Etiology of Cancer Extrinsic factors Intrinsic facors o Chemical carcinogens Hereditary factors . Chemotherapeutic Agents .Radiation Metal Fibers and dust .Dietary evirus
Etiology of Cancer Extrinsic factors •Chemical carcinogens •Chemotherapeutic Agents •Radiation •Metal •Fibers and Dust •Dietary •Virus Intrinsic facors •Hereditary factors
Chemotherapeutic Agents: Leukemia following chemotherapy for ovarian cancer TYPE OF RELATIVE RISK TREATMENT No, OF PATIENTS (95%CI*) P VALUE CASES CONTROLS Surgery only 78 Radiotherapy only 15 1.6(0.51-4.8) 0.43 Chemotherapy onl y 41 52 12.0(4.4-32) <0.00l Radiotherapy and 65 98(34-28) <0.00l chemotherapy Total 10l 304 #95%CI denotes 95 percent confidence interval Kaldor JM, etal. NEJM, 1990
Chemotherapeutic Agents: Leukemia following chemotherapy for ovarian cancer Kaldor JM, et al. NEJM, 1990
Etiology of Cancer Extrinsic factors Intrinsic facors o Chemical carcinogens Hereditary factors o Chemotherapeutic Agents .Radiation Metal Fibers and dust .Dietary evirus
Etiology of Cancer Extrinsic factors •Chemical carcinogens •Chemotherapeutic Agents •Radiation •Metal •Fibers and Dust •Dietary •Virus Intrinsic facors •Hereditary factors
Radiation Ultraviolet . basal cell carcinoma, squamous cell carcinoma nizing .Atomic bomb, nuclear accidents, diagnostic and therapeutic procedures and professional exposures .Additive effect with smoking Radon .Lung cancer more than additive effect with smoking
Radiation Ultraviolet •basal cell carcinoma, squamous cell carcinoma Ionizing •Atomic bomb, nuclear accidents, diagnostic and therapeutic procedures and professional exposures •Additive effect with smoking Radon •Lung cancer •More than additive effect with smoking
Etiology of Cancer Extrinsic factors Intrinsic facors o Chemical carcinogens Hereditary factors o Chemotherapeutic Agents .Radiation Metal Fibers and dust .Dietary evirus
Etiology of Cancer Extrinsic factors •Chemical carcinogens •Chemotherapeutic Agents •Radiation •Metal •Fibers and Dust •Dietary •Virus Intrinsic facors •Hereditary factors