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Cancer Excess as a Marker of Disparity: The Case of Occupational and Environmental Cancer

Explore the connection between occupational and environmental factors and cancer disparity, highlighting the need for prevention and early detection.

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Cancer Excess as a Marker of Disparity: The Case of Occupational and Environmental Cancer

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  1. Cancer Excess as a Marker of Disparity: The Case of Occupational and Environmental Cancer Melissa A. McDiarmid, MD, MPH, DABT University of Maryland School of Medicine Division of Occupational and Environmental Medicine World Health Organization Collaborating Centre for Occupational Health

  2. World Health Organization Collaborating Centre for Occupational Health Health Disparity …definitions vary but most address differences in health status between one population in comparison to a more advantaged group. (Carter-Pokras & Baquet, 2002) …most address issues of equity

  3. Excess as Disparity Too much of a bad thing regarding health status…

  4. Cancer Facts • 1.5 million new cancer cases in 2013 (WHO) • 70% increase in new cases over next 2 decades • Majority of increase in LMICs • ILO estimates ~70,000 occupational cancer deaths annually • Occupational cancer is the biggest killer at work in High Income Countries (WHO Classification) https://goo.glo/fuUXsl August 2013

  5. Preventing Disease Through Healthy Environments • Annually about 19% of all cancers are attributed to environmental/occupational exposure • Resulting in 1.3 million deaths • Occupational exposures cause 5.3 – 8.4% of all cancers, and among men, up to 30% of all lung cancer deaths.

  6. Environment Health Threats • Arising from: • Manufacturing • Energy production • Fossil fuel consumption • Unsustainable resource use • Agriculture • These activities are associated with growing problems of: • Hazardous waste • Air and water pollution • Occupational exposures • Climate change • Unequal capabilities in technology and infrastructure Slide shared by W. Suk

  7. Distribution of Work-related illness by WHO regions https://www.wsh-institute.sg/files/wshi/upload/cms/file/Global%20Estimates%20of%20Occupational%20Accidents%20and%20Work-related%20Illness%202014.pdf

  8. Most frequent carcinogens and exposures at work in the United States 85% of the cancer cases come from the top ten chemical agents

  9. National Institutes of Health U.S. Department of Health and Human Services

  10. Global Infections and Cancer • ~16% of newly diagnosed cancers may be attributable to infections. • Mechanisms of cancer induction: interactions between the environment, host genetics, and other factors. • Less-developed countries had a higher percentage of infection-related cancers. Slide shared by W. Suk

  11. No country can treat it’s way out of this problem... What is our response? prevention is key. K. Straif, IARC/CR

  12. Policy and Advocacy Planning Diagnosis and Treatment Prevention Palliative Care Early Detection

  13. Bernardino Ramazzini

  14. Scientific Session III: Cancer Disparities, Occupational and Environmental Risks and Prevention Strategies • CT screening for lung cancer: an unprecedented opportunity to reduce occupational cancer mortality Steven Markowitz, USA • Low dose chest CT in asbestos-exposed workers Laura Welch, USA • Cancer excesses in Ramazzini Institute clinical cohort Angela Guaragna, Italy • The role of general practitioners in contrasting cancer care disparities Pier Giorgi Natali, Italy

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