1. Non-communicable diseases (NCDs) I Obesity & Cancer

2. Non-communicable diseases (NCDs)
Is a disease which is not infectious. Not caused by a pathogen.
It might result from hereditary factors, improper diet (high cholesterol, salt, sugar, industrially processed) smoking, alcohol consumption, obesity, physical inactivity.
(3 Major risk categories: Genetic, environment, behavior)
Those resulting from lifestyle factors are sometimes called diseases of affluent societies.
Examples include hypertension, diabetes, cardiovascular disease, cancer, and mental health problems, asthma, atherosclerosis, allergy etc.

3. Warning: becoming dominant in all middle and low income countries and not limited to the affluent countries.
NCDs, is responsible for almost 60% of world deaths (31.7 million deaths) and 43% of the global burden of diseases.

4. NCDs Situation in Palestine:
NCDs are the leading cause of death among adult population in the Palestinian society, contribute to more than 50% of causes of death among adults
common Risk factors to NCDs in Palestinian population.
Tobacco consumption.
Diet rich in saturated fat, and in simple sugars, with the decreased consumption of fibers.
Inactivity,
Stress
Familial

5. Challenges to NCD care
Lack of national policies for NCD prevention and control
Low resources for NCD prevention & control.
Weak reporting system and Weak national data
Lack of NCD surveillance systems
Fragmented and uncoordinated care
PHC capacity to deal with NCDs is poor …
THERE ARE HOWEVER A NUMBER OF CHALLENGES THAT WE STILL HAVE TO OVERCOME:
FIRST THERE IS A CLEAR LACK OF NATIONAL POLICIES FOR THE PREVENTION AND CONTROL OF NCDs AS HIGHLIGHTED BY THE ASSESSMENT OF NATIONAL CAPACITY FOR NCD PREVENTION AND CONTROL CARRIED OUT BY WHO IN IN FACT, THIS SURVEY INDICATED THAT LESS THAN HALF THE COUNTRIES REPORTED HAVING NCD POLICIES (43%).
FEW COUNTRIES HAVE A SPECIAL GOVERNMENT BUDGET ALLOCATION FOR NCD PREVENTION AND CONTROL. AND, LESS THAN HALF OF THE COUNTRIES SURVEYED HAVE CHRONIC DISEASE TREATMENT GUIDELINES. THE AVAILABILITY AND AFFORDABILITY OF ESSENTIAL DRUGS FOR NCDs IS VARIABLE AMONG COUNTRIES. IN GENERAL, THE PRIMARY HEALTH CARE CAPACITY TO DEAL WITH NCDs IS POOR.
THERE IS ALSO A LACK OF GOOD SURVEILLANCE SYSTEMS.
FINALLY, THERE SEEMS TO BE FRAGMENTED AND UNCOORDINATED CARE. THE PRIMARY HEALTH CARE CAPACITY OF MOST NATIONS TO DEAL WITH NCDs IS POOR.

6. How to strengthen health systems for NCDs?
Financing (increased, better and sustained
Regulation (assured quality and affordability)
Service Delivery (ensured access and availability)
Governance (improved performance)

7. Obesity

11. Obesity defined as abnormal or excessive fat accumulation that may impair health
According to the National Institutes of Health, almost one-third of Americans are obese.
Obesity is growing problem across the globe.
Worldwide, more than 300 million adults are obese, according to (WHO).
Obesity is the second-leading cause of preventable death in the U.S, surpassed only by smoking. At least 300,000 Americans die each year as a result of factors attributed to obesity, American Obesity Association

12. Obesity is a major risk factor for a number of serious health conditions, including:
Coronary heart disease.
Cancer.
Diabetes.
Fatty liver disease.
Gallbladder disease.
High blood pressure..
Osteoarthritis.
Stroke.
Sleep apnea and other breathing problems.

13. Classification
Obesity, in absolute terms, is an increase of body adipose tissue (fat tissue) mass.
BMI
Body mass index or BMI is a simple and widely used method for estimating body fat mass.

14. BMI is an accurate reflection of body fat percentage in the majority of the adult population. It is less accurate in people such as body builders and pregnant women in whom body composition is affected.
BMI is calculated by dividing the subject's weight by the square of his or her height:
BMI = kg / m2

15. Classification
BMI
underweight
Less than 18.5
normal weight
18.5–24.9
overweight
25.0–29.9 is
class I obesity
30.0–34.9 is
class II obesity
35.0–39.9

16. Questions ??

17. The literature breaks down "class III" obesity into further categories:
Any BMI = 40 is severe obesity
A BMI of 40.0–44.9 is morbid obesity
A BMI of ≥ 45 – 50 or >50 is super obese
Finish

18. Cancer

19. Cancer
medical term: (malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth, invasion and sometimes metastasis (spread to other locations in the body via lymph or blood).
Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age.

20. Facts
Cancer is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in Globally, about 1 in 6 deaths is due to cancer.
Approximately 70% of deaths from cancer occur in low- and middle-income countries.
Around one third of deaths from cancer are due to the 5 leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use

21. Tobacco use is the most important risk factor for cancer and is responsible for approximately 22% of cancer deaths.
More than 90% of high-income countries reported treatment services are available compared to less than 30% of low-income countries.

22. The most common cancers are (9.6 million deaths) :
Lung (2.09 million cases)
Breast (2.09 million cases)
Colorectal (1.80 million cases)
Prostate (1.28 million cases)
Skin cancer (1.04 million cases)
Stomach (1.03 million cases)
(WHO, 2018)

23. What causes cancer?
Cell changes result from 3 categories of external agents, including:
physical carcinogens, radiation
chemical carcinogens, such as tobacco smoke, food and drinking water contaminants
biological carcinogens, such as infections from certain viruses, bacteria, or parasites.
* Ageing is another fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age

24. Other risk factors:
Tobacco use, alcohol use, unhealthy diet, and physical inactivity are major cancer risk factors worldwide.
Some chronic infections are risk factors for cancer including Helicobacter pylori (stomach cancer), Human papillomavirus (HPV) (cervical cancer), Hepatitis B virus, Hepatitis C virus (Liver cancer), and Epstein-Barr virus (breast cancer).
Infection with HIV substantially increases the risk of cancers such as cervical cancer.

25. Between 30–50% of cancers can currently be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies.

27. Modify and avoid risk factors can significantly reduce the burden of cancer:
tobacco use
being overweight or obese
unhealthy diet with low fruit and vegetable intake
lack of physical activity
alcohol use
sexually transmitted HPV-infection
infection by hepatitis or other carcinogenic infections
ionizing and ultraviolet radiation
urban air pollution
indoor smoke from household use of solid fuels.