Oncology and public health lectures
Week 1
Lecture 1: Opening and introduction of the course
Definition public health
= the science and art of preventing disease, prolonging life and promoting health through the
organized efforts of society.
Health = a state of complete physical, mental and social wellbeing and not merely the absence of
disease or infirmity.
Oncology and public health
Cancer is a significant public health problem
WHO factsheet on cancer 2018:
- One of leading causes of death globally, estimated 9,6 million deaths in 2018
- Globally, about 1/8 deaths is due to cancer
- Around 1/3 of deaths from cancer are due to 5 leading behavioural and dietary risks:
o High body mass index
o Low fruit and vegetable intake
o Lack of physical activity
o Tobacco use
o Alcohol use
Cancer in the Netherlands
- Leading cause of death (all types together)
- Most common types
o Lung cancer
o Colon cancer
o Breast cancer
o Prostate cancer
- The incidence rises in the Netherlands. There is an increase of new cancer patients each year
- 5 year prevalence: this is also increasing each year.
, - Mortality: 1/3 deaths in the Netherlands is due to cancer. This is why it is an important
health issue in the Netherlands.
COVID-19 and cancer
- Population based screenings stopped → around April, the population based screening
(breast cancer screening, colon cancer screening etc.) stopped.
- Patients hesitant to go to the GP or hospital due to COVID
- This causes a dip in the amount of cancer patients, because less screening and less diagnoses
due to the fact that patients will not go to the doctor.
- Regular care including cancer are stopped → this will have a lot of consequences.
This course is about the public health related issues in oncology related to phases: prevention,
diagnosis, treatment, survivorship and the end of life.
Lectures:
- In total 22 lectures.
- Biomedical and public health topic
- Live zoom sessions (8) and pre-recorded lectures and Q & A (14)
- Clinicians and researchers will give the lectures on their own topic
Work groups:
- 4 topics → enrol yourself today before 17.00 via canvas
- 6 meetings
- Report + presentation of literature review in groups of 4 students
Reflection report (final term 5)
- Based on patient’s experiences
- Describe problems in daily practice from scientific point of view
, o Live patient presentation AYA
o Video patient presentations (palliative care, rare cancers, work)
Examination
- Written exam (open questions/proctoring): 70%
- Work groups: 30%
o Literature review
o Oral presentation
o Presence at work groups
- Reflection report → pass or fail
All information on canvas → files gives modules per week – pages
Each week Monday (13.30) → overview next week
Final terms, the student is able to:
1. Recall basic principles of tumour development and progression, diagnosis and treatment
2. Explain basic principles of cancer screening programs and cancer epidemiology
3. Describe basic public health related issues in oncology related to phases: prevention,
diagnosis and treatment, survivorshop and the end of life.
4. Explain late effects and long-term consequences of cancer diagnosis and treatment, and
possible intervention strategies, managing these consequences and their effectiveness
5. Illustrate patients experiences and point out translation of research into clinical practice
6. Identify a relevant oncology and public health problem for an assignment topic.
Lecture 2: Introduction in public health
Literature: Ch13 Adult public health
Definition of public health = the science and art of preventing disease, prolonging life and promoting
health through the organized efforts of society (Acheson, 1988) → WHO: the science and art of
preventing disease, prolonging life and promoting health through the organized efforts and informed
choices of society, organizations, public and private, communities and individuals.
Health = a state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity.
Organized efforts of society = informed choice of society, organization, public and private,
communities and individuals. So everybody involved in society is involved in public health. The focus
is mostly in groups.
So, the public health refers to collective actions to improve population health.
WHO: all organized measures (whether public or private) to prevent disease, promote health and
prolong life among the populations as a whole.
Application of public health: what are the types of research associated?
- Epidemiology (studying the occurance of disease in group level) and community diagnosis
(this is what you see in the news; infection rate)
- Collective prevention and health promotion
- Health care organization and performance → how is it organized so that everyone has access
to the health care? Is the performance safe, cost-effective etc.
Public health: focus is on population, in public health it starts with disease prevention, in public
health they look at health promotion, interventions are mostly on environmental and behaviour
level.
, Medical science: focus on individual, in medical science the doctor starts with the diagnosis,
treatment is needed, the interventions in medical science are medical care, so treatments and
therapies.
Application of public health:
- In public health there is a difference in the level of application.
o From local areas (in 1 city) to the world population
- Causes of disease (causes of causes: why are people with a low-income easier to become
obese; is this due their eating or due to their environment cause of a cause)
o From individual levels; behaviours to broader environments
- Prevention of disease
o From individual patients to national policies, f.e. a tax measure to make cigarettes
more expensive.
- General health outcomes
o Quality of life to healthy life expectancy, where studies focus on an increase of
healthy life expectancy
Public health:
- Covid-pandemic is a public health crisis
Public health functions: 3 main/core functions
1. Assessment and monitoring of the health of communities and populations at risk to identify
health problems and priorities → this is probably the basic function of public health
2. The formulation of public policies designed to solved identified local and national health
problems and priorities
3. Assure that all populations have access to appropriate and cost-effective care, including
health promotion and disease prevention services
There are 10 essential public health services
Video: public health = discipline that addresses health at a population level.
Clinic medicine = looks at patients on an individual level. Public health looks at groups, including sick
and healthy people, could be a country or global health.
What do public health professionals do? They try to do 2 things: understand and act.
1. Understand = surveillance and research. They start with research on the exposure = risk
factors and interventions and outcomes = disability and disease. The public health
professionals will try to understand magnitude and distribution = how big, how much is the
problem (socially, geography). With this they can see whether there is a relationship
between exposure and outcomes and secondly, they want to plan interventions to improve
public health.