Cancers – epidemiology and risk factors

From Oncology for Medical Students
Ideal oncology curriculum > Cancers – epidemiology and risk factors

Objective 1.2

At graduation, the student should be able to:

a) describe the epidemiological concepts of morbidity (incidence and prevalence), mortality, relative risk and survival in relation to common cancers
b) discuss the role of statistical information, including surveillance and monitoring data, and understanding the medical practitioner’s need to be able to access numerical information
c) discuss the purpose of cancer registries
d) describe risk factors for various malignancies – genetic and non-genetic
e) list the most frequently diagnosed malignancies and the most common causes of cancer death in Australia; describe in a general way how these are different in different parts of the world
f) describe the differential rates of cancers and their outcome in Indigenous and non-Indigenous Australians and the reasons behind them
g) describe the differing outcomes of cancers, in general, between rural and urban populations and the reasons behind them.

Prerequisite knowledge

  • Statistical concepts of relative and absolute values
  • Inherited and acquired risk factors
  • DNA structure and function
  • Mendelian genetics

Representative questions that suggest the required depth of knowledge

1. Describe the role of epidemiology in establishing causes of cancer and identifying risk factors for cancer. Give examples of causes of cancer and risk factors for cancer and explain the differences between them.

Essential in answer:

  • Concept of risk – definitions, relative v absolute risk
  • Concept of causation
  • Understanding of data collection

2. Answer, in language you would use, the question from 45 year-old Mabel Jones: "What caused my bowel cancer doctor? And what are the risks that other members of my family will get cancer?"

Essential in answer:

  • Knowledge of risk factors for colorectal cancers
  • Knowledge of genetics of colorectal cancers

3. What proportion of breast cancer patients have an identifiable genetic cause?

(a) 1%
(b) < 5%
(c) 5-10%
(d) 30%

Answer: (c)

4. Which conditions are associated with an increased risk of colon cancer?

Essential in answer:

  • Ulcerative colitis
  • Crohn’s disease
  • Familial polyposis
  • Other familial conditions including hereditary non-polyposis coli syndrome (HNPCC)
  • Benign polyps of the bowel
  • Previous colon cancer