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cinoma of greater than 1.5 cm should be considered candidates for radioiodine ablation [12]. In contrast to other solid neoplasms, the presence of regional lymph node metastases with a well-differentiated thyroid cancer has no strong correlation with REFERENCES 1. Ferlay J, Bray F, Parkin DM, Pisani P, eds (2001) Globocan 2000: Cancer Incidence and Mortality Worldwide (IARC Cancer Bases No. 5), Lyon, IARCPress. 2. Duffy BJ, Fitzgerald PJ (1950) Thyroid cancer in childhood and adolescence. Report of twenty-eight cases. J Clin Endocrinol Metab, 10: 1296-1308. 3. Shore RE (1992) Issues and epidemiological evidence regarding radiation-induced thyroid cancer. Radiat Res, 131: 98-111. 4. Franceschi S, Boyle P, Maisonneuve P, La Vecchia C, Burt AD, Kerr DJ, MacFarlane GJ (1993) The epidemiology of thyroid carcinoma. Crit Rev Oncog, 4: 25-52. 5. Braverman LE (1990) Iodine induced thyroid disease. Acta Med Austriaca, 17 Suppl 1: 29-33. 6. Williams ED, Doniach I, Bjarnason O, Michie W (1977) Thyroid cancer in an iodide rich area: a histopathological study. Cancer, 39: 215-222. 7. Franceschi S, Talamini R, Fassina A, Bidoli E (1990) Diet and epithelial cancer of the thyroid gland. Tumori, 76: 331-338. 8. Negri E, Dal Maso L, Ron E, La Vecchia C, Mark SD, Preston-Martin S, McTiernan A, Kolonel L, Yoshimoto Y, Jin F, Wingren G, Rosaria GM, Hardell L, Glattre E, Lund E, Levi F, Linos D, Braga C, Franceschi S (1999) A pooled analysis of case-control studies of thyroid cancer. II. Menstrual and reproductive factors. Cancer Causes Control, 10: 143-155. 260 Human cancers by organ site overall survival. Independent predictors of prognosis include patient’s age, gender, tumour size, histological grade and type, local invasion, multicentricity and the presence of systemic metastatic disease. Five-year relative survival rates for this type of malignancy vary greatly according 9. Franceschi S, Preston-Martin S, Dal Maso L, Negri E, La Vecchia C, Mack WJ, McTiernan A, Kolonel L, Mark SD, Mabuchi K, Jin F, Wingren G, Galanti R, Hallquist A, Glattre E, Lund E, Levi F, Linos D, Ron E (1999) A pooled analysis of case-control studies of thyroid cancer. IV. Benign thyroid diseases. Cancer Causes Control, 10: 583-595. 10. Hofstra RM, Landsvater RM, Ceccherini I, Stulp RP, Stelwagen T, Luo Y, Pasini B, Hoppener JW, van Amstel HK, Romeo G (1994) A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma. Nature, 367: 375- 376. 11. Gagel RF, Goepfert H, Callender DL (1996) Changing concepts in the pathogenesis and management of thyroid carcinoma. CA Cancer J Clin, 46: 261-283. 12. Fraker DL, Skarulis M, Livolsi V (1997) Thyroid tumors. In: DeVita VTJ, Hellman S, Rosenberg SA eds, Cancer Principles and Practice of Oncology, Philadelphia, Lippincott-Raven Publishers, 1629-1652. 13. Gilliland FD, Hunt WC, Morris DM, Key CR (1997) Prognostic factors for thyroid carcinoma. A populationbased study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973-1991. Cancer, 79: 564-573. to histological type, ranging from 98% for papillary carcinoma and 92% for follicular carcinoma, to 11% for anaplastic carcinoma [13]. Overall five-year survival rates vary significantly geographically (Fig. 5.141). WEBSITES The British Thyroid Association: http://www.british-thyroid-association.org/ The European Thyroid Association: http://www.eurothyroid.com/
KIDNEY CANCER SUMMARY > Cancer of the kidney is the 15 th most common cancer in the world and most prevalent in developed countries. Close to 190,000 cases are diagnosed each year worldwide and men are generally affected more frequently than women. > Tobacco smoking is an established cause. Excess body weight (obesity) has also been identified as a risk factor, particularly in women. > Patients with late stage diagnosis face a poor prognosis. Recent advances in imaging allow the early detection of asymptomatic tumours. The five-year survival rate is approximately 50%. Definition In adults, 85-90% of cases of kidney cancer are renal cell carcinomas, a very heterogeneous group of tumours (mainly adenocarcinomas) which arise from cells of the proximal convoluted renal tubule. Transitional cell carcinoma is a less common tumour type that arises from the transitional cell epithelium in the renal pelvis, ureter and urethra. Wilms tumour (nephroblastoma) is an embryonal malignancy that afflicts 1 in 10,000 children. Epidemiology The incidence of kidney cancer is considerably higher in developed countries than in less developed countries (Fig. 5.142) and appears to be increasing over the past decade [1,2]. More than 189,000 new cases are diagnosed worldwide each year. In Western Europe, for example, kidney cancer is the sixth most frequently occurring cancer, incidence being particularly high in the Bas-Rhin region of France [3]. Incidence is also exceptionally high in the Czech Republic < 1.3 < 2.1 Fig. 5.142 Global burden of kidney cancer in men, showing a generally higher incidence in more developed countries. and among Scandinavian populations. Kidney cancer is relatively less common among Asian and African peoples, although renal cell carcinoma appears to be increasing in black American men [4]. Men are affected by kidney cancer more than women, the sex ratio being 1.6- 2.0:1 [5]. Most cases occur between ages 50-70, but kidney cancer may be diagnosed over a broad age range including young adults [1]. Wilms tumour is responsible for 5-15% of childhood cancers, affecting females slightly more than males. This tumour occurs with highest frequency in the black population of USA and Africa, and with lowest in Eastern Asia [1]. Kidney cancer causes the deaths of more than 91,000 people each year. Etiology Kidney cancer has consistently been found to be more common in cigarette smokers than in non-smokers. The association was first established as causative for transitional cell carcinoma of the bladder < 3.6 < 8.3 Age-standardized incidence/100,000 population < 22.2 and has now been extended to renal cell carcinomas, the risk increasing two-fold for heavy smokers [6]. An increased risk of renal cell carcinoma has been linked to obesity, particularly in women, as has diuretic therapy, again especially in women [7]. Leather tanners, shoe workers and dry cleaning employees have an increased risk as reported in some studies, as do workers exposed to asbestos and trichloroethylene. The influence of beverages, in particular coffee and alcohol, has not been clearly determined despite many studies. Phenacetin is carcinogenic: patients with kidney damage secondary to phenacetin-containing analgesic abuse have an increased risk of transitional cell carcinoma (Medicinal drugs, p48). Patients with multicystic kidney disease consequent on long-term dialysis, adult polycystic kidney disease and tuberous sclerosis also have an increased propensity to develop renal cell carcinoma and von Hippel-Lindau disease, an autosomal dominant condition, is a predisposing factor. Kidney cancer 261
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WORLD HEALTH ORGANIZATION WHO OMS I
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WORLD CANCER REPORT Editors Bernard
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CONTENTS Foreword 9 1 The global bu
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The global burden of cancer Cancer
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Fig. 1.2 Incidence and mortality of
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Central and Southern Europe differ
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Incidence of cancer in South Centra
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from documentation of disease to a
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TOBACCO SUMMARY >In addition to lun
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Fig. 2.3 Smoking by children is inc
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Cancers positively Sex Standardized
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PHARMACOLOGICAL APPROACHES TO SMOKI
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level the dose—response relations
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lipoprotein-associated cholesterol,
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Agent Cancer site/cancer Main indus
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Industry, occupation Cancer site/ca
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to occupational exposures in develo
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Air pollutant WHO Air Quality Guide
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der cancer of the order of 50% is p
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AFLATOXIN B 1 HEPATITIS VIRUS (chro
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Fig. 2.30 Correlation between regio
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MEDICINAL DRUGS SUMMARY > Certain d
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Drug or drug combination Cancer IAR
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Agent or substance Cancer site/canc
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sources of electromagnetic fields [
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CHRONIC INFECTIONS SUMMARY > Infect
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Infection Subclinical Mutagenic fac
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TUMOURS ASSOCIATED WITH HIV/AIDS Ap
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DIET AND NUTRITION SUMMARY > Up to
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Fig. 2.54 The age-adjusted mortalit
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OVERWEIGHT, OBESITY AND PHYSICAL AC
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IMMUNOSUPPRESSION SUMMARY >Persiste
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Fig. 2.64 Cancer following immunosu
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Syndrome Gene Location Cancer site/
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viduals, confirmation of a gene def
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REPRODUCTIVE FACTORS AND HORMONES S
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PHYTO-ESTROGENS AND CANCER PEVENTIO
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Indicator Number of oral contracept
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Mechanisms of tumour development Th
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The stages in tumorigenesis have be
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PRECURSOR LESIONS IN CHEMOPREVENTIO
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CARCINOGEN ACTIVATION AND DNA REPAI
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adducts, a few weeks or months for
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I Reactive oxygen species Methylati
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which remove the mismatched bases,
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Common human oncogenes Many common
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product of the RB1 gene (pRb) and a
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ates a molecular bridge between p53
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potential cancer genes altered thro
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One of the earliest genes to be ide
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Regulation of the cell cycle and co
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CELL-CELL COMMUNICATION SUMMARY > C
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Connexin genes and tumour suppressi
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APOPTOSIS SUMMARY > The term apopto
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Caspase-8 Caspase-3 c-FLIP Procaspa
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ways. Several options are under inv
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INVASION AND METASTASIS SUMMARY > T
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laminin, entactin and also heparan
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Target Example of agent Comments Ad
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organs, and to respond to local gro
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TOBACCO CONTROL SUMMARY > Tobacco-i
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Region Deaths due to % of total dea
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ipated, is primarily attributable t
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smoke. This may be achieved in part
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there is no evidence for the effica
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industries, processes and occupatio
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stoves arises in rural areas of dev
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Climbing plants on trellis at end r
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HEPATITIS B VACCINATION SUMMARY > P
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Fig. 4.17 Chronic active HBV-associ
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HUMAN PAPILLOMAVIRUS VACCINATION SU
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Vaccine Site of trial Number of pat
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prolonged use. Similar drugs, that
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aspirin and other non-steroidal ant
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SCREENING FOR BREAST CANCER SUMMARY
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Fig. 4.35 Cumulative mortality from
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SCREENING FOR PROSTATE CANCER SUMMA
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Fig. 4.39 Poster designed for an an
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is around 10% for cancer (out of ev
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45 with one positive rehydrated FOB
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eing based on (i) time trends in th
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Fig. 4.48 Women at a clinic in Indi
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SCREENING FOR ORAL CANCER SUMMARY >
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India will provide useful informati
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cer incidence following cure of inf
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100 50 25 10 5 2.5 1 Japan Males Fe
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Human cancers by organ site Maligna
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tobacco smoking: age at start, aver
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diagnosis is usually confirmed by h
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is frequent and survival rates are
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Fig. 5.14 Physician reading digital
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Markers of prognosis in breast canc
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cer in the contralateral breast (Ch
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100 50 25 10 5 2.5 1 Japan Chile Po
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depends on staging. Small intramuco
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Fig. 5.30 A diet rich in fresh frui
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ane protein involved in cell adhesi
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LIVER CANCER SUMMARY > About 560,00
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Fig. 5.39 A woman in the Gambia pre
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REFERENCES 1. Ferlay J, Bray F, Par
Page 203 and 204: Certain Possible Uncertain Age Andr
Page 205 and 206: Management The dramatic division be
Page 207 and 208: TUMOUR NORMAL Gastrula PGC 2n Impri
Page 209 and 210: CANCERS OF THE FEMALE REPRODUCTIVE
Page 211 and 212: Fig. 5.62 Five-year relative surviv
Page 213 and 214: Inheritance of high-penetrance gene
Page 215 and 216: invasive malignant. Malignant germ
Page 217 and 218: OESOPHAGEAL CANCER SUMMARY >Cancer
Page 219 and 220: Fig. 5.76 A radiographic view of an
Page 221 and 222: with a stent; laser recannulation,
Page 223 and 224: Fig. 5.82 Risk of bladder cancer am
Page 225 and 226: Partial cystectomy is appropriate f
Page 227 and 228: poorly known since hypopharyngeal c
Page 229 and 230: Fig. 5.92 Oral leukoplakia with mil
Page 231 and 232: LYMPHOMA SUMMARY > Malignant lympho
Page 233 and 234: T Fig. 5.101 Nuclear magnetic reson
Page 235 and 236: Fig. 5.106 Five-year relative survi
Page 237 and 238: Fig. 5.109 The immediate aftermath
Page 239 and 240: A B Fig. 5.113 Acute myeloid leukae
Page 241 and 242: Fig. 5.118 Five-year relative survi
Page 243 and 244: Fig. 5.120 Age-specific incidence a
Page 245 and 246: Hereditary condition Mode of inheri
Page 247 and 248: MELANOMA SUMMARY > Approximately 13
Page 249 and 250: Fig. 5.131 Primary melanoma with a
Page 251 and 252: THYROID CANCER SUMMARY > Cancer of
Page 253: Papillary carcinoma RET/PTC TRK BRA
Page 257 and 258: Stage Clear cell carcinoma Papillar
Page 259 and 260: TUMOURS OF THE NERVOUS SYSTEM SUMMA
Page 261 and 262: ing the optic tract, brain stem and
Page 263 and 264: mut = mutant p53 wt = wildtype p53
Page 265 and 266: SURGICAL ONCOLOGY SUMMARY > Surgica
Page 267 and 268: Year Radical mastectomy (%) Modifie
Page 269 and 270: TELEMEDICINE The prospects for tele
Page 271 and 272: Equipment Energy 50% depth dose App
Page 273 and 274: CANCER EDUCATION IN MEDICAL COURSES
Page 275 and 276: Fig. 6.10 Crystals of cisplatin: mo
Page 277 and 278: Responsiveness Cancer (in decreasin
Page 279 and 280: Most of the world’s most common c
Page 281 and 282: treatment of cancer. The problems l
Page 283 and 284: duction. It is clear that tumour ce
Page 285 and 286: REHABILITATION SUMMARY > Rehabilita
Page 287 and 288: cer and its associated disability.
Page 289 and 290: REFERENCES 1. Garden FH, Gillis TA
Page 291 and 292: Cancer pain relief varies and in so
Page 293 and 294: EMERGING ISSUES IN PALLIATIVE CARE
Page 295 and 296: Cancer control The negative impact
Page 297 and 298: priority to cancer control activiti
Page 299 and 300: Prevention of cancer Every country
Page 301 and 302: - Assessing the magnitude of the ca
Page 303 and 304: high-risk women. Further details on
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ecords departments are either rudim
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THE INTERNATIONAL AGENCY FOR RESEAR
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in the capitals/urban areas of four
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in the overall cancer strategy. WHO
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68% 1955 1975 1995 2025 32% 40% by
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Fig. 7.15 A grandfather at work in
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Fig. 7.17 Main causes of death in d
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Contributors and Reviewers Sources
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Dr Vera Luiz da Costa e Silva Tobac
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Georgia Moore Centers for Disease C
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REVIEWERS Dr Sandra E. Brooks 405 W
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2.53 T. Norat and E. Riboli, IARC 2
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Gastroenterology, 118(2 Suppl 1): S
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5.106 & 5.107 IARC/SEER/Osaka Cance
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4.17 R. Lambert, IARC/Adapted from
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Brain cancer, see nervous system tu
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Fibroblast growth factor (FGF), 117
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Microarray, 240 Micronutrients, 65,
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S Saccharin, 64, 85 Salicin, 153 Sa
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