Chapter 12: Cancer Biology MULTIPLE CHOICE
1. Which cancer originates from connective tissue? a. Osteogenic sarcoma c. Multiple myeloma b. Basal cell carcinoma d. Adenocarcinoma ANS A
!ancers arising from connective tissue usually have the suffi" -sarcoma. -sarcoma. #he remaining options are not cancers that originate in the connective tissue and$ in addition$ are a re lac%ing the common suffi". &#S 1
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-. !arcinoma refers to abnormal cell proliferation originating from hich tissue origin? a. Blood vessels c. !onnective tissue b. (pithelial cells d. /landular tissue ANS B
Only cancers arising from epithelial cells are called carcinomas. carcinomas. &#S 1
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*. !arcinoma in situ is characteri0ed by hich changes? a. !ells have bro%en through the local basement membrane. b. !ells have invaded immediate surrounding tissue. c. !ells remain locali0ed in the glandular or suamous cells. d. !ellular and tissue alterations indicate dysplasia. ANS !
!arcinoma in situ 2!3S4 refers to preinvasive epithelial malignant tumors of glandular or suamous cell origin. #hese early stage cancers are locali0ed to the epithelium and have not bro%en through the local basement membrane or invaded the surrounding tissue. 5ysplasia refers to changes in mature cell structure. &#S 1
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,. Which term is used to describe a muscle cell ce ll shoing a reduced ability to form ne muscle
hile appearing highly disorgani0ed? a. 5ysplasia b. 6yperplasia
c. Myoplasia d. Anaplasia
ANS 5
Anaplasia is Anaplasia is defined as the loss of cellular differentiation$ irregularities of the si0e and shape of the nucleus$ and the loss of normal tissue structure. 3n clinical specimens$ anaplasia is recogni0ed by a loss of organi0ation and a significant increase in nuclear si0e ith evidence of ongoing proliferation. #he remaining options refer to specific changes in the cell. &#S 1
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:. What are tumor cell mar%ers? a. 6ormones$ en0ymes$ antigens$ and antibodies that are produced by cancer cells b. 'eceptor sites on tumor cells that can be identified and mar%ed c. !yto%ines that are produced against cancer cells d. 3dentification mar%s that are used in administering radiation therapy ANS A
#umor 2biologic4 mar%ers are substances produced by both benign and malignant cells that are found either in or on the tumor cells or in the blood$ spinal fluid$ or urine. #umor mar%ers may include hormones$ en0ymes$ genes$ antigens$ and antibodies. #he other options do not accurately describe e"amples of tumor mar%ers and their function. &#S 1
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+. #he function of the tumor cell mar%er is to a. &rovide a definitive diagnosis of cancer. b. #reat certain types of cancer. c. &redict here cancers ill develop. d. Screen individuals at high ris% for cancer. ANS 5
Screening and identifying individuals at high ris% for cancer are ays tumor mar%ers can be used. #hese mar%ers are not used to definitively diagnosis or treat c ancer and are not useful in predicting specific sites of cancer development. &#S 1
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;. Which statement supports the hypothesis that intestinal polyps are benign neoplasms and the
first stage in the development of colon cancer? a. !ancer cells accumulate sloer than noncancer cells. b. An accumulation of mutations in specific genes is reuired for the development of
cancer. c. #umor invasion and metastasis progress more sloly in the gastrointestinal tract. d. Apoptosis is triggered by diverse stimuli$ including e"cessive groth. ANS B
Multiple genetic mutations are reuired for the evolution of full8blon canc er. #he #he remaining options do not address the progression of benign to metastatic tumors. &#S 1
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7. Autocrine stimulation is the ability of cancer cells to a. Stimulate angiogenesis to create their on blood supply. b. (ncourage secretions that turn off normal groth inhibitors. c. Secrete groth factors that stimulate their on groth. d. 5ivert nutrients aay from normal tissue for their on use. ANS !
!ancer cells must have mutations that enable them to proliferate in the absence of e"ternal e" ternal groth signals. #o achieve this$ some cancers acuire the ability ab ility to secrete groth factors that stimulate their on groth$ a process %non as autocrine stimulation. stimulation. #he remaining options do not describe autocrine stimulation.
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9. Apoptosis is a2an4 a. Normal mechanism for cells to self8destruct self8destruct hen groth is e"cessive b. Antigroth signal activated by the tumor8suppressor gene Rb gene Rb c. Mutation of cell groth stimulated by the TP53 gene d. #ransformation #ransformation of cells from dysplasia to anaplasia ANS A
Normal cells have a mechanism that causes them to self8destruct hen groth is e"cessive and cell cycle chec%points have been ignored. 5iverse stimuli$ including normal development and e"cessive groth$ trigger this self8destruct mechanism$ called apoptosis. apoptosis. #he remaining options do not describe apoptosis. &#S 1
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1<. Many cancers create a mutation of ras. ras. ras is ras is a2an4 a. #umor8suppressor #umor8suppressor gene ge ne b. /roth8promoting gene c. 3ntracellular8signaling 3ntracellular8signaling protein that regulates cell groth d. !ell surface receptor that allos signaling to the nucleus concerning cell groth ANS !
=p to one8third of all cancers have an activating mutation in the gene for an intracellular signaling protein called ras. ras. #his mutant ras stimulates ras stimulates cell groth even hen groth factors are missing. #he remaining options do not describe ras. ras. &#S 1
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11. Oncogenes are genes that are capable of a. =ndergoing mutation that directs the synthesis of proteins to accelerate the rate of
tissue proliferation b. 5irecting synthesis of proteins to regulate groth and to provide necessary replacement of tissue c. (ncoding proteins that negatively regulate the s ynthesis of proteins to slo or halt the replacement of tissue d. =ndergoing mutation that directs malignant tissue toard blood vessels and lymph nodes for metastasis ANS A
Oncogenes are mutant genes that$ before mutation$ direct synthesis of proteins that positively regulate 2accelerate4 proliferation. #he remaining options do not describe oncogenes. &#S 1
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1-. Bur%itt lymphomas designate a chromosome that has a piece of chromosome 7 fused to a
piece of chromosome 1,. #his is an e"ample of hich mutation of normal genes to oncogenes? a. &oint mutation c. /ene amplification b. !hromosome translocation d. !hromosome fusion
ANS B
!hromosome translocations$ in hich a piece of one chromosome is translocated to another chromosome$ can activate oncogenes. One of the best e"amples is the t27>1,4 translocation found in many Bur%itt lymphomas> t27>1,4 designates a chromosome that has a piece of chromosome 7 fused to a piece of chromosome 1,. #he remaining options are not best depicted by a Bur%itt lymphoma. &#S 1
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1*. 3n childhood neuroblastoma$ the N-myc the N-myc oncogene oncogene undergoes hich type of mutation of
normal gene to oncogene? a. &oint mutation b. !hromosome fusion
c. /ene amplification d. !hromosome translocation
ANS !
Amplifications are the result of the duplication of a small piece of a chromosome over and over again> conseuently$ instead of the normal to copies of a gene $ tens or even hundreds of o f copies are present 2see !hapter ,4. #he N-myc #he N-myc oncogene oncogene is amplified in -: of childhood neuroblastoma. &#S 1
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1,. What aberrant change causes the abnormal groth in retinoblastoma? a. &roto8oncogenes are changed to oncogenes. b. #he tumor8suppressor gene is turned off. o ff. c. /enetic amplification causes the groth. d. !hromosomes 9 and -1 are fused. ANS B
One of the first discovered tumor8suppressor genes$ the retinoblastoma (Rb) gene$ (Rb) gene$ normally strongly inhibits the cell division cycle. When it is inactivated$ the cell division cycle can proceed unchec%ed. #he Rb #he Rb gene gene is mutated in childhood retinoblastoma. #he remaining options do not describe the abnormal abnor mal groth in retinoblastoma. &#S 1
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1:. #o #o @hits are reuired to inactivate tumor8suppressor genes because a. (ach allele must be altered$ and each person has to copies$ or alleles$ of each
gene$ one from each parent. b. #he first hit stops tissue groth$ and the second hit is need ed to cause abnormal tissue groth. c. #umor8suppressor #umor8suppressor genes are larger than proto8oncogenes$ reuiring to hits h its to effect carcinogenesis. d. #he first hit is insufficient to cause enough damage to cau se a mutation. ANS A
A single genetic event can activate an oncogene$ acting in a dominant manner in the cell. 6oever$ each person has to copies$ or alleles$ of each gene$ one from each parent. p arent. #herefore to hits are reuired to inactivate the to alleles of a tumor8suppressor gene$ alloing the process to become active. #he remaining options do not describe the reason to hits are reuired.
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1+. #he ras gene ras gene converts from a proto8oncogene to an oncogene by a. 5esignating a chromosome that has a piece of one chromosome fused to a piece of
another chromosome b. 5uplicating a small piece of a chromosome$ repeatedly ma%ing numerous copies c. Altering one or more nucleotide base pairs d. &romoting proliferation of groth signals b y impairing tumor8suppressor genes ANS !
A point mutation is the alteration of one or a fe nucleotide base pairs. #his type of mutation can have profound effects on the activity of proteins. A point mutation in the ras gene ras gene converts it from a regulated proto8oncogene to an unregulated oncogene$ an accelerator of cellular proliferation. #he remaining options do not describe point mutation as it affects the conversion of a ras gene. ras gene. &#S 1
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1;. 6o do cancer cells use the en0yme telomerase? telomerase? a. #o repair the telomeres to restore somatic cell groth b. As an intracellular signaling chemical to stimulate cell division c. #o sitch sitch off the telomerase to enable cells to divide indefinitely d. #o sitch on the telomerase to enable cells to divide indefinitely ANS 5
!ancer cells$ hen they reach a critical age$ someho activate telomerase to restore and maintain their telomeres and thereby ma%e it possible for cells to d ivide over and over again. #he remaining options do not describe de scribe ho cancer cells use telomerase. &#S 1
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17. What are characteristics of benign tumors? a. Benign tumors invade local tissues. b. Benign tumors spread through the lymph nodes. no des. c. Benign tumors cause systemic symptoms. d. Benign tumors include the suffi" -oma. -oma. ANS 5
Benign tumors are usually encapsulated and ell8differentiated. #hey retain some normal tissue structure and do not invade the capsules surrounding them or spread to regional lymph nodes or distant locations. Benign tumors are generally named according to the tissues from hich they arise and include the suffi" -oma. -oma. Benign tumors do not cause systemic symptoms. &#S 1
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19. Which terms represent the correct nomenclature for benign an d malignant tumors of adipose
tissue$ respectively? a. Ciposarcoma$ lipoma b. Cipoma$ liposarcoma ANS B
c. Adisarcoma$ adipoma d. Adipoma$ adisarcoma
3n general$ cancers are named according to the cell type from hich they originate 2e.g.$ lip for cancers that originate in adipose or fat tissue4$ hereas benign tumors use the suffi" -oma. -oma. !ancers arising from connective tissue usually have the suffi" sarcoma. &#S 1
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-<. What is the maDor virus involved in the development dev elopment of cervical cancer? a. 6erpes simple" virus type + c. 6uman papillomavirus b. 6erpes simple" virus type d. 6uman immunodeficiency virus ANS !
3nfection ith specific subtypes of human papillomavirus 26&E4 cause virtually all cervical cancers. #he remaining options are not %non to be associated ith cervical cancer. &#S 1
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-1. #he &apanicolaou 2&ap4 test is used to screen for hich cancer? a. Ovarian c. !ervical b. =terine d. Eaginal ANS !
#he &ap test$ an e"amination of cervical epithelial scrapings$ readily detects early oncogenic human papillomavirus 26&E4infection. #he &ap test is not used for screening the other cancer sites listed. &#S 1
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--. What is the s%in8related health ris% induced by some types of chemotherapy? a. 3nfection c. &ain b. =ltraviolet damage d. (rythema ANS A
5ecreased reneal rates of the epidermal layers in the s%in may lead to s%in brea%don and dryness$ altering the normal barrier protection against infection. 'adiation therapy may cause s%in erythema 2redness4. &ain and ultraviolet damage is not related to chemotherapies. &#S 1
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-*. Which cancers are all associated ith chronic inflammation? a. Brain$ muscle$ and endocrine b. !olon$ thyroid gland$ and urinary bladder c. Bone$ blood cells$ and liver d. (ye$ tracheal$ and %idney ANS B
Some organs appear to be more susceptible to the oncogenic effects of chronic inflammation> for e"ample$ the /3 tract$ prostate$ thyroid gland$ p ancreas$ urinary bladder$ pleura$ and s%in. One large study found a ++ increase in the ris% of lung cancer among a mong omen ith chronic asthma$ an inflammatory disease of the airays. At present$ no research supports a lin% beteen the remaining options and chronic inflammation. &#S 1
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-,. !hronic inflammation causes cancer by a. 3ncreasing vasodilation and permeability that alter cellular response to 5NA
damage b. Ciberating lysosomal en0ymes hen cells are damaged that initiates mutations c. 'eleasing compounds such as reactive o" ygen species that promote mutations d. 3ncreasing the abundance of leu%otrienes that are associated ith some cancers ANS !
3nflammatory cells release compounds$ such as reactive o"ygen species 2'OS4 and other reactive molecules$ that can promote mutations and bloc% the cellular response to 5NA damage. At present$ no research supports the other options as factors related to inflammation causing cancer. &#S 1
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-:. 3nherited mutations that predispose to cancer are almost invariably hat %ind of gene? a. &roto8oncogenes c. #umor8suppressor #umor8suppressor genes b. Oncogenes d. /roth8promoting genes ANS !
3nherited mutations that predispose to cancer are almost invariably in tumor8suppressor genes. At present$ no research supports the other options as factors related to ho inherited mutations cause cancer. &#S 1
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-+. What is the conseuence for cells hen the functioning TP53 gene TP53 gene is lost as a result of
mutation? a. !ells undergo apoptosis. b. !ells escape apoptosis.
c. !ells receive less o"ygen. d. !ells adhere more readily.
ANS B
#he most common mutations conferring resistance to apoptosis occur in the TP53 gene. TP53 gene. #he remaining options do not accurately describe the effect hen the functioning TP53 gene TP53 gene is lost as a result of mutation. &#S 1
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-;. Which gastrointestinal tract condition can be an ou tcome of both chemotherapy and radiation
therapy? a. 3ncreased cell turnover b. !onstipation
c. Stomatitis d. Bloody stool
ANS !
!hemotherapy and radiation therapy may ma y cause a decreased cell turnover$ thereby leading to oral ulcers 2stomatitis4$ malabsorption$ and diarrhea. None diarrhea. None of the other options options accurately describe related conditions resulting from chemotherapy andFor radiation therapies. &#S 1
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-7. What is the role of vascular endothelial groth factor 2E(/)4 and basic fibroblast groth
factor 2b)/)4 in cell metastasis? a. #o stimulate stimulate groth of nearby tumor cells b. #o develop ne blood vessels to feed cancer cells c. #o prevent cancer cells from escaping apoptosis d. #o act as a chemical gradient to guide cells to blood vessels ANS B
By recruiting ne vascular endothelial cells and initiating the proliferation of e"isting blood vessel cells$ the angiogenic factors$ such as VE! and groth factor b!! $ allo small cancers to become large cancers. None cancers. None of the other options options accurately describe the role of the various stated factors on cell metastasis. &#S 1
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-9. 3t has been determined that a tumor is in stage -. What is the meaning of this finding? a. !ancer is confined to the organ of origin. b. !ancer has spread to regional structures. c. !ancer is locally invasive. d. !ancer has spread to distant sites ANS !
!ancer confined to the organ of origin is stage 1> cancer that is locally invasive is stage -> cancer that has spread to regional structures$ such as the lymph nodes$ is stage *> and cancer that has spread to distant sites$ such as a liver cancer spreading to the lung or a prostate cancer spreading to bone$ is stage ,. &#S 1
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*<. Which statement is true regarding true regarding pain and cancer? a. &ain is primarily a result of pressure caused by the tumor. b. &ain indicates the metastasis of a cancer. c. &ain is usually the initial symptom of cancer. d. &ain is generally associated ith late8stage cancer. ANS 5
&ain is generally associated ith the late stages of can cer. &ressure$ obstructi obstruction$ on$ invasion of a structure sensitive to pain$ stretching$ tissue destruction$ and inflammation can cause pain. &ain is not the initial symptom of cancer nor does it indication that the cancer has h as metastasi0ed. &#S 1
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*1. Which cancer may be treated ith radiation delivered by brachytherapy? a. Cung c. !ervical b. !olon d. Brain ANS !
'adiation sources$ such as small 1-:38labeled capsules 2also called see"s called see"s4$ 4$ can also be temporarily placed into body cavities$ a delivery method termed brachytherapy. Brachytherapy is useful in the treatment of cervical$ prostate$ and head and nec% cancers. Brachytherapy is not used in the treatment of the other cancers.
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*-. #he survival rate for stage 3E 6odg%in disease can be as high as a. 99 c. ,< b. ;< d. -< ANS B
Survival rates for 6odg%in disease is 99 for stage 3 and ;< for stage 3E. &#S 1
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**. What is the cause of anemia in a patient diagnosed ith pancreatic cancer? can cer? a. 3mpaired pancreatic function c. !hronic bleeding b. Malnutrition d. Malabsorption of iron ANS 5
3ron is malabsorbed in individuals ith gastric$ pancreatic$ or upper intestinal canc er. !ommonly associated ith malignancy$ mechanisms of anemia include chronic bleeding 2resulting in iron deficiency4$ severe malnutrition$ cytoto"ic chemotherapy$ and malignancy in blood8forming organs. #he pancreas is not involved in the formation formation of blood components. !hronic bleeding and iron deficiency can accompany colorectal or genitourinary malignancies. &#S 1
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*,. By hat process do cancer cells ce lls multiply in the absence of e"ternal groth signals? a. &roto8oncogene c. 'eliance on careta%er genes b. Autocrine stimulation d. &leomorphology ANS B
!ancer cells must have mutations that enable them to proliferate in the absence of e"ternal e" ternal groth signals. #o achieve this$ some cancers acuire the ability ab ility to secrete groth factors that stimulate their on groth$ a process %non as autocrine stimulation. stimulation. #he other options are not involved in the proliferation of cancer cells in the absence of e"ternal groth g roth signals. &#S 1
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*:. What is the role of careta%er genes? a. Maintenance of genomic integrity b. &roliferation of cancer cells
c. Secretion of groth factors d. 'estoration of normal tissue structure
ANS A
!areta%er genes are responsible for the maintenance of genomic integrity. #he other options are not roles assumed by careta%er genes. &#S 1
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*+. 3n a normal$ nonmutant state$ an oncogene is referred to as a a. Basal cell c. !areta%er gene b. #arget cell d. &roto8oncogene ANS 5
3n its normal nonmutant state$ an oncogene is referred to as a proto-oncogene a proto-oncogene.. #he other options are not terms used to identify a nonmutant oncogene. &#S 1
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*;. Which statement is true regarding true regarding pleomorphic cells? a. &leomorphic cells are similar in si0e. b. #hey share a common shape. c. #hey are a result of anaplasia. d. &leomorphic cells differentiate uniformly. ANS !
3n contrast to normal cells$ hich are uniform in si0e and shape$ anaplastic cells are of variable si0e and shape and abnormally differentiate$ ma%ing them pleomorphic. &#S 1
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*7. What is the most commonly reported symptom of cancer treatment? a. Nausea c. 6air loss b. )atigue d. Weight loss ANS B
)atigue is the most freuently reported symptom of cancer and cancer treatment. Although patients report the other options$ they are not as freuently e"perienced as fatigue. &#S 1
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*9. #he most common site of metastasis for a patient diagnosed ith p rostate cancer is hich
location? a. Bones b. Brain
c. Bladder d. Gidney
ANS A
#he bone$ especially the lumbar spine area$ is the most common metastasis site for prostate cancer. &#S 1
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,<. Which statement concerning benign tumors is true? true? a. #he resulting pain is severe. c. Benign tumors are fast groing. b. Benign tumors are not encapsulated. d. #he cells are ell8differentiated. ell8differentiated. ANS 5
A benign tumor is ell8differentiated ith its tissue appearing similar to the tissue from hich it arose. #he other options are characteristic of a malignant tumor. &#S 1
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MULTIPLE RESPONSE
,1. Normally$ hich cells are considered immortal 2never die4? (#elect all that apply$) a. /erm
b. c. d. e.
Stem Blood (pithelial Muscle
ANS A$ B
=sually$ germ cells 2those that generate sperm and eggs4 and stem cells are the only cells in the body that are immortal. Other cells in the body are not immortal and can divide only a limited number of times. #he remaining options do not identify the appropriate cells. &#S 1
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,-. What is the most common route for distant metastasis? (#elect all that apply$) a. Seeding b. Blood c. Cymphatic Cymphatic vessels d. 3nvasion e. &roliferation ANS B$ !
#o transition transition from local to distant metastasis$ the cancer cells must also be able to invade local blood and lymphatic vessels. #he remaining options are not directly related to distant distant metastasis. &#S 1
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,*. What cellular characteristics are affected by anaplasia? (#elect all that apply$) a. Si0e b. Ability to differentiate c. Cife e"pectancy d. #issue structure e. Shape ANS ANS A$ B$ B$ 5$ 5$ (
Anaplasia is defined as the loss of cellular differentiation$ irregularities of the si0e and shape of the nucleus$ and loss of normal tissue structure. Cife e"pectancy is not generally included in this term. &#S 1
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n osocomial infections among patients ith cancer? ,,. What are the most common causes of nosocomial (#elect all that apply$) a. 3ndelling medical devices b. Suppressed immune system c. Eisitor8intr Eisitor8introduced oduced microorganisms d. &oor appetite e. 3nadeuate ound care ANS A$ !$ !$ (
6ospital8acuired 2nosocomial4 infections increase because of indelling medical devices$ inadeuate ound care$ and the introduction of microorganisms from visitors and other individuals. A suppressed immune system and a poor appetite appe tite are possible causes of infections but they are not nosocomial in nature. &#S 1
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,:. Which statements concerning aging and the occurrence of cancer are true? true? (#elect all that
apply$) a. 5ecline in immunologic functions b. &redisposition to nutritional inadeuacies c. =nillingness to access health care services d. 'eluctance to engage in cancer screenings e. (ffects of immobility on the immune system ANS A$ B$ B$ (
Many common malignancies occur mostly in older age as a result of immunologic functions declining ith age. Older persons are predisposed to nutritional inadeuacies$ and malnutrition impairs immunocompetence. )ar8advanced cancer often results in immobility and general debility that orsens ith age. No research supports a correlation beteen aging and a reluctance to see% health care$ in general$ or cancer screenings$ in particular. &#S 1
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MTCHIN!
%atch the phrases &ith the correspon"ing correspon"ing terms$ HHHHHH A. 3s the process of cancer cell groth. HHHHHH B. 3s used to %ill cancer cells hile minimi0ing damage to normal structures. HHHHHH !. 3s guided by molecular analysis in specific diseases. HHHHHH 5. #a%es #a%es advantage of specific vulnerabilities in specific cancer cells. HHHHHH (. &rovides a frameor% to determine treatment. ,+. ,;. ,7. ,9. :<.
!hemotherapy 'adiation Staging Angiogenesis #arget agent
,+. ANS 5 &#S 1 '() &age *9+ MS! All chemotherapeutic chemotherapeutic agents ta%e ta%e advantage of specific vulnerabilities vulnerabilities in target target cancer cells. cells. ,;. ANS B &#S 1 '() &ages *9;8*97 MS! 'adiation therapy therapy is used to %ill cancer cells cells hile minimi0ing minimi0ing damage to normal structures. structures. ,7. ANS ( &#S 1 '() &ages *9*8*9, MS! Staging may alter alter the choice of of therapy$ therapy$ ith more more aggressive therapy therapy being delivered delivered to more invasive disease 2advanced staging4. ,9. ANS A &#S 1 '() &age *71 MS! Angiogenesis is the process process of groth and proliferation of cancer cells. cells. :<. ANS ! &#S 1 '() &ages *9;8*97 MS! #he neest highly targeted targeted agents that that are used to treat cancer e"ploit e"ploit specific vulnerabilities vulnerabilities uncovered by molecular analysis in specific diseases.
M3!S #he neest highly targeted agents that are used to treat can cer e"ploit specific vulnerabilities uncovered by molecular analysis in specific diseases. %atch the organism factor &ith &ith the cancer it causes$ HHHHHH A. 6&E HHHHHH B. 6uman herpesvirus 266E4 7 HHHHHH !. 6epatis B virus 26BE4 HHHHHH 5. 'elicobacter 5. 'elicobacter pylori :1. :-. :*. :,.
!ervical cancer Gaposi sarcoma Civer cancer Stomach cancer
:1. ANS A &#S 1 '() &ages *7-8*7* MS! 6&E infecti infection on causes causes human cervical cervical cancer cancer.. :-. ANS B &#S 1 '() &age *7* MS! 66E87 66E87 infectio infection n causes Gaposi Gaposi sarcoma. sarcoma. :*. ANS ! &#S 1 '() &age *7* MS! !hronic hepatitis hepatitis infection ith 6BE or or hepatis ! virus virus 26!E4 is the the leading cause cause of liver cancer. :,. ANS 5 &#S 1 '() &age *7, MS! !hronic 6. 6. pylori8associated pylori8associated inflammation inflammation causes causes stomach stomach cancer. cancer.
