Editing Cancer (section)

{{Short description|Group of diseases involving cell growth}}
{{About|the group of diseases}}
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{{Infobox medical condition
| name = Cancer
| image = Tumor Mesothelioma2 legend.jpg
| caption = A coronal [[CT scan]] showing a malignant [[mesothelioma]]<br />Legend: →&nbsp;[[tumor]]&nbsp;←, ✱&nbsp;central [[pleural effusion]], 1 & 3&nbsp;[[lung]]s, 2&nbsp;[[Vertebral column|spine]], 4&nbsp;[[rib]]s, 5&nbsp;[[aorta]], 6&nbsp;[[spleen]], 7 & 8&nbsp;[[kidney]]s, 9&nbsp;[[liver]]
| field = [[Oncology]]
| synonyms = [[malignancy|Malignant]] [[neoplasm|tumor]], malignant [[neoplasm]]
| pronounce = {{IPAc-en|audio=en-us-cancer.ogg|ˈ|k|æ|n|s|ər}}
| symptoms = Lump, abnormal bleeding, prolonged cough, unexplained [[weight loss]], change in [[bowel movement]]s<ref name=NHS2012/>
| complications = 
| onset = 
| duration = 
| causes = 
| risks = Exposure to [[carcinogen]]s, tobacco, [[obesity]], poor [[Diet (nutrition)|diet]], [[lack of physical activity]], excessive [[Alcohol (drug)|alcohol]], certain infections, genetics<ref name=WHO2018/><ref name=Enviro2008/>
| diagnosis = 
| differential = 
| prevention = 
| treatment = [[Radiation therapy]], surgery, [[chemotherapy]], [[targeted therapy]]<ref name=WHO2018/><ref name=TCT2018/>
| medication = 
| prognosis = Average [[five-year survival]] 66% (USA)<ref name=Seer2014/>
| frequency = 24 million annually (2019)<ref name="kocarnik">{{cite journal | vauthors = Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD, etal | title = Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019 | journal = JAMA Oncology | volume = 8 | issue = 3 | pages = 420–444 | date = March 2022 | pmid = 34967848 | pmc = 8719276 | doi = 10.1001/jamaoncol.2021.6987 |issn = 2374-2437}}</ref>
| deaths = 10 million annually (2019)<ref name=kocarnik/>
}}
 
'''Cancer''' is a group of [[disease]]s involving [[Cell growth#Disorders|abnormal cell growth]] with the potential to [[Invasion (cancer)|invade]] or [[Metastasis|spread]] to other parts of the body.<ref name=WHO2018/><ref name=WhatIsCancerNCI/> These contrast with [[benign tumor]]s, which do not spread.<ref name=WhatIsCancerNCI/> Possible [[Signs and symptoms of cancer|signs and symptoms]] include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in [[defecation|bowel movements]].<ref name=NHS2012>{{cite web |title=Cancer – Signs and symptoms |url=http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx |website=NHS Choices |access-date=10 June 2014 |url-status=live |archive-url=https://web.archive.org/web/20140608104550/http://www.nhs.uk/Conditions/cancer/Pages/symptoms.aspx |archive-date=8 June 2014}}</ref> While these symptoms may indicate cancer, they can also have other causes.<ref name=NHS2012/> [[List of cancer types|Over 100 types]] of cancers affect humans.<ref name=WhatIsCancerNCI/>
 
[[Tobacco use]] is the cause of about 22% of cancer deaths.<ref name=WHO2018>{{cite web |title=Cancer |url=https://www.who.int/en/news-room/fact-sheets/detail/cancer |website=World Health Organization |access-date=19 December 2018 |date=12 September 2018}}</ref> Another 10% are due to [[obesity]], poor [[Diet (nutrition)|diet]], [[sedentary lifestyle|lack of physical activity]] or [[Alcohol abuse|excessive alcohol consumption]].<ref name=WHO2018/><ref>{{cite web |title=Obesity and Cancer Risk |url=http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3 |publisher=National Cancer Institute |access-date=4 July 2015 |date=3 January 2012 |url-status=live |archive-url=https://web.archive.org/web/20150704154440/http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3 |archive-date=4 July 2015}}</ref><ref>{{cite journal | vauthors = Jayasekara H, MacInnis RJ, Room R, English DR | title = Long-Term Alcohol Consumption and Breast, Upper Aero-Digestive Tract and Colorectal Cancer Risk: A Systematic Review and Meta-Analysis | journal = Alcohol and Alcoholism | volume = 51 | issue = 3 | pages = 315–30 | date = May 2016 | pmid = 26400678 | doi = 10.1093/alcalc/agv110 | doi-access = free }}</ref> Other factors include certain infections, exposure to [[ionizing radiation]], and environmental pollutants.<ref name="Enviro2008">{{cite journal |vauthors=Anand P, Kunnumakkara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, Sung B, Aggarwal BB |date=September 2008 |title=Cancer is a preventable disease that requires major lifestyle changes |journal=Pharmaceutical Research |volume=25 |issue=9 |pages=2097–116 |doi=10.1007/s11095-008-9661-9 |pmc=2515569 |pmid=18626751}}{{Erratum|doi=10.1007/s11095-008-9690-4|pmid=18626751|checked=yes}}</ref> [[infectious causes of cancer|Infection]] with specific viruses, bacteria and parasites is an environmental factor causing approximately 16–18% of cancers worldwide.<ref>{{Cite journal|title=Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis|first1=Catherine|last1=de Martel|first2=Damien|last2=Georges|first3=Freddie|last3=Bray|first4=Jacques|last4=Ferlay|first5=Gary M|last5=Clifford|date=15 February 2020|journal=The Lancet Global Health|volume=8|issue=2|pages=e180–e190|doi=10.1016/S2214-109X(19)30488-7|pmid=31862245 |doi-access=free}}</ref> These infectious agents include ''[[Helicobacter pylori]]'', [[hepatitis B]], [[hepatitis C]], [[human papillomavirus infection]], [[Epstein–Barr virus]], [[Human T-lymphotropic virus 1]], [[Kaposi's sarcoma-associated herpesvirus]] and [[Merkel cell polyomavirus]]. [[HIV|Human immunodeficiency virus]] (HIV) does not directly cause cancer but it causes immune deficiency that can magnify the risk due to other infections, sometimes up to several thousandfold (in the case of [[Kaposi's sarcoma]]). Importantly, vaccination against [[hepatitis B]] and [[human papillomavirus]] have been shown to nearly eliminate the risk of cancers caused by these viruses in persons successfully vaccinated prior to infection.

These environmental factors act, at least partly, by changing the [[gene]]s of a cell.<ref name=WCR2014Scr/> Typically, many genetic changes are required before cancer develops.<ref name=WCR2014Scr/> Approximately 5–10% of cancers are due to inherited genetic defects.<ref name=ACS-heredity>{{cite web |publisher=[[American Cancer Society]] |title=Heredity and Cancer |access-date=22 July 2013 |url=http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer |url-status=live |archive-url=https://web.archive.org/web/20130802043732/http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer |archive-date=2 August 2013}}</ref> Cancer can be detected by certain signs and symptoms or screening tests.<ref name=WHO2018/> It is then typically further investigated by [[medical imaging]] and confirmed by [[biopsy]].<ref>{{cite web |title=How is cancer diagnosed? |url=http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/testingbiopsyandcytologyspecimensforcancer/testing-biopsy-and-cytology-specimens-for-cancer-how-is-cancer-diagnosed |website=American Cancer Society |date=29 January 2013 |access-date=10 June 2014 |url-status=live |archive-url=https://web.archive.org/web/20140714120018/http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/testingbiopsyandcytologyspecimensforcancer/testing-biopsy-and-cytology-specimens-for-cancer-how-is-cancer-diagnosed |archive-date=14 July 2014}}</ref>
 
The risk of developing certain cancers can be reduced by not smoking, maintaining a healthy weight, limiting alcohol intake, eating plenty of vegetables, fruits, and [[whole grain]]s, [[vaccination]] against certain infectious diseases, limiting consumption of [[processed meat]] and [[red meat]], and limiting exposure to direct sunlight.<ref name=Kushi2012>{{cite journal |vauthors=Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T |s2cid=2067308 |title=American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity |journal= CA: A Cancer Journal for Clinicians |volume=62 |issue=1 |pages=30–67 |year=2012 |pmid=22237782 |doi=10.3322/caac.20140|doi-access=free }}</ref><ref>{{cite journal |vauthors=Parkin DM, Boyd L, Walker LC |title=16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010 |journal=British Journal of Cancer |volume=105 | issue = Suppl 2 |pages=S77–81 |date=December 2011 |pmid=22158327 |pmc=3252065 |doi=10.1038/bjc.2011.489}}</ref> Early detection through screening is useful for [[cervical cancer|cervical]] and [[colorectal cancer]].<ref name=WCR2014Scr>{{cite book |title=World Cancer Report 2014 |date=2014 |publisher=World Health Organization |isbn=978-92-832-0429-9 |url=http://www.searo.who.int/publications/bookstore/documents/9283204298/en/ |pages=Chapter 4.7 |archive-url=https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/ |archive-date=12 July 2017 }}</ref> The benefits of [[breast cancer screening|screening for breast cancer]] are controversial.<ref name=WCR2014Scr/><ref name=Got2013>{{cite journal |vauthors=Gøtzsche PC, Jørgensen KJ |title=Screening for breast cancer with mammography |journal=The Cochrane Database of Systematic Reviews |volume=2013 |issue=6 |pages=CD001877 |date=June 2013 |pmid=23737396 |pmc=6464778 |doi=10.1002/14651858.CD001877.pub5}}</ref> Cancer is often treated with some combination of [[radiation therapy]], surgery, [[chemotherapy]] and [[targeted therapy]].<ref name=WHO2018/><ref name=TCT2018>{{cite web |url=https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet |title=Targeted Cancer Therapies |website=cancer.gov |publisher=National Cancer Institute |date=26 February 2018 |access-date=28 March 2018 }}</ref> More [[Personalized medicine|personalized therapies]] that harness a patient's immune system are emerging in the field of [[cancer immunotherapy]].<ref>{{cite journal |last1=Mishra |first1=AK |last2=Ali |first2=A |last3=Dutta |first3=S |last4=Banday |first4=S |last5=Malonia |first5=SK |title=Emerging Trends in Immunotherapy for Cancer |journal=Diseases |date=6 Sep 2022 |volume=10 |issue=3 |page=60 |doi=10.3390/diseases10030060 |doi-access=free |pmid=36135216 |pmc=9498256 }}</ref> Pain and symptom management are an important part of care.<ref name=WHO2018/> [[Palliative care]] is particularly important in people with advanced disease.<ref name=WHO2018/> The chance of survival depends on the type of cancer and [[cancer staging|extent of disease]] at the start of treatment.<ref name=WCR2014Scr/> In children under 15 at diagnosis, the [[five-year survival rate]] in the [[developed world]] is on average 80%.<ref name=WCR2014Peads>{{cite book |title=World Cancer Report 2014 |date=2014 |publisher=World Health Organization |isbn=978-92-832-0429-9 |url=http://www.searo.who.int/publications/bookstore/documents/9283204298/en/ |pages=Chapter 1.3 |archive-url=https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/ |archive-date=12 July 2017 }}</ref> For cancer in the United States, the average five-year survival rate is 66% for all ages.<ref name=Seer2014>{{cite web |title=SEER Stat Fact Sheets: All Cancer Sites |publisher=National Cancer Institute |url=http://seer.cancer.gov/statfacts/html/all.html |access-date=18 June 2014 |url-status=live |archive-url=https://web.archive.org/web/20100926191037/http://seer.cancer.gov/statfacts/html/all.html |archive-date=26 September 2010}}</ref>

In 2015, about 90.5&nbsp;million people worldwide had cancer.<ref name=GBD2015Pre>{{cite journal |author=GBD |author-link=Global Burden of Disease Study |collaboration=Disease and Injury Incidence and Prevalence Collaborators |title=Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 |journal= The Lancet |date=8 October 2016 |volume=388 |issue=10053 |pages=1545–1602 |pmid=27733282 |doi=10.1016/S0140-6736(16)31678-6 |pmc=5055577}}</ref> In 2019, annual cancer cases grew by 23.6&nbsp;million people, and there were 10 million deaths worldwide, representing over the previous decade increases of 26% and 21%, respectively.<ref name=kocarnik /><ref>{{cite journal|doi=10.1146/annurev-cancerbio-030419-033612|doi-access=free|title=Metabolic Drivers in Hereditary Cancer Syndromes|year=2020| vauthors = Sciacovelli M, Schmidt C, Maher ER, Frezza C |journal=Annual Review of Cancer Biology|volume=4|pages=77–97}}</ref>

The most common types of cancer in males are [[lung cancer]], [[prostate cancer]], [[colorectal cancer]], and [[stomach cancer]].<ref name=WCR2014>{{cite book |title=World Cancer Report 2014 |date=2014 |publisher=World Health Organization |isbn=978-92-832-0429-9 |pages=Chapter 1.1}}</ref><ref name="auto">{{cite journal | vauthors = Siegel RL, Miller KD, Wagle NS, Jemal A | title = Cancer statistics, 2023 | journal = CA | volume = 73 | issue = 1 | pages = 17–48 | date = January 2023 | pmid = 36633525 | doi = 10.3322/caac.21763 | doi-access = free }}</ref> In females, the most common types are [[breast cancer]], colorectal cancer, lung cancer, and [[cervical cancer]].<ref name=WCR2014Scr/><ref name=auto/> If [[skin cancer]] other than [[melanoma]] were included in total new cancer cases each year, it would account for around 40% of cases.<ref>{{cite journal | vauthors = Dubas LE, Ingraffea A | title = Nonmelanoma skin cancer | journal = Facial Plastic Surgery Clinics of North America | volume = 21 | issue = 1 | pages = 43–53 | date = February 2013 | pmid = 23369588 | doi = 10.1016/j.fsc.2012.10.003 }}</ref><ref name=Cak2012>{{cite journal | vauthors = Cakir BÖ, Adamson P, Cingi C | title = Epidemiology and economic burden of nonmelanoma skin cancer | journal = Facial Plastic Surgery Clinics of North America | volume = 20 | issue = 4 | pages = 419–422 | date = November 2012 | pmid = 23084294 | doi = 10.1016/j.fsc.2012.07.004 }}</ref> In children, [[acute lymphoblastic leukemia]] and [[brain tumors]] are most common, except in Africa, where [[non-Hodgkin lymphoma]] occurs more often.<ref name=WCR2014Peads/> In 2012, about 165,000 children under 15 years of age were diagnosed with cancer.<ref name=WCR2014/> The risk of cancer increases significantly with age, and many cancers occur more commonly in developed countries.<ref name=WCR2014Scr/> Rates are increasing as [[population ageing|more people live to an old age]] and as lifestyle changes occur in the developing world.<ref name=Epi11>{{cite journal | vauthors = Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D | title = Global cancer statistics | journal = CA | volume = 61 | issue = 2 | pages = 69–90 | date = February 2011 | pmid = 21296855 | doi = 10.3322/caac.20107 | s2cid = 30500384 | doi-access = free }}</ref> The global total economic costs of cancer were estimated at [[United States dollar|US$]]1.16&nbsp;trillion (equivalent to ${{Inflation|US|1.16|2010|r=2}} trillion in {{Inflation/year|US}}) per year {{as of|2010|lc=y}}.<ref name=WCR2014Eco>{{cite book |title=World Report 2014 |date=2014 |publisher=World Health Organization |isbn=978-92-832-0429-9 |url=http://www.searo.who.int/publications/bookstore/documents/9283204298/en/ |pages=Chapter 6.7 |archive-url=https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/ |archive-date=12 July 2017 }}</ref>

[[File:En.Wikipedia-VideoWiki-Cancer.webm|thumb|thumbtime=0:32|upright=1.35|Video summary ([[Wikipedia:VideoWiki/Cancer|script]])]]
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