2. BREAST CANCER

3. Breast cancer  Breast cancer is one of the commonest causes of death in many developed countries in middle-aged women, and is becoming frequent in developing countries as well.

4. Screening for breast cancer  There is evidence that screening for breast cancer has a favourable effect on mortality from breast cancer.

5. TECHNIQUES OF SCREENING  The basic techniques for early detection of breast cancer are :  (a) breast self examination (BSE) by the patient  (b) palpation by a physician  (c) thermography and  (d) mammography.

6. RISK FACTORS  The established risk factors of breast cancer include the following:  AGE  FAMILY HISTORY  PARITY  AGE AT MENARCHE AND MENOPAUSE

7. Risk Factors  HORMONAL FACTORS  PRIOR BREAST BIOPSY  DIET  SOCIO-ECONOMIC STATUS  OTHERS

8. PREVENTION  PRIMARY PREVENTION: The aims of primary prevention are towards elimination of risk factors.  Promotion of cancer education.

9. SECONDARY PREVENTION Breast screening leads to  Early diagnosis of breast cancer,  It will influence the treatment and, hopefully, mortality.

10. LUNG CANCER

11. Lung cancer  Lung Cancer is directly associated with smoking  In countries where cigarette smoking has only recently begun, lung cancer deaths still remain low, it will rise with the passage of time if the smoking has not been stoped.

12. Screening for Lung Cancer  At present there are only two techniques for screening of lung cancer,  Chest radiograph  Sputum cytology.  Mass radiography has been suggested for early diagnosis at six monthly intervals,

13. EPIDEMIOLOGICAL FEATURES  AGE :  About a third of all lung cancer deaths occur below the age of 65.  SEX:  In many industrialized countries, the incidence of lung cancer is at present increasing more in females than in males due to increased rate of smoking.

14. RISK FACTORS  Smoking:  Air pollution, radioactivity,  Occupational exposure to asbestos, arsenic and its compounds,  Chromates, particles containing polycyclic aromatic hydrocarbons and certain nickel- bearing dusts.

15. PREVENTION Primary prevention: Broadly these methods include:  a.Public information and education  b.Legislative and restrictive measures  c.Smoking cessation activities  d.National and international coordination.

16. SECONDARY PREVENTION  This rests on  Early detection of cases  Active treatment.

17. STOMACH CANCER

18. Stomach cancers  Stomach cancer is the world's second most common cancer, with over 1 million new cases per year.  Most gastric cancers are Aden carcinomas. In contrast to the overall decreasing trend, there has recently been a rapid increase of cancers localized to the cardia (the upper part of the stomach).

19. Causative Agents  Infection with the bacterium Helicobacter pylori contributes to the risk, probably by interacting with the other factors.

20. Preventive Factors  The constant decline of stomach cancer is linked to  Improved food preservation practices;  Better nutrition more rich in vitamins from fresh vegetables and fruits; and  Less consumption of preserved, and salted foods.

21. Symptoms  These are nonspecific, which explains why most of the cases are diagnosed when the disease is at an advanced stage.  Patients may complain of weight loss, fatigue or gastric discomfort.  Diagnosis is performed by barium X-rays and with biopsy.

22. Treatment  This cancer is treated by surgical removal of the tumour, with or without adjuvant chemotherapy

23. Prognosis  Stomach cancer cases have a generally poor survival prognosis, averaging no more than 20% survival after five years.  If the tumour is localized to the stomach, 60% of patients survive five years or more. However, only 18% of all cases are diagnosed at this early stage.