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FAQs About Cancer

What is cancer?
What causes cancer?
What are the most common types of cancer?
Who gets cancer?
How can I find out more about a particular cancer?
What can I do to lower my risk of developing or dying from cancer?
What is a population based Cancer Registry?
What is the NICRs method of operation?
What is the latest year of complete cancer registration data?
Does the NICR investigate claims of cancer clusters in certain areas?
How many newly diagnosed cancer cases are there in Northern Ireland each year and how many deaths are there from cancer on an annual basis?
Is cancer hereditary?
How do the rates of cancer in Northern Ireland compare with the rest of the UK and Ireland?
What is meant by the behaviour of a tumour?

What is cancer?

Our body cells are continually growing, dying and being replaced.  Cancer is the result of a breakdown in the normal growth of body cells.  Normal growth is regulated by our genes.  Some genes programme for cell growth (oncogenes) while others stop growth (tumour suppressor genes).  There are several ways in which a normal cell can become a cancerous cell:

  • The growth, oncogenes, may become overactive.
  • The tumour suppressor gene is underactive or even switched off completely.
  • The rate of change from normal to faulty genes is increased.  This may be due to a fault in the way the body repairs faulty genes or increased damage to genes, as occurs with carcinogens such as tar products from tobacco.

Whether a damaged cell becomes a cancer is a complex process, involving changes in several types of genes.  Whether a cancer cell spreads depends on the type of cancer, local inflammation, immune response and tumour promoting growth factors.

Once a tumour is established, it may spread locally and to other sites/parts of the body (metastasise).  Treatment depends on the tumour, its size and whether it has spread or not.  Treatments include surgery, radiation, and drugs (chemotherapy).

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What causes cancer?

Cancer can develop as a result of factors related to environment, lifestyle, and heredity. While our current understanding of the causes of cancer is incomplete, many risk factors that increase the possibility of getting cancer have been identified. These include:

  • Age (50% of all cancers are diagnosed in patients aged 69 years and over);
  • History of cancer in the family;
  • Tobacco use;
  • Excessive alcohol consumption;
  • Lack of balanced diet, in particular insufficient consumption of fruit and vegetables;
  • Lack of physical activity and/or obesity;
  • Ultraviolet radiation from sunshine or sunbeds;
  • Exposure to certain chemicals such as asbestos, benzene or radon gas;
  • Exposure to ionising radiation;
  • Infections such as human papillomavirus, Hepatitis B, Helicobacter Pylori;
  • Treatments such as exposure to oestrogen through Hormone Replacement Therapy;
  • Late or lack of reproduction in women;
  • Lack of breast feeding in women;

Many of these risk factors can be avoided however others, such as age and inherited risk factors, are unavoidable. However, as we age we can help protect ourselves by avoiding further risk factors where possible and by getting regular checkups so that, if cancer develops, it is likely to be found early. Of the remaining avoidable factors some, such as tobacco use, can increase the risk of getting cancers of the lung, mouth, throat, oesophagus, stomach, pancreas, kidneys, bladder and cervix by a significant amount while others increase the risk only by a slight margin.

Commonly discussed possible causes such as non-ionising radiation (such as that from mobile phones) or other electromagnetic fields (such as those emitted by electricity pylons) have not been proven to have a carcinogenic effect.

Further details on risks and protective factors for each of the main cancers can be found under Cancer Causes and Prevention Section.

Further information on causes can be found at Cancer Research UK.

 

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What are the most common types of cancer?

Non Melanoma Skin Cancer, which is easily treated and rarely causes death, accounts for a quarter of all cancers diagnosed in N. Ireland. In males, the serious cancers of the trachea, bronchus and lung account for 1 in 8 of all cancers diagnosed, with an average of 615 cases diagnosed each year between 2006 and 2010. In females a fifth of all cancers diagnosed are breast cancer, with an average of 1,149 cases diagnosed each year between 2006 and 2010. Lung cancer in females accounts for 8% (411 per year) of all cases diagnosed in women. Most Common Cancers 2006-2010 download.

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Who gets cancer?

Unfortunately almost anyone can develop cancer, even children and young adults who lead active, healthy lives.  The largest number of cancers occur in the 65+ age group.

Incidence of cancer among people aged 65 years and over N. Ireland

Incidence of cancer by age – 2006-2010 N. Ireland

The number of cases of cancer has increased 34% between 1993 (8,397 cases) and 2010 (11,269 cases).

The increase is because of:

1. More people in the population.
2. More older persons in the population (cancer is more common in older persons).
3. Increases in particular cancers such as prostate cancer - 473 cases in 1993 increased to 942 cases in 2010.

  • Those who smoke have a much higher risk of developing cancer, especially cancers of the lung, throat, mouth, stomach, oesophagus (gullet), pancreas, kidney and  bladder.  In most developed countries, tobacco accounts for as much as 30% of all malignant tumours (World Health Organization).
  • Some infections also increase the risk of cancer, Human papilloma Virus (HPV) increases the risk of cancer of the cervix (neck of the womb) there is a vaccine for this.  Information on the HPV vaccine can be found on the Public Health Agency website.
  • Hepatitis B infection is associated with an increased risk of Liver cancer.  There is a vaccine for this.
  • Helicobacter Pylori infection is associated with an increase in Stomach cancer there is drug treatment, triple therapy to eliminate H. Pylori infection.

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How can I find out more about a particular cancer?

Cancer Focus Northern Ireland has a very useful website, they also offer a Freephone cancer helpline service on 0800 783 3339 from 9.00am - 1.00pm Monday - Friday and a stop smoking service.

Cancer Research UK has a wealth of information about the charity and about cancer on their website.

National Cancer Institute in the US also has a very informative website.

OncoLink offers multimedia information regarding all aspects of cancer and cancer therapy.  Aims to promote cancer research, to educate and to care for patients with cancer.

Action Cancer provides general information about common cancers, as well as detailing organisation activities such as campaigns, fundraising and events. 

Macmillan Cancer Support provides practical, medical and financial support and pushes for better cancer care.

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What can I do to lower my risk of developing or dying from cancer?

Information on Cancer Causes and Prevention can be found here.

In order to help prevent cancer it is advised to follow the European Code Against Cancer.  

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What is a population based Cancer Registry?

A population based cancer registry aims to collect data on all malignant and certain non-malignant tumours diagnosed in its catchment population.  The data includes details on the patient, the tumour and treatment, and deaths.  Procedures for cancer registration are widely established throughout the world and generally follow guidelines established by bodies such as the Union for International Cancer Control (UICC), the International Agency for Research on Cancer (IARC), the International Association of Cancer Registries (IACR) and the World Health Organization (WHO).

Population based cancer registries are an important tool for the monitoring of time trends and geographical variations in cancer incidence.  In 1989 a working group for the English Registrar General's Medical Advisory Committee noted that in addition to these traditional uses of cancer registration the system had become vital in several other areas:  These included:

  1. the management of the substantial resources required for the preventative, curative and laboratory services for cancer;
  2. the planning and evaluation of clinical management and treatment based on accurate and unbiased survival data and clinical trials;
  3. research into causes of cancer, involving case control studies and the flagging of cohorts and information for health education and health promotion for both professionals and the public.

Future uses of cancer registration (especially if linked with other databases) were identified including evaluating programmes of care, quality assurance and relating costs to clinical outcome.  Cancer registration is also essential for participation in international research into the aetiology and epidemiology of cancer.

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What is the NICR's method of operation?

The Cancer Registry collects its information electronically using the hospital Patient Administration System (PAS), the Pathology Laboratory System, the hospital multidisciplinary team meeting system (CaPPS) and to a lesser extent, the Death Certificates and Radiology Systems.  Approximately 90,000 notifications are recorded annually for 10,000 patients (including 2,500 non-melanoma skin cancers).  The data are checked electronically, for errors such as wrong site/morphology combinations and wrong sex/site combinations, using programmes from the International Association for Research on Cancer (IARC) and the Surveillance, Epidemiology and End Results (SEER) programme in the USA.

Notifications are then matched to identify duplicates or new cases.  In the majority of cases, each notification received from PAS will have a pathology or cytology report confirming the diagnosis.  However, some cancer patients e.g. some lung cancer patients, may not have a microscopically verified tumour as material for a biopsy may be difficult to obtain.  Trained Registry staff examine the hospital notes for these 'PAS only' cases so that exact date and method of diagnosis can be assigned to the patient.  Additional information is also sought from GP records or cases notified to the Registry solely from death registrations.  Once this checking process is complete the records are anonymised for analysis.

The Registry has held cancer information on our population of 1.8 million since 1993 and has produced numerous reports.

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What is the latest year of complete cancer registration data?

The NICR has complete incidence data for 1993 to 2010 and mortality data for 1993 to 2010. Survival data is available for comparison for 1993-1995, 1996-2000 and 2001-2005 with estimates for 2006-2010.  See online statistics.

Data for 2011 is expected to be released early 2013.

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Does the NICR investigate claims of cancer clusters in certain areas?

Yes, please see the section on Cancer Clusters.

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How many newly diagnosed cancer cases are there in Northern Ireland each year and how many deaths are there from cancer on an annual basis? 

 

Trends in cancer incidence and mortality

 

Incidence

Mortality

Year

Number of cases

Crude rate per 100,000 persons

Number of cancer deaths

Crude rate per 100,000 persons

1993

8,397

513.4

3,640

222.6

1994

8,313

505.7

3,621

220.3

1995

8,282

502.2

3,606

218.7

1996

8,668

521.6

3,615

217.5

1997

8,501

508.7

3,603

215.6

1998

8,604

512.8

3,668

218.6

1999

8,611

512.9

3,555

211.7

2000

8,734

519.0

3,562

211.7

2001

8,746

517.7

3,673

217.4

2002

9,192

541.8

3,665

216.0

2003

9,484

557.0

3,744

219.9

2004

9,486

554.6

3,760

219.8

2005

9,672

560.9

3,740

216.9

2006

10,208

586.1

3,867

222.0

2007

10,728

609.8

3,838

218.2

2008

11,363

640.2

3,953

222.7

2009

11,798

659.5

3,869

216.3

2010

11,269

626.3

4,030

224.0

 

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Is cancer hereditary?

In the strictest sense of the word, cancer is not a hereditary disease as you will not definitely get cancer if one or more of your parents have had the disease.  You can however inherit a tendency to develop a particular cancer, but even if this inheritance occurs it will not definitely result in that cancer actually developing.

Research into the genetic causes is ongoing.  More information on this area is available from Cancer Research UK.

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How do the rates of cancer in Northern Ireland compare with the rest of the UK and Ireland?

Compared to the UK and Ireland as a whole, Northern Ireland has a slightly higher rate of new female cases of cancer diagnosed but has an equivalent male incidence rate.  Mortality rates in Northern Ireland however are lower than UK and Ireland.

More information on this area is available in the Cancer Atlas available from the Office of National Statistics (ONS).

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What is meant by the behaviour of a tumour?

There are 4 types of behaviour.

Benign: this is usually a slow-growing tumour that may displace but does not invade or infiltrate surrounding tissues; a tumour considered not to have malignant or invasive potential.

In-situ: an in-situ tumour is one with malignant potential which has remained confined to the tissue in which it originated.

Invasive (also known as malignant): an invasive tumour is not (or is no longer) confined to the tissue in which it originated.  Most tumours are invasive.

Uncertain: an uncertain tumour is one which, at the time of diagnosis, cannot be classified as either benign or malignant.

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Contact Information

N. Ireland Cancer Registry
Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences
Queen's University Belfast
Mulhouse Building
Grosvenor Road
Belfast
BT12 6DP

Tel: +(44)28 9063 2573
Fax: +(44)28 9024 8017
Email: nicr@qub.ac.uk

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