ten big rank of cancer in indonesia 2009 edit

8/11/2019 Ten Big Rank of Cancer in Indonesia 2009 Edit

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TEN BIG RANK OF CANCERand

CANCER HEREDITY

Totok UtoroDepartment of Pathology

Gadjah Mada University School of Medicine


2/60

Epidemiologi : umum

1. Karakter umum

Kanker terjadi akibat gangguan pertumbuhan

sel dan sifatnya

studi kausal harus sampaike tingkat selular dan subselular (molekular)

2. Karakter kusus

Studi pola kanker di populasi penting untuk

mengetahui asal dari kanker mis lingkungan,

polusi (rokok, pekerjaan, kendaraan, pabrik),

perilaku (aktivitas seksual), faktor keturunan.


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Epidemiologi : Faktor risiko

1. Umur

Makin tua pengaruh karsinogen makin kuat

2. Diet

Perbedaan geografis insiden kankermencerminkan perbedaan diet

Minuman alkohol berpengaruh terhadapkarsinogenesis

3. LingkunganPolusi (rokok, pekerjaan, kendaraan, pabrik)

Ativitas seksual

4. Perubahan genetik


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Insiden Kanker

Insiden nasional dan angka mortalitas menggambarkan kemungkinan individu

menderita kanker gambar

Angka-angka bersifat dinamis kasuskanker juga dinamis

Ada kecenderungan angka menurun,

walau masih melampaui angka kesakitan& kematian karena penyakit

kardiovaskular


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Cancer epidemiology


6/60

Faktor geografik & lingkungan

Perbedaan menyolok insiden kanker

menurut geografik

Lingkungan berhubungan erat dengan

geografi

Ca Paru: Amerika 2X Jepang, Belgia >

Amerika

Ca lambung: Jepang 7-8 X Amerika

Keganasan anak kira-kira sama


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Comparison between native Japanese,Japanese immigrants and Calif.white


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FREKUENSI RELATIF KANKER PADA LAKI-LAKI DI SENTER

YOGYAKARTA TH 1994-1999

163

184

260

367

380

439

511

608

661

725

2.41

2.72

3.85

5.43

5.63

6.50

7.57

9.00

9.79

10.74

0 100 200 300 400 500 600 700 800

TESTIS

186

URINE BLADDER

188

SOFT TISSUE

171

NASOPHARYNX

147

RECTUM

154

Series2

Series1


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FREKUENSI RELATIF KANKER PADA LAKI-LAKI DI SENTER

YOGYAKARTA TH.1994-1996

2

3

5

6

7

10

13

17

19

19

24

32

32

48

50

51

52

60

60

65

71

73

74

75

78

93

94

103

110

116

149

163

184

260

367380

439

511

608

661

725

0.03

0.04

0.07

0.09

0.10

0.15

0.19

0.25

0.28

0.28

0.36

0.47

0.47

0.71

0.74

0.76

0.77

0.89

0.89

0.96

1.05

1.08

1.101.11

1.16

1.38

1.39

1.53

1.63

1.72

2.21

2.41

2.72

3.85

5.435.63

6.50

7.57

9.00

9.79

10.74

0 100 200 300 400 500 600 700 800

RES/ HEMATOPOETIC

169

BASE OF ORAL

CAVITY

NERVES, OTHERS

192

INTESTINE, OTHERS

159

PANCREAS

157

GALL BLADDER

156

GASTER

151

PERITONEUM

158

EYE

190

THYROID

193

BONE

170

URINE BLADDER

188

PROSTATE

185

RECTUM

154

PERESENTASE

JUMLAH


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FREKUENSI RELATIF KANKER PADA PEREMPUAN DI SENTER

YOGYAKARTA TH 1994-1999

282

286

407

453

503

638

792

855

921

1993

3216

2.32

2.36

3.36

3.73

4.15

5.26

6.53

7.05

7.59

16.43

26.51

0 500 1000 1500 2000 2500 3000 3500

SOFT TISSUE

171

COLON

153

CORPUS UTERI

182

NOT KNOWN

199

OVARY

183

FEMALE BREAST

174

Series2

Series1


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THE BIG TEN CANCER IN FEMALE IN INDONESIA IN1994-1997

1530

1669

1851

1864

2139

2665

3456

4712

11582

16597

2.55

2.79

3.09

3.11

3.57

4.45

5.77

7.87

19.34

27.71

0 5000 10000 15000 20000

SOFT TISSUE

171

CORPUS UTERI

182

RECTUM

154

SKIN

173

FEMALE BREAST

174

Series2

Series1


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FREKUENSI RELATIF KANKER PADA PEREMPUAN DI SENTER

YOGYAKARTA TH.1994-1996

1

3

3

4

5

7

8

8

9

14

20

2227

35

36

38

38

44

46

52

59

65

72

75

81

83

84

97

101

118

124

142

262

282

286

407

453503

638

792

855

921

1993

0.01

0.02

0.02

0.03

0.04

0.06

0.07

0.07

0.07

0.12

0.16

0.18

0.22

0.29

0.30

0.31

0.31

0.36

0.38

0.43

0.49

0.54

0.59

0.620.67

0.68

0.69

0.80

0.83

0.97

1.02

1.17

2.16

2.32

2.36

3.36

3.734.15

5.26

6.53

7.05

7.59

16.43

0 500 1000 1500 2000 2500

ENDOCRINE GLAND, OTHERS

194

PHARYNX, OTHERS

149

BASE OF ORAL CAVITY

144

LARYNX

161

GASTER

151

LIPS

140

LIVER

155

ORAL, OTHERS

145

EYE190

URINE BLADDER

188

OTHER LOCATIONS

195

SOFT TISSUE

171

LYMPHNODE

196

NOT KNOWN

199

CERVIX UTERI

180

PERSENTASE

JUMLAH


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Frekwensi Relatif kanker : 1994 1998(YK)

LAKI-LAKI PEREMPUAN

1 725 Mama 3216

2 Rektum 661 1993

3 608 Ovarium 921

4 Nasofaring 511 855

5 439 Tak diketahui 792

6 Soft tissue 380 638

7 367 Korpus uteri 503

8 Bladder 260 453

9 184 Kolon 407

10 Testis 163 286

11 Jaringan lunak 282


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FREKUENSI RELATIF KANKER PADA KEDUA JENIS

KELAMIN DI SENTER YOGYAKARTA TH. 1994-1996

340

484

521

534

626

716

893

1087

1309

2091

2.68

3.82

4.11

4.21

4.94

5.65

7.04

8.57

10.32

16.49

0 500 1000 1500 2000 2500

CORPUS UTERI

182

COLON153

OVARY

183

RECTUM

154

CERVIX UTERI

180

PERSENTASE

JUMLAH


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FREKUENSI RELATIF KANKER PADA KEDUA JENIS KELAMIN DI

SENTER YOGYAKARTA TH.1994-1996

1

23

45

77

715

1515

1619

3738

4245

5362

6464

6576

8389

9494

9899

107115

116126

157165

189240

281290

340484

521534

626716

8931087

13092091

0.01

0.020.02

0.030.04

0.060.06

0.060.12

0.120.12

0.130.150.29

0.30

0.330.35

0.420.49

0.500.50

0.510.60

0.650.70

0.740.74

0.770.78

0.840.91

0.910.99

1.241.30

1.491.89

2.222.29

2.683.82

4.114.21

4.945.65

7.048.57

10.3216.49

0 500 1000 1500 2000 2500


194

RES/ HEMATOPOETIC

169

PHARYNX, OTHERS

149

MALE BREAST

175

INTESTINE, OTHERS

159

PENIS

187

GUM

143

GALL BLADDER

156

ORAL, OTHERS

145

PERITONEUM158

OROPHARYNX

146

BONE

170

URINE BLADDER

188

CORPUS UTERI

182

NASOPHARYNX

147

RECTUM

154

FEMALE BREAST

174

PERSENTASE

JUMLAH


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DISTRIBUSI KANKER PADA PEREMPUAN MENURUT

KELOMPOK UMUR DI INDONESIA TH. 1994-1997

0

1000

2000

3000

4000

5000

6000

75

171 SOFT TISSUE

147 NASOPHARYNX

182 CORPUS UTERI

196 LYMPHNODE

154 RECTUM

193 THYROID

173 SKIN

183 OVARY

174 FEMALE BREAST180 CERVIX UTERI


17/60

DISTRIBUSI KANKER PADA LAKI-LAKI MENURUT KELOMPOK

UMUR DI INDONESIA TH. 1994-1997

0

100

200

300

400

500

600

700

800

900

1000

75

160 NASAL CAVITY

153 COLON

188 URINE BLADDER

162 LUNG

185 PROSTATE

171 SOFT TISSUE

154 RECTUM

196 LYMPHNODE

173 SKIN147 NASOPHARYNX


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FREKUENSI RELATIF KANKER PADA KEDUA JENIS

KELAMIN DI INDONESIA TH. 1994-1997

3041

3401

3453

4453

4523

4712

5061

6628

11583

16597

3.27

3.65

3.71

4.78

4.86

5.06

5.44

7.12

12.44

17.83

0 5000 10000 15000 20000

COLON

153

THYROID193

LYMPHNODE

196

NASOPHARYNX

147

FEMALE BREAST

174

PERSENTASE

JUMLAH


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FREKUENSI RELATIF KANKER PADA KEDUA JENIS KELAMIN DI

INDONESIA TH. 1994-1997

2

36

41

45

46

50

80

92

117

125

151

217

250

280

281

375

401

402

429

480

488

523

564

608

624

767

776

791804

827

857

869

932

951

1170

1548

1851

1865

2173

2219

3041

3401

3453

4453

4523

4712

5061

6628

11583

16597

0 .0 0

0 .0 4

0 .0 4

0 .0 5

0 .0 5

0 .0 5

0 .0 9

0.10

0.13

0.13

0.16

0 .2 3

0 .2 7

0 .3 0

0 .3 0

0 .4 0

0 .4 3

0 .4 3

0 .4 6

0.52

0.52

0.56

0 .6 1

0 .6 5

0 .6 7

0 .8 2

0 .8 3

0 .8 50 .8 6

0 .8 9

0 .9 2

0 .9 3

1.00

1.02

1.26

1.66

1.99

2 .0 0

2 .3 3

2 .3 8

3 .2 7

3 .6 5

3.71

4.78

4 .8 6

5.06

5.44

7.12

12.4 4

17.83

0 5000 10000 15000 20000

RESPIRATORY TR, OTHERS

165

HYPOPHARYNX

148

MALE BREAST

175

PLEURA

163

GALL BLADDER

156

GU M

143

SMALL INTESTINE

152

PERITONEUM

158

KIDNEY

189

GASTER

151

BRAIN

191

OROPHARYNX

146

CORPUS UTERI

182

URINE BLADDER

188

THYROID193

OVARY

183

FEMALE BREAST

174

PERSENTASE

JUMLAH


20/60

CANCER IN FEMALE IN INDONESIA IN1994-1997

2

2

2

16

17

19

20

22

28

59

60

65

86

122

124

145

156

161

192

230

267

271

276

278

280

281

344

352

366

386

401

430

482

485

493

641

767

1470

1530

1669

1851

1864

2139

2665

3456

4712

11582

16597

0.00

0.00

0.00

0.03

0.03

0.03

0.03

0.04

0.05

0.10

0.10

0.11

0.14

0.20

0.21

0.24

0.26

0.27

0.32

0.38

0.45

0.45

0.46

0.46

0.47

0.470.57

0.59

0.61

0.64

0.67

0.72

0.80

0.81

0.82

1.07

1.28

2.45

2.55

2.79

3.09

3.11

3.57

4.45

5.77

7.87

19.34

27.71

0 5000 10000 15000 20000

RESPIRATORY TR, OTHERS

16 5

PENIS

18 7

PHARYNX, OTHERS

14 9

INTESTINE, OTHERS

15 9

HEART

16 4

PLEURA

16 3

L IPS

14 0

LARYNX

16 1

RES/ HEMATOPOETIC

16 9

GU M

14 3

KIDNEY

18 9

GASTER

15 1

PLACENTA

18 1

TONGUE

14 1

BRAIN

19 1

UTERINE

17 9

BONE

17 0

URINE BLADDER

18 8

FEMALE TRACT, OTHERS

18 4

SOFT T ISSUE

17 1

CORPUS UTERI

18 2

RECTUM

15 4

S K I N

17 3

FEMALE BREAST

17 4

PERSENTASE

JUMLA H


21/60

THE BIG TEN CANCER IN MALE IN INDONESIA IN 1994-1997

907

1571

1688

1726

1863

1871

2314

2659

3172

3392

2.73

4.73

5.09

5.20

5.61

5.64

6.97

8.01

9.56

10.22

0 500 1000 1500 2000 2500 3000 3500 4000

NASAL CAVIT Y

160

LUNG

162

PROSTATE

185

RECTUM

154

SKIN

173

Series2

Series1


22/60

CANCER IN MALE IN DONESIA IN 1994-1997

19

22

24

29

30

58

64

65

65

80

105

152

159

183

245

246

258

268

293

357

424

441

460

478

491

515

521

588

608

688

788

808

907

1571

1688

1726

1863

1871

2314

2659

3172

3392

0.06

0.07

0.07

0.09

0.09

0.17

0.19

0.20

0.20

0.24

0.32

0.46

0.48

0.55

0.74

0.74

0.78

0.81

0.88

1.08

1.28

1.33

1.39

1.44

1.48

1.55

1.57

1.77

1.83

2.07

2.37

2.44

2.73

4.73

5.09

5.20

5.61

5.64

6.97

8.01

9.56

10.22

0 500 1000 1500 2000 2500 3000 3500 4000

PHARYNX, OTHERS

14 9


194

INTESTINE, OTHERS

15 9

HEART

16 4

PLEURA

16 3

GALL BLADDER

15 6

PANCREAS

15 7

PERITONEUM

15 8

OTHER LOCATIONS

19 5

ORAL, OTHERS

145

SAL IVARY

142

TONGUE

14 1

BRAIN

19 1

OROPHARYNX

14 6

TESTIS

186

THYROID

193

NASAL CAVITY

16 0

LUNG

16 2

PROSTATE

18 5

RECTUM

15 4

S K I N

17 3

PERSENTAS E

JUMLA H

F k i R l tif k k 1994 1998 (YK)


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Frekwensi Relatif kanker : 1994 1998(YK)

LAKI-LAKI PEREMPUAN

1 725 Mama 3216

2 Rektum 661 1993

3 608 Ovarium 921

4 Nasofaring 511 855

5 439 Tak diketahui 792

6 Soft tissue 380 638

7 367 Korpus uteri 503

8 Bladder 260 453

9 184 Kolon 407

10 Testis 163 286

11 Jaringan lunak 282


24/60

Frekwensi Relatif kanker : 1994 1998(Laki-laki, YK)

1. 725

2. Rektum 661

3. 608

4 Nasofaring 511

5 439

6 Soft tissue 380

7 3678 Bladder 260

9 184

10 Testis 163


25/60

Cancer epidemiology


26/60

Tumor penting pada laki-laki

NASOFARING


27/60


PROSTAT


28/60


PARU


29/60


KANDUNG KEMIH


30/60


REKTUM


31/60


KULIT


32/60

Tumor penting pada perempuan

PAYUDARA


33/60


LEHER RAHIM


34/60


OVARIUM


35/60


KOLON


36/60


JARINGAN LUNAK


37/60

Frekwensi Relatif kanker : 1994 1998(Perempuan YK)

1. Mama 3216

2. 1993

3. Ovarium 921

4. 8555. Tak diketahui 792

6. 638

7. Korpus uteri 503

8. 4539. Kolon 407

10 . 286

11. Jaringan lunak 282


38/60

HEREDITY & CANCER

Question

Is cancer inherited?

EvidenceLung cancer in most instances clearly related tocigarette smoking, yet,

mortality to lung cancer has been shown to be four

times greater among non-smoking relatives(parents & siblings) of lung cancer patients thannon-smoking relatives of controls


39/60

Hereditary forms of cancers

can be divided into 3 categories:

1. Inherited Cancer Syndromes

(autosomal dominant)2. Familial Cancers

3. Autosomal Recessive Syndromes of

Defective DNA Repair


40/60

HEREDITAS & KANKER

Pertanyaan

Is cancer inherited?

Kejadian Untuk Ca paru pada umumnya hubungannyadengan merokok cukup jelas

Mortalitas Ca paru empat kali lebih besar pada

keluarga penderita yang merokok (orang tuadan saudara sekandung), dibandingkan dengankontrol


41/60

Diseases associatedwith cigarette smoking


42/60

Bentuk herediter kanker dapat

dibedakan menjadi 3 kategori


(autosomal dominant)

2. Familial Cancers

3. Autosomal Recessive Syndromes of

Defective DNA Repair


43/60

1.Inherited Cancer Syndromes


Satu gena mutan diturunkan sangat mening-katkan risiko terjadinya tumor

Predisposisi tumor ini menunjukkan gambaranpola keturunan dominan autosomal

Indikasi predisposisi yang diturunkan ini tampakdari riwayat keluarga yang jelas/kuat pada kasus

tumor yang jarang, dan/atau hubungannyadengan fenotipa marker


44/60

1.Inherited Cancer Syndromes


Jenis tumor

Familial retinoblastomaFamilial adenomatous polyposis of the colon

Multiple endocrine neoplasia syndromes (MEN)

Neurofibromatosis type 1 and 2

Von HippelLindau Syndromes


45/60

1. InheritedCancer Syndromes

A. RETINOBLASTOMA

Carriers of mutant Rb genehave a 10,000 foldincreased risk of developingretinoblastoma (familialtype)

greatly increased of

developing second cancer(ostreosarcoma)


46/60

B. Multiple endocrine neoplasia (MEN)

The familial occurrence of the combination of:

medullary thyroid Ca, bilateral pheochromocy-tomas, hyperparathyroidism (due to tumor)

Mutation of ret proto-oncogene that istransmitted in the germ-line



47/60


C. Neurofibromatosis type 1 and 2Von Recklinghausen

- multiple benign neurofibromas, cafe au lait

spot, iris hamartoma, increased risk of

developing fibrosarcomas

- mutation of NF-1 and NF-2 (tumor suppressor

genes which functions as a GAP protein thatinactivates ras)


48/60

D. Familial Adenomatous PolyposisColi

Another hereditary disorder marked byan extraordunarily high risk of cancer

Autosomal dominant mutation from birthinnumerable polypoid adenomas

mostly develop colon Ca by age of 50


Adenoma-Carcinoma Sequence


49/60

Adenoma-Carcinoma Sequence


50/60


E. Von Hippel-Lindau Syndrome

Germ line mutation of VHNgene on

chromosome 3p hereditary renal cell

cancer, phaeochromocytoma, hemangio-

blastoma of the CNS, retinal angioma,

renal cyst


51/60

2. Familial Cancers

Evident familial clustering of cancer but role of

inherited predisposition may not be clear in an

individual case Breast Cancer

Ovarian cancer

Colon cancer other than familial

adenomatous polyps


52/60

3. Autosomal Recessive

Syndromes ofDefective DNA Repair

1.Xeroderma pigmentosum2.Ataxia telangiectasia

3.Bloom syndrome

4.Fancony anemia


53/60

1.Xeroderma pigmentosum- autosomal recessive disorder

hypersensitive to UV

- increased incidence of skin cancers

- defect in genes that function in nucleotide

excision repair, which is required for repair

of UV-induced pyrimidine dimers

3.Autosomal Recessive Syndromes of Defective DNA Repair


54/60


Ataxia Telangiectasia AT gene

(mutation in single gene)

Gradual loss of Purkinje cells Immunodeficiency

Acute sensitivity to ionizing radiation

Profound susceptibility to lymphoid

malignancies


55/60


Bloom Syndrome

Hypersensitivity to ionizing

radiation

Developmental defects

Predisposition to cancer


56/60


Fanconi anemia

Hypersensitivity to DNA cross-

linking agents (nitrogen mustard)

Anemia

Predisposition to cancer


57/60

Acquired Pre

neoplastic Disorders

Cell replication is involved in canceroustransformation

Fertile soil for the origin of malignant neoplasm:

- regenerative proliferation: hepatoma- hyperplasia: endometrium

- dysplasia: cervical

- metaplasia: bronchogenic Ca the risk to develop neoplasm is

greater than average


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Certain non-neoplastic disorder pre-neoplastic

- chronic atrophic gastritis

- solar keratosis

- leukoplakia

The great majority of instances no malignant

neoplasm emerges the term persists becauseit calls attention to the increased risk

Acquired Preneoplastic Disorders

The q estion then


59/60

The question then .

Is there any risk with all benign neoplasms?

although some risk may be inherent, most benignneoplasm neoplasms do not become cancerous.

Some malignant tumors were developed from benign

tumors: leiomyoma leiomyosarcoma, pleomorphic

adenoma

CaWas the tumor an indolent form of cancer from the outset,

or was there a malignant focus in the benign tumor?

Generalization is impossible because each type of

benign neoplasm is associated with a particular level ofrisk ranging from almost zero to frequently present


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ten big rank of cancer in indonesia 2009 edit

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