Oncology in midlife and beyond

Abstract

The onset of the menopause is often a time when women's concerns can act as a powerful trigger to encourage healthy modifications in lifestyle which will maintain, or improve, their general health. This document aims to help women to understand their potential risks, to encourage them to find proactive preventive strategies by modifying some of their attitudes, and to use health resources (when available) to be screened. Cancer is an important cause of death but not the primary cause of mortality. Cardio/circulatory diseases represent 35-40% of causes of death in most developed countries and 20-25% of women will die from cancers in Western Europe, Australasia, high-income North America, high-income Asia Pacific, East Asia and Southern Latin America. Breast cancer, lung cancer and colorectal cancer are prevalent in most regions of the world. Cervical cancer remains a hallmark of low access to health care. Preventive strategies (decreasing smoking and alcohol consumption, losing weight, eating a healthy diet and undertaking physical activity) and implementation of screening could help to significantly decrease the incidence of and mortality from cancer. The mortality/incidence ratio is higher in developing countries compared to high-income regions as well as in subgroups of populations in developed countries with lower socioeconomic levels. Implementation of better diagnostic methods and management of cancer according to the local resources will help to decrease the mortality rate in developing countries, and effort has to be made to decrease social inequities and improve access to health care for low-income groups. In conclusion, cancer incidence is increasing as a consequence of longer life expectancy all over the world. National health programs are mandatory to implement screening and to improve individual management. Finally, educating women so that they are aware of ways to improve their general health, to minimize their own risk factors and to identify signs of change in their own health which may be markers of impending cancer will help to reduce the burden of disease and improve the prognosis for tumors detected at an earlier stage.

Menopause and Cancers

“…3 Breast cancer remains the leading cause of death among women in less developed countries. 4 The importance of this finding is a reflection on the intimate relationship between modifiable lifestyle risks, namely smoking, and cancer death. Incidence rates of cancers for women are twice as high in the developed regions; however, mortality rates are only 8% to 15% higher than those in low-and middle-income countries.…”

“…The disparity in incidence and mortality rates likely reflects the detection and treatment of risk factors. 4 …”

“…2,3 In developed regions of the world the cause of death for 20% to 25% of women is cancer, compared with 35% to 40% of deaths attributable to cardiopulmonary diseases. 4 One in 3 women will be diagnosed with a cancer during her lifetime, and current cancer survivorship of both women and men in the United States is estimated at 13.7 million people and is rapidly growing. 1 Cancer risk can be mitigated by lifestyle maintenance and modification in addition to preventive screening.…”

“…1 Cancer risk can be mitigated by lifestyle maintenance and modification in addition to preventive screening. 4 Genetic mutations and previous cancers may affect screening modalities and frequencies. 5 Women who have had cancer treatments, namely cytotoxic chemotherapy or radiation therapy, may undergo premature menopause.…”

Povezanost količine i distribucije masnog tkiva s tumorskim karakteristikama invazivnog karcinoma dojke u postmenopauzalnih žena

“…Za usporedbu, prema podacima Registra za rak Hrvatskog zavoda za javno zdravstvo, incidencija karcinoma dojke u Republici Hrvatskoj za 2014. godinu iznosila je 119,2/100 000, a stopa mortaliteta 48,3/100 000, čime se Republika Hrvatska nalazi iznad europskog prosjeka (incidencija u Europi 89,4/100 000; mortalitet u Europi 28,7/100 000) 3 . Oko 67 % svih slučajeva karcinoma dojke javlja se u postmenopauzalnih žena, a značajnu razliku između premenopauzalne i postmenopauzalne incidencije karcinoma dojke najbolje predočuje usporedba dobno standardiziranih stopa incidencije (12,8 -29,4/100 000 vs 65,4 -307,6/100 000) 4,5 .…”