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TOBACCO AND CANCERS OF THE DIGESTIVE TRACT

Increase student knowledge on cancers from tobacco use, identify carcinogens in smoke, understand risks for digestive cancers and urge smoking cessation for better cancer management.

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TOBACCO AND CANCERS OF THE DIGESTIVE TRACT

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  1. TOBACCO AND CANCERS OF THE DIGESTIVE TRACT Mini Lecture 3 Module: Tobacco Effects and Neoplasia

  2. Objectives of the Mini Lecture GOAL OF MINI LECTURE: Increase students’ knowledge of the risks of developing cancer associated with tobacco use. LEARNING OBJECTIVES: Students will be able to: • Identify carcinogens in cigarette smoke and mechanisms of carcinogenesis • Understand how tobacco is a risk factor for digestive cancers, lung cancer, and urogenital cancer • Appreciate the adverse effects of smoking on cancer management and the need for smoking cessation

  3. Contents Core Slides • Tobacco and Digestive Cancers • Tobacco and Digestive Cancer Risk (1) • Tobacco and Digestive Cancer Risk (2) • Smokeless Tobacco and GI Cancers • Alcohol and Smoking: Combined Effects • Alcohol and Smoking: Combined Rehabilitation

  4. CORE SLIDES Tobacco and GastrointestinalCancers Mini Lecture 2 Module: Tobacco Effects and Neoplasia

  5. Tobacco and Digestive Cancers Types of digestive cancers caused by tobacco use are: • Oral cancers • Pharynx • Larynx • Oesophagus • Liver • Pancreas • Stomach • Large intestine • Rectum 1. Polesel et al. 2008

  6. Tobacco and Digestive Cancer Risk (1) • Smoking is a strong risk factor for oesophageal squamous-cell carcinoma and cardia adenocarcinoma.1 • Individuals who smoke 25 or more cigarettes per day have a seven-fold increased risk of oral and pharyngeal cancer compared with nonsmokers.2 • There is a direct association between smoking and the risk of hepatocellular carcinoma.2 www.stjohn.org/MacombIR/Chemoemb/ 1. Lagergren et al. 2000; 2. Pelucchi et al. 2006

  7. Tobacco and Digestive Cancer Risk (2) • Smoking greatly increases the risk of dying from stomach cancer.1 • Even smoking just 2 cigarettes per day increases the risk of oral, pharyngeal and oesophageal in smokers.2 • Those who stopped smoking remained at increased risk of colon cancer even if they stopped over 10 years ago.3 http://www.elements4health.com/images/stories/conditions/digestive-system.jpg 1. American Cancer Society 2002; 2. Polesel et al. 2008; 3. Slattery et al.1997

  8. India Smokeless Tobacco andGI Cancers in India • Over 90% of oral cancer in India is attributable to tobacco use.1 • Chewers are also at risk for stomach cancer.2 www.drugsandpoisons.com/2006_11_01_archive.html 1. Dikshit and Kanhere 2000; 2. Phukan et al. 2005

  9. Alcohol and Smoking:Combined Effects • Alcohol is a cancer promoter via one or more of the following mechanisms: • Increased permeability of mucosal cells to tobacco smoke carcinogens due to solubilization by alcohol; • Presence of low levels of carcinogenic substances in alcoholic beverages; or • Cellular injury produced by ethanol metabolites. • Alcohol, when combined with cigarette smoke, significantly increases the risk of cancer in the upper aero-digestive tract. 1. Schlecht et al.1999

  10. Alcohol and Smoking:Combined Rehabilitation • The dramatic added cancer morbidity and subsequent mortality associated with smoking and drinking provides a strong argument for targeting public health campaigns to curb the effect of both exposures simultaneously. 1. Schlecht et al.1999

  11. The most important health message a doctor can give to patients is to quit smoking.

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