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This chapter outlines a course in cancer epidemiology that integrates simple principles of biology with epidemiologic characteristics, so that the discipline emerges as a hybrid of empirical research and biomedical insight. The goal of cancer epidemiology is not only to describe the principal risk factors of various forms of cancer, but to evaluate the compatibility of the risk profile of a particular cancer with alternative biologic hypotheses. The chapter presents an option for the structure of the course, which can be adjusted to accommodate the experience and style of the instructor, as well as the background and pace of the class. It covers teaching approaches for a short review of biology, assessment of causality in cancer epidemiology, descriptive cancer epidemiology, and cancer causation by exposure category and cancer site. It ends with a suggestion for an evaluation tool that can help instructors and students assess their progress and accomplishments in the context of the goals of the course.

In the United States, an estimated 57,400 cases of cancer of the urinary bladder are diagnosed and 12,500 deaths from the disease occur each year. These account for 6% of all new cases of cancer among men and 2% of cases among women, as well as 3% of cancer deaths among men and 1% among women. This chapter reviews the epidemiology of bladder cancer. Topics covered include demographic patterns, risk factors, biological markers of exposure, tumor markers, and preventive measures.

This chapter discusses the link between occupational carcinogens and cancer. Topics covered include sources of evidence on risk to humans due to chemicals, published literature in the field of occupational cancer, percentage of cancer attributable to occupation, occupational cancer epidemiology, molecular epidemiology and gene environment interactions, cancer prevention, and structural challenges and obstacles to conduct epidemiological research on occupational cancer.

Cancer of the pancreas remains a serious medical and public health problem because of difficulties in early diagnosis, aggressive behavior, resistance to therapy, and limited opportunities for prevention. This chapter reviews the epidemiology of pancreatic cancer. Topics covered include classification, diagnosis, incidence, mortality, survival, time trends in the United States, risk factors, host factors, molecular pathogenesis, and prevention.

This chapter provides an update on the epidemiology of lung cancer with an emphasis on the rapidly expanding literature exploring host susceptibility to tobacco carcinogenesis. It also reviews chemoprevention and lung screening trials.

Cancer of the thyroid is relatively uncommon, although it is the most common malignancy of the endocrine system and is the eighth ranking cancer among women. The prognosis is extremely good for papillary and follicular carcinoma and extremely poor for anaplastic carcinoma. This chapter reviews the epidemiology of thyroid cancer, taking histology into account whenever possible.

Breast cancer is the most common cancer diagnosis and the second leading cause of cancer death among women in the United States. Over 211,000 women and 1,600 men in the United States are diagnosed with breast cancer each year, and 40,000 Americans die of this disease annually. This chapter reviews the epidemiology of breast cancer. Topics covered include classification, demographic patterns, environmental factors, host factors, pathogenesis, and preventive measures.

The leukemias arise from malignant transformation of hematopoietic stem or progenitor cells that originate in the bone marrow, lymph nodes, and/or other lymphoid tissue with immune function. A small pool of stem cells, which persists throughout an individual's lifetime, differentiates to early precursors, then divides into multiple subtypes, and ultimately produces large numbers of end-stage cells of myeloid and lymphoid lineage progeny. Because the effector or end-stage cells of each lineage have a finite lifespan and, therefore, cannot transmit mutations, all leukemias are the consequence of derangements of growth and differentiation of the pluripotential early precursors of myeloid or lymphoid progeny. This chapter discusses the epidemiology of the myeloid and lymphoid leukemias.

Prostate cancer is the most commonly diagnosed cancer in American men and its incidence is rising internationally. Although intensively studied, little is known conclusively about its causes, with the exception of older age, African-American racial group, and family history of prostate cancer. This chapter reviews the epidemiology of prostate cancer. Topics covered include classification, demographic patterns, environmental and host risk factors, pathogenesis, and preventive measures.

This chapter reviews the epidemiology of cutaneous and ocular melanomas. Cutaneous melanoma is the most lethal form of skin cancer. There were an estimated 160,000 new cases diagnosed worldwide in 2002, more than 80% in developed countries, and 41,000 deaths, 66% in developing countries. Sun exposure is its major cause, although a variety of phenotypic and genotypic characteristics contribute substantially to the risk of this complex disease. Ocular melanoma is globally much less significant than cutaneous melanoma and shows little current evidence of uptrend in incidence, in contrast to the continuing uptrend in melanoma. Melanocytes that give risk to ocular melanomas lie principally in pigmentary epithelia that extend continuously from the choroid, a vascular membrane that separates the neural elements of the retina from the fibrous outer covering of the eye (the sclera), anteriorly to the ciliary body and iris.

This chapter reviews the epidemiology of colorectal cancer, focusing on adenocarcinomas, which comprise the vast majority of the cases. The etiologies of colon and rectal cancer overlap, but the differences between the two will be addressed when relevant.

This chapter reviews the epidemiology of cancers of the oral cavity, pharynx, lip, and salivary glands. In the United States (1996–2000), invasive cancers of the OCP/lip/salivary gland account for 2.7% of cancers among men and 1.5% of cancers among women. It is estimated that 27,700 cases will be diagnosed with these malignancies in the United States in 2003 and about 7,200 will die from these cancers. The lifetime risk of being diagnosed with OCP/lip/salivary gland cancers for a US male is 1.4% and 0.7% for a US female.

Nearly 12,400 children and adolescents under the age of twenty years will be newly diagnosed with cancer each year in the United States. This means that a newborn has an approximately 1 in 315 chance of developing cancer in the first two decades of life. This chapter reviews the epidemiology of cancer in children. Topics covered include overall incidence, mortality and morbidity, acute lymphoblastic leukemia and acute myeloid leukemia, brain/central nervous system cancers, lymphomas, sympathetic nervous system tumors, soft tissue sarcoma, renal cancers, bone tumors, germ cell tumors, retinoblastoma, and hepatic tumors.

Cervical cancer is the second most common cancer among women, ranking first in many developing countries. This chapter reviews the epidemiology of cervical cancer. Topics covered include classification, precursor lesions, molecular characteristics, demographic patterns, environmental risk factors, host factors, pathogenesis, and preventive measures.

Malignant tumors of the kidney account for about 2% of all new cancer cases in the United States and worldwide, with 38,890 cases and 12,840 deaths estimated for 2006 in the United States. This chapter reviews the epidemiology of renal cancer. Demographic patterns and risk factors are discussed.

Cancer of the testis is relatively uncommon in the United States, accounting for approximately 1% of cancers in males. It is most commonly diagnosed in males between the ages of 15 and 44, and occurs more often in white than black men. This chapter reviews the epidemiology of testicular cancer. Topics covered include classification, demographic patterns, environmental factors, pathogenesis, and preventive measures.

Hodgkin lymphoma (HL) is a malignant disease involving the lymph nodes, spleen, and other lymphoid tissue. This chapter reviews the epidemiology of HL. Topics covered include the history of HL, incidence and mortality, classification, demographic patterns, childhood social environment, infectious exposures, occupational and environmental exposures, host factors, and pathogenesis.

Cancer epidemiology is an important topic for health professionals in clinical medicine and public health. Teaching of cancer epidemiology, however, presents considerable difficulties; some are related to the variable background of the students, while others are inherent to the topic itself. The goal of a fifteen-to-twenty-hour course in cancer epidemiology is to integrate simple principles of biology with epidemiologic characteristics and concepts, so that the discipline moves beyond biostatistics into the realm of biomedical sciences. In other words, the goal of cancer epidemiology is not only to describe the principal risk factors of various forms of cancer but to evaluate the compatibility of the risk profile of a particular cancer with alternative biologic hypotheses. In this chapter, an option for the structure of the course is presented which could be adjusted to accommodate the expertise and style of the instructor as well as the background and pace of the class.