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Lifetime Probability of Developing Cancer, Men, 20022004* Site Risk All sites† Prostate 1 in 2 1 in 6 Lung and bronchus 1 in 13 Colon and rectum 1 in 18 Urinary bladder‡ 1 in 27 Melanoma 1 in 41 Non-Hodgkin lymphoma 1 in 46 Kidney 1 in 59 Leukemia 1 in 67 Oral Cavity 1 in 71 Stomach 1 in 88 * For those free of cancer at beginning of age interval. † All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder. ‡ Includes invasive and in situ cancer cases Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.2.1 Statistical Research and Applications Branch, NCI, 2007. http://srab.cancer.gov/devcan Lifetime Probability of Developing Cancer, Women, US, 2002-2004 Site Risk All sites† Breast 1 in 3 1 in 8 Lung & bronchus 1 in 16 Colon & rectum 1 in 19 Uterine corpus 1 in 41 Non-Hodgkin lymphoma 1 in 53 Melanoma 1 in 61 Ovary 1 in 71 Pancreas 1 in 76 Urinary bladder‡ 1 in 85 Uterine cervix 1 in 142 * For those free of cancer at beginning of age interval. † All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder. ‡ Includes invasive and in situ cancer cases Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.2.1 Statistical Research and Applications Branch, NCI, 2007. http://srab.cancer.gov/devcan Cancer Survival*(%) by Race,1996-2003 Site African WhiteAmerican Absolute Difference All Sites 67 57 10 Breast (female) 90 78 12 Colon 66 55 11 Esophagus 18 11 7 Leukemia 51 40 11 Non-Hodgkin lymphoma 65 56 9 Oral cavity 62 41 21 Prostate 99 95 4 Rectum 66 58 8 Urinary bladder 81 65 16 Uterine cervix 74 66 8 Uterine corpus 86 61 25 *5-year relative survival rates based on cancer patients diagnosed from 1996 to 2003 and followed through 2004. Source: Surveillance, Epidemiology, and End Results Program, 1975-2004, Division of Cancer Control and Population Sciences, National Cancer Institute, 2007. Trends in Five-year Relative Survival (%)* Rates, US, 19752003 Site 1975-1977 1984-1986 1996-2003 • All sites 50 54 66 • Breast (female) 75 79 89 • Colon 51 59 65 • Leukemia 35 42 50 • Lung and bronchus 13 13 16 • Melanoma 82 87 92 • Non-Hodgkin lymphoma 48 53 64 • Ovary 37 40 45 • Pancreas 2 3 5 • Prostate 69 76 99 • Rectum 49 57 66 • Urinary bladder 74 78 81 *5-year relative survival rates based on follow up of patients through 2004. Source: Surveillance, Epidemiology, and End Results Program, 1975-2004, Division of Cancer Control and Population Sciences, National Cancer Institute, 2007. Cancer Death Rates* in Children 0-14 Years by Sex, US, 20002004 Site Male Female Total All sites 2.7 2.3 2.5 Leukemia 0.9 0.7 0.8 0.4 0.3 0.4 Brain/ONS 0.8 0.7 0.7 Non-Hodgkin lymphoma 0.1 0.1 0.1 Soft tissue 0.1 0.1 0.1 Bone and Joint 0.1 0.1 0.1 Kidney and Renal pelvis 0.1 0.1 0.1 Acute Lymphocytic *Per 100,000, age-adjusted to the 2000 US standard population. ONS = Other nervous system Source: Surveillance, Epidemiology, and End Results Program, 1975-2004, Division of Cancer Control and Population Sciences, National Cancer Institute, 2007. CELL DIVISION Division Growth, preparing for division • Growth after division • The time when cells differentiate • Longest phase DNA Synthesis – Duplication of chromosomes Division stops when the cell reaches it’s function CELLULAR REPRODUCTION STEM CELL Normal, fully differentiated cells with special functions, fixed life span and slow (or no) growth. CANCER REPRODUCTION Continuous reproduction of poorly differentiated highly malignant cancer cells. CELLULAR REPRODUCTION STEM CELL Continuous reproduction of moderately differentiated moderately malignant cancer cells. CELLULAR REPRODUCTION STEM CELL Continuous reproduction of well differentiated low malignant cancer cells. ENVIRONMENT • • • • Chemicals Viruses X-rays Radioactive Materials ENVIRONMENT • Chemicals • Occupational • Life-style • Water ENVIRONMENT • Chemicals • Occupational • Life-style • Smoking • Dietary ENVIRONMENT • Dietary • Smoked, pickled, cured • High in nitrates • Cooked at high temps • High Fat ENVIRONMENT • Chemicals • Occupational • Life-style • Water ENVIRONMENT • Viruses • Papovirsuses • Adenoviruses • Herpesviruses • B-type viruses • C-type Viruses ENVIRONMENT • • • • • Chemicals Viruses X-rays Radioactive Materials Oxidative Stress GENETICS • Diseases • Immune System defects GENETICS • Breast • 1 in 5 vs. 1 in 12 • Stomach • Colon • 20x • Uterine • Prostate • Lung GENETICS • Diseases • Xeroderma pigmentosum • Franconi's Anemia • Bloom's Syndrome • Garner's Syndrome • Ataxia Telangiectasia CARCINOGENESIS COLON CANCER 140 Mortality Ratio 120 100 80 60 40 20 0 1 2 Job Level 3 4&5 Vena et al. Am J Clin Nutr 45:328-327, 1987 Normal Colon Cancer Patient McTiernan et al. Cancer Epidemiology Biomarkers Prevention 15:1588-97, 2006 COLON CELL PROLIFERATION AND EXERCISE 20 Proliferation Markers (%) 19.5 19 18.5 Before 18 After 17.5 17 16.5 Controls Exercise >250 min/wk McTiernan et al. Cancer Epidemiology Biomarkers Prevention 15:1588-97, 2006 BREAST CANCER 120 Mortality Ratio 100 80 60 40 20 0 1 2 Job Level 3 to 5 Vena et al. Am J Clin Nutr 45:328-327, 1987 MAMMOGRAPHIC DENSITY AND PHYSICAL ACTIVITY IN POSTMENOPAUSAL WOMEN 6000 5000 4000 <30 BMI 3000 >30 BMI 2000 1000 0 Low Moderate High Irwin, ML, et al. Breast Cancer Research and Treatment 95:171-178, 2006 Estrone concentration REPRODUCTIVE HORMONES AND PHYSICAL ACTIVITY 46 45.5 45 44.5 44 43.5 43 42.5 42 41.5 41 40.5 Control Exercise Baseline 3 months 12 months McTiernan, et al. Cancer Research 64:2923-2928, 2004. Estradiol Concentration REPRODUCTIVE HORMONES AND PHYSICAL ACTIVITY 18.5 18 17.5 Control 17 Exercise 16.5 16 Baseline 3 months 12 months McTiernan, et al. Cancer Research 64:2923-2928, 2004. EPIDEMIOLOGY: PHYSICAL ACTIVITY AND CANCER 350 Percent Risk (%) 300 250 200 Risk Reduction 150 100 50 0 Rectal Prostate Lung IMMUNE FUNCTION Pain Fatigue Nausea Sleep Disturbances Depression Shortness of Breath Exercisers Non-Exercisers Memory Loss Weight Loss Skin Problems Hot Flashes Concentration Hair Loss 0 2 4 6 8 Mustain, KM, et al Support Care Cancer 14:732-741, 2006.