34291 - UNIVERSITY OF PITTSBURGH CANCER INSTITUTE A...

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U NIVERSITY OF P ITTSBURGH C ANCER I NSTITUTE A National Cancer Institute (NCI)-designated Comprehensive Cancer Center The Importance of Prioritizing Cancer Prevention at Major Academic Cancer Centers Ronald B. Herberman, MD University of Pittsburgh Cancer Institute http://www.upmccancercenters.com March 2009
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Current Research Paradigm at Most Academic Cancer Centers Main focus on Developing & improving cancer therapies Carcinogenesis Early detection Little attention on cancer prevention or risk reduction
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Traditional Cancer Prevention Activities at Academic Cancer Centers (1) Research on healthy lifestyles Strategies to reduce unhealthy behaviors Smoking prevention; exercise; better nutrition; calorie reduction Molecular carcinogenesis research (gene- environment interactions) Identification of genes contributing to risk Identification of environmental risk factors
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Traditional Cancer Prevention Activities at Academic Cancer Centers (2) Screening of populations for genetic risk factors & genetic counseling of individuals with genetic risk Research to develop new, more sensitive and specific biomarkers for early detection of cancer Screening of populations for early detection of certain cancers
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Prevention Provides Greatest Impact on Wide Variety of Diseases Greatest public health advance of 19 th and 20 th century was prevention of infectious diseases Greatest impact on heart disease was the wide implementation of statins to reduce risk Key impact of seat belts and helmets on reduction of traumatic injuries Preventive and risk-reducing strategies also will most likely have the greatest impact on reducing burden of cancer
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Heart disease provides an excellent example of successful prevention Over the last 30 years heart disease has decreased significantly. 50% of this decrease is attributed to drug prevention strategies. Pharmacologic intervention using cholesterol and blood pressure lowering drugs has been used to prevent atherogenesis.
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UPCI and UPMC Cancer Centers: Integrates Across The Cancer Continuum To Improve Patient Care [Source: The Pennsylvania Comprehensive Cancer Control Plan, December, 2003]
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Epidemiology Describes Four Levels For Cancer Prevention Primordial or Societal Prevention Avoids the emergence and establishment of social, economic, and cultural patterns of living that are known to contribute to elevated risk of disease Primary Prevention Controlling causes and risk factors Condoms, needle exchange or vaccine to prevent spread of HIV, HBV or HPV Secondary Prevention (from onset of disease to normal diagnosis) Develop safe accurate methods of detection (at early curable stage) and development of preventive drugs, vaccines Tertiary Prevention Reducing ongoing morbidity or mortality once cancer is diagnosed Monitoring for early detection of second primary cancers Modified from Basic Epidemiology, R. Beaglehole, et al, 1993
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Inherited Gene Defects Do Not Explain All Cancer Risk Fewer than 1 in 10 cases of breast cancer arises in women born with genetic defects -National Cancer Institute
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This note was uploaded on 02/23/2012 for the course SCI 310 taught by Professor Staff during the Fall '10 term at Rutgers.

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34291 - UNIVERSITY OF PITTSBURGH CANCER INSTITUTE A...

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