Aantekeningen Oncology and Public Health
Lecture 1: Introduction
There is a big increase in long cancer in woman. This is because woman started smoking much later
compared to man. In man the most common cancers are prostate, skin and lung. In woman the most
common cancers are breast, skin and lung.
In the next 10 years, 1 in 13 persons in the Netherlands will be living with cancer.
In the Netherlands: cancer is the leading cause of death. Around one third of deaths from cancer are
due to 5 leading behavioral and dietary risks:
1. High body mass index
2. Low fruit and vegetable intake
3. Lack of physical activity
4. Tabacco use
5. Alcohol use
Public health: the science and art of preventing disease, prolonging life and promoting health through
the organized efforts of society (Acheson, 1988). Health is a state of complete physical, mental and
social wellbeing and not merely the absence of disease or infirmity (WHO, 1948).
Oncology and public health:
• Focus on prevention: limit risk factors for cancer (obesity, smoking, alcohol use, UV radiation)
• Increase health care capacity: working in health care should be made more attractive
• Efficient organization of health care: use of technology (the right care at the right location)
• Digitalization: connecting data
• Support the needs of patients and survivors
• Increase quality of life and quality of end-of-life
1
, Lecture 2: Introduction in public health
Definition of Public Health
Public health = the science and art of preventing disease, prolonging life and promoting health through
the organized efforts and informed choices of society, organization, public and private, communities
and individuals. It refers to collective actions to improve population health. The WHO (World Health
Organization) states that Public Health are “all organized measures (whether public or private) to
prevent disease, promote health, and prolong life among the population as a whole.
Three fields of public health research:
1. Epidemiology and community diagnosis
2. Collective prevention and health promotion
3. Health care organization and performance
Public health Medical science
Population Individual
Disease prevention Diagnosis
Health promotion Treatment
Interventions (environment, human behavior) Intervention (medical care)
Application of public health:
• Population
▪ From local areas to the work population
• Causes of disease (“causes of causes”)
▪ From behaviors to broader environments
• Prevention of disease
▪ From individual patients to national policies
• General health outcomes
▪ From quality of life to healthy life expectancy
Main public health functions (WHO):
o Assessment and monitoring of the health of communities and populations at risk to identify
health problems and priorities
o The formulation of public policies designed to solve identified local and national health
problems and priorities
o Assure that all populations have access to appropriate and cost-effective care, including health
promotion and diseases prevention services
There are already some major public health achievements. Since 1900 there are vaccinations, safer
workplaces and controls of infectious diseases. Since 1920 there are safer and healthier foods,
healthier mothers and babies and family planning. Since 1965 there is fluoridation of drinking water,
motor-vehicle safety, recognition of tabacco use as a health hazard and a decline in deaths from
coronary heart disease and stroke. The biggest success in public heal until now is the improved sewage
disposal and clean water supply systems.
2
,Global burden of cancer
Cancer is a leading cause of death. Cancer causes 1 in 8 death worldwide. Nowadays more people get
cancer. This because of a couple of reasons. There is an increase in global population, there is an
increase in age, more people are screened (so more diagnosis) and there is an increase in risk factors
for cancer.
Some cancers are geographic dependent. For example, for stomach cancer there is a 7x increased risk
in Japan and Korea because of the consumption of smoked fish. In Australia and sunny parts of south
US there is a higher chance of getting melanoma. Liver cancer is more prevalent in South-east Asia and
east Africa because of hepatitis B. Thyroid cancer is mainly caused by a deficiency of iodine in local
food and water supplies.
Prevention of cancer
There are three types of prevention of diseases:
1. Primary prevention
▪ Prevent the disease from occurring
▪ E.g. encouraging healthy lifestyles, increase tax on tabacco and alcohol and
vaccination
2. Secondary prevention
▪ Detect and treat the disease in an early phase before symptoms occur
▪ E.g. screening for breast, cervical or colon cancer
3. Tertiary prevention
▪ Prevent damage and pain from the disease, slow down the disease, and prevent the
disease from causing other problems
▪ E.g. survivorship care (improve HFQoL) and prevention of cancer recurrence
Factors influencing cancer risk
Living healthy helps to prevent cancer. It can reduce the risk of cancer by 30-35%. Other studies have
shown that physical activities lower the risk of getting colon cancer by 24%.
Smoking is the main risk of developing cancer. After smoking the main risk of developing cancer are an
unhealthy lifestyle, obesity, alcohol, inactivity’s and sun exposure.
3
, WCRF recommendations
These are the WCRF recommendations:
1. Be a healthy weight
▪ This can best be achieved by maintaining energy balance throughout life by being
physically active, eating a diet rich in wholegrains, vegetables, fruits and pulses,
limiting fast food consumption and other processed foods high in fat, starches or sugar
and limiting consumption of sugar sweetened drinks.
2. Be physically active
▪ Move more, sit less
3. Limit consumption of sugar sweetened drinks
▪ Regular consumption of sugar sweetened drinks is a cause of body weight gain,
overweight and obesity
4. Limit alcohol consumption
Why Public Health policy?
Public health is much of a behavior passive reflection of ‘upstream’ factors rather than active choice
(environmental, economic and social factors (outside most people’s control). Thus effectiveness of
behavioural change relies on policies that influence upstream factors and social norms that determine
people’s behaviours (“causes of causes”). Public health policy (i.e. laws, regulations, guidelines)
therefore is animportant and sometimes even critical determinant of population health.
4
Lecture 1: Introduction
There is a big increase in long cancer in woman. This is because woman started smoking much later
compared to man. In man the most common cancers are prostate, skin and lung. In woman the most
common cancers are breast, skin and lung.
In the next 10 years, 1 in 13 persons in the Netherlands will be living with cancer.
In the Netherlands: cancer is the leading cause of death. Around one third of deaths from cancer are
due to 5 leading behavioral and dietary risks:
1. High body mass index
2. Low fruit and vegetable intake
3. Lack of physical activity
4. Tabacco use
5. Alcohol use
Public health: the science and art of preventing disease, prolonging life and promoting health through
the organized efforts of society (Acheson, 1988). Health is a state of complete physical, mental and
social wellbeing and not merely the absence of disease or infirmity (WHO, 1948).
Oncology and public health:
• Focus on prevention: limit risk factors for cancer (obesity, smoking, alcohol use, UV radiation)
• Increase health care capacity: working in health care should be made more attractive
• Efficient organization of health care: use of technology (the right care at the right location)
• Digitalization: connecting data
• Support the needs of patients and survivors
• Increase quality of life and quality of end-of-life
1
, Lecture 2: Introduction in public health
Definition of Public Health
Public health = the science and art of preventing disease, prolonging life and promoting health through
the organized efforts and informed choices of society, organization, public and private, communities
and individuals. It refers to collective actions to improve population health. The WHO (World Health
Organization) states that Public Health are “all organized measures (whether public or private) to
prevent disease, promote health, and prolong life among the population as a whole.
Three fields of public health research:
1. Epidemiology and community diagnosis
2. Collective prevention and health promotion
3. Health care organization and performance
Public health Medical science
Population Individual
Disease prevention Diagnosis
Health promotion Treatment
Interventions (environment, human behavior) Intervention (medical care)
Application of public health:
• Population
▪ From local areas to the work population
• Causes of disease (“causes of causes”)
▪ From behaviors to broader environments
• Prevention of disease
▪ From individual patients to national policies
• General health outcomes
▪ From quality of life to healthy life expectancy
Main public health functions (WHO):
o Assessment and monitoring of the health of communities and populations at risk to identify
health problems and priorities
o The formulation of public policies designed to solve identified local and national health
problems and priorities
o Assure that all populations have access to appropriate and cost-effective care, including health
promotion and diseases prevention services
There are already some major public health achievements. Since 1900 there are vaccinations, safer
workplaces and controls of infectious diseases. Since 1920 there are safer and healthier foods,
healthier mothers and babies and family planning. Since 1965 there is fluoridation of drinking water,
motor-vehicle safety, recognition of tabacco use as a health hazard and a decline in deaths from
coronary heart disease and stroke. The biggest success in public heal until now is the improved sewage
disposal and clean water supply systems.
2
,Global burden of cancer
Cancer is a leading cause of death. Cancer causes 1 in 8 death worldwide. Nowadays more people get
cancer. This because of a couple of reasons. There is an increase in global population, there is an
increase in age, more people are screened (so more diagnosis) and there is an increase in risk factors
for cancer.
Some cancers are geographic dependent. For example, for stomach cancer there is a 7x increased risk
in Japan and Korea because of the consumption of smoked fish. In Australia and sunny parts of south
US there is a higher chance of getting melanoma. Liver cancer is more prevalent in South-east Asia and
east Africa because of hepatitis B. Thyroid cancer is mainly caused by a deficiency of iodine in local
food and water supplies.
Prevention of cancer
There are three types of prevention of diseases:
1. Primary prevention
▪ Prevent the disease from occurring
▪ E.g. encouraging healthy lifestyles, increase tax on tabacco and alcohol and
vaccination
2. Secondary prevention
▪ Detect and treat the disease in an early phase before symptoms occur
▪ E.g. screening for breast, cervical or colon cancer
3. Tertiary prevention
▪ Prevent damage and pain from the disease, slow down the disease, and prevent the
disease from causing other problems
▪ E.g. survivorship care (improve HFQoL) and prevention of cancer recurrence
Factors influencing cancer risk
Living healthy helps to prevent cancer. It can reduce the risk of cancer by 30-35%. Other studies have
shown that physical activities lower the risk of getting colon cancer by 24%.
Smoking is the main risk of developing cancer. After smoking the main risk of developing cancer are an
unhealthy lifestyle, obesity, alcohol, inactivity’s and sun exposure.
3
, WCRF recommendations
These are the WCRF recommendations:
1. Be a healthy weight
▪ This can best be achieved by maintaining energy balance throughout life by being
physically active, eating a diet rich in wholegrains, vegetables, fruits and pulses,
limiting fast food consumption and other processed foods high in fat, starches or sugar
and limiting consumption of sugar sweetened drinks.
2. Be physically active
▪ Move more, sit less
3. Limit consumption of sugar sweetened drinks
▪ Regular consumption of sugar sweetened drinks is a cause of body weight gain,
overweight and obesity
4. Limit alcohol consumption
Why Public Health policy?
Public health is much of a behavior passive reflection of ‘upstream’ factors rather than active choice
(environmental, economic and social factors (outside most people’s control). Thus effectiveness of
behavioural change relies on policies that influence upstream factors and social norms that determine
people’s behaviours (“causes of causes”). Public health policy (i.e. laws, regulations, guidelines)
therefore is animportant and sometimes even critical determinant of population health.
4
