Hoorcollege 1
Chapter 1 - introduction
Incidence of cancer is defined to be the number of new cases that is registered within a
certain period (mostly 1 year). To be able to follow the incidence in time, or to enable
comparison between regions, the incidence is mostly expressed as the number of new
cases per 100.000 inhabitants/persons each year: the crude incidence rate
Prevalence of cancer comprises all persons who somewhere in time have been diagnosed
with cancer; and are still living at a certain date. Hence, this is a diverse group, ranging from
persons who have been cured from cancer in the past to persons who just have been
diagnosed with cancer. The period can be unlimited, but also defined. As an example: the 5
year prevalence on january 1st, 2020, comprises all still living people who have been
diagnosed with cancer since january 1st, 2015.
Mortality of cancer comprises the number of patients who died as a result of cancer within a
certain period (mostly 1 year)
Survival is the percentage of patients still living at a certain period after diagnosis. the
presented survival is a relative survival that approaches the ‘cancer-specific survival’. this
means that the survival observed is corrected for the expected death within a comparable
population (with respect to country/region, gender, age and calender year).
incident increases but mortality not
meeste kankers komen vaker voor in het westen
- er is minder screening in armere landen, dus minder diagnoses in lage inkomst
landen
top ranking of cancer as leading cause of premature death partly reflects marked declines in
mortality rates of stroke and coronary heat disease in many countries.
man - longkanker en prostaat kanker
vrouw - borstkanker
top ranking of cancer as leading course of premature death partly reflects marked declines in
mortality rates of stroke and coronary heart disease in many countries
mortaliteit heeft afgenomen meestal
,What is cancer?
what is the clinical definition of cancer?
- cancer is a group of diseases
- more than 1– cancer types can be distuingished (or even every tumor is different?)
- uncontrolled cell growth
- invasive and forming metastases
does a patient with a tumor always have cancer? No.
- a tumor is a mass of cells
- not every tumor is invasive and metastasing
- benign tumors are no cancer, only malignant tumors are cancer
why is a malignant tumor life threatening?
- invasion of organs disturbs organ function
- cancer cells compete with normal cells for nutrients and oxygen - in gehele lichaam
- growing tumors can cause obstruction
what is the difference between carcinoma, adenocarcinoma, sarcoma and lymphoma?
- carcinomas arise from epithelia (85% of all cancers)
- adenocarcinomas arise from glandular tissues (e.g breast)
- sarcomas arise from mesodermal tissues
- lymphomas arise from white blood cells
why is the incidence of carcinomas much higher than of other cancers?
- carcinomas are derived from epithelial cells
- epithelial cells align our body (inside and outside)
- epithelial cells are most exposed to carcinogens
carcinogens
- a carcinogen is an agent causing cancer (compound, radiation, etc.)
- a carcinogen causes alterations in the DNA of a cell (chapter 2)
- cancer cells contain many alterations in the DNA
- the accumulation of mutations in the DNA of a cell causes stepwise development of
cancer (oncogenesis, carcinogenesis)
development of cancer (oncogenesis)
- cancer is clonal
- tumors are heterogeneous
, cancer is a disease of the
genome
- is cancer
inheritable?
- no. Almost all of the mutations develop in somatic cells and will not be
passed to the next generation of offspring
- however, some inherited germline mutations can increase the chance to
develop cancer and can be passed on to the next generation of offspring,
these mutations are rarely involved in causing cancer immediatly (chapter 6)
why does the risk to develop cancer increase at an older age?
- an accumulation of mutations in the DNA is needed for the development of cancer
- it is a matter of chance and time (exposure to carcinogens)
- the incidence of cancer is increasing due to longer life expectancy
main characteristics of cancer
‘hallmarks of cancer’
6 stuks + 4 in boek
characteristics of cancer
- a tumor is more than just tumor cells
- fibroblast
- immune cells
- endotheel cellen
- kanker cellen
, The growth of a tumor
disturbed balance between proliferation, cell death and differentiation
- de-differentiation, differentiation, proliferation, apoptosis
oncogenes and tumor suppressor genes
- oncogenes
- suppressor genes
Chapter 1 - introduction
Incidence of cancer is defined to be the number of new cases that is registered within a
certain period (mostly 1 year). To be able to follow the incidence in time, or to enable
comparison between regions, the incidence is mostly expressed as the number of new
cases per 100.000 inhabitants/persons each year: the crude incidence rate
Prevalence of cancer comprises all persons who somewhere in time have been diagnosed
with cancer; and are still living at a certain date. Hence, this is a diverse group, ranging from
persons who have been cured from cancer in the past to persons who just have been
diagnosed with cancer. The period can be unlimited, but also defined. As an example: the 5
year prevalence on january 1st, 2020, comprises all still living people who have been
diagnosed with cancer since january 1st, 2015.
Mortality of cancer comprises the number of patients who died as a result of cancer within a
certain period (mostly 1 year)
Survival is the percentage of patients still living at a certain period after diagnosis. the
presented survival is a relative survival that approaches the ‘cancer-specific survival’. this
means that the survival observed is corrected for the expected death within a comparable
population (with respect to country/region, gender, age and calender year).
incident increases but mortality not
meeste kankers komen vaker voor in het westen
- er is minder screening in armere landen, dus minder diagnoses in lage inkomst
landen
top ranking of cancer as leading cause of premature death partly reflects marked declines in
mortality rates of stroke and coronary heat disease in many countries.
man - longkanker en prostaat kanker
vrouw - borstkanker
top ranking of cancer as leading course of premature death partly reflects marked declines in
mortality rates of stroke and coronary heart disease in many countries
mortaliteit heeft afgenomen meestal
,What is cancer?
what is the clinical definition of cancer?
- cancer is a group of diseases
- more than 1– cancer types can be distuingished (or even every tumor is different?)
- uncontrolled cell growth
- invasive and forming metastases
does a patient with a tumor always have cancer? No.
- a tumor is a mass of cells
- not every tumor is invasive and metastasing
- benign tumors are no cancer, only malignant tumors are cancer
why is a malignant tumor life threatening?
- invasion of organs disturbs organ function
- cancer cells compete with normal cells for nutrients and oxygen - in gehele lichaam
- growing tumors can cause obstruction
what is the difference between carcinoma, adenocarcinoma, sarcoma and lymphoma?
- carcinomas arise from epithelia (85% of all cancers)
- adenocarcinomas arise from glandular tissues (e.g breast)
- sarcomas arise from mesodermal tissues
- lymphomas arise from white blood cells
why is the incidence of carcinomas much higher than of other cancers?
- carcinomas are derived from epithelial cells
- epithelial cells align our body (inside and outside)
- epithelial cells are most exposed to carcinogens
carcinogens
- a carcinogen is an agent causing cancer (compound, radiation, etc.)
- a carcinogen causes alterations in the DNA of a cell (chapter 2)
- cancer cells contain many alterations in the DNA
- the accumulation of mutations in the DNA of a cell causes stepwise development of
cancer (oncogenesis, carcinogenesis)
development of cancer (oncogenesis)
- cancer is clonal
- tumors are heterogeneous
, cancer is a disease of the
genome
- is cancer
inheritable?
- no. Almost all of the mutations develop in somatic cells and will not be
passed to the next generation of offspring
- however, some inherited germline mutations can increase the chance to
develop cancer and can be passed on to the next generation of offspring,
these mutations are rarely involved in causing cancer immediatly (chapter 6)
why does the risk to develop cancer increase at an older age?
- an accumulation of mutations in the DNA is needed for the development of cancer
- it is a matter of chance and time (exposure to carcinogens)
- the incidence of cancer is increasing due to longer life expectancy
main characteristics of cancer
‘hallmarks of cancer’
6 stuks + 4 in boek
characteristics of cancer
- a tumor is more than just tumor cells
- fibroblast
- immune cells
- endotheel cellen
- kanker cellen
, The growth of a tumor
disturbed balance between proliferation, cell death and differentiation
- de-differentiation, differentiation, proliferation, apoptosis
oncogenes and tumor suppressor genes
- oncogenes
- suppressor genes
