how to prevent risk factor of cancer

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選項 1

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(１)do you know：cancer screen can help detect disease in early stage, in order to decrease mortality rate

yes

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(2)52 researches analysis showed：those who have most activity group have a lower risk of cancer (by 24%) than most sedentary group（exercise also lower risk of breast cancer）

possible mechanism：exercise may decrease insulin, hormone, prostaglandin, growth factor in circulation, and enhance immunity

exercise in daily life

no exercise

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(3) do you know：cancer may result from (1) lifestyle（consuming greasy food, cigarette, lack of exercise）(2)environment（pollution, radiation, ultraviolet）(3)Gene mutation(4)infection（HBV, HCV, EBV, HPV, bacteria, parasite) can also lead to cancer but no symptom initially

yes, and notice already

no, I don't know

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(4) most skin cancer result from sun exposure, and cancer risk related to cumulative sun exposure, bulla from sunburn is more dangerous

suggestion: hat, sunglass, protective clothes, avoid sun exposure in 10am-3pm .higher risk: light skin color, much nevus, family history

be careful and put on sunscreen

never mind

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(5) American Cancer society revealed that consuming more water and vegetable is the easiest way to prevent cancer，it decrease about 20% risk of cancer (each day: 3 coups of vegetable+ 2 cups of fruit.=about 300g or 1.5 bowel of vegetable+fruit amount: size of 2 fists )

would eat more vegetable and fruit

do not like to eat vegetable or fruit

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(6)do you know Health Promotion Administration(TAIWAN) provides free cancer screen (1)Cervical smear for>30 y/o female ,once/year (2)mammography once/2 year for 45-69 y/o female，40-44 y/o with family history(second degree)(3)stool occult blood screen for 50-74 y/o，once/2 year(4)those who smoke or consume betel nut, >30 y/o, oral cancer screen, once/2 year

qualify, and have already underwent the screen

never, or not qualify in age

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(7) Do you know virus can lead to cancer( infection cause 2 million cancer case annually in the world）

Dr. Harald zur Hausen stated that：globally, 21% of cancer case related to infection, higher than the cancer risk causing by smoking( which is 18%) .he supposed the actual risk should be higher

Yes, notice already

No, never notice

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(8) According to WHO, cancer is a leading cause of mortality，it claimed 7 million lives annually in the world. WHO demonstrated that 22% cancer death and 71% lung cancer death are resulted from cigarette

in lower income countries, HBV, HCV, and HPV take up 20% cancer death

would try hard to lead a healthy lifestyle

do not care

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(９) 30% cancer case can prevent through healthy lifestyle, such as less cigarette or alcohol consuming, avoid unhealthy food, exercise more, implement immune improving plan, prevent HBV, HCV, HPV infection

would try hard to have a healthy lifestyle

do not care lifestyle

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(10) there are 100-200 kinds of HPV subtype, 40 kinds grow in genital mucosa membrane, 15 kinds of HPV can cause cancer, such as cervical cancer, cancer in Head and neck cancer, or anus

research in USA: 75～80％ sexual active adult got genital HPV before 50 years old, but the prevalence in female with only one sexual partner all her life is only 14.3%， Among 3326 heterosexual men, the prevalence of genital HPV of any type was 53 percent [93]. Almost one-third of study participants were infected with oncogenic HPV types

try hard to live a healthy lifestyle

do not care

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(11) In 2008, there were 530,000 new cases of cervical cancer, and 275000 cases died from cervical cancer in the world.

99.7% infected by HPV，>70% were type 16 or 18 HPV.There were 2000 new cases every year in Taiwan, 950 cases died of cervical cancer. In the past, 80% were found in invasive stage, but currently due to promotion of Pap smear, annual mortality cases decrease already

notice and care

do not care

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(12) According to a research in 2010, cases of cervical abnormality related to HPV 16,18 in 17000 females in Bogota in Colombia, decreased by more than 90% after HPV vaccine injection( HPV-16 prevalence was 50.4% in Colombia women in Bogota )

Gardasil(HPV-6,11,16,18 use pGAL110 yeast as vector, Cervaix use L1 protein of Baculovirus as vector

consider to receive HPV vaccine, and encourage other people to receive vaccine

do not consider to receive HPV vaccine and do not encourage other people to receive vaccine

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(13) risk factor of CIN 2，CIN 3 : smoke ( 2-4 times risk) , HPV ( 15 times risk), smoke and infected by HPV(66 times risk)

other risk factors of cervical cancer：smoke, oral contraceptives, immune impairment, type 2 Herpes Simplex Virus , Chlamydia infection assist in persistent HPV infection

notice and be careful

never mind

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(14) EB virus is a Carcinogenic factor to Nasopharyngeal carcinoma, so is nitrite(additive) in processed meat

ＥＢvirus can transmitted by saliva. 90% adults have be infected in many areas in the world

aware ( using serving utensils)

not aware

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(15)Obesity increase the risk of endometrial cancer by 39%. postmenopausal breast cancer by 9%. renal cancer. esophageal cancer

20% of all cancer cases were estimated to be caused by obesity

body weight under control

never mind

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(16)male who gain 21kg after 20 years old have 60% higher risk of colon cancer than male who only gain 1-5kg after 20 y/o. Female who lose 10 kg body weight after menopause, their risk of breast cancer decrease by 50%

Obesity effect：fat cells produce Estrogen－＞Breast cancer or Endometrial cencer。Chronic inflammation.increased insulin－＞Colon cancer

try to lose body weight

increasing body weight

stable body weight

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(17) a report revealed daily consumption of meat(g)：Japanese: 30g．English: 197g．Americans: 280g．New Zealand 309g；Colon cancer mortality (every 100 thousand female)：Japanese 7．English 20．American 30．New Zealand 40

In the report, people in Newzealand consumed the most meat everyday, and their colon cancer mortality was highest

do not eat much meat everyday

eat a lot of meat everyday

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(18) risk factor of colon cancer：(1)every 18cm increase in waistline，gain a higher 30% risk of colon cancer

waistline under control

under steady increase

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(19) risk factor of colon cancer：(2)every 100g red meat daily consumption increase risk of colon cancer by 29%　

too much white meat consumption increase risk too

no much red meat consumption

eat a lot of red meat

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(20) risk factor of colon cancer：(3)every 30g increase of alcohol daily consumption increase 27% risk of colon cancer

seldom drink

drink alcohol frequently

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(21) risk factor of colon cancer (4) smoker have 25% higher risk of colon cancer

non smoker

smoker

victim of secondhand smoke

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(22) risk of colon cancer (5)every 50g increase of processed meat daily consumption，gain 21% risk of colon cancer 　

seldom eat processed meat

eat a lot of processed meat

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(23) risk factor of colon cancer：(6) every 7 kg of body weight gain，increase 15% risk of colon cancer　

normal body weight

overweight

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(24) elevated insulin=>insulin like growth hormone-->stimulate cell proliferation．*diabetes mellitus increase risk of liver cancer, pancreatic cancer, endometrial cancer．and slightly increase the risk of colon cancer, breast cancer, bladder cancer

suggest:decrease sweet, beverage, lipid acid consumption and exercise more( too much sweet consumption deplete insulin, lack of exercise, lipid acid will lead to Diabetes mellitus

refrain from consuming to much sugar

never refrain from consuming sugar

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(25) researches demonstrated：the group whose diet contained the largest amount of fruit and vegetable had 50% lower risk of colon cancer than the group whose diet contained the smallest amount of fruit and vegetable

, while some researches showed no significance, and other 14 researches showed：the group who consumed fruit and vegetable >800g everyday had lower relative risk 0.74, compared to the group daily consumed <200g

eat more fruit and vegetable

eat less fruit and vegetable

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(26) Daily fiber consumption: every 10g fiber daily consumption decrease the risk of colon cancer by 10%（researches showed whole grains are associated with lower risk of distal colon cancer ; instead of vegetable fiber or bean fiber

every 100g brown rice contain 3.3g dietary fiber( white rice contain:0.3～0.4g）and contain Vit B1 4-5 times of Vit B1 in white rice. Whole grains contain fiber, Vitamins, Minerals ,activated trace element in cereal germs

consume whole grains

only eat refined rice

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(27) protective factor against colon cancer：Resistant Starch, Folic acid ( daily 800microgram decrease 31% relative risk of colon cancer than 250 microgram daily group) Calcium,Vitamin B6,Vitamin D,Magnesium, Garlic, omega 3 fatty acid

Aspirin and NSAID decrease the risk of colon cancer (but with other side effects)

be careful about what you eat

not careful

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(28) no matter gene mutation caused by chemicals-induced or virus-induced or congenital cell mutation, normal immune system will clean abnormal cell. Once a tumor is detected by CXR, it has already reached 1 cm and proliferated for 30 generations, contained 1000,000,000 cancer cells( progress in 10 years)

When cancer cells proliferated to 10,000,000 cancer cells( reached 0.2cm) ,unless there is angiogenesis, the tumor can't grow rapidly under nutrition supply insufficiency　

so prevention better than cure

do not care now

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(29) risk factor of lung cancer：Smoke, Radiation therapy, Environmental toxin：second-hand smoke, Asbestos, Radon, Arsenic, Chromium, Nickel, ionizing radiation, Polycyclic Aromatic Hydrocarbons, Pulmonary fibrosis, AIDS, oncogenes

no exposure

maybe expose already

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(30) Protective factor of lung cancer：Cruciferous vegetables, anti-oxidant, phytoestrogen

but researches revealed B-Carotene does not benefit for smoker with regard to lung cancer

would consume more Cruciferous vegetables

dislike vegetables

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(31) risk factor of head and neck cancer：cigarette, alcohol, betel nuts, EBV, HPV, HSV (virus infection)．

Occupation exposure：tetrachloroethylene (dry cleaning solvent), asbestos, pesticide, man-made mineral fibers, Polycyclic Aromatic Hydrocarbons, textile worker, plastic/rubber worker, carpenter, Camphor refiner, leatherworker, decorator, plasterer, smith, Agent Orange

no exposure

exposed to these materials

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(32) salt-preserved food, processed meat, pickled vegetable consumption--->damage gastric mucosa+stimulate cell proliferation-->increase the risk of gastric cancer

in these 50 years, prevalence of gastric cancer decreased because of the use of refrigerator, so less food preserved by salt or smoke

seldom eat pickled food or processed meat

often eat pickled food or processed meat

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(33) chronic gastritis may result in atrophic gastritis and cell abnormality

Helicobactor pylori or high-sodium diet lead to chronic gastritis-->(cell damage.produce free radical )--->atrophic gastritis (lack of gastric acid. local Vitamin C decrease)->increase gastrin->gastric epithelial cell proliferate

seldom have stomach ache

have frequent stomach ache

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(34) Diet with much：<fried food, processed meat/fish, alcohol > Lack of：<Vegetable, fruit, milk, Vitamin A >increase the risk of gastric cancer

(1).Nitrate in food( or added in processed meat or cheese ) ->reduction through bacteria in sliva -> Nitrite ->carcinogen: N-nitroso (2) Gastrectomy ( especially Billroth II)-> lack of gastric acid-->certain bacteria overgrowth-->transform nitrate into carcinogen: N-nitroso

be careful of what you eat

not careful

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(35) the group who consumed the largest amount of fruit：decrease 10%-40% risk of gastric cancer (compared with the group consumed the smallest amount of fruit)　

Lack of citrus fruit consumption increase the risk of gastric cancer. The possible reason is fruit contain Vitamin C-->decrease the production of oncogene: N-nitroso

eat citrus fruit frequently

seldom eat citrus fruit

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(36) Grain fiber play a strong protective role against diffuse gastric cancer

some studies showed all kinds of fiber protect too(OR=0.58-0.63)

eat whole grain

only eat white rice

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(37) Other risk factor of gastric cancer：ＢＭＩ＞２５, smoke (x1.53), peptic ulcer with persistent H.pylori infection, gastric surgery, EB virus infection, oncogene, gastric polyp, atrophic gastritis－＞pernicious anemia

occupation exposure：coal mine, tin mine, steel manufacturing, rubber manufacturing

no exposure

be exposed to these materials

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(38) Protective factor against liver cancer：statins( lipid lowering medications), omega-3 lipid acid, white meat, fish, Vitamin Ｅ, coffee

Coffee do not benefit with regard to colon cancer．may be harmful in high concentration

I knew and I was careful about food

never mind

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(39) risk factor of liver cancer: HBV (accumulative risk of liver cancer of HBsAg carrier： male 27%．female 8%) HCV (accumulative risk of liver cancer：male 24%．female 17%) others: Peanut, corn, soy bean are eat to contaminated by aflatoxin. HBV carrier with aflatoxin exposure：ｘ59.4 times of risk )

risk relate to virus load．risk decrease to half after treatment

seldom eat peanut, molded food, stale food, miso, fermented bean curd ,stinky tofu

often eat food listed above

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(40) Other risk factor of liver cancer：cigarette, alcohol, betel nut, contaminated water, Diabetes mellitus, fatty liver, hemochromatosis, certain kind of EGF gene, EGF over-expression, red meat, saturated fat

no these risk factors

have these risk factors

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(41) Do you think you live in a healthy state

yes

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