Extensive summary and class notes of Oncology and Public Health part of the Minor Biomedical topics in Health care. This course focuses on oncology from a societal and public health perspective. The course will be on cancer development, diagnosis, treatment and late effects of cancer, and public he...
LECTURE 1. Opening and introduction to course
Mostly done cancer tests: breast, cervix, and colon cancers.
The incidence of cancer is rising with 3000 patients per year. During COVID fewer diagnoses,
because people didn’t show up to their GP.
- Men: prostate, skin, lung, bowel. In the beginning, more men had lung cancer, but
now also women, because they started smoking later.
- Women: breast, skin, lung, bowel, lymph node and leukaemia.
o Woman started smoking later -> therefore they also started to get lung cancer
later. Hence, lung cancer is now an upcoming cancer type in women.
Survival rate (5-year survival) = W 70%, M 66%.
20 year prevalence: in 2032, 1 in 13 will have (a history of) cancer.
Oncology is a public health issue, oncology is the leading cause of death.
1/3 of all cancer types is due to behavioural and dietary risks:
- High BMI.
- Low fruit and vegetable intake.
- Lack of physical activity.
- Tobacco use.
- Alcohol use.
Public health: the science and art of preventing disease, prolonging life and promoting health
through the organized efforts of society.
Health is a state of complete physical, mental and social wellbeing and not merely the
absence of disease or infirmity.
- The focus of oncology and public health is on:
o Prevention.
o Increasing health care capacity.
o Making the organization of health care more efficient.
o Digitalization.
o Supporting the needs of patients and survivors.
o Increasing the quality of life and quality of end-of-life.
Answers to the quiz:
- More men than women are diagnosed with cancer in the Netherlands; probably
because diagnosis happen less in women – not that there are less women with
cancer.
- The incidence of cancer in the Netherlands in 2019 was about 119.000; the
prevalence is way higher.
- Breast cancer screening is an example of secondary prevention = early detection/
diagnosis; with secondary prevention the disease is already present– primary
screening is when the individual takes steps to prevent a disease from happening.
- 40-50% of new cancers causes are diagnosed during the working age (18-65) – for
instance because people are working until a later age.
,- More than 85% of all cancer types can be considered ‘rare’ cancer types.
- Most prevalent cancer type in women is breast cancer
- Most prevalent cancer types in men is prostate cancer
- In the Netherlands people usually get screened for colon cancer at the age of 55.
- In the Netherlands people usually get screened for breast cancer at the age of 50.
- In the Netherlands people usually get screened for cervical cancer at the age of 35.
- 1/3 of all cancer are caused by an unhealthy lifestyle
- 5-10% of all cancer have a genetical component
- Palliative care and intense life prolonging therapy can be combined.
- The prevalence of distress in patient with cancer is 1/3 of all patient.
- Colorectal cancer is the type of screening program that has the highest uptake rates
in the Netherlands together with breast cancer.
- Cannabis can be used to relieve pain in patients with cancer.
,LECTURE 2. Introduction in public health
X Definition of public health
The science and art of (1) preventing disease, (2) prolonging life and (3) promoting health in
the public through organized efforts and informed choices of society.
- Society: organizations, public and private, communities, and individuals.
- Public: communities, countries, or global health.
→ collective action to improve population health.
3 most important goals (3Ps):
- Preventing disease
- Prolonging life
- Promoting health
X Public health application
Three fields of public health research:
1. Epidemiology and community diagnosis.
o Epidemiology: the branch of medicine which deals with the incidence,
distribution, and possible control of diseases and other factors relating to
health.
o Community diagnosis: a quantitative and qualitative description of the health
of citizens and the factors which influence their health.
2. Collective prevention and health promotion.
o Screening and information.
3. Health care organization and performance
o How is health care (in a city) organized, how is health provided? How is the
access to health organizations (GP/ hospital) distributed? Is it accessible for
everyone?
Public health vs medical science:
- Public health and cancer: trying to decrease the risk factors – through screening.
o But also through environmental control.
- Populations: From local areas to the world population.
- Causes of diseases (causes of causes): From behaviours to broader environment.
o Advertisements for smoking banned, taxes for cigarettes - because it causes
smoking.
, o Why do people smoke? Why do people keep smoking?
- Prevention of disease: From individual patients to national policies.
o What can the government do to prevent it? What can the society do to
prevent disease?
o Smoking behaviour.
- General health outcomes: From quality of life to healthy life expectancy.
o Where do we get our gains, what can you do to improve this? is living longer
always better or quality of life?
X Public health function
- Assessment and monitoring:
o At a population level – how many people get cancer or how many are healthy?
o To identify health problems and priorities in risk populations.
▪ Mesothelioma risk with asbestos? Relation asbestos and mesothelioma
= 1 on 1. Working with asbestos has a huge latency period (can be 40
years) before mesothelioma occurs. 500-600 people are dying of
mesothelioma.
- Formulation of public policies:
o What kind of policy should be considered in the disease situation? What is
necessary to improve public health.
▪ What kind of policy should be used in asbestos, ban on asbestos?
- Access to appropriate and cost-effective care:
o Assure that all populations have access to health care.
▪ Including health promotion and diseases prevention services.
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