million in the U.S., with the most common being neuroblastoma. [26] Data from 2004 to 2008 in the United States indicates that the overall age-adjusted incidence of cancer was approximately 460 per 100,000 men and women per year. [27]

Cancer is responsible for about 25% of all deaths in the U.S., and is a major public health problem in many parts of the world. The statistics below are estimates for the U.S. in 2008, and may vary substantially in other countries. They exclude basal and squamous cell skin cancers, and carcinoma in situ in locations other than the urinary bladder. [20] As seen, breast/prostate cancer, lung cancer and colorectal cancer are responsible for approximately half of cancer incidence. The same applies for cancer mortality, but with lung cancer replacing breast/prostate cancer as the main cause.[ citation needed ]

In 2016, an estimated 1,685,210 new cases of cancer will be diagnosed in the United States and 595,690 people will die from the disease. [28]

MaleFemale
most common (by occurrence) [20] most common (by mortality) [20] most common (by occurrence) [20] most common (by mortality) [20]
prostate cancer (25%)lung cancer (31%) breast cancer (26%)lung cancer (26%)
lung cancer (15%)prostate cancer (10%)lung cancer (14%)breast cancer (15%)
colorectal cancer (10%)colorectal cancer (8%)colorectal cancer (10%)colorectal cancer (9%)
bladder cancer (7%) pancreatic cancer (6%) endometrial cancer (7%)pancreatic cancer (6%)
non-Hodgkin lymphoma (5%) liver & intrahepatic bile duct (4%) non-Hodgkin lymphoma (4%) ovarian cancer (6%)
skin melanoma (5%) leukemia (4%) thyroid cancer (4%)non-Hodgkin lymphoma (3%)
kidney cancer (4%) esophageal cancer (4%)Skin melanoma (4%)leukemia (3%)
oral and pharyngeal cancer (3%) bladder cancer (3%) ovarian cancer (3%) uterine cancer (3%)
leukemia (3%) non-Hodgkin lymphoma (3%) kidney cancer (3%)liver & intrahepatic bile duct (2%)
pancreatic cancer (3%) kidney cancer (3%)leukemia (3%) brain and other nervous system (2%)
other (20%)other (24%)other (22%)other (25%)

Incidence of a second cancer in survivors

In the developed world, one in three people will develop cancer during their lifetimes. If all cancer patients survived and cancer occurred randomly, the normal lifetime odds of developing a second primary cancer (not the first cancer spreading to a new site) would be one in nine. [29] However, cancer survivors have an increased risk of developing a second primary cancer, and the odds are about one in 4.5. [29] About half of these second primaries can be attributed to the normal one-in-nine risk associated with random chance. [29]

The increased risk is believed to be primarily due to the same risk factors that produced the first cancer, such as the person's genetic profile, alcohol and tobacco use, obesity, and environmental exposures, and partly due, in some cases, to the treatment for the first cancer, which might have included mutagenic chemotherapeutic drugs or radiation. [29] Cancer survivors may also be more likely to comply with recommended screening, and thus may be more likely than average to detect cancers. [29]

Children

Childhood cancer and cancer in adolescents is rare (about 150 cases per million yearly in the US). Leukemia (usually acute lymphoblastic leukemia) is the most common cancer in children aged 1–14 in the U.S., followed by the central nervous system cancers, neuroblastoma, Wilms' tumor, and non-Hodgkin's lymphoma. [20] Statistics from the SEER program of the US NCI demonstrate that childhood cancers increased 19% between 1975 and 1990, mainly due to an increased incidence in acute leukemia. Since 1990, incidence rates have decreased. [30]

Infants

The age of peak incidence of cancer in children occurs during the first year of life, in infants. The average annual incidence in the United States, 1975–1995, was 233 per million infants. [30] Several estimates of incidence exist. According to SEER, [30] in the United States:

Teratoma (a germ cell tumor) often is cited as the most common tumor in this age group, but most teratomas are surgically removed while still benign, hence not necessarily cancer. Prior to the widespread routine use of prenatal ultrasound examinations, the incidence of sacrococcygeal teratomas diagnosed at birth was 25 to 29 per million births.[ citation needed ]

Female and male infants have essentially the same overall cancer incidence rates, a notable difference compared to older children.[ citation needed ]

White infants have higher cancer rates than black infants. Leukemias accounted for a substantial proportion of this difference: the average annual rate for white infants (48.7 per million) was 66% higher than for black infants (29.4 per million). [30]

Relative survival for infants is very good for neuroblastoma, Wilms' tumor and retinoblastoma, and fairly good (80%) for leukemia, but not for most other types of cancer.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Lung cancer</span> Malignant tumor characterized by uncontrolled cell growth in lung tissue

Lung cancer, also known as lung carcinoma, is a malignant tumor that begins in the lung. Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals. Damaged airway cells gain the ability to multiply unchecked, causing the growth of a tumor. Without treatment, tumors spread throughout the lung, damaging lung function. Eventually lung tumors metastasize, spreading to other parts of the body.

<span class="mw-page-title-main">Prostate cancer</span> Male reproductive organ cancer

Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system below the bladder. Early prostate cancer causes no symptoms. Most cases are detected after screening tests – typically blood tests for levels of prostate-specific antigen (PSA) – indicate unusual growth of prostate tissue. Diagnosis requires a biopsy of the prostate. If cancer is present, the pathologist assigns a Gleason score, with a higher score representing a more dangerous tumor. Medical imaging is performed to look for cancer that has spread outside the prostate. Based on the Gleason score, PSA levels, and imaging results, a cancer case is assigned a stage 1 to 4. Higher stage signifies a more advanced, more dangerous disease.

<span class="mw-page-title-main">Cancer</span> Group of diseases involving abnormal cell growth and spread

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans.

The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored but each study will have overarching similarities.

<span class="mw-page-title-main">Mesothelioma</span> Cancer associated with asbestos

Mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs. The area most commonly affected is the lining of the lungs and chest wall. Less commonly the lining of the abdomen and rarely the sac surrounding the heart, or the sac surrounding the testis may be affected. Signs and symptoms of mesothelioma may include shortness of breath due to fluid around the lung, a swollen abdomen, chest wall pain, cough, feeling tired, and weight loss. These symptoms typically come on slowly.

<span class="mw-page-title-main">Uterine cancer</span> Medical condition

Uterine cancer, also known as womb cancer, includes two types of cancer that develop from the tissues of the uterus. Endometrial cancer forms from the lining of the uterus, and uterine sarcoma forms from the muscles or support tissue of the uterus. Endometrial cancer accounts for approximately 90% of all uterine cancers in the United States. Symptoms of endometrial cancer include changes in vaginal bleeding or pain in the pelvis. Symptoms of uterine sarcoma include unusual vaginal bleeding or a mass in the vagina.

<span class="mw-page-title-main">Kidney cancer</span> Medical condition

Kidney cancer, also known as renal cancer, is a group of cancers that starts in the kidney. Symptoms may include blood in the urine, a lump in the abdomen, or back pain. Fever, weight loss, and tiredness may also occur. Complications can include spread to the lungs or brain.

<span class="mw-page-title-main">Malignancy</span> Tendency of a medical condition to become progressively worse

Malignancy is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer.

In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection.

A cancer registry is a systematic collection of data about cancer and tumor diseases. The data are collected by Cancer Registrars. Cancer Registrars capture a complete summary of patient history, diagnosis, treatment, and status for every cancer patient in the United States, and other countries.

<span class="mw-page-title-main">Alcohol and cancer</span> Relationship between cancer and the consumption of alcohol

Alcohol causes cancers of the oesophagus, liver, breast, colon, oral cavity, rectum, pharynx, and larynx, and probably causes cancers of the pancreas. Consumption of alcohol in any quantity can cause cancer. The more alcohol is consumed, the higher the cancer risk, and no amount can be considered safe. Alcoholic beverages were classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC) in 1988. An estimated 3.6% of all cancer cases and 3.5% of cancer deaths worldwide are attributable to consumption of alcohol. 740,000 cases of cancer in 2020 or 4.1% of new cancer cases were attributed to alcohol.

<span class="mw-page-title-main">Aging-associated diseases</span> Type of disease

An aging-associated disease is a disease that is most often seen with increasing frequency with increasing senescence. They are essentially complications of senescence, distinguished from the aging process itself because all adult animals age but not all adult animals experience all age-associated diseases. The term does not refer to age-specific diseases, such as the childhood diseases chicken pox and measles, only diseases of the elderly. They are also not accelerated aging diseases, all of which are genetic disorders.

<span class="mw-page-title-main">Cancer in dogs</span>

Cancer is the leading cause of death in dogs. It is estimated that 1 in 3 domestic dogs will develop cancer, which is the same incidence of cancer among humans. Dogs can develop a variety of cancers and most are very similar to those found in humans. Dogs can develop carcinomas of epithelial cells and organs, sarcomas of connective tissues and bones, and lymphomas or leukemias of the circulatory system. Selective breeding of dogs has led certain pure-bred breeds to be at high-risk for specific kinds of cancer.

<span class="mw-page-title-main">Brian MacMahon</span> American epidemiologist and cancer researcher (1923–2007)

Brian MacMahon was a British-born American epidemiologist who chaired the Department of Epidemiology of the Harvard School of Public Health from 1958 until 1988. Best known for his work on the epidemiology of breast cancer, he also pioneered research on associations between passive smoking and lung cancer, and between diet and risk of cancer.

<span class="mw-page-title-main">Male breast cancer</span> Medical condition

Male breast cancer (MBC) is a cancer in males that originates in their breasts. Males account for less than 1% of new breast cancers with about 20,000 new cases being diagnosed worldwide every year. Its incidence rates in males vs. females are, respectively, 0.4 and 66.7 per 100,000 person-years. The worldwide incidences of male as well as female breast cancers have been increasing over the last few decades. Currently, one of every 800 men are estimated to develop this cancer during their lifetimes.

Cancer survival rates vary by the type of cancer, stage at diagnosis, treatment given and many other factors, including country. In general survival rates are improving, although more so for some cancers than others. Survival rate can be measured in several ways, median life expectancy having advantages over others in terms of meaning for people involved, rather than as an epidemiological measure.

<span class="mw-page-title-main">Epidemiology of breast cancer</span>

Worldwide, breast cancer is the most common invasive cancer in women. Breast cancer comprises 22.9% of invasive cancers in women and 16% of all female cancers.

Exposure to ionizing radiation is known to increase the future incidence of cancer, particularly leukemia. The mechanism by which this occurs is well understood, but quantitative models predicting the level of risk remain controversial. The most widely accepted model posits that the incidence of cancers due to ionizing radiation increases linearly with effective radiation dose at a rate of 5.5% per sievert; if correct, natural background radiation is the most hazardous source of radiation to general public health, followed by medical imaging as a close second. Additionally, the vast majority of non-invasive cancers are non-melanoma skin cancers caused by ultraviolet radiation. Non-ionizing radio frequency radiation from mobile phones, electric power transmission, and other similar sources have been investigated as a possible carcinogen by the WHO's International Agency for Research on Cancer, but to date, no evidence of this has been observed.

Cancer is caused by genetic changes leading to uncontrolled cell growth and tumor formation. The basic cause of sporadic (non-familial) cancers is DNA damage and genomic instability. A minority of cancers are due to inherited genetic mutations. Most cancers are related to environmental, lifestyle, or behavioral exposures. Cancer is generally not contagious in humans, though it can be caused by oncoviruses and cancer bacteria. The term "environmental", as used by cancer researchers, refers to everything outside the body that interacts with humans. The environment is not limited to the biophysical environment, but also includes lifestyle and behavioral factors.

<span class="mw-page-title-main">Childhood cancer</span> Medical condition

Childhood cancer is cancer in a child. About 80% of childhood cancer cases in high-income countries, can be successfully treated thanks to modern medical treatments and optimal patient care. However, only about 10% of children diagnosed with cancer reside in high-income countries where the necessary treatments and care is available. Childhood cancer represents only about 1% of all types of cancers diagnosed in children and adults. For this reason, childhood cancer is often ignored in control planning, contributing to the burden of missed opportunities for its diagnoses and management in countries that are low- and mid-income.

References

  1. ↑ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov 11, 2009.
  2. ↑ "Cancer incidence". Our World in Data. Retrieved 20 February 2020.
  3. ↑ Brawley OW (2004). "Prostate cancer screening: clinical applications and challenges". Urol. Oncol. 22 (4): 353–7. doi:10.1016/j.urolonc.2004.04.014. PMID   15283896.
  4. ↑ Bedard PL, Krzyzanowska MK, Pintilie M, Tannock IF (2007). "Statistical power of negative randomized controlled trials presented at American Society for Clinical Oncology annual meetings". J. Clin. Oncol. 25 (23): 3482–7. doi:10.1200/JCO.2007.11.3670. PMID   17687153.
  5. ↑ "SEER Surveillance Epidemiology and End Results" . Retrieved 2007-11-02.
  6. ↑ Furlow B (September 2007). "Accuracy of US cancer surveillance under threat". Lancet Oncol. 8 (9): 762–3. doi:10.1016/S1470-2045(07)70258-9. PMID   18348351.
  7. ↑ "VA Cancer Data Blockade May Imperil Surveillance". Medpage Today. 31 August 2007.
  8. ↑ "States and V.A. at Odds on Cancer Data". New York Times. 10 October 2007.
  9. ↑ "Negative Impact of HIPAA on Population-Based Cancer Registry Research: Update of a Brief Survey" (PDF). IOM Presentation. 14 June 2007. Archived from the original (PDF) on 2009-02-05.
  10. ↑ "Cancer Facts and Figures 2012". Journalist's Resource.org. 2012-01-09.
  11. 1 2 Johnson, George (28 December 2010). "Unearthing Prehistoric Tumors, and Debate". The New York Times.
  12. ↑ de Magalhaes JP (2013). "How ageing processes influence cancer". Nature Reviews Cancer. 13 (5): 357–65. doi:10.1038/nrc3497. PMID   23612461. S2CID   5726826.
  13. ↑ Belikov, Aleksey V. (22 September 2017). "The number of key carcinogenic events can be predicted from cancer incidence". Scientific Reports. 7 (1): 12170. Bibcode:2017NatSR...712170B. doi:10.1038/s41598-017-12448-7. PMC   5610194 . PMID   28939880.
  14. ↑ Belikov, Aleksey V.; Vyatkin, Alexey; Leonov, Sergey V. (2021-08-06). "The Erlang distribution approximates the age distribution of incidence of childhood and young adulthood cancers". PeerJ. 9: e11976. doi: 10.7717/peerj.11976 . ISSN   2167-8359. PMC   8351573 . PMID   34434669.
  15. ↑ Doll R, Peto R (1981). "The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today". J. Natl. Cancer Inst. 66 (6): 1191–308. doi:10.1093/jnci/66.6.1192. PMID   7017215. S2CID   36210635.
  16. ↑ Danaei G, Vander Hoorn S, Lopez AD, Murray CJ, Ezzati M (2005). "Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors". Lancet. 366 (9499): 1784–93. doi: 10.1016/S0140-6736(05)67725-2 . PMID   16298215. S2CID   17354479.
  17. ↑ Bernstein, H.; Bernstein, C.; Payne, C. M.; Dvorak, K. (2009). "Bile acids as endogenous etiologic agents in gastrointestinal cancer". World Journal of Gastroenterology. 15 (27): 3329–3340. doi: 10.3748/wjg.15.3329 . PMC   2712893 . PMID   19610133.
  18. 1 2 3 "WHO calls for prevention of cancer through healthy workplaces" (Press release). World Health Organization. 2007-04-27. Archived from the original on May 1, 2007. Retrieved 2007-10-13.
  19. ↑ "National Institute for Occupational Safety and Health- Occupational Cancer". United States National Institute for Occupational Safety and Health. Retrieved 2007-10-13.
  20. 1 2 3 4 5 6 7 8 9 10 11 12 Jemal A, Siegel R, Ward E, et al. (2008). "Cancer statistics, 2008". CA Cancer J Clin. 58 (2): 71–96. doi:10.3322/CA.2007.0010. PMID   18287387. S2CID   43737426.
  21. ↑ Cancer: Number one killer (9 November 2000). BBC News online. Retrieved 2005-01-29.
  22. ↑ Khatib O, Aljurf M (2008). "Cancer prevention and control in the Eastern Mediterranean region: the need for a public health approach". Hematol Oncol Stem Cell Ther. 1 (1): 44–52. doi: 10.1016/s1658-3876(08)50060-4 . PMID   20063528.
  23. ↑ "Cancer kills 1300 Indians every day". Delhi Daily News. Retrieved 2015-05-17.
  24. ↑ National Cancer Registry Programme (2013). Three-year report of population based cancer registries:2009-2011. NCDIR-ICMR, Bangalore.
  25. ↑ "Cancer cases on the rise but death rate is falling". The Hindu. 2015-05-29. ISSN   0971-751X . Retrieved 2016-02-27.
  26. ↑ SEER 1999 , Cancer among infants (PDF) pp. 149–156
  27. ↑ SEER Stat Fact Sheets: All Sites by Surveillance Epidemiology and End Results, a project of the U.S. National Cancer Institute, posted October 20, 2011
  28. ↑ "Cancer Statistics". National Cancer Institute. 2015-04-02. Retrieved 2016-11-17.
  29. 1 2 3 4 5 Rheingold, Susan; Neugut, Alfred; Meadows, Anna (2003). "156". In Frei, Emil; Kufe, Donald W.; Holland, James F. (eds.). Cancer medicine 6 . Hamilton, Ont: BC Decker. ISBN   978-1-55009-213-4.
  30. 1 2 3 4 Ries LA, Smith MA, Gurney JG, Linet M, Tamra T, Young JL, Bunin GR, eds. (1999). Cancer Incidence and Survival among Children and Adolescents, United States SEER program 1975–1995. Bethesda MD: National Cancer Institute, SEER Program. NIH Pub. No. 99-4649.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.