Search+for+Better+Health

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 * Search for Better Health**

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 * Outcome 5 **

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Outcome 6 Due Monday 8th February

6.4 You have chosen a non-infectious disease to investigate. It is wise to choose a disease that you have already studied eg cystic fibrosis, Down syndrome, lung cancer __or__ a disease that particularly interests you.

Submit this to me on an A4 sheet of paper under the headings: Occurrence - where and when does it occur? Under what conditions is it likely to occur? Symptoms Cause Treatment/management

Include at least 2 references to support your research.

6.3 We have looked at the epidemiology of lung cancer in class. Complete the sheet given to you in class. I suggest you do the "easy" page first. We can look at the harder graphs next week. More information can be found in your text book page 309-312

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//EPIDEMIOLOGY -ADDITIONAL NOTES (from BIF)//

//Epiemiology is the study of disease and its prevalence in the community. The studies investigate the distribution and frquency patterns of the disease and all possible risk factors. It is highly quantitative using statistics to determine the probability of the cause and effect// //relationship.//

//Epidemiological studies involve groups of people eg cohort study or case control study and each must have a control group. Sometimesa cluster investigation is carried out// //where there is a high proportion of people with a particular disease and they are associated with a particular job, environment etc.//


 * A cohort study** follows patients with a certain condition and/or are receiving treatment. A control group (without disease but otherwise the same)also followed. The health issues that develop in each group are compared over a long time.


 * A case control study** involves people with condition and compare with people who do not have the condiiton. Each person is questioned about past history and relationships drawn from an analysis of results. Again, the lag time between exposure (eg smoking) and disease must be accounted for.

A good website is http://www.cancercouncil.com.au

==History of Cigarette Smoking and Lung Cancer ==

The most salient fact in the history of lung cancer is that it was very, very rare before the invention of cigarettes.
If one goes into a medical library and pages through old medical texts from the nineteenth century, one finds almost no reference to lung cancer. If one searches through the medical literature up to the year 1900, there are only references to a total of 100 cases of lung cancer. Even as late as 1912, Adler could find only 374 cases. Grosse reviewed 100 years of autopsies in Dresden, Germany, and found that the incidence of lung cancer had gone from 0.3% in 1852 to 5.66% in 1952. In the nineteenth century, tobacco was smoked by gentlemen only in the form of cigars. Cigarettes, which were basically the sweepings off the floor of the cigar factory, were only smoked by the very poor. As machines to mass produce cigarettes came into the fore in the 1880s, smoking cigarettes became more common but the number of cigarettes smoked was still, relatively small. During World War I tobacco companies gave away free cigarettes to millions of soldiers, and it was only after the war that large numbers of Americans smoked cigarettes. Since there is a time lag of approximately 20 to 30 years between the onset of smoking and the development of lung cancer, the damage done was not immediately apparent. Doctors were surprised to see a sudden epidemic of lung cancer cases in the 1930s. They quickly discovered the association between smoking and lung cancer. Large statistical studies in England and the United States in the 1950s (Doll and Hill, Cutler) conclusively proved beyond any shadow of a doubt that cigarette smoking markedly increased the chances of developing lung cancer. By the 1970s, lung cancer had gone from one of the rarest of cancers to the number one killer cancer in the Western world. Women did not smoke in the early twentieth century U.S.A.. They were therefore, targeted by an intense marketing campaign in the 1930s, featuring elegant women in evening dresses smoking Lucky Strikes in Cigarette holders. Later they were the target of Virginia Slims. When I was in surgical training at the Mayo Clinic in the early 1970s lung cancer in women was still unusual, but by 1985, lung cancer had became the number one cause of cancer death in women. The 1990s are the era of discovery, as defectors from the tobacco industry provide an inside view of the treacherous behavior of the tobacco industry and our elected officials. Hopefully, the 1990s will end as the era of tobacco **CONTROL.**

Epidemiology
Worldwide, lung cancer is the most common cancer in terms of both incidence and mortality (1.35 million new cases per year and 1.18 million deaths), with the highest rates in Europe and North America.[|[125]]The population segment most likely to develop lung cancer is over-fifties who have a history of smoking. Lung cancer is the second most commonly occurring form of cancer in most Western countries, and it is the leading cancer-related cause of death. In contrast to the mortality rate in men, which began declining more than 20 years ago, women's lung cancer mortality rates have been rising for over the last decades, and are just recently beginning to stabilize.[|[126]] The evolution of "[|Big Tobacco]" plays a significant role in the smoking culture.[|[127]] Tobacco companies have focused their efforts since the 1970s at marketing their product toward women and girls, especially with "light" and "low-tar" cigarettes [|[1]]. Among lifetime nonsmokers, men have higher age-standardized lung cancer death rates than women. Not all cases of lung cancer are due to smoking, but the role of [|passive smoking] is increasingly being recognized as a risk factor for lung cancer—leading to policy interventions to decrease undesired exposure of nonsmokers to others' tobacco smoke. Emissions from automobiles, factories, and power plants also pose potential risks.[|[10]][|[12]][|[128]] [|Eastern Europe] has the highest lung cancer mortality among men, while northern Europe and the U.S. have the highest mortality among women. Lung cancer incidence is currently less common in developing countries.[|[129]] With increased smoking in developing countries, the incidence is expected to increase in the next few years, notably in China[|[130]] and India.[|[131]] Lung cancer incidence (by country) has an inverse correlation with [|sunlight] and [|UVB] exposure. One possible explanation is a preventive effect of [|vitamin D] (which is produced in the skin on exposure to sunlight).[|[132]] From the 1950s, the incidence of lung adenocarcinoma started to rise relative to other types of lung cancer.[|[133]] This is partly due to the introduction of filter cigarettes. The use of filters removes larger particles from tobacco smoke, thus reducing deposition in larger airways. However the smoker has to inhale more deeply to receive the same amount of nicotine, increasing particle deposition in small airways where adenocarcinoma tends to arise.[|[134]] The incidence of lung adenocarcinoma in the U.S. has fallen since 1999. This may be due to reduction in environmental air pollution.[|[133]]