12. Pencegahan kanker komperhensif

Prevensi Kanker
secara
Komperhensif
Fatwa ST. Dewi
Public Health Dept.
Faculty of Medicine, GMU
References
Mackay J., Jemal A., Lee N.C.,
Parkin, D.M., 2006, The Cancer Atlas,
Atlanta, Georgia, USA
 CDC, 2007, Cancer Prevention &
Early Detection, Facts and Figures

Type of Prevention
Primary prevention
Disease or injury
Impairment
Secondary prevention
Disability
Tertiary prevention
Dependency
Prevensi Kanker

Sesi I:


Primary prevention: sebelum terkena kanker
 promotif dan protektif
Sesi II:


Secondary prevention: setelah terkena
kanker, untuk meminimalisasi keterbatasan,
kecacatan  kuratif
Tertiary prevention: setelah mendapatkan
kecacatan untuk minimalisasi
ketergantungan  rehabilitatif
Prevensi Kanker

Prevensi kanker adalah tindakan
antisipatif untuk:
• Menghilangkan atau meminimalisasi
paparan penyebab kanker
• Mengurangi kerentanan terkena kanker
Prevensi Primer = Promosi
Kesehatan
Promosi Kesehatan:
Enabling people to control their own health 
manipulate unhealthy lifestyle become
healthy
 Kanker dikaitkan dengan perilaku tidak
sehat sebagai penyebabnya
 Faktor risiko: meningkatkan resiko
terserang penyakit
 Faktor proteksi: Menurunkan resiko
terserang penyakit

Faktor-faktor Risiko Kanker
1.
2.
Keturunan: retinoblastoma, kanker
payudara
Faktor lingkungan:
1.
Kimiawi:
1. Tar (rokok) Kanker paru
2. Radiasi iodinasi leukemia
3. Alkohol  kanker mulur
2.
3.
Fisika: papara UV  kanker kulit
Biologis: Hepatitis B  hepatoma
Major Risk Factors of
Cancer
1.
2.
3.
4.
5.
Smoking: Lung cancer, oral cavity, larynx,
oesophagus, stomach
Overweight and obesity: Oral,
oesophagus, gastric, colorectal high fiber
diet and physical acitivity
Occupational and environmental
exposure: Lung Ca (asbestos), Bladder
(aniline dyes), leukaemia (benzene)
Infection and infestation: Liver (Hepatitis B
and C), Cervix (HPV), stomach (Helicobacter
pilory), Bladder (schistosomiasis)
UV radiation: Skin cancer
Controlling NCD: From disease specific to major
shared risk factors
D.
Environmental
Factors
•
•
•
•
•
Globalization
Urbanization
Poverty
Low education
Stress
C. Behavioral
Factors
• Unhealthy diet
• Physical
inactivity
• Smoking
• Alcoholic
drinking
B. Biological
Factors
• Hipertension
• High blood
glucose
• High
cholesterol
• Obesity
NCD and its risk factors (Dans et al., 2011)
A. Diseases
•
•
•
•
•
Heart disease
Stroke
Diabetes
Cancer
COPD
Secondary prevention: risk assessment
Taken from:
Labarthe, 2011
Facts on Cancer Prevention

One third of Ca are preventable:





Smoking: responsible for 80-90% Lung Ca
and 30% of all Ca death in developing
countries: oral cavity, larynx, oesophagus,
stomach
Diet: obesity related with Ca oesophagus,
colorectum, breast, endometrium, kidney
High fiber diet, physical activity and normal
body weight  protective factors of Ca
Physical exercise- gastric and colon cancer
Healthy lifestyle for other type of cancer
Primary Prevention:
Cancer Health Promotion




Determinants + unknown factors  Cancer
There is a dose response relationships
between : exposure of agent and Cancer
Exposure  not totally avoid Cancer
Eliminate the carcinogen will be the best:




Remove carcinogen
Replacement carcinogen
Impeding contact with carcinogen
Vaccination (Hepatitis B)
Primary Prevention:
Cancer Health Promotion
General habit to avoid cancer:
1.
2.
3.
4.
5.
6.
7.
Do not smoke
High fiber intake (fresh fruit, vegetables
and cereals)
Limit the fat intake
Avoid becoming overweight
Moderate the consumption of alcoholic
drinks
Avoid excessive exposure to the sun
Using health working protection 
substances that may cause cancer
How to do primary
prevention of cancer
1.
2.
Identify readiness to change
behavior among target
Decide level of behavior changing
and needed strategies
Table 2. Stages of readiness to change
and action that appropriate
Stage
Action
Not interested (Precontemplation
stage)
Give information
Uncertain about prospect
(Contemplation stage)
Give opportunity to weigh
up pros and cons of
changing
Ready to change (Preparation)
Discuss how to proceed
with behavior
Action
Reinforcement
Maintenance
Reinforcement
Level of Target Behavior Change and Health
Promotion Objectives
Level
Objectives
Individual
Knowledge, Attitude, Behaviors, Physiology
Organizational
Policies, Practices, Programs, Facilities,
Resources
Community
Policies, Practices, Programs, Facilities,
Resources
Government
Policies, Programs, Facilities, Resources,
Legislations/ordinances, Regulation,
Enforcement