Cancer is a dreadful disease.But like any other disease it depends on certain risk factors which predisposes certain people to have it and certain people to not have it.This slide shows details of a project undertaken by 20 medical students of the reputed Nil Ratan Sircar Medical College of Kolkata, so as to understand cancer and associate it with its risk factors. This study has been conducted in NRS itself selecting various groups of cancer and non cancer patients with varying pathologies.This project attempts to establish the fact that simple lifestyle modifications may reduce your chances of actually acquring Cancer.Simple changes in diet like avoiding junk food can actually lower the risk of getting Colon Cancer. So please go through the slides so as to get a perspective of the disease and what simple measures can be taken, on your behalf to avoid it.

1. `
Risks Of Cancer

2. INTRODUCTION
Risks Of Cancer
•Cancer, a malignant neoplasm, is a broad group of diseases, all involving
uncoordinated and unregulated cell growth, often leading to fatality.
•Carcinogens are a class of substances that are directly responsible for
damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic,
radiation, sun, exhaust fumes- all these attribute to the formation of cancer.
• As we age, there is an increase in the number of possible cancer causing
mutations in our DNA, making it an important risk factor.

3. Risks Of Cancer
•The importance of studying the risk factors lies in the fact that
many cancers are closely linked to certain behaviours that are
easiest to prevent.
•While few diagnosed cancers can be traced to heredity, most
have their origins in an individual’s lifestyle choices and
environmental factors leading to cancer maybe dietary factors,
use of tobacco products and alcohol, obesity, lack of sufficient
physical activity, pollutants, physical agents, infections, stress,
radiation and sunlight.

4. OBJECTIVES OF THE STUDY
• TO FIND OUT THE VARIOUS RISK FACTORS OF CANCER
• TO FIND OUT THE MOST PREVALENT CANCERS AMONG THE
PATIENTS ATTENDING NRSMCH
• TO ASSESS THE VARIOUS SOCIO-DEMOGRAPHIC FACTORS IN
RELATION TO THE CANCERS
• A COMPARISON OF THE CANCER V/S NON CANCER PATIENTS
TO UNDERSTAND THE PRECIPITATING FACTORS
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5. MATERIALS AND METHODS
• TYPE OF STUDY-OBSERVATIONAL,DESCRIPTIVE
• STUDY DESIGN-CROSS SECTIONAL, DESCRIPTIVE
• STUDY AREA- NRSMCH HOSPITAL WARDS
• TIME OF STUDY-1 MONTH
• STUDY POPULATION-PATIENTS ATTENDING NRSMCH
• SAMPLE SIZE-400
• SAMPLING-PURPOSIVE SAMPLING
• TOOL USED-PREDESIGNED AND PRETESTED SCHEDULE
• TECHNIQUES-INTERVIEW AND RECORD ANALYSIS
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6. DEPENDING ON THE RISK FACTORS USUALLY
ASSOCIATED WITH THE MAJORITY OF CANCERS, WE
BASED OUR STUDY ON THE FOLLOWING PARAMETERS
• Demographic Details
• Diet History
• Lifestyle
• Addiction History
• Obstetric & Gynaecological History
• Occupation And Environment History
• Provisional Diagnosis of the Cases
• Past History
• Family History
Risks Of Cancer

7. TABLE NO 1- DISTRIBUTION OF STUDY
POPULATION ACCORDING TO AGE
AGE(yrs) CANCER
<12 38(19%)
12-18 10(5%)
19-40 52(26%)
41-60 80(40%)
>60 20(10%)
TOTAL 200(%)
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N=400

8. TABLE NO 2- DISTRIBUTION OF STUDY
POPULATION ACCORDING TO GENDER
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PATIENTS MALE FEMALE TOTAL
NON-CANCER 95(46.8%) 105(53.3%) 200
CANCER 108(53.2%) 92(46.7%) 200
TOTAL 203 197 400
N=400

9. TABLE NO 3- DISTRIBUTION OF STUDY POPULATION
ACCORDING TO RESIDENCE/LOCALITY
LOCALITY NON CANCER CANCER
URBAN 72 (36%) 50(25%)
RURAL 128(64%) 150(75%)
TOTAL 200(100%) 200(100%)
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N=400

10. TABLE NO 4 – DISTRIBUTION OF STUDY
POPULATION ACCORDING TO OCCUPATION
OCCUPATION CANCER
SERVICE 19(9.5%)
BUSINESS 10(5%)
MANUAL LABOUR 81(40.5%)
RETIRED 18(9%)
NA(PAED) 25(12.5%)
HOME-MAKER 41(20.5%)
STUDENT 6(3%)
TOTAL 200(100%)
N=400

11. TABLE NO 5 – DISTRIBUTION OF STUDY
POPULATION ACCORDING TO PER CAPITA
INCOME
PER CAPITA
INCOME CANCER
<MEAN
(Rs 3532) 180(90%)
>MEAN
(Rs 3532) 20(10%)
TOTAL 200(100%)
N=400

12. Risks Of Cancer

13. TABLE NO 6– DISTRIBUTION OF STUDY
POPULATION ACCORDING TO DIET
N=400
CANCER
9(4.5%)
191(95.5%)
200(100%)
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14. TABLE NO 7- DISTRIBUTION OF STUDY POPULATION
ACCORDING TO CONSUMPTION OF JUNK FOOD
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CANCER
123(61.5%)
77(38.5%)
200(100%)
N=400

15. TABLE NO 8 – DISTRIBUTION OF STUDY POPULATION
ACCORDING TO CONSUMPTION OF ARTIFICIALLY
COLOURED SUBSTANCES
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N=400
CONSUMPTION OF
COLOURED FOOD
CANCER
57(28.5%)
143(71.5%)
200(100%)

16. TABLE NO 9 – DISTRIBUTION OF STUDY
POPULATION ACCORDING TO LIFESTYLE
Risks Of Cancer
LIFESTYLE CANCER
SEDENTARY 117(58.5%)
ACTIVE 83(41.5%)
TOTAL 200(100%)
N=400

17. ADDICTION HISTORY
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ALCOHOLISM
SMOKING TOBACCO

18. SMOKING NON CANCER CANCER
YES
•present
•past
43(21.5%)
29
14
54(27%)
43
11
NO 157(78.5%) 146(73%)
TOTAL 200(100%) 200(100%)
TABLE NO 10- DISTRIBUTION OF STUDY
POPULATION ACCORDING TO INCIDENCE OF
SMOKING
N=400

19. Risks Of Cancer
MATERIAL NON-CANCER CANCER
BIDI 21(72.4%) 32(74.4%)
CIGARETTE 8(27.6%) 11(25.6%)
TOTAL 29 43
TABLE NO 11 – DISTRIBUTION OF CURRENT SMOKERS
ACCORDING SMOKING MATERIALS
N=72

20. Risks Of Cancer
TABLE NO 12 – DISTRIBUTION OF PAST SMOKERS
ACCORDING SMOKING MATERIALS
MATERIAL NON-CANCER CANCER
BIDI 12(85.7%) 8(72.7%)
CIGARETTE 2(14.3%) 3(27.3%)
TOTAL 14 11
N=25

21. TABLE NO 13 – DISTRIBUTION OF STUDY
POPULATION ACCORDING TO TOBACCO
CONSUMPTION
CANCER
27(13.5%)
20
7
173(86.5%)
200(100%)
N=400

22. TABLE NO 14- DISTRIBUTION OF STUDY POPULATION
ACCORDING TO ALCOHOL CONSUMPTION
ALCOHOL CANCER
YES
•present
•past
19(9.5%)
14
5
32(16%)
23
9
NO 181(90.5%) 168(84%)
TOTAL 1(6.25%) 2(11.76%)
N=400

23. OBSTETRIC AND
GYNAECOLOGICAL
HISTORY
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24. TABLE NO 15-DISTRIBUTION OF
FEMALE PATIENTS ACCORDING
TO OBSTETRIC HISTORY -
PARITY
N=197
PARITY NON CANCER CANCER
≤2 47(44.8%) 45(48.9%)
>2 24(22.9%) 27(29.3%)
Not Applicable 34(32.4%) 20(21.7%)
TOTAL 105 92

25. Risks Of Cancer
AGE AT 1ST PREGNANCY NON CANCER CANCER
≤20 43(40.9%) 41(44.6%)
21-30 21(20%) 20(21.7%)
>30 7(6.6%) 11(11.9%)
Not Applicable 34(32.4%) 20(21.7%)
TOTAL 105 92
TABLE NO 16-DISTRIBUTION
OF FEMALE
PATIENTSACCORDING TO
OBSTETRIC HISTORY – AGE
AT 1ST PREGNANCY
N=197

26. Risks Of Cancer
TABLE NO 17-DISTRIBUTION
OF FEMALE PATIENTS
ACCORDING TO MENSTRUAL
HISTORY
MENSTRUAL HISTORY NON CANCER CANCER
PRE MENSTRUAL 19(18%) 14(15.2%)
MENSTRUATING 66(62.8%) 37(40.2%)
POST MENOPAUSAL 20(19%) 41(44.6%)
TOTAL 105 92
N=197

27. Risks Of Cancer
TABLE NO 18-DISTRIBUTION
OF FEMALE PATIENTS
ACCORDING TO
CONTRACEPTIVE HISTORY
CONTRACEPTIVE
HISTORY
NON CANCER CANCER
YES
•OCP
•IUCD
22
18
4
10
10
0
NO 83 82
TOTAL 105 92
N=197

28. Risks Of Cancer
TABLE NO 19 - DISTRIBUTION
OF FEMALE PATIENTS
ACCORDING TO
GYNAECOLOGICAL HISTORY
GYN. DISORDER NON CANCER CANCER
WHITE DISCHARGE 24(22.9%) 13(14.1%)
OTHER ILLNESS 6(5.7%) 1(1%)
ABSENT 75 78
TOTAL 105 92

29. 0%
10%
20%
30%
40%
50%
60%
70%
<28.87yrs >28.87yrs
55%
45%
22.95%
65.85%
NON CANCER CANCER
FIGURE NO 1 – STUDY
OF PREPONDERANCE OF
CANCERS IN POST
MENOPAUSAL WOMEN
ON THE BASIS OF
NUMBER OF
MENSTRUATING YEARS
N=61
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30. Systems Affected Cancer(%)
Haematopoietic System 22.5
Respiratory System 7
Gastro Intestinal
System
21.5
Excretory System 1
Reproductive 33
Central Nervous System 4.5
Musculo Skeletal
System
2
Endocrine System 0
Vascular System 2
Oropharyngeal System 6.5
TOTAL 100
TABLE NO 21- DISTRIBUTION OF THE CANCER PATIENTS
ACCORDING TO SYSTEMS AFFECTED
N=200

31. TABLE NO 22- DISTRIBUTION OF THE CANCER PATIENTS
ACCORDING TO TYPES OF CANCER
CANCER PERCENTAGE
ALL 11%
AML 4.5%
CA BREAST 16%
CA CERVIX 4%
CA OVARY 5%
CA ENDOMETRIUM 4%
CA LUNG 6.5%
CA BRONCHUS 1.5%
CA STOMACH 9%
CA COLON 3.5%
CA RECTUM 5%
ORAL CANCER 6%
BRAIN TUMOUR 4%
CA GALL BLADDER 2.5%
Other cancers include CA Bladder , CA prostrate, CA parotid, melanomas and lymphomas.

32. TABLE NO-23 HISTORY OF SIGNIFICANT DISEASES OR PRE
CANCEROUS LESIONS IN CANCER PATIENTS
*multiple response present
HISTORY CANCER PATIENTS
1. HISTORY OF CANCER 7(3.5%)
2.ORAL LESIONS 9(4.5%)
3.BENIGN BREAST DISEASE 20(10%)
4.HISTORY OF PREVIOUS SURGERY 42(21%)
5.TUBERCULOSIS 0
6.DIABETES MELLITUS 7(3.5%)
7.JAUNDICE 25(12.5%)
8.HYPERTENSION 13(6.5%)
9.HEART DISEASE 4(2%)
10.HYPERCHOLESTEROLEMIA 3(1.5%)
11.OTHER CHRONIC DISORDERS 16(8%)
12.NO HISTORY 59(29.5%)
NN=200

33. Risks Of Cancer
1ST DEGREE RELATIVE
12(18.2%)
4(9.3%)
1(6.7%)
2(4.4%)
1(3.2%)
20
TABLE NO 24 – DISTRIBUTION OF CANCER
PATIENTS ACCORDING TO FAMILIAL
PREDISPOSITION OF CANCERS

34. SUMMARY
The following observations have come up in our study:
• Cancer predominance maximum(40%) in the 41-60 age group
• In our study population, rural people affected 3 times more with
cancer than urban people
• Cancer incidences maximum in the labourer class, followed by
housewives and children
• More than 90% of both cancer and non cancer patients came
from lower socio economic backgrounds
Risks Of Cancer

35. Risks Of Cancer
•95.5% of the cancer patients were non vegetarians
•Greater percentage of cancer patients consumed junk and
coloured foods than non cancer patients
•More than 50% of cancer patients lead sedentary lives.
•About 1/4th cancer patients either smoke or have a history of
smoking, mostly bidis
•Tobacco- a common addiction in about 13% cancer cases
•16% of cancer patients consume alcohol compared to 9.5% non
cancer cases
…continued

36. …continued
• Cancer incidence found to increase by about 4% in parity<2
• Percentage of cancer patients is almost double than that of non
cancer patients, when age of 1st pregnancy is >30 yrs.
• 30% more cancer cases observed than non cancer in post
menopausal women, with such chances being almost thrice with
prolonged reproductive life, i.e. late menopause.

37. …continued
• 16% of cancer patients with CA breast, majority had
history of benign breast disease
• ALL next common; notable 9% with CA stomach , 6% with
lung and oral cancers
• 20% of cancer cases with history of previous surgery
• Family history of cancers maximum in reproductive system
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38. PROBLEMS IDENTIFIED
• Lack of awareness about the risks of cancer among the
patients and how to avoid them
• Negligence for treatment , on the part of the patients ,
observed in many cases
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39. RECOMMENDATIONS AND CONCLUSION
• Decrease consumption of junk food and artificially coloured
food
• Regular walking , exercise or other forms of physical activity
• Abstain from smoking, taking tobacco , drinking alcohol and
using other addictives
• Limit number of children to two
• Avoid long hours under sun, use protective measures
• Avoid contact with harmful chemicals or such, as much as
possible, or take proper precautions
Finally, we can conclude that with the proper knowledge and
necessary precautions, chances of cancers can be reduced, if
not abolished.

40. LIMITATIONS
• Study conducted only amongst patients attending
NRSMCH
• Hospital based and not community based study
• No follow up on the cases
• Most patients belonged to middle and lower
income groups
• Calculations may have had analyzing mistakes
• Some of the patients were non cooperative
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41. REFERENCES
• www.google.com
• Wikipedia
• PARK’S Textbook of Preventive And Social Medicine
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42. ACKNOWLEDGEMENTS
We would like to thank
• Dr. Anima Halder, Head, Department of Community
Medicine
• Our guide and teacher, Dr. Sonali Sain, Department of
Community Medicine
• Departments of Radiology , Haematology , Surgery ,
Gynaecology , Paediatrics , Medicine , Orthopaedics
• The patients and their families
• All the students who did this project
Risks Of Cancer