Wikipedia twwiki https://tw.wikipedia.org/wiki/Kratafa_Titiriw MediaWiki 1.39.0-wmf.23 first-letter Media Soronko Nkitahode Dwumadini Dwumadini nkitahode Wikipedia Wikipedia nkitahode File File nkitahode MediaWiki MediaWiki nkitahode Nhwɛsoɔ Nhwɛsoɔ nkitahode Mmoa Mmoa nkitahode Nkyekyεmu Nkyekyεmu nkitahode TimedText TimedText talk Module Module talk Gadget Gadget talk Gadget definition Gadget definition talk 3 6468 133293 125514 2022-08-09T12:51:49Z MediaWiki message delivery 4551 /* Translation notification: Wikimedia Foundation elections/2022/Announcement/Board voter email */ new section wikitext text/x-wiki Me din de Kwame Obiri, na me yɛ Ghana ni. Me wɔ ha sɛ mɛboa ama Twi Wikipedia akɔso. [[File:Wikipedia20 animated MediaWiki 1MB.gif|Wikipedia20 animated MediaWiki 1MB]] == How we will see unregistered users == <div lang="en" dir="ltr" class="mw-content-ltr"> <section begin=content/> Hi! You get this message because you are an admin on a Wikimedia wiki. When someone edits a Wikimedia wiki without being logged in today, we show their IP address. As you may already know, we will not be able to do this in the future. This is a decision by the Wikimedia Foundation Legal department, because norms and regulations for privacy online have changed. Instead of the IP we will show a masked identity. You as an admin '''will still be able to access the IP'''. There will also be a new user right for those who need to see the full IPs of unregistered users to fight vandalism, harassment and spam without being admins. Patrollers will also see part of the IP even without this user right. We are also working on [[m:IP Editing: Privacy Enhancement and Abuse Mitigation/Improving tools|better tools]] to help. If you have not seen it before, you can [[m:IP Editing: Privacy Enhancement and Abuse Mitigation|read more on Meta]]. If you want to make sure you don’t miss technical changes on the Wikimedia wikis, you can [[m:Global message delivery/Targets/Tech ambassadors|subscribe]] to [[m:Tech/News|the weekly technical newsletter]]. We have [[m:IP Editing: Privacy Enhancement and Abuse Mitigation#IP Masking Implementation Approaches (FAQ)|two suggested ways]] this identity could work. '''We would appreciate your feedback''' on which way you think would work best for you and your wiki, now and in the future. You can [[m:Talk:IP Editing: Privacy Enhancement and Abuse Mitigation|let us know on the talk page]]. You can write in your language. The suggestions were posted in October and we will decide after 17 January. Thank you. /[[m:User:Johan (WMF)|Johan (WMF)]]<section end=content/> </div> 18:20, 4 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:Johan (WMF)@metawiki using the list at https://meta.wikimedia.org/w/index.php?title=User:Johan_(WMF)/Target_lists/Admins2022(8)&oldid=22532697 --> == Translation notification: Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections|Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+Board+of+Trustees%2FCall+for+feedback%3A+Board+of+Trustees+elections&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-01-10. <div lang="en" class="mw-content-ltr">''This year four seats of the WMF Board of Trustees are to be newly filled and there will be a Call for Feedback about the Board of Trustees selection processes from 10 January to 7 February 2022.'' ''The [[Movement Strategy and Governance]] team is supporting this Call for Feedback. For widest outreach across the Wikiverse we kindly ask you to support this by helping us out with additional translations.'' '''Postscriptum: During the last year many of you have helped us a lot to reach out to many different communities by translating in dozens of languages. We are utterly grateful for this - thanks to all of you for your ongoing support! You are the best!''' </div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 17:25, 7 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections/Call for Feedback about the Board of Trustees elections is now open/Short == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections/Call for Feedback about the Board of Trustees elections is now open/Short|Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections/Call for Feedback about the Board of Trustees elections is now open/Short]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+Board+of+Trustees%2FCall+for+feedback%3A+Board+of+Trustees+elections%2FCall+for+Feedback+about+the+Board+of+Trustees+elections+is+now+open%2FShort&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-01-13. <div lang="en" class="mw-content-ltr">Hi all, the [[Movement Strategy and Governance]] team is asking you for your help. We want to invite communities globally to a Call for Feedback about the Board of Trustees selection processes from 10 January to 7 February 2022. We want to send out a message next Friday to all communities in as many languages as possible. It is '''only 130 words'''! Your help is very much appreciated! Thank you for your time!</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 21:02, 11 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation request == Can you please translate this? : List of articles every Wikipedia should have : Africa is the second largest continent in the world. It makes up about a fifth of the world's land.[3] It is surrounded by large areas of water. There are 54 fully recognised and independent countries in Africa, and 14.7% (1.216 billion) of the world's population lives there.[3] It is thought to be the continent where the first humans evolved. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:17, 18 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}. Okay I will translate it but please do not blank the discussion as it will serve as a reference in future. Thank you --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:38, 18 Ɔpɛpɔn 2022 (UTC) Just a doubt: Is there any relation between Akan and Twi? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 19:01, 18 Ɔpɛpɔn 2022 (UTC) They are the same. Akan is broad -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 19:41, 18 Ɔpɛpɔn 2022 (UTC) If they are the same, how come there are two different wikis? Do you speak both? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 07:50, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}, Kindly check the community portals,there is a discussion where we are trying to reach a consensus to merge both wikis --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:51, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Robertjamal12}} I have written something [https://tw.wikipedia.org/wiki/Wikipedia:Community_Portal#Adeser%C9%9Bde%C9%9B%2FProposal here]. Basically, the ideeal would be to keep tha Akan Wikipedia and transfer the Twi articles there as Akan is the macrolanguage and Twi just a dialect. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:54, 19 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}} ::* '''en''' List of articles every Wikipedia should have ::Africa is the second largest continent in the world. It makes up about a fifth of the world's land.[3] It is surrounded by large areas of water. There are 54 fully recognised and independent countries in Africa, and 14.7% (1.216 billion) of the world's population lives there.[3] It is thought to be the continent where the first humans evolved. ::*'''tw''' Atwerɛsɛm dodoɔ a ɛwɔ sɛ wikipedia ɛnya ::Wɔ wiase afanaa nyinaa Abibirem na ɛtɔ so mmienu a ɛso wɔ wiase. Ɛfa wiase no asaase bɛyɛ nnum. Ɛne nsuo akɛseɛ na atwa ahyia. Yɛwɔ amaman aduonum nan(54) a yɛagye wɔn atom ne wɔn a wɔnnan obiara wɔ abibirem, ɛna ɔhamu nkyekyɛmu du nan akyirepɔ nson(14.7)a ɛyɛ ( ɔpepepe baako, ahanu ne du nsia)(1.216) a nnipa dodoɔ a ɛwɔ wiase te hɔ. Ɛyɛ beaɛ a nnipa a ɛdikan baa wiase tenaeɛ. -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:01, 19 Ɔpɛpɔn 2022 (UTC) I just found this article [[Abibiman]]. Apparently, it means Africa as well. Is it maybe another dialect? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:08, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}, They are literally the same -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:22, 19 Ɔpɛpɔn 2022 (UTC) : I have redirected one to the other. Also, could you please translate this: * The National Development Planning Commission is a Ghanaian state agency committed to eradicating poverty and reducing inequalities in deprived areas and rural communities. * History: The history of Africa begins with the first modern human beings and continues to its present difficult state as a politically developing continent. Thanks --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:44, 19 Ɔpɛpɔn 2022 (UTC) Does "Aburokyiri" mean "Europe"? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 12:34, 19 Ɔpɛpɔn 2022 (UTC) :Yes -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 12:39, 19 Ɔpɛpɔn 2022 (UTC) I believe [[Kratafa a ɛdi mu|this]] one should be deleted. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:09, 19 Ɔpɛpɔn 2022 (UTC) :Definitely - [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:10, 19 Ɔpɛpɔn 2022 (UTC) How do you say "Elections in Ghana"? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:15, 19 Ɔpɛpɔn 2022 (UTC) :Ghana abatoɔ -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:22, 19 Ɔpɛpɔn 2022 (UTC) * Subdivisions of Ghana * Parliament of Ghana * Politics of Ghana * Elections in Africa * Government of Ghana * Ghanaian law --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:24, 19 Ɔpɛpɔn 2022 (UTC) :* Subdivisions of Ghana - I don't get the concept :* Parliament in Ghana - Ghana mmrahyɛbadwam - [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:26, 19 Ɔpɛpɔn 2022 (UTC) :*:* Politics of Ghana - Ghana amanyɔsɛm :*:* Elections in Africa - Abibrem abatoɔ -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:29, 19 Ɔpɛpɔn 2022 (UTC) :*:*:* Government of Ghana - Ghana aban :*:*:* Ghanaian law - Ghana mmra - [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:33, 19 Ɔpɛpɔn 2022 (UTC) == Translation requests == Could you please translate this? * Folk festivals in Ghana ** Music festivals in Ghana *** Festivals in Ghana *** Ghanaian music *** Entertainment events in Ghana *** Arts festivals in Ghana ** Cultural festivals in Ghana *** Festivals in Ghana --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:41, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}} :Ghanaian music > Ghanafoɔ dwom :Music festivals in Ghana > Ghana dwom afahyɛ ahodoɔ :Entertainment events in Ghana > Ghana anigyie dwabɔ ahodoɔ :Cultural festivals in Ghana > Ghana amammrɛ afahyɛ ahodoɔ :Festivals in Ghana > Afahy3 ahodoɔ a ɛwɔ Ghana or Ghana afahyɛ ahodoɔ --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:16, 19 Ɔpɛpɔn 2022 (UTC) * Religious festivals in Ghana * Entertainment in Ghana * Tourist attractions in Ghana * Events in Ghana * District capitals in Ghana --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:35, 19 Ɔpɛpɔn 2022 (UTC) Also, I don't understand this [[:Category:CS1 English-language sources (en)|category]]. Maybe it is better to delete it. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:50, 19 Ɔpɛpɔn 2022 (UTC) :Alright, I will look into it -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:53, 19 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}} Please note that there is a [[tw:Category:Ghana Afahyɛ|category ]] which means Ghanaian Festival(s) -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 15:20, 19 Ɔpɛpɔn 2022 (UTC) : Which one is better "Category:Ghana afahyɛ" or "Category:Ghana afahyɛ ahodoɔ"? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 15:52, 19 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}} Category:Ghana afahyɛ ahodoɔ is better -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 15:53, 19 Ɔpɛpɔn 2022 (UTC) ::: Could you please delete [[:Category:Ghana Afahyɛ|this]]? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 15:58, 19 Ɔpɛpɔn 2022 (UTC) ::::I think its best if redirected -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 16:02, 19 Ɔpɛpɔn 2022 (UTC) :::::Ok, perfect. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 16:51, 19 Ɔpɛpɔn 2022 (UTC) == Translation requests == Could you please translate this? : Africa's ancient historic period includes the rise of Egyptian civilization. It also includes the development of other societies outside the Nile River Valley, and the interaction between these societies and civilizations outside of Africa. Thanks --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 07:34, 20 Ɔpɛpɔn 2022 (UTC) Also, could you please translate this. : Morocco is a country in Africa. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:22, 20 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}. Morocco is a country in Africa - Morocco yɛ ɔman ɛwɔ Abibrem -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:45, 20 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}},we are yet to agree on a term in Twi for that.-- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:50, 20 Ɔpɛpɔn 2022 (UTC) Oh ok. No worries. Would it be possible for you to translate that fragment above about Africa, please? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:52, 20 Ɔpɛpɔn 2022 (UTC) :I'm still working on that, getting the direct translation is a bit difficult -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:53, 20 Ɔpɛpɔn 2022 (UTC) :: Oh, ok, thanks. Also, there is a category named [[:Category:Itali|Itali]] but the article is [[Italy]]. Which one is the correct one? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:01, 20 Ɔpɛpɔn 2022 (UTC) :::They are both correct, Itali can be redirected to Italy -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:04, 20 Ɔpɛpɔn 2022 (UTC) I have found [[Itali|this article]]. I don't know what it says but if it is about Italy the information should be moved to Italy then. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:07, 20 Ɔpɛpɔn 2022 (UTC) :Yeah I agree, there are so many mistakes in that article, the special letters are completely wrong '''ɛ''' is '''3''' and '''ɔ''' is ''')'''. I will fix it later -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:11, 20 Ɔpɛpɔn 2022 (UTC) ::The article is okay just the special letters -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:12, 20 Ɔpɛpɔn 2022 (UTC) :::Could you please translate this? :::This is a list of basic subjects for which Wikipedia should have a corresponding high-quality article, and ideally a featured article. It also serves as a centralized watchlist and tracks the status of some of Wikipedia's most essential articles. :::Ideally this page should list approximately 1,000 of the most vital Wikipedia articles. :::Thanks. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 11:26, 21 Ɔpɛpɔn 2022 (UTC) ::::Ok, This is a bit difficult but will consult a few language experts and get back -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 11:29, 21 Ɔpɛpɔn 2022 (UTC) Hello, how do you say "references" in Twi? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 08:08, 22 Ɔpɛpɔn 2022 (UTC) :We haven't agreed on a term to use yet. There is an upcoming event where we plan to agree on which term to use --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 08:11, 22 Ɔpɛpɔn 2022 (UTC) :. Oh, ok. Could you please translate this? Edgar Alexei Robert von Wahl or de Wahl (23 August 1867 – 9 March 1948) was a Baltic German teacher, mathematician and linguist. He is most famous for being the creator of Interlingue (known as Occidental throughout his life), a naturalistic constructed language based on the Indo-European languages, which was initially published in 1922. Thanks. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 08:37, 22 Ɔpɛpɔn 2022 (UTC) == Translation notification: Template:Education/News/Contents == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Template:Education/News/Contents|Template:Education/News/Contents]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Template%3AEducation%2FNews%2FContents&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 08:48, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Template:Education/News/Drafts == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Template:Education/News/Drafts|Template:Education/News/Drafts]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Template%3AEducation%2FNews%2FDrafts&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 09:00, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation request == How do you say? * Constituencies of the Parliament of Ghana * List of Ghana Parliament constituencies * Parliament of Ghana --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:40, 22 Ɔpɛpɔn 2022 (UTC) :Constituencies of the Parliament of Ghana - Ghana mmrahyɛbadwam mpɛsoa :List of Ghana Parliament constituencies - Mpɛsoa dodoɔ a ɛwɔ Ghana mmrahyɛbadwam :Parliament of Ghana - Ghana mmrahyɛbadwam :-- {{ping|Caro de Segeda}} [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:46, 22 Ɔpɛpɔn 2022 (UTC) ::Thank you so much for the help here. it's really helping -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:51, 22 Ɔpɛpɔn 2022 (UTC) I have changed [[Template:Ghanaian constituencies|this]] template. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:50, 22 Ɔpɛpɔn 2022 (UTC) :Thank you, I really appreciate that -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:52, 22 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}}, Please could you make the V.T.E on the template horizontal. It's vervital and makes the box big even if its closed -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:57, 22 Ɔpɛpɔn 2022 (UTC) :::I am sorry but my knowledge about template is not that advanced. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:59, 22 Ɔpɛpɔn 2022 (UTC) ::::Ok no worries, Thank you [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:02, 22 Ɔpɛpɔn 2022 (UTC) :::::Could you please translate this? Cosmoglotta is the central journal of the Interlingue movement and the official journal of the Interlingue-Union. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:16, 22 Ɔpɛpɔn 2022 (UTC) ::::::I saw you created [[tw:Category:Mantamu a ɛwɔ Ghana|this]] category but another exist already [[tw:category:Mantam a ɛwɔ Ghana|here]] --{{ping| Caro de Segeda}} [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:19, 22 Ɔpɛpɔn 2022 (UTC) ::::::sorry if I don't respond to your translations in time. Some of the words needs confirmation [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:31, 22 Ɔpɛpɔn 2022 (UTC) :::::::Oh, no worries. Thanks for letting me know. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:47, 22 Ɔpɛpɔn 2022 (UTC) ::::::::Could you please translate this? Edgar de Wahl (23 August 1867 – 9 March 1948) was a Baltic German teacher, mathematician and linguist. He is most famous for being the creator of Interlingue (known as Occidental throughout his life), a naturalistic constructed language based on the Indo-European languages, which was initially published in 1922. ::::::::Thanks [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 16:28, 23 Ɔpɛpɔn 2022 (UTC) == Translation notification: Template:Education/News/Drafts == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Template:Education/News/Drafts|Template:Education/News/Drafts]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Template%3AEducation%2FNews%2FDrafts&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 14:33, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Education/Newsletter/January 2022/Headlines == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Education/Newsletter/January 2022/Headlines|Education/Newsletter/January 2022/Headlines]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Education%2FNewsletter%2FJanuary+2022%2FHeadlines&language=tw&action=page translate to Twi] The priority of this page is high. The deadline for translating this page is 2022-01-24. <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 17:26, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Education/Newsletter/January 2022 == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Education/Newsletter/January 2022|Education/Newsletter/January 2022]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Education%2FNewsletter%2FJanuary+2022&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 17:29, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Leadership Development Task Force/Call for Feedback Announcement == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Leadership Development Task Force/Call for Feedback Announcement|Leadership Development Task Force/Call for Feedback Announcement]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Leadership+Development+Task+Force%2FCall+for+Feedback+Announcement&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-02-07. <div lang="en" class="mw-content-ltr">Good day to you from [[Movement Strategy and Governance]]! The coming weeks see a Call for Feedback concerning the creation of a movementwide [[Leadership_Development_Task_Force]]. We are announcing it by a short message of '''only 60 words''' to be distributed globally on Tuesday. Global distribution asks for native language support, so we kindly ask for your help to have as many translations as possible available. It should be a few minutes of work only. Thank you very much for your help, [[User:MediaWiki message delivery|MediaWiki message delivery]] ([[User talk:MediaWiki message delivery|talk]]) 10:13, 4 Ogyefuo 2022 (UTC)</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 10:13, 4 Ogyefuo 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: ContribuLing 2022 == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:ContribuLing 2022|ContribuLing 2022]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-ContribuLing+2022&language=tw&action=page translate to Twi] The priority of this page is medium. <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 12:05, 12 Ogyefuo 2022 (UTC) <!-- Message sent by User:WikiLucas00@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Universal Code of Conduct/Enforcement guidelines == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Universal Code of Conduct/Enforcement guidelines|Universal Code of Conduct/Enforcement guidelines]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Universal+Code+of+Conduct%2FEnforcement+guidelines&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 15:18, 22 Ogyefuo 2022 (UTC) <!-- Message sent by User:Ericliu1912@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Ukraine's Cultural Diplomacy Month == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Ukraine's Cultural Diplomacy Month|Ukraine's Cultural Diplomacy Month]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Ukraine%27s+Cultural+Diplomacy+Month&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 01:50, 2 Ɔbɛnem 2022 (UTC) <!-- Message sent by User:Juan90264@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Article creations == Hello. It seems like some articles you created, such as [[Ama Pomaa Boateng]], were copied from akwiki ([[:ak:Ama Pomaa Boateng]]). Even if there are not changes needed to translate between the two languages, you do need to attribute the copied content as per [[:en:Wikipedia:Text of Creative Commons Attribution-ShareAlike 3.0 Unported License|the license]]. This could just be a note in an edit summary of the source, a note on the article's talk page, or similar. Please let me know if you have any questions. Best regards, [[User:Vermont|Vermont]] ([[User talk:Vermont|Nkitahode bea]]) 02:38, 2 Ɔbɛnem 2022 (UTC) :Hello {{ping|Vermont}}, Thank you for the heads up. -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 06:52, 2 Ɔbɛnem 2022 (UTC) == Translation notification: Universal Code of Conduct/Enforcement guidelines/Voting/Translations == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Universal Code of Conduct/Enforcement guidelines/Voting/Translations|Universal Code of Conduct/Enforcement guidelines/Voting/Translations]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Universal+Code+of+Conduct%2FEnforcement+guidelines%2FVoting%2FTranslations&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-03-06. <div lang="en" class="mw-content-ltr">Next Monday the ratification for the UCoC Enforcement Guidelines starts, an important step concerning an important document. We would like to invite people from all the global communities to take part in this process. To make the voting available in as many native languages as possible, we would appreciate your help in translations! '''This is 189 words only''', just a few minutes of simple work and it is an important contribution to strengthen your community's voice. Thank you very much for your help, [[User:DBarthel (WMF)|DBarthel (WMF)]] </div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 13:51, 4 Ɔbɛnem 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Have you voted in the UCoC enforcement guidelines ratification? == Hi! {{ping|User:Robertjamal12}} The ratification voting process for the [[m:Special:MyLanguage/Universal Code of Conduct/Enforcement guidelines|revised enforcement guidelines]] of the [[m:Special:MyLanguage/Universal Code of Conduct|Universal Code of Conduct]] (UCoC) is now open! '''[[m:Special:MyLanguage/Universal Code of Conduct/Enforcement guidelines/Voting|Voting commenced on SecurePoll]]''' on 7 March 2022 and will conclude on 21 March 2022. Please [[m:Universal Code of Conduct/Enforcement guidelines/Voter information|read more on the voter information and eligibility details]]. Please vote and encourage other editors of Twi Wikipedia to also vote. Regards,[[User:Zuz (WMF)|Zuz (WMF)]] ([[User talk:Zuz (WMF)|Nkitahode beaɛ]]) 11:18, 11 Ɔbɛnem 2022 (UTC) == IP Block Exemption == Hi! {{ping|User:Robertjamal12}} Please, can you add these usernames to IP block exemptions. We are working on a project and they have been blocked Username: Naa Dromo Akai Username: Zinatu J Username: O.A.Janet Username: W. Entsie Username: Nyarko O.R Username: Obengkofi Username: Kebenyi Regards, [[User:Jemima2019|Jemima2019]] ([[User talk:Jemima2019|Nkitahode beaɛ]]) 17:25, 15 Ɔbɛnem 2022 (UTC) :Ok sure -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 18:18, 15 Ɔbɛnem 2022 (UTC) == Account creation == Hi! {{ping|User:Robertjamal12}} Please can you create an account for these people. Username: Naa dromo E-mail: dromonaakai@gmail.com Username: O.A. Janet E-mail: janetobeng64@gmail.com Username: W. Entsie E-mail: williamentsie641@gmail.com. Username: Nyarko O.R E-mail: rachelnyarko99@gmail.com Username :Tutu E-mail: stephenofosu82@gmail.com Username: kebenyi E-mail: benyikweku100@gmail.com Username: kofiobeng E-mail : asarek662@gmail.com Regards, [[User:Jemima2019|Jemima2019]] ([[User talk:Jemima2019|Nkitahode beaɛ]]) 12:46, 16 Ɔbɛnem 2022 (UTC) == Translation notification: ContribuLing 2022/Program == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:ContribuLing 2022/Program|ContribuLing 2022/Program]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-ContribuLing+2022%2FProgram&language=tw&action=page translate to Twi] The priority of this page is medium. The deadline for translating this page is 2022-03-31. <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 15:49, 26 Ɔbɛnem 2022 (UTC) <!-- Message sent by User:WikiLucas00@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: GLAM School/Questions == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:GLAM School/Questions|GLAM School/Questions]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-GLAM+School%2FQuestions&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-12-31. <div lang="en" class="mw-content-ltr">GLAM School is a project by AvoinGLAM to chart out, uncover, and support practices that help GLAM professionals, GLAM-Wiki volunteers, Open GLAM advocates and others to be more empowered to contribute to Wikimedia and other open projects. In 2022 we are conducting surveys, chats, and interviews across organizations and networks involved in providing Open Access to cultural heritage. This page lists the questions that are used in the survey and the interviews.</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 08:53, 26 Oforisuo 2022 (UTC) <!-- Message sent by User:Susannaanas@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: GLAM School/Questions == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:GLAM School/Questions|GLAM School/Questions]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-GLAM+School%2FQuestions&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-12-31. <div lang="en" class="mw-content-ltr">Thank you for the wonderful work you are doing! I have made a couple of small modifications to the existing text and added one new section. I hope you would be willing to have a look at those. Thank you again! Cheers, Susanna</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 07:07, 29 Oforisuo 2022 (UTC) <!-- Message sent by User:Susannaanas@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: GLAM School == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:GLAM School|GLAM School]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-GLAM+School&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-12-31. <div lang="en" class="mw-content-ltr">The GLAM School main page is ready for translation. I hope the syntax still remained correct after I changed the page a lot. Thank you for your amazing help!</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 18:20, 4 Kotonimma 2022 (UTC) <!-- Message sent by User:Susannaanas@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == How to add today's featured articles/news on main page (home page) == Greetings Robertjamal12! How are "today's featured articles/news" added on main page of a Wikipedia without changing or touching the Wikipedia main page itself? I have seen on Chewa Wikipedia (ny.wikipedia.org) and on your home wiki of Twi Wikipedia that featured articles and news change almost every two days,if not in a day, yet if you check the "main page history",it shows it was last edited in 2021 or few months ago.But its content change every day. How do these articles change periodically? Where are they written? Is there some place where they are first written before showing up on main page? Your quick response will be highly appreciated! Thank you! [[Dwumadini:Tumbuka Arch|Tumbuka Arch]] ([[Dwumadini nkitahode:Tumbuka Arch|Nkitahode beaɛ]]) 17:33, 26 Ayɛwohomumɔ 2022 (UTC) :Hello {{ping|Tumbuka Arch}}, Thank you for reaching out, as Amir indicated 1. '''Put the content of the featured article or news in a template'''. Please do you know your way around Templates? Kindly share a link to your home wiki, then let's create it together -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 08:52, 27 Ayɛwohomumɔ 2022 (UTC) ::Hello Robertjamal12, ::Thank you for a helping hand. ::Please lets create. ::This wiki is (tum.wikipedia.org) and its my home wiki and i am a native speaker of that language (Tumbuka).Everything else on this wiki has been done by myself including fixing the home page by manually adding featured articles(without using templates) ,page colours,search buttons,page dates,etc,.Last month i signed on translate wiki and translated the whole wiki myself before the interface came live in Tumbuka language 4 days ago. ::Back to the case on hand,i really like the way your home page of Twi looks.Unfortunately,I don't know how to create these templates of featured articles\news but i know the other templates used when creating a notable person's bio such as ''infobox templates''. ::Even if you direct me well, i may get stuck somewhere,so would you please just do it yourself on my home page as i watch and learn? It would be great if it looks exactly like yours(your Twi home page) or any other way around.If there may be something that you need to ask or point on the wiki,i am here. ::I am the most contributor on this wiki with over 2,200 edits and the most active user on the wiki. ::Thank you! ::Your quick action will highly be appreciated. [[Dwumadini:Tumbuka Arch|Tumbuka Arch]] ([[Dwumadini nkitahode:Tumbuka Arch|Nkitahode beaɛ]]) 04:46, 29 Ayɛwohomumɔ 2022 (UTC) == Translation notification: Wikimedia Foundation elections/2022/Announcement/Board voter email == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation elections/2022/Announcement/Board voter email|Wikimedia Foundation elections/2022/Announcement/Board voter email]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+elections%2F2022%2FAnnouncement%2FBoard+voter+email&language=tw&action=page translate to Twi] The priority of this page is high. <div lang="en" class="mw-content-ltr">Hi all! The community vote of this year's Board Elections are close. As always voter mails will be sent out. To invite as many community members as possible in their native tongue your help is very much appreciated. While there are already plenty of translations we would appreciate you to check for languages still missing and to contribute translations for these. The mails are short, just a bit about two times '''200 words''', a few minutes of work. Your support is very important as it helps communities to learn about the election and to cast their vote. Best, Denis Barthel (WMF) (Movement Strategy and Governance)</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 12:51, 9 Ɔsanaa 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> ak4am6ugikuzbk0vbn82nldiut7k4h4 133302 133293 2022-08-09T21:51:17Z MediaWiki message delivery 4551 /* Translation notification: Wikimedia Foundation elections/2022/Announcement/Board voter email */ new section wikitext text/x-wiki Me din de Kwame Obiri, na me yɛ Ghana ni. Me wɔ ha sɛ mɛboa ama Twi Wikipedia akɔso. [[File:Wikipedia20 animated MediaWiki 1MB.gif|Wikipedia20 animated MediaWiki 1MB]] == How we will see unregistered users == <div lang="en" dir="ltr" class="mw-content-ltr"> <section begin=content/> Hi! You get this message because you are an admin on a Wikimedia wiki. When someone edits a Wikimedia wiki without being logged in today, we show their IP address. As you may already know, we will not be able to do this in the future. This is a decision by the Wikimedia Foundation Legal department, because norms and regulations for privacy online have changed. Instead of the IP we will show a masked identity. You as an admin '''will still be able to access the IP'''. There will also be a new user right for those who need to see the full IPs of unregistered users to fight vandalism, harassment and spam without being admins. Patrollers will also see part of the IP even without this user right. We are also working on [[m:IP Editing: Privacy Enhancement and Abuse Mitigation/Improving tools|better tools]] to help. If you have not seen it before, you can [[m:IP Editing: Privacy Enhancement and Abuse Mitigation|read more on Meta]]. If you want to make sure you don’t miss technical changes on the Wikimedia wikis, you can [[m:Global message delivery/Targets/Tech ambassadors|subscribe]] to [[m:Tech/News|the weekly technical newsletter]]. We have [[m:IP Editing: Privacy Enhancement and Abuse Mitigation#IP Masking Implementation Approaches (FAQ)|two suggested ways]] this identity could work. '''We would appreciate your feedback''' on which way you think would work best for you and your wiki, now and in the future. You can [[m:Talk:IP Editing: Privacy Enhancement and Abuse Mitigation|let us know on the talk page]]. You can write in your language. The suggestions were posted in October and we will decide after 17 January. Thank you. /[[m:User:Johan (WMF)|Johan (WMF)]]<section end=content/> </div> 18:20, 4 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:Johan (WMF)@metawiki using the list at https://meta.wikimedia.org/w/index.php?title=User:Johan_(WMF)/Target_lists/Admins2022(8)&oldid=22532697 --> == Translation notification: Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections|Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+Board+of+Trustees%2FCall+for+feedback%3A+Board+of+Trustees+elections&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-01-10. <div lang="en" class="mw-content-ltr">''This year four seats of the WMF Board of Trustees are to be newly filled and there will be a Call for Feedback about the Board of Trustees selection processes from 10 January to 7 February 2022.'' ''The [[Movement Strategy and Governance]] team is supporting this Call for Feedback. For widest outreach across the Wikiverse we kindly ask you to support this by helping us out with additional translations.'' '''Postscriptum: During the last year many of you have helped us a lot to reach out to many different communities by translating in dozens of languages. We are utterly grateful for this - thanks to all of you for your ongoing support! You are the best!''' </div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 17:25, 7 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections/Call for Feedback about the Board of Trustees elections is now open/Short == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections/Call for Feedback about the Board of Trustees elections is now open/Short|Wikimedia Foundation Board of Trustees/Call for feedback: Board of Trustees elections/Call for Feedback about the Board of Trustees elections is now open/Short]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+Board+of+Trustees%2FCall+for+feedback%3A+Board+of+Trustees+elections%2FCall+for+Feedback+about+the+Board+of+Trustees+elections+is+now+open%2FShort&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-01-13. <div lang="en" class="mw-content-ltr">Hi all, the [[Movement Strategy and Governance]] team is asking you for your help. We want to invite communities globally to a Call for Feedback about the Board of Trustees selection processes from 10 January to 7 February 2022. We want to send out a message next Friday to all communities in as many languages as possible. It is '''only 130 words'''! Your help is very much appreciated! Thank you for your time!</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 21:02, 11 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation request == Can you please translate this? : List of articles every Wikipedia should have : Africa is the second largest continent in the world. It makes up about a fifth of the world's land.[3] It is surrounded by large areas of water. There are 54 fully recognised and independent countries in Africa, and 14.7% (1.216 billion) of the world's population lives there.[3] It is thought to be the continent where the first humans evolved. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:17, 18 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}. Okay I will translate it but please do not blank the discussion as it will serve as a reference in future. Thank you --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:38, 18 Ɔpɛpɔn 2022 (UTC) Just a doubt: Is there any relation between Akan and Twi? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 19:01, 18 Ɔpɛpɔn 2022 (UTC) They are the same. Akan is broad -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 19:41, 18 Ɔpɛpɔn 2022 (UTC) If they are the same, how come there are two different wikis? Do you speak both? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 07:50, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}, Kindly check the community portals,there is a discussion where we are trying to reach a consensus to merge both wikis --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:51, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Robertjamal12}} I have written something [https://tw.wikipedia.org/wiki/Wikipedia:Community_Portal#Adeser%C9%9Bde%C9%9B%2FProposal here]. Basically, the ideeal would be to keep tha Akan Wikipedia and transfer the Twi articles there as Akan is the macrolanguage and Twi just a dialect. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:54, 19 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}} ::* '''en''' List of articles every Wikipedia should have ::Africa is the second largest continent in the world. It makes up about a fifth of the world's land.[3] It is surrounded by large areas of water. There are 54 fully recognised and independent countries in Africa, and 14.7% (1.216 billion) of the world's population lives there.[3] It is thought to be the continent where the first humans evolved. ::*'''tw''' Atwerɛsɛm dodoɔ a ɛwɔ sɛ wikipedia ɛnya ::Wɔ wiase afanaa nyinaa Abibirem na ɛtɔ so mmienu a ɛso wɔ wiase. Ɛfa wiase no asaase bɛyɛ nnum. Ɛne nsuo akɛseɛ na atwa ahyia. Yɛwɔ amaman aduonum nan(54) a yɛagye wɔn atom ne wɔn a wɔnnan obiara wɔ abibirem, ɛna ɔhamu nkyekyɛmu du nan akyirepɔ nson(14.7)a ɛyɛ ( ɔpepepe baako, ahanu ne du nsia)(1.216) a nnipa dodoɔ a ɛwɔ wiase te hɔ. Ɛyɛ beaɛ a nnipa a ɛdikan baa wiase tenaeɛ. -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:01, 19 Ɔpɛpɔn 2022 (UTC) I just found this article [[Abibiman]]. Apparently, it means Africa as well. Is it maybe another dialect? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:08, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}, They are literally the same -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:22, 19 Ɔpɛpɔn 2022 (UTC) : I have redirected one to the other. Also, could you please translate this: * The National Development Planning Commission is a Ghanaian state agency committed to eradicating poverty and reducing inequalities in deprived areas and rural communities. * History: The history of Africa begins with the first modern human beings and continues to its present difficult state as a politically developing continent. Thanks --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:44, 19 Ɔpɛpɔn 2022 (UTC) Does "Aburokyiri" mean "Europe"? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 12:34, 19 Ɔpɛpɔn 2022 (UTC) :Yes -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 12:39, 19 Ɔpɛpɔn 2022 (UTC) I believe [[Kratafa a ɛdi mu|this]] one should be deleted. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:09, 19 Ɔpɛpɔn 2022 (UTC) :Definitely - [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:10, 19 Ɔpɛpɔn 2022 (UTC) How do you say "Elections in Ghana"? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:15, 19 Ɔpɛpɔn 2022 (UTC) :Ghana abatoɔ -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:22, 19 Ɔpɛpɔn 2022 (UTC) * Subdivisions of Ghana * Parliament of Ghana * Politics of Ghana * Elections in Africa * Government of Ghana * Ghanaian law --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:24, 19 Ɔpɛpɔn 2022 (UTC) :* Subdivisions of Ghana - I don't get the concept :* Parliament in Ghana - Ghana mmrahyɛbadwam - [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:26, 19 Ɔpɛpɔn 2022 (UTC) :*:* Politics of Ghana - Ghana amanyɔsɛm :*:* Elections in Africa - Abibrem abatoɔ -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:29, 19 Ɔpɛpɔn 2022 (UTC) :*:*:* Government of Ghana - Ghana aban :*:*:* Ghanaian law - Ghana mmra - [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:33, 19 Ɔpɛpɔn 2022 (UTC) == Translation requests == Could you please translate this? * Folk festivals in Ghana ** Music festivals in Ghana *** Festivals in Ghana *** Ghanaian music *** Entertainment events in Ghana *** Arts festivals in Ghana ** Cultural festivals in Ghana *** Festivals in Ghana --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:41, 19 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}} :Ghanaian music > Ghanafoɔ dwom :Music festivals in Ghana > Ghana dwom afahyɛ ahodoɔ :Entertainment events in Ghana > Ghana anigyie dwabɔ ahodoɔ :Cultural festivals in Ghana > Ghana amammrɛ afahyɛ ahodoɔ :Festivals in Ghana > Afahy3 ahodoɔ a ɛwɔ Ghana or Ghana afahyɛ ahodoɔ --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:16, 19 Ɔpɛpɔn 2022 (UTC) * Religious festivals in Ghana * Entertainment in Ghana * Tourist attractions in Ghana * Events in Ghana * District capitals in Ghana --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:35, 19 Ɔpɛpɔn 2022 (UTC) Also, I don't understand this [[:Category:CS1 English-language sources (en)|category]]. Maybe it is better to delete it. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:50, 19 Ɔpɛpɔn 2022 (UTC) :Alright, I will look into it -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:53, 19 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}} Please note that there is a [[tw:Category:Ghana Afahyɛ|category ]] which means Ghanaian Festival(s) -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 15:20, 19 Ɔpɛpɔn 2022 (UTC) : Which one is better "Category:Ghana afahyɛ" or "Category:Ghana afahyɛ ahodoɔ"? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 15:52, 19 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}} Category:Ghana afahyɛ ahodoɔ is better -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 15:53, 19 Ɔpɛpɔn 2022 (UTC) ::: Could you please delete [[:Category:Ghana Afahyɛ|this]]? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 15:58, 19 Ɔpɛpɔn 2022 (UTC) ::::I think its best if redirected -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 16:02, 19 Ɔpɛpɔn 2022 (UTC) :::::Ok, perfect. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 16:51, 19 Ɔpɛpɔn 2022 (UTC) == Translation requests == Could you please translate this? : Africa's ancient historic period includes the rise of Egyptian civilization. It also includes the development of other societies outside the Nile River Valley, and the interaction between these societies and civilizations outside of Africa. Thanks --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 07:34, 20 Ɔpɛpɔn 2022 (UTC) Also, could you please translate this. : Morocco is a country in Africa. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:22, 20 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}}. Morocco is a country in Africa - Morocco yɛ ɔman ɛwɔ Abibrem -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:45, 20 Ɔpɛpɔn 2022 (UTC) :{{ping|Caro de Segeda}},we are yet to agree on a term in Twi for that.-- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:50, 20 Ɔpɛpɔn 2022 (UTC) Oh ok. No worries. Would it be possible for you to translate that fragment above about Africa, please? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 13:52, 20 Ɔpɛpɔn 2022 (UTC) :I'm still working on that, getting the direct translation is a bit difficult -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 13:53, 20 Ɔpɛpɔn 2022 (UTC) :: Oh, ok, thanks. Also, there is a category named [[:Category:Itali|Itali]] but the article is [[Italy]]. Which one is the correct one? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:01, 20 Ɔpɛpɔn 2022 (UTC) :::They are both correct, Itali can be redirected to Italy -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:04, 20 Ɔpɛpɔn 2022 (UTC) I have found [[Itali|this article]]. I don't know what it says but if it is about Italy the information should be moved to Italy then. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 14:07, 20 Ɔpɛpɔn 2022 (UTC) :Yeah I agree, there are so many mistakes in that article, the special letters are completely wrong '''ɛ''' is '''3''' and '''ɔ''' is ''')'''. I will fix it later -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:11, 20 Ɔpɛpɔn 2022 (UTC) ::The article is okay just the special letters -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 14:12, 20 Ɔpɛpɔn 2022 (UTC) :::Could you please translate this? :::This is a list of basic subjects for which Wikipedia should have a corresponding high-quality article, and ideally a featured article. It also serves as a centralized watchlist and tracks the status of some of Wikipedia's most essential articles. :::Ideally this page should list approximately 1,000 of the most vital Wikipedia articles. :::Thanks. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 11:26, 21 Ɔpɛpɔn 2022 (UTC) ::::Ok, This is a bit difficult but will consult a few language experts and get back -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 11:29, 21 Ɔpɛpɔn 2022 (UTC) Hello, how do you say "references" in Twi? --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 08:08, 22 Ɔpɛpɔn 2022 (UTC) :We haven't agreed on a term to use yet. There is an upcoming event where we plan to agree on which term to use --- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 08:11, 22 Ɔpɛpɔn 2022 (UTC) :. Oh, ok. Could you please translate this? Edgar Alexei Robert von Wahl or de Wahl (23 August 1867 – 9 March 1948) was a Baltic German teacher, mathematician and linguist. He is most famous for being the creator of Interlingue (known as Occidental throughout his life), a naturalistic constructed language based on the Indo-European languages, which was initially published in 1922. Thanks. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 08:37, 22 Ɔpɛpɔn 2022 (UTC) == Translation notification: Template:Education/News/Contents == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Template:Education/News/Contents|Template:Education/News/Contents]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Template%3AEducation%2FNews%2FContents&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 08:48, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Template:Education/News/Drafts == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Template:Education/News/Drafts|Template:Education/News/Drafts]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Template%3AEducation%2FNews%2FDrafts&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 09:00, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation request == How do you say? * Constituencies of the Parliament of Ghana * List of Ghana Parliament constituencies * Parliament of Ghana --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:40, 22 Ɔpɛpɔn 2022 (UTC) :Constituencies of the Parliament of Ghana - Ghana mmrahyɛbadwam mpɛsoa :List of Ghana Parliament constituencies - Mpɛsoa dodoɔ a ɛwɔ Ghana mmrahyɛbadwam :Parliament of Ghana - Ghana mmrahyɛbadwam :-- {{ping|Caro de Segeda}} [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:46, 22 Ɔpɛpɔn 2022 (UTC) ::Thank you so much for the help here. it's really helping -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:51, 22 Ɔpɛpɔn 2022 (UTC) I have changed [[Template:Ghanaian constituencies|this]] template. --[[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:50, 22 Ɔpɛpɔn 2022 (UTC) :Thank you, I really appreciate that -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:52, 22 Ɔpɛpɔn 2022 (UTC) ::{{ping|Caro de Segeda}}, Please could you make the V.T.E on the template horizontal. It's vervital and makes the box big even if its closed -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 09:57, 22 Ɔpɛpɔn 2022 (UTC) :::I am sorry but my knowledge about template is not that advanced. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 09:59, 22 Ɔpɛpɔn 2022 (UTC) ::::Ok no worries, Thank you [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:02, 22 Ɔpɛpɔn 2022 (UTC) :::::Could you please translate this? Cosmoglotta is the central journal of the Interlingue movement and the official journal of the Interlingue-Union. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:16, 22 Ɔpɛpɔn 2022 (UTC) ::::::I saw you created [[tw:Category:Mantamu a ɛwɔ Ghana|this]] category but another exist already [[tw:category:Mantam a ɛwɔ Ghana|here]] --{{ping| Caro de Segeda}} [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:19, 22 Ɔpɛpɔn 2022 (UTC) ::::::sorry if I don't respond to your translations in time. Some of the words needs confirmation [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 10:31, 22 Ɔpɛpɔn 2022 (UTC) :::::::Oh, no worries. Thanks for letting me know. [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 10:47, 22 Ɔpɛpɔn 2022 (UTC) ::::::::Could you please translate this? Edgar de Wahl (23 August 1867 – 9 March 1948) was a Baltic German teacher, mathematician and linguist. He is most famous for being the creator of Interlingue (known as Occidental throughout his life), a naturalistic constructed language based on the Indo-European languages, which was initially published in 1922. ::::::::Thanks [[User:Caro de Segeda|Caro de Segeda]] ([[User talk:Caro de Segeda|talk]]) 16:28, 23 Ɔpɛpɔn 2022 (UTC) == Translation notification: Template:Education/News/Drafts == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Template:Education/News/Drafts|Template:Education/News/Drafts]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Template%3AEducation%2FNews%2FDrafts&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 14:33, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Education/Newsletter/January 2022/Headlines == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Education/Newsletter/January 2022/Headlines|Education/Newsletter/January 2022/Headlines]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Education%2FNewsletter%2FJanuary+2022%2FHeadlines&language=tw&action=page translate to Twi] The priority of this page is high. The deadline for translating this page is 2022-01-24. <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 17:26, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Education/Newsletter/January 2022 == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Education/Newsletter/January 2022|Education/Newsletter/January 2022]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Education%2FNewsletter%2FJanuary+2022&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 17:29, 22 Ɔpɛpɔn 2022 (UTC) <!-- Message sent by User:ZI Jony@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Leadership Development Task Force/Call for Feedback Announcement == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Leadership Development Task Force/Call for Feedback Announcement|Leadership Development Task Force/Call for Feedback Announcement]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Leadership+Development+Task+Force%2FCall+for+Feedback+Announcement&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-02-07. <div lang="en" class="mw-content-ltr">Good day to you from [[Movement Strategy and Governance]]! The coming weeks see a Call for Feedback concerning the creation of a movementwide [[Leadership_Development_Task_Force]]. We are announcing it by a short message of '''only 60 words''' to be distributed globally on Tuesday. Global distribution asks for native language support, so we kindly ask for your help to have as many translations as possible available. It should be a few minutes of work only. Thank you very much for your help, [[User:MediaWiki message delivery|MediaWiki message delivery]] ([[User talk:MediaWiki message delivery|talk]]) 10:13, 4 Ogyefuo 2022 (UTC)</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 10:13, 4 Ogyefuo 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: ContribuLing 2022 == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:ContribuLing 2022|ContribuLing 2022]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-ContribuLing+2022&language=tw&action=page translate to Twi] The priority of this page is medium. <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 12:05, 12 Ogyefuo 2022 (UTC) <!-- Message sent by User:WikiLucas00@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Universal Code of Conduct/Enforcement guidelines == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Universal Code of Conduct/Enforcement guidelines|Universal Code of Conduct/Enforcement guidelines]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Universal+Code+of+Conduct%2FEnforcement+guidelines&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 15:18, 22 Ogyefuo 2022 (UTC) <!-- Message sent by User:Ericliu1912@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Ukraine's Cultural Diplomacy Month == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Ukraine's Cultural Diplomacy Month|Ukraine's Cultural Diplomacy Month]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Ukraine%27s+Cultural+Diplomacy+Month&language=tw&action=page translate to Twi] <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 01:50, 2 Ɔbɛnem 2022 (UTC) <!-- Message sent by User:Juan90264@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Article creations == Hello. It seems like some articles you created, such as [[Ama Pomaa Boateng]], were copied from akwiki ([[:ak:Ama Pomaa Boateng]]). Even if there are not changes needed to translate between the two languages, you do need to attribute the copied content as per [[:en:Wikipedia:Text of Creative Commons Attribution-ShareAlike 3.0 Unported License|the license]]. This could just be a note in an edit summary of the source, a note on the article's talk page, or similar. Please let me know if you have any questions. Best regards, [[User:Vermont|Vermont]] ([[User talk:Vermont|Nkitahode bea]]) 02:38, 2 Ɔbɛnem 2022 (UTC) :Hello {{ping|Vermont}}, Thank you for the heads up. -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 06:52, 2 Ɔbɛnem 2022 (UTC) == Translation notification: Universal Code of Conduct/Enforcement guidelines/Voting/Translations == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Universal Code of Conduct/Enforcement guidelines/Voting/Translations|Universal Code of Conduct/Enforcement guidelines/Voting/Translations]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Universal+Code+of+Conduct%2FEnforcement+guidelines%2FVoting%2FTranslations&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-03-06. <div lang="en" class="mw-content-ltr">Next Monday the ratification for the UCoC Enforcement Guidelines starts, an important step concerning an important document. We would like to invite people from all the global communities to take part in this process. To make the voting available in as many native languages as possible, we would appreciate your help in translations! '''This is 189 words only''', just a few minutes of simple work and it is an important contribution to strengthen your community's voice. Thank you very much for your help, [[User:DBarthel (WMF)|DBarthel (WMF)]] </div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 13:51, 4 Ɔbɛnem 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Have you voted in the UCoC enforcement guidelines ratification? == Hi! {{ping|User:Robertjamal12}} The ratification voting process for the [[m:Special:MyLanguage/Universal Code of Conduct/Enforcement guidelines|revised enforcement guidelines]] of the [[m:Special:MyLanguage/Universal Code of Conduct|Universal Code of Conduct]] (UCoC) is now open! '''[[m:Special:MyLanguage/Universal Code of Conduct/Enforcement guidelines/Voting|Voting commenced on SecurePoll]]''' on 7 March 2022 and will conclude on 21 March 2022. Please [[m:Universal Code of Conduct/Enforcement guidelines/Voter information|read more on the voter information and eligibility details]]. Please vote and encourage other editors of Twi Wikipedia to also vote. Regards,[[User:Zuz (WMF)|Zuz (WMF)]] ([[User talk:Zuz (WMF)|Nkitahode beaɛ]]) 11:18, 11 Ɔbɛnem 2022 (UTC) == IP Block Exemption == Hi! {{ping|User:Robertjamal12}} Please, can you add these usernames to IP block exemptions. We are working on a project and they have been blocked Username: Naa Dromo Akai Username: Zinatu J Username: O.A.Janet Username: W. Entsie Username: Nyarko O.R Username: Obengkofi Username: Kebenyi Regards, [[User:Jemima2019|Jemima2019]] ([[User talk:Jemima2019|Nkitahode beaɛ]]) 17:25, 15 Ɔbɛnem 2022 (UTC) :Ok sure -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 18:18, 15 Ɔbɛnem 2022 (UTC) == Account creation == Hi! {{ping|User:Robertjamal12}} Please can you create an account for these people. Username: Naa dromo E-mail: dromonaakai@gmail.com Username: O.A. Janet E-mail: janetobeng64@gmail.com Username: W. Entsie E-mail: williamentsie641@gmail.com. Username: Nyarko O.R E-mail: rachelnyarko99@gmail.com Username :Tutu E-mail: stephenofosu82@gmail.com Username: kebenyi E-mail: benyikweku100@gmail.com Username: kofiobeng E-mail : asarek662@gmail.com Regards, [[User:Jemima2019|Jemima2019]] ([[User talk:Jemima2019|Nkitahode beaɛ]]) 12:46, 16 Ɔbɛnem 2022 (UTC) == Translation notification: ContribuLing 2022/Program == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:ContribuLing 2022/Program|ContribuLing 2022/Program]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-ContribuLing+2022%2FProgram&language=tw&action=page translate to Twi] The priority of this page is medium. The deadline for translating this page is 2022-03-31. <div lang="en" class="mw-content-ltr"></div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 15:49, 26 Ɔbɛnem 2022 (UTC) <!-- Message sent by User:WikiLucas00@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: GLAM School/Questions == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:GLAM School/Questions|GLAM School/Questions]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-GLAM+School%2FQuestions&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-12-31. <div lang="en" class="mw-content-ltr">GLAM School is a project by AvoinGLAM to chart out, uncover, and support practices that help GLAM professionals, GLAM-Wiki volunteers, Open GLAM advocates and others to be more empowered to contribute to Wikimedia and other open projects. In 2022 we are conducting surveys, chats, and interviews across organizations and networks involved in providing Open Access to cultural heritage. This page lists the questions that are used in the survey and the interviews.</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 08:53, 26 Oforisuo 2022 (UTC) <!-- Message sent by User:Susannaanas@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: GLAM School/Questions == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:GLAM School/Questions|GLAM School/Questions]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-GLAM+School%2FQuestions&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-12-31. <div lang="en" class="mw-content-ltr">Thank you for the wonderful work you are doing! I have made a couple of small modifications to the existing text and added one new section. I hope you would be willing to have a look at those. Thank you again! Cheers, Susanna</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 07:07, 29 Oforisuo 2022 (UTC) <!-- Message sent by User:Susannaanas@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: GLAM School == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:GLAM School|GLAM School]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-GLAM+School&language=tw&action=page translate to Twi] The deadline for translating this page is 2022-12-31. <div lang="en" class="mw-content-ltr">The GLAM School main page is ready for translation. I hope the syntax still remained correct after I changed the page a lot. Thank you for your amazing help!</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 18:20, 4 Kotonimma 2022 (UTC) <!-- Message sent by User:Susannaanas@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == How to add today's featured articles/news on main page (home page) == Greetings Robertjamal12! How are "today's featured articles/news" added on main page of a Wikipedia without changing or touching the Wikipedia main page itself? I have seen on Chewa Wikipedia (ny.wikipedia.org) and on your home wiki of Twi Wikipedia that featured articles and news change almost every two days,if not in a day, yet if you check the "main page history",it shows it was last edited in 2021 or few months ago.But its content change every day. How do these articles change periodically? Where are they written? Is there some place where they are first written before showing up on main page? Your quick response will be highly appreciated! Thank you! [[Dwumadini:Tumbuka Arch|Tumbuka Arch]] ([[Dwumadini nkitahode:Tumbuka Arch|Nkitahode beaɛ]]) 17:33, 26 Ayɛwohomumɔ 2022 (UTC) :Hello {{ping|Tumbuka Arch}}, Thank you for reaching out, as Amir indicated 1. '''Put the content of the featured article or news in a template'''. Please do you know your way around Templates? Kindly share a link to your home wiki, then let's create it together -- [[User:Robertjamal12|<span style="font-family:EF Barbedor;color:#00F">''Robertjamal12''</span>]] [[User talk:Robertjamal12|<span style="color:#00F">~🔔</span>]] 08:52, 27 Ayɛwohomumɔ 2022 (UTC) ::Hello Robertjamal12, ::Thank you for a helping hand. ::Please lets create. ::This wiki is (tum.wikipedia.org) and its my home wiki and i am a native speaker of that language (Tumbuka).Everything else on this wiki has been done by myself including fixing the home page by manually adding featured articles(without using templates) ,page colours,search buttons,page dates,etc,.Last month i signed on translate wiki and translated the whole wiki myself before the interface came live in Tumbuka language 4 days ago. ::Back to the case on hand,i really like the way your home page of Twi looks.Unfortunately,I don't know how to create these templates of featured articles\news but i know the other templates used when creating a notable person's bio such as ''infobox templates''. ::Even if you direct me well, i may get stuck somewhere,so would you please just do it yourself on my home page as i watch and learn? It would be great if it looks exactly like yours(your Twi home page) or any other way around.If there may be something that you need to ask or point on the wiki,i am here. ::I am the most contributor on this wiki with over 2,200 edits and the most active user on the wiki. ::Thank you! ::Your quick action will highly be appreciated. [[Dwumadini:Tumbuka Arch|Tumbuka Arch]] ([[Dwumadini nkitahode:Tumbuka Arch|Nkitahode beaɛ]]) 04:46, 29 Ayɛwohomumɔ 2022 (UTC) == Translation notification: Wikimedia Foundation elections/2022/Announcement/Board voter email == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation elections/2022/Announcement/Board voter email|Wikimedia Foundation elections/2022/Announcement/Board voter email]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+elections%2F2022%2FAnnouncement%2FBoard+voter+email&language=tw&action=page translate to Twi] The priority of this page is high. <div lang="en" class="mw-content-ltr">Hi all! The community vote of this year's Board Elections are close. As always voter mails will be sent out. To invite as many community members as possible in their native tongue your help is very much appreciated. While there are already plenty of translations we would appreciate you to check for languages still missing and to contribute translations for these. The mails are short, just a bit about two times '''200 words''', a few minutes of work. Your support is very important as it helps communities to learn about the election and to cast their vote. Best, Denis Barthel (WMF) (Movement Strategy and Governance)</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 12:51, 9 Ɔsanaa 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> == Translation notification: Wikimedia Foundation elections/2022/Announcement/Board voter email == Hello Robertjamal12, You are receiving this notification because you signed up as a translator to Twi on Meta. The page [[:metawikipedia:Wikimedia Foundation elections/2022/Announcement/Board voter email|Wikimedia Foundation elections/2022/Announcement/Board voter email]] is available for translation. You can translate it here: * [https://meta.wikimedia.org/w/index.php?title=Special:Translate&group=page-Wikimedia+Foundation+elections%2F2022%2FAnnouncement%2FBoard+voter+email&language=tw&action=page translate to Twi] The priority of this page is high. <div lang="en" class="mw-content-ltr">Hi all! The community vote of this year's Board Elections are close. As always voter mails will be sent out. To invite as many community members as possible in their native tongue your help is very much appreciated. While there are already plenty of translations we would appreciate you to check for languages still missing and to contribute translations for these. The mails are short, just a bit about two times '''200 words''', a few minutes of work. Your support is very important as it helps communities to learn about the election and to cast their vote. Best, Denis Barthel (WMF) (Movement Strategy and Governance)</div> Your help is greatly appreciated. Translators like you help Meta to function as a truly multilingual community. You can [https://meta.wikimedia.org/wiki/Special:TranslatorSignup change your notification preferences]. Thank you! Meta translation coordinators&lrm;, 21:51, 9 Ɔsanaa 2022 (UTC) <!-- Message sent by User:DBarthel (WMF)@metawiki using the list at https://meta.wikimedia.org/wiki/Special:NotifyTranslators --> r73khyo33frsmcrm9miyptboaandcju 10 12259 133294 133144 2022-08-09T14:46:09Z Nana Sintim 11223 /* Atenaeɛ ho nsɛmfua (Environmental related terminologies) */ wikitext text/x-wiki =='''Entries'''== *''Type '''<nowiki>~~~~</nowiki>''' next to the article(s) '''you have worked on''' and click '''publish changes'''.'' *A facilitator will review '''Twi Wikipedia, Wikicommons and Wikidata items''' and add {{Wei}} If the entry worked on meets the rules. =='''Mmarahyɛbadwam ho nsɛm (Parliamentary related terminologies)'''== # [[:en:Elections]] - [[Abatoɔ]] # [[:en:Parliament]] - [[Mmarahyɛbadwafie]] [[Dwumadini:Opoku Akaadom Sympathy|Opoku Akaadom Sympathy]] ([[Dwumadini nkitahode:Opoku Akaadom Sympathy|Nkitahode beaɛ]]) 17:11, 4 Kitawonsa 2022 (UTC) [[Dwumadini:Opoku Akaadom Sympathy|Opoku Akaadom Sympathy]] gets '''3marks''' {{not done}} # [[:en:Member of Parliament]] - [[Mmarahyɛbadwani]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 12:59, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3.6marks''' {{done}} # [[:en:Law]] - [[Mmara]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 21:37, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3marks''' {{not done}} # [[:en:Constitution]] - [[Amanmmara]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 19:10, 16 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{not done}} # [[:en:Speaker of Parliament]] - [[Mmarahyɛbadwafie Kasamafoɔ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 06:29, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''4marks''' {{done}} # [[:en:Justice]] - [[Atɛntenee]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:00, 24 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks'''{{done}} # [[:en:Corruption]] - [[Porɔɛe]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:49, 29 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''1mark'''{{done}} # [[:en: Bribery]] - [[Kɛtɛasehyɛ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:49, 29 Kitawonsa 2022 (UTC) # [[:en: Constituency]] - [[Mpasua]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC) [[Dwumadini:AC Krah|AC Krah]] gets '''2.4marks''' {{not done}} # [[:en: Amendment]] - [[Nsakraeɛ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 06:58, 8 Kitawonsa 2022 (UTC) [[Dwumadini:Afia360|Afia360]] gets '''3.6marks''' {{done}} # [[:en: President]] - [[Ɔmanpanin]] # [[:en: Appoint]] - [[Y'apaw Obi]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:09, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] '''2.6marks''' {{not done}} # [[:en: Bylaws]] - [[Mmaranketewa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:46, 3 Ɔsanaa 2022 (UTC) # [[:en: Minister]] - [[Mansoafoɔ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 08:49, 30 Kitawonsa 2022 (UTC) # [[:en:Minority]] - [[Ɛdɔm kumaa]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 07:19, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]]'''3.5marks''' {{done}} # [[:en:Majority]] - [[Ɛdɔm kɛseɛ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:21, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3.6marks''' {{done}} # [[:en:Court]] - [[Asɛmdibia]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:46, 3 Ɔsanaa 2022 (UTC) # [[:en:Minority Leader]] - [[Ɛdɔm Kumaa Panin]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 07:19, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2.8marks''' [[Dwumadini:Nana Sintim|Nana Sintim]] gets '''0.6marks'''{{not done}} # [[:en:Majority Leader]] - [[Ɛdɔm kɛseɛ Panin]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 07:19, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2marks''' {{done}} # [[:en:Democracy]] - [[Kabi-Ma-Menkabi]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 18:35, 27 Kitawonsa 2022 (UTC) # [[:en:Prime Minister]] - [[Man soafo panyin]] # [[:en:Municipality ]] - [[Munisipal]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 17:01, 9 Kitawonsa 2022 (UTC) # [[:en:District]] - [[Mansini]] [[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:Deputy Minister]] - [[Soafo Abadiakyiri]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:14, 9 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Politician]] - [[Amammuifo]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:57, 11 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.2marks''' {{done}} # [[:en:Political Party]] - [[Amanyɔ kuo]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 19:13, 13 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2marks''' {{not done}} # [[:en:New Patriotic Party]] - [[New Patriotic Party (NPP)]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 22:20, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''4marks {{done}} # [[:en:Republic]] - [[Adehyeman]] # [[:en:National Democratic Congress]] - [[National Democratic Congress (NDC)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:19, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''4marks'''{{done}} # [[:en:Convention People's Party]] - [[Convention People's Party (CPP)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 11:05, 23 Kitawonsa 2022 (UTC) # [[:en:People's National Convention]] - [[People's National Convention (PNC)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:47, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2marks''' {{not done}} # [[:en:All People's Congress]] - [[All People's Congress (APC)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 10:01, 30 Kitawonsa 2022 (UTC) # [[:en:Democratic Freedom Party]] - [[Democratic Freedom Party (DFP)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:39, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''4marks''' {{done}} # [[:en:Democratic People's Party]] - [[Democratic People's Party (DPP)]] [[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''4marks''' {{done}} # [[:en:Every Ghanaian Living Everywhere Party]] - [[Every Ghanaian Living Everywhere Party(EGLEP)]] # [[:en:Great Consolidated Popular Party]] - [[Great Consolidated Popular Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 23:50, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3marks''' [[Dwumadini:Opoku Akaadom Sympathy|Opoku Akaadom Sympathy]] gets '''0.6marks''' {{done}} # [[:en:Ghana Democratic Republican Party]] - [[Ghana Democratic Republican Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:27, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3marks''' {{done}} # [[:en:Ghana Freedom Party]] - [[Ghana Freedom Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 21:18, 3 Kitawonsa 2022 (UTC) [[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''4marks''' {{done}} # [[:en:Ghana National Party]] - [[Ghana National Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:29, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3marks''' {{done}} # [[:en:Ghana Union Movement]] - [[Ghana Union Movement]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:57, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.8marks''' {{done}} # [[:en:Liberal Party of Ghana]] - [[Liberal Party of Ghana]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 01:52, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.2marks''' {{done}} # [[:en:National Democratic Party ]] - [[National Democratic Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 03:42, 6 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.8marks''' {{done}} # [[:en:National Reform Party]] - [[National Reform Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 02:23, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.2marks''' {{done}} # [[:en:New Vision Party ]] - [[New Vision Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 02:52, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.2marks''' {{done}} # [[:en:People's Action Party ]] - [[People's Action Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 10:36, 30 Kitawonsa 2022 (UTC) # [[:en:People's Destiny Party]] - [[People's Destiny Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 01:33, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:Power Unity Party]] - [[Power Unity Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 20:06, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.2marks''' {{done}} # [[:en:Progressive People's Party]] - [[Progressive People's Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 18:35, 27 Kitawonsa 2022 (UTC) # [[:en:Reformed Patriotic Democrats]] - [[Reformed Patriotic Democrats]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 04:02, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.4marks''' {{done}} # [[:en:United Democratic Party]] - [[United Democratic Party]] # [[:en:United Development System Party]] - [[United Development System Party]] [[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 22:50, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:United Front Party]] - [[United Front Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:55, 30 Kitawonsa 2022 (UTC) # [[:en:United Ghana Movement]] - [[United Ghana Movement]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.2marks''' {{done}} # [[:en:United Progressive Party]] - [[United Progressive Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 08:02, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.4marks''' {{done}} # [[:en:United Renaissance Party]] - [[United Renaissance Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 03:17, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:Yes People's Party]] - [[Yes People's Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 19:57, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:Ghana Redevelopment Party]] - [[Ghana Redevelopment Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2marks''' {{done}} # [[:en:Independent People's Party]] - [[Independent People's Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 23:37, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.6marks''' {{done}} # [[:en:National Convention Party]] - [[National Convention Party]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 06:31, 5 Kitawonsa 2022 (UTC) # [[:en:National Independence Party ]] - [[National Independence Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:59, 9 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''4marks''' {{done}} # [[:en:People's Convention Party ]] - [[People's Convention Party ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 06:35, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''1.4marks''' {{done}} # [[:en:People's Heritage Party ]] - [[People's Heritage Party ]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.2marks''' {{done}} # [[:en:United Love Party ]] - [[United Love Party ]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:45, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.2marks''' {{done}} # [[:en:Action Congress Party]] - [[Action Congress Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.3marks {{done}} # [[:en:All People's Party]] - [[All People's Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 14:04, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.2marks''' {{done}} # [[:en:People's National Party]] - [[People's National Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:36, 30 Kitawonsa 2022 (UTC) # [[:en:Popular Front Party]] - [[Popular Front Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.6marks''' {{done}} # [[:en:Social Democratic Front ]] - [[Social Democratic Front ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:41, 9 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1mark''' {{done}} # [[:en:Third Force Party]] - [[Third Force Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 19:59, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1mark''' {{done}} # [[:en:United National Convention ]] - [[United National Convention ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:18, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1.8marks''' {{done}} # [[:en:All People's Republican Party ]] - [[All People's Republican Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:47, 9 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1mark''' {{done}} # [[:en:Justice Party ]] - [[Justice Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 15:04, 30 Kitawonsa 2022 (UTC) # [[:en:National Alliance of Liberals]] - [[National Alliance of Liberals]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.8marks''' {{done}} # [[:en:People's Action Party]] [[People's Action Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 10:31, 30 Kitawonsa 2022 (UTC) # [[:en:Progress Party]] - [[Progress Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:55, 30 Kitawonsa 2022 (UTC) # [[:en:United Nationalist Party ]] - [[United Nationalist Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:55, 30 Kitawonsa 2022 (UTC) # [[:en:United Party ]] - [[United Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:08, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''3marks''' {{done}} # [[:en:United Gold Coast Convention]] - [[United Gold Coast Convention]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Anlo Youth Organization]] - [[Anlo Youth Organization]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Federation of Youth Organization]] - [[Federation of Youth Organization]][[Dwumadini:AC Krah|AC Krah]] gets '''2.8marks''' {{done}} # [[:en:Ghana Congress Party]] - [[Ghana Congress Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:14, 9 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.8marks''' {{done}} # [[:en:Muslim Association Party]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:14, 5 Kitawonsa 2022 (UTC) - [[Muslim Association Party]][[Dwumadini:Nana Sintim|Nana Sintim]] gets '''2.2marks''' {{done}} # [[:en:National Liberation Movement ]] - [[National Liberation Movement ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:44, 27 Kitawonsa 2022 (UTC) # [[:en:Northern People's Party ]] - [[Northern People's Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:36, 30 Kitawonsa 2022 (UTC) # [[:en:Togoland Congress]] - [[Togoland Congress]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 04:31, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1.6marks''' {{done}} # [[:en:Greater Accra Region]] - [[Greater Accra Region]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:46, 3 Ɔsanaa 2022 (UTC) # [[:en:Eastern Region]] - [[Eastern Region]] # [[:en:Ahafo Region]] - [[Ahafo Mantam]][[Dwumadini:Rsaawah|Rsaawah]] ([[Dwumadini nkitahode:Rsaawah|Nkitahode beaɛ]]) 12:38, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Rsaawah|Rsaawah]] gets '''4marks''' {{done}} # [[:en:Ashanti Region]] - [[Ashanti Region]] # [[:en:Bono East Region]] - [[Bono East Region]][[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Brong Ahafo Region]] - [[Brong Ahafo Mantam]][[Dwumadini:S A Habadah|S A Habadah]] ([[Dwumadini nkitahode:S A Habadah|Nkitahode beaɛ]])[[Dwumadini:S A Habadah|S A Habadah]] gets '''4marks''' {{done}} # [[:en:Central Region]] - [[Central Region]][[Dwumadini:Rsaawah|Rsaawah]] gets '''4marks''' {{done}} # [[:en:North-East Region]] - [[North-East Region]] # [[:en:Northern Region]] - [[Northern Region]] # [[:en:Oti Region]] - [[Oti Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Savannah Region]] - [[Savannah Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Upper East Region]] - [[Upper East Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Upper West Region]] - [[Upper West Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Western Region]] - [[Western Region]] # [[:en:Western North Region]] - [[Western North Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Volta Region]] - [[Volta Region]] # [[:en:Kumasi]] - [[Kumasi]] # [[:en:Sunyani]] - [[Sunyani]] # [[:en:Techiman]] - [[Techiman]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 08:17, 7 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''3marks {{not done}} # [[:en:Goaso]] - [[Goaso]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:05, 5 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Cape Coast]] - [[Cape Coast]][[Dwumadini:Rsaawah|Rsaawah]] ([[Dwumadini nkitahode:Rsaawah|Nkitahode beaɛ]]) 10:32, 7 Kitawonsa 2022 (UTC)[[Dwumadini:Rsaawah|Rsaawah]] gets '''4marks''' {{done}} # [[:en:Kofiridua]] - [[Kofiridua]] # [[:en:Accra]] - [[Accra]] # [[:en:Tamale]] - [[Tamale]] # [[:en:Damongo]] - [[Damongo]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.6marks''' {{done}}} # [[:en:Nalerigu]] - [[Nalerigu]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:05, 5 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Bolgatanga]] - [[Bolgatanga]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 22:37, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Wa]] - [[Wa]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:36, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3marks''' {{done}} # [[:en:Ho]] - [[Ho]] # [[:en:Dambai]] - [[Dambai]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:01, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Takoradi]] - [[Takoradi]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:01, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Wiawso]] - [[Wiawso]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:01, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} =='''Adwuma ho nsɛmfua (Work related terminologies)'''== # [[:en:Teacher]] - [[Ɔkyerɛkyerɛni]] [[Dwumadini: Christian|Christian]] # [[:en:Farmer]] - [[Ɔkuani]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:17, 9 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Blacksmith]] - [[Ɔtomfoɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:36, 24 Kitawonsa 2022 (UTC) # [[:en: Boxer]] - [[Akuturukubɔfoɔ]] # [[:en:Butcher]] - [[Nankwaaseni]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:26, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3.2marks''' {{done}} # [[:en:Banker]] - [[Sikakorabea adwumayɛni]] # [[:en:Wood worker]] - [[Dua dwomfoɔ]][[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Doctor]] - [[Ɔyaresafoɔ /Dokota]] # [[:en:Driver]] - [[Ɔhyenkani /Ɔhyenkafoɔ]] # [[:en:Judge]] - [[Ɔtenmuafoɔ ]] # [[:en:Jury]] - [[Apamfoɔ]] # [[:en:Lawyer]] - [[Mmaranimni]] # [[:en:Mason]] - [[Ɔdansifoɔ]] # [[:en:Nurse]] - [[Ayaresadwumamu boafoɔ / Nɛɛse]] # [[:en:Pharmacist]] - [[Oduyɛfoɔ]] # [[:en:President]] - [[Ɔmanpanin]] # [[:en:Fashion designer]] - [[Adepamni]] # [[:en:Seamstress]] - [[Ɔbaa adepamni]][[Dwumadini:Rsaawah|Rsaawah]] gets '''2marks''' {{done}} # [[:en:Secretary]] - [[Ɔtwerɛtwerɛfoɔ / Ɔtwerɛtwerɛni]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:48, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:Security]] - [[Ɔwɛnfoɔ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:18, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:Trader]] - [[Ɔdwadini]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:55, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks''' {{done}} # [[:en:Secondary School]] - [[Ntoasoɔ Sukuu]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:11, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:University]] - [[Suapɔn]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:22, 17 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} =='''Abusuabɔ ho nsɛmfua (Family related terminologies)'''== # [[:en:Family]] - [[Abusua]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 11:16, 24 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}}[[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:19, 11 Kitawonsa 2022 (UTC) # [[:en:Family member]] - [[Abusuani]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 11:18, 24 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Family head]] - [[Abusuapanin]] # [[:en:Parents]] - [[Awofoɔ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:49, 25 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''3marks''' {{done}} # [[:en:Man]] - [[ɔbarima]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]])[[Dwumadini:Afriyie34|Afriyie34]]gets '''3marks''' {{done}} # [[:en:Woman]] - [[ɔbaa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 08:02, 26 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Father]] - [[Agya]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 10:52, 26 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Mother]] - [[Maame]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:29, 26 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Baby]] - [[Akwadaa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 05:27, 28 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Siblings]] - [[Anuanom]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 17:38, 28 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Sister]] - [[Nua baa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:47, 29 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Brother]] - [[Nua bɛrima]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 17:06, 29 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''4marks''' {{done}} # [[:en:Grandmother]] - [[Nana baa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 03:45, 30 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''4marks''' {{done}} # [[:en:Grandfather]] - [[Nana bɛrima]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 14:32, 30 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''4marks''' {{done}} # [[:en:Sister-inlaw]] - [[Akumaa]] # [[:en:Rivals]] - [[Akorafoɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 22:19, 29 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Boy]] - [[Abɛrimaa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:01, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Girl]] - [[Abaayewa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:01, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Widow]] - [[Okunafoɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:05, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Son]] - [[ɔbabɛrima]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:05, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.4marks''' {{done}} # [[:en:Daugther]] - [[ɔbabaa]] # [[:en:Adopted child]] - [[Abanoma]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 12:19, 31 Kitawonsa 2022 (UTC) # [[:en:Orphan]] - [[Agyanka]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:58, 3 Ɔsanaa 2022 (UTC) # [[:en:Twins]] - [[Ntaafoɔ]][[Dwumadini:Gkagabby|Gkagabby]] ([[Dwumadini nkitahode:Gkagabby|Nkitahode beaɛ]]) 08:29, 3 Ɔsanaa 2022 (UTC) # [[:en:Triplet]] - [[Ahenasa]] # [[:en:Friendship]] - [[Adamfofa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:04, 31 Kitawonsa 2022 (UTC) # [[:en:Dating]] - [[Mpenatweɛ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:49, 3 Ɔsanaa 2022 (UTC) # [[:en:Royal]] - [[Dehyeɛ]] # [[:en:Old man]] - [[Akɔkora]] # [[:en:Old woman]] - [[Aberewa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 01:19, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks''' {{done}} # [[:en:Firstborn child]] - [[Piesie]] # [[:en:Lastborn child]] - [[Kaakyire]] # [[:en:Young woman]] - [[Ababaawa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:49, 3 Ɔsanaa 2022 (UTC) # [[:en:Young man]] - [[Abranteɛ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 01:08, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks''' {{done}} =='''Apɔmuden ho nsɛmfua (Health related terminologies)'''== # [[:en:Health]] - [[Apowmuden]] # [[:en:Sickness]] - [[Yareɛ]] # [[:en:Diseases]] - [[Nyarewa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:53, 29 Kitawonsa 2022 (UTC) # [[:en:Hospital]] - [[Ayaresabea]][[Dwumadini:Antwiaa1996|Antwiaa1996]] ([[Dwumadini nkitahode:Antwiaa1996|Nkitahode beaɛ]]) 10:11, 13 Kitawonsa 2022 (UTC) # [[:en:Syringe]] - [[Paneɛ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 00:16, 4 Ɔsanaa 2022 (UTC) # [[:en:Medicine]] - [[Aduro]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 17:34, 3 Ɔsanaa 2022 (UTC) # [[:en:Herbalist]] - [[Odunsini]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:37, 24 Kitawonsa 2022 (UTC) # [[:en:Itch]] - [[Ahokeka]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 15:20, 2 Ɔsanaa 2022 (UTC) # [[:en:Whooping cough]] - [[Nsamanwa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Headache]] - [[Tipayɛ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:53, 29 Kitawonsa 2022 (UTC) # [[:en:Stomach ache]] - [[Yafunu yareɛ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Constipation]] - [[Ayamtim]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:58, 11 Kitawonsa 2022 (UTC) # [[:en:Diabetes]] - [[Asikyireyareɛ]] # [[:en:Cholera]] - [[Ayamtunini/Kɔlera]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:53, 29 Kitawonsa 2022 (UTC) # [[:en:Goiter]] - [[Kɔmpɔ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:23, 22 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:22, 22 Kitawonsa 2022 (UTC) # [[:en:Gonorrhea]] - [[Babaso]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:02, 28 Kitawonsa 2022 (UTC) # [[:en:Cancer]] - [[Kokoram]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 15:19, 31 Kitawonsa 2022 (UTC) # [[:en:Rheumatism]] - [[Sasabrɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Convulsion]] - [[Asensene]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Asthma]] - [[Ntehyeewa]] # [[:en:Cripple]] - [[Bafan]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:37, 24 Kitawonsa 2022 (UTC) # [[:en:Muteness]] - [[Emum]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:55, 17 Kitawonsa 2022 (UTC) # [[:en:Blindness]] - [[Anifra]] # [[:en:Kwashiokor]] - [[Kwashiokor]] # [[:en:Malaria]] - [[Atiridii yare]] # [[:en:Paralysis]] - [[Mmubuo]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:09, 22 Kitawonsa 2022 (UTC) # [[:en:Vomitting]] - [[Ɛfeɛ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:09, 22 Kitawonsa 2022 (UTC) # [[:en:Hypertension]] - [[Mogyamorosoɔ]] # [[:en:Ulcer]] - [[Ayamkuro]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:09, 22 Kitawonsa 2022 (UTC) # [[:en:Stroke]] - [[Nnwodwoeɛ]] # [[:en:Measles]] - [[Ntoboro]] # [[:en:Eczema]] - [[Ɛkrɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:34, 14 Kitawonsa 2022 (UTC) # [[:en:Rashes]] - [[Nsawansawa]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:58, 11 Kitawonsa 2022 (UTC) # [[:en:Ringworm]] - [[Kakawirewire]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:45, 17 Kitawonsa 2022 (UTC) =='''Atenaeɛ ho nsɛmfua (Environmental related terminologies)'''== Environmental related # [[:en:Buildings]] - [[Adan]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:10, 12 Kitawonsa 2022 (UTC) # [[:en:Trees]] - [[Nnua]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Flowers]] - [[Nhweren]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Animals]] - [[Mmoa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Humans]] - [[Nnipa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:32, 12 Kitawonsa 2022 (UTC) # [[:en:Clouds]] - [[Ewiem]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Air]] - [[Nframa]] # [[:en:Machines]] - [[Afidie]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 05:03, 29 Kitawonsa 2022 (UTC) # [[:en:River]] - [[Nsutene]][[Dwumadini:Mbaidoo|Mbaidoo]] ([[Dwumadini nkitahode:Mbaidoo|Nkitahode beaɛ]]) 14:43, 14 Kitawonsa 2022 (UTC) # [[:en:Sea]] - [[Ɛpo]][[Dwumadini:Mbaidoo|Mbaidoo]] ([[Dwumadini nkitahode:Mbaidoo|Nkitahode beaɛ]]) 14:43, 14 Kitawonsa 2022 (UTC) # [[:en:Car]] - [[Ɛhyɛn]][[Dwumadini:Mbaidoo|Mbaidoo]] ([[Dwumadini nkitahode:Mbaidoo|Nkitahode beaɛ]]) 14:43, 14 Kitawonsa 2022 (UTC) # [[:en:Train]] - [[Keteke]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 23:01, 20 Kitawonsa 2022 (UTC) # [[:en:Canoe]] - [[Kudoɔ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Ship ]] - [[Suhyɛn]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Aircraft/aeroplane]] - [[Wiemhyɛn]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:50, 19 Kitawonsa 2022 (UTC) # [[:en:Airport]] - [[Wiemhyɛn gyinabea]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:27, 17 Kitawonsa 2022 (UTC) # [[:en:Port/harbor]] - [[Suhyɛn gyinabea]] # [[:en:Train station]] - [[Keteke gyinabea]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:34, 14 Kitawonsa 2022 (UTC) # [[:en:Forest]] - [[Kwaeɛ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 23:01, 20 Kitawonsa 2022 (UTC) # [[:en:Court]] - [[Asɛm dibea]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:51, 3 Ɔsanaa 2022 (UTC) # [[:en:Church building]] - [[Asɔre dan]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:34, 14 Kitawonsa 2022 (UTC) # [[:en:Church]] - [[Asɔre]] [[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 14:46, 9 Ɔsanaa 2022 (UTC) # [[:en:Mosque]] - [[Nkramosom dan]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:38, 24 Kitawonsa 2022 (UTC) # [[:en:Muslim]] - [[Nkramoni]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:38, 24 Kitawonsa 2022 (UTC) # [[:en:Islam]] - [[Nkramosom]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:38, 24 Kitawonsa 2022 (UTC) # [[:en:Christian]] - [[Kristoni]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Christianity]] - [[Kristosom]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Rainbow]] - [[Nyankontɔn]] # [[:en:Gun]] - [[Etuo]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 03:21, 1 Ɔsanaa 2022 (UTC) # [[:en:Water]] - [[Nsuo]] # [[:en:Railway]] - [[Keteke kwan]] # [[:en:Road]] - [[Lɔre kwan]] # [[:en:Stadium]] - [[Agoprama]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:50, 19 Kitawonsa 2022 (UTC) # [[:en:Market]] - [[Aguaso]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:20, 31 Kitawonsa 2022 (UTC) # [[:en:Land]] - [[Asaase]] # [[:en:Mountain]] - [[Bepɔ]] # [[:en:Sun]] - [[Awia]] # [[:en:Moon]] - [[Bosome]] # [[:en:Star]] - [[Nsoroma]][[Dwumadini:Ebensarfo|Ebensarfo]] ([[Dwumadini nkitahode:Ebensarfo|Nkitahode beaɛ]]) 16:50, 19 Kitawonsa 2022 (UTC) # [[:en:Birds]] - [[Nnomaa]][[Dwumadini:Ebensarfo|Ebensarfo]] ([[Dwumadini nkitahode:Ebensarfo|Nkitahode beaɛ]]) 15:39, 19 Kitawonsa 2022 (UTC) dz5jrdjjn3jnxe97zagjfbyezfsuyqm 133296 133294 2022-08-09T15:09:57Z Nana Sintim 11223 /* Apɔmuden ho nsɛmfua (Health related terminologies) */ wikitext text/x-wiki =='''Entries'''== *''Type '''<nowiki>~~~~</nowiki>''' next to the article(s) '''you have worked on''' and click '''publish changes'''.'' *A facilitator will review '''Twi Wikipedia, Wikicommons and Wikidata items''' and add {{Wei}} If the entry worked on meets the rules. =='''Mmarahyɛbadwam ho nsɛm (Parliamentary related terminologies)'''== # [[:en:Elections]] - [[Abatoɔ]] # [[:en:Parliament]] - [[Mmarahyɛbadwafie]] [[Dwumadini:Opoku Akaadom Sympathy|Opoku Akaadom Sympathy]] ([[Dwumadini nkitahode:Opoku Akaadom Sympathy|Nkitahode beaɛ]]) 17:11, 4 Kitawonsa 2022 (UTC) [[Dwumadini:Opoku Akaadom Sympathy|Opoku Akaadom Sympathy]] gets '''3marks''' {{not done}} # [[:en:Member of Parliament]] - [[Mmarahyɛbadwani]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 12:59, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3.6marks''' {{done}} # [[:en:Law]] - [[Mmara]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 21:37, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3marks''' {{not done}} # [[:en:Constitution]] - [[Amanmmara]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 19:10, 16 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{not done}} # [[:en:Speaker of Parliament]] - [[Mmarahyɛbadwafie Kasamafoɔ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 06:29, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''4marks''' {{done}} # [[:en:Justice]] - [[Atɛntenee]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:00, 24 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks'''{{done}} # [[:en:Corruption]] - [[Porɔɛe]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:49, 29 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''1mark'''{{done}} # [[:en: Bribery]] - [[Kɛtɛasehyɛ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:49, 29 Kitawonsa 2022 (UTC) # [[:en: Constituency]] - [[Mpasua]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC) [[Dwumadini:AC Krah|AC Krah]] gets '''2.4marks''' {{not done}} # [[:en: Amendment]] - [[Nsakraeɛ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 06:58, 8 Kitawonsa 2022 (UTC) [[Dwumadini:Afia360|Afia360]] gets '''3.6marks''' {{done}} # [[:en: President]] - [[Ɔmanpanin]] # [[:en: Appoint]] - [[Y'apaw Obi]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:09, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] '''2.6marks''' {{not done}} # [[:en: Bylaws]] - [[Mmaranketewa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:46, 3 Ɔsanaa 2022 (UTC) # [[:en: Minister]] - [[Mansoafoɔ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 08:49, 30 Kitawonsa 2022 (UTC) # [[:en:Minority]] - [[Ɛdɔm kumaa]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 07:19, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]]'''3.5marks''' {{done}} # [[:en:Majority]] - [[Ɛdɔm kɛseɛ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:21, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3.6marks''' {{done}} # [[:en:Court]] - [[Asɛmdibia]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:46, 3 Ɔsanaa 2022 (UTC) # [[:en:Minority Leader]] - [[Ɛdɔm Kumaa Panin]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 07:19, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2.8marks''' [[Dwumadini:Nana Sintim|Nana Sintim]] gets '''0.6marks'''{{not done}} # [[:en:Majority Leader]] - [[Ɛdɔm kɛseɛ Panin]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 07:19, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2marks''' {{done}} # [[:en:Democracy]] - [[Kabi-Ma-Menkabi]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 18:35, 27 Kitawonsa 2022 (UTC) # [[:en:Prime Minister]] - [[Man soafo panyin]] # [[:en:Municipality ]] - [[Munisipal]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 17:01, 9 Kitawonsa 2022 (UTC) # [[:en:District]] - [[Mansini]] [[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:Deputy Minister]] - [[Soafo Abadiakyiri]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:14, 9 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Politician]] - [[Amammuifo]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:57, 11 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.2marks''' {{done}} # [[:en:Political Party]] - [[Amanyɔ kuo]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 19:13, 13 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2marks''' {{not done}} # [[:en:New Patriotic Party]] - [[New Patriotic Party (NPP)]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 22:20, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''4marks {{done}} # [[:en:Republic]] - [[Adehyeman]] # [[:en:National Democratic Congress]] - [[National Democratic Congress (NDC)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:19, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''4marks'''{{done}} # [[:en:Convention People's Party]] - [[Convention People's Party (CPP)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 11:05, 23 Kitawonsa 2022 (UTC) # [[:en:People's National Convention]] - [[People's National Convention (PNC)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:47, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''2marks''' {{not done}} # [[:en:All People's Congress]] - [[All People's Congress (APC)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 10:01, 30 Kitawonsa 2022 (UTC) # [[:en:Democratic Freedom Party]] - [[Democratic Freedom Party (DFP)]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:39, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''4marks''' {{done}} # [[:en:Democratic People's Party]] - [[Democratic People's Party (DPP)]] [[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''4marks''' {{done}} # [[:en:Every Ghanaian Living Everywhere Party]] - [[Every Ghanaian Living Everywhere Party(EGLEP)]] # [[:en:Great Consolidated Popular Party]] - [[Great Consolidated Popular Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 23:50, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3marks''' [[Dwumadini:Opoku Akaadom Sympathy|Opoku Akaadom Sympathy]] gets '''0.6marks''' {{done}} # [[:en:Ghana Democratic Republican Party]] - [[Ghana Democratic Republican Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:27, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3marks''' {{done}} # [[:en:Ghana Freedom Party]] - [[Ghana Freedom Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 21:18, 3 Kitawonsa 2022 (UTC) [[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''4marks''' {{done}} # [[:en:Ghana National Party]] - [[Ghana National Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:29, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3marks''' {{done}} # [[:en:Ghana Union Movement]] - [[Ghana Union Movement]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:57, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.8marks''' {{done}} # [[:en:Liberal Party of Ghana]] - [[Liberal Party of Ghana]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 01:52, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.2marks''' {{done}} # [[:en:National Democratic Party ]] - [[National Democratic Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 03:42, 6 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.8marks''' {{done}} # [[:en:National Reform Party]] - [[National Reform Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 02:23, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.2marks''' {{done}} # [[:en:New Vision Party ]] - [[New Vision Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 02:52, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.2marks''' {{done}} # [[:en:People's Action Party ]] - [[People's Action Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 10:36, 30 Kitawonsa 2022 (UTC) # [[:en:People's Destiny Party]] - [[People's Destiny Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 01:33, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:Power Unity Party]] - [[Power Unity Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 20:06, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.2marks''' {{done}} # [[:en:Progressive People's Party]] - [[Progressive People's Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 18:35, 27 Kitawonsa 2022 (UTC) # [[:en:Reformed Patriotic Democrats]] - [[Reformed Patriotic Democrats]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 04:02, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.4marks''' {{done}} # [[:en:United Democratic Party]] - [[United Democratic Party]] # [[:en:United Development System Party]] - [[United Development System Party]] [[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 22:50, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:United Front Party]] - [[United Front Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:55, 30 Kitawonsa 2022 (UTC) # [[:en:United Ghana Movement]] - [[United Ghana Movement]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.2marks''' {{done}} # [[:en:United Progressive Party]] - [[United Progressive Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 08:02, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.4marks''' {{done}} # [[:en:United Renaissance Party]] - [[United Renaissance Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 03:17, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:Yes People's Party]] - [[Yes People's Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 19:57, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2marks''' {{done}} # [[:en:Ghana Redevelopment Party]] - [[Ghana Redevelopment Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2marks''' {{done}} # [[:en:Independent People's Party]] - [[Independent People's Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 23:37, 3 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''2.6marks''' {{done}} # [[:en:National Convention Party]] - [[National Convention Party]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 06:31, 5 Kitawonsa 2022 (UTC) # [[:en:National Independence Party ]] - [[National Independence Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:59, 9 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''4marks''' {{done}} # [[:en:People's Convention Party ]] - [[People's Convention Party ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 06:35, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''1.4marks''' {{done}} # [[:en:People's Heritage Party ]] - [[People's Heritage Party ]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.2marks''' {{done}} # [[:en:United Love Party ]] - [[United Love Party ]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:45, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.2marks''' {{done}} # [[:en:Action Congress Party]] - [[Action Congress Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.3marks {{done}} # [[:en:All People's Party]] - [[All People's Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 14:04, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''3.2marks''' {{done}} # [[:en:People's National Party]] - [[People's National Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:36, 30 Kitawonsa 2022 (UTC) # [[:en:Popular Front Party]] - [[Popular Front Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.6marks''' {{done}} # [[:en:Social Democratic Front ]] - [[Social Democratic Front ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:41, 9 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1mark''' {{done}} # [[:en:Third Force Party]] - [[Third Force Party]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 19:59, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1mark''' {{done}} # [[:en:United National Convention ]] - [[United National Convention ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:18, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1.8marks''' {{done}} # [[:en:All People's Republican Party ]] - [[All People's Republican Party ]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 00:47, 9 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1mark''' {{done}} # [[:en:Justice Party ]] - [[Justice Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 15:04, 30 Kitawonsa 2022 (UTC) # [[:en:National Alliance of Liberals]] - [[National Alliance of Liberals]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.8marks''' {{done}} # [[:en:People's Action Party]] [[People's Action Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 10:31, 30 Kitawonsa 2022 (UTC) # [[:en:Progress Party]] - [[Progress Party]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:55, 30 Kitawonsa 2022 (UTC) # [[:en:United Nationalist Party ]] - [[United Nationalist Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 14:55, 30 Kitawonsa 2022 (UTC) # [[:en:United Party ]] - [[United Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:08, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''3marks''' {{done}} # [[:en:United Gold Coast Convention]] - [[United Gold Coast Convention]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Anlo Youth Organization]] - [[Anlo Youth Organization]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:40, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Federation of Youth Organization]] - [[Federation of Youth Organization]][[Dwumadini:AC Krah|AC Krah]] gets '''2.8marks''' {{done}} # [[:en:Ghana Congress Party]] - [[Ghana Congress Party]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:14, 9 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.8marks''' {{done}} # [[:en:Muslim Association Party]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:14, 5 Kitawonsa 2022 (UTC) - [[Muslim Association Party]][[Dwumadini:Nana Sintim|Nana Sintim]] gets '''2.2marks''' {{done}} # [[:en:National Liberation Movement ]] - [[National Liberation Movement ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 23:44, 27 Kitawonsa 2022 (UTC) # [[:en:Northern People's Party ]] - [[Northern People's Party ]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 22:36, 30 Kitawonsa 2022 (UTC) # [[:en:Togoland Congress]] - [[Togoland Congress]][[Dwumadini:Daniella Damptey|Daniella Damptey]] ([[Dwumadini nkitahode:Daniella Damptey|Nkitahode beaɛ]]) 04:31, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Daniella Damptey|Daniella Damptey]] gets '''1.6marks''' {{done}} # [[:en:Greater Accra Region]] - [[Greater Accra Region]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:46, 3 Ɔsanaa 2022 (UTC) # [[:en:Eastern Region]] - [[Eastern Region]] # [[:en:Ahafo Region]] - [[Ahafo Mantam]][[Dwumadini:Rsaawah|Rsaawah]] ([[Dwumadini nkitahode:Rsaawah|Nkitahode beaɛ]]) 12:38, 5 Kitawonsa 2022 (UTC)[[Dwumadini:Rsaawah|Rsaawah]] gets '''4marks''' {{done}} # [[:en:Ashanti Region]] - [[Ashanti Region]] # [[:en:Bono East Region]] - [[Bono East Region]][[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Brong Ahafo Region]] - [[Brong Ahafo Mantam]][[Dwumadini:S A Habadah|S A Habadah]] ([[Dwumadini nkitahode:S A Habadah|Nkitahode beaɛ]])[[Dwumadini:S A Habadah|S A Habadah]] gets '''4marks''' {{done}} # [[:en:Central Region]] - [[Central Region]][[Dwumadini:Rsaawah|Rsaawah]] gets '''4marks''' {{done}} # [[:en:North-East Region]] - [[North-East Region]] # [[:en:Northern Region]] - [[Northern Region]] # [[:en:Oti Region]] - [[Oti Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Savannah Region]] - [[Savannah Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Upper East Region]] - [[Upper East Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Upper West Region]] - [[Upper West Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Western Region]] - [[Western Region]] # [[:en:Western North Region]] - [[Western North Region]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Volta Region]] - [[Volta Region]] # [[:en:Kumasi]] - [[Kumasi]] # [[:en:Sunyani]] - [[Sunyani]] # [[:en:Techiman]] - [[Techiman]][[Dwumadini:Afia360|Afia360]] ([[Dwumadini nkitahode:Afia360|Nkitahode beaɛ]]) 08:17, 7 Kitawonsa 2022 (UTC)[[Dwumadini:Afia360|Afia360]] gets '''3marks {{not done}} # [[:en:Goaso]] - [[Goaso]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:05, 5 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Cape Coast]] - [[Cape Coast]][[Dwumadini:Rsaawah|Rsaawah]] ([[Dwumadini nkitahode:Rsaawah|Nkitahode beaɛ]]) 10:32, 7 Kitawonsa 2022 (UTC)[[Dwumadini:Rsaawah|Rsaawah]] gets '''4marks''' {{done}} # [[:en:Kofiridua]] - [[Kofiridua]] # [[:en:Accra]] - [[Accra]] # [[:en:Tamale]] - [[Tamale]] # [[:en:Damongo]] - [[Damongo]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:23, 7 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3.6marks''' {{done}}} # [[:en:Nalerigu]] - [[Nalerigu]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:05, 5 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Bolgatanga]] - [[Bolgatanga]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 22:37, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Wa]] - [[Wa]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:36, 4 Kitawonsa 2022 (UTC)[[Dwumadini:Nana Sintim|Nana Sintim]] gets '''3marks''' {{done}} # [[:en:Ho]] - [[Ho]] # [[:en:Dambai]] - [[Dambai]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:01, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Takoradi]] - [[Takoradi]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:01, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} # [[:en:Wiawso]] - [[Wiawso]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:01, 4 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''4marks''' {{done}} =='''Adwuma ho nsɛmfua (Work related terminologies)'''== # [[:en:Teacher]] - [[Ɔkyerɛkyerɛni]] [[Dwumadini: Christian|Christian]] # [[:en:Farmer]] - [[Ɔkuani]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 00:17, 9 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Blacksmith]] - [[Ɔtomfoɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:36, 24 Kitawonsa 2022 (UTC) # [[:en: Boxer]] - [[Akuturukubɔfoɔ]] # [[:en:Butcher]] - [[Nankwaaseni]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:26, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3.2marks''' {{done}} # [[:en:Banker]] - [[Sikakorabea adwumayɛni]] # [[:en:Wood worker]] - [[Dua dwomfoɔ]][[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Doctor]] - [[Ɔyaresafoɔ /Dokota]] # [[:en:Driver]] - [[Ɔhyenkani /Ɔhyenkafoɔ]] # [[:en:Judge]] - [[Ɔtenmuafoɔ ]] # [[:en:Jury]] - [[Apamfoɔ]] # [[:en:Lawyer]] - [[Mmaranimni]] # [[:en:Mason]] - [[Ɔdansifoɔ]] # [[:en:Nurse]] - [[Ayaresadwumamu boafoɔ / Nɛɛse]] # [[:en:Pharmacist]] - [[Oduyɛfoɔ]] # [[:en:President]] - [[Ɔmanpanin]] # [[:en:Fashion designer]] - [[Adepamni]] # [[:en:Seamstress]] - [[Ɔbaa adepamni]][[Dwumadini:Rsaawah|Rsaawah]] gets '''2marks''' {{done}} # [[:en:Secretary]] - [[Ɔtwerɛtwerɛfoɔ / Ɔtwerɛtwerɛni]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:48, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:Security]] - [[Ɔwɛnfoɔ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:18, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:Trader]] - [[Ɔdwadini]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:55, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks''' {{done}} # [[:en:Secondary School]] - [[Ntoasoɔ Sukuu]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:11, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} # [[:en:University]] - [[Suapɔn]] [[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:22, 17 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''3marks''' {{done}} =='''Abusuabɔ ho nsɛmfua (Family related terminologies)'''== # [[:en:Family]] - [[Abusua]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 11:16, 24 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}}[[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 00:19, 11 Kitawonsa 2022 (UTC) # [[:en:Family member]] - [[Abusuani]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 11:18, 24 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Family head]] - [[Abusuapanin]] # [[:en:Parents]] - [[Awofoɔ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:49, 25 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''3marks''' {{done}} # [[:en:Man]] - [[ɔbarima]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]])[[Dwumadini:Afriyie34|Afriyie34]]gets '''3marks''' {{done}} # [[:en:Woman]] - [[ɔbaa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 08:02, 26 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Father]] - [[Agya]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 10:52, 26 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Mother]] - [[Maame]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:29, 26 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Baby]] - [[Akwadaa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 05:27, 28 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Siblings]] - [[Anuanom]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 17:38, 28 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]]gets '''4marks''' {{done}} # [[:en:Sister]] - [[Nua baa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:47, 29 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Brother]] - [[Nua bɛrima]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 17:06, 29 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''4marks''' {{done}} # [[:en:Grandmother]] - [[Nana baa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 03:45, 30 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''4marks''' {{done}} # [[:en:Grandfather]] - [[Nana bɛrima]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 14:32, 30 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''4marks''' {{done}} # [[:en:Sister-inlaw]] - [[Akumaa]] # [[:en:Rivals]] - [[Akorafoɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 22:19, 29 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Boy]] - [[Abɛrimaa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:01, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Girl]] - [[Abaayewa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:01, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Widow]] - [[Okunafoɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:05, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''3marks''' {{done}} # [[:en:Son]] - [[ɔbabɛrima]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:05, 28 Kitawonsa 2022 (UTC)[[Dwumadini:AC Krah|AC Krah]] gets '''2.4marks''' {{done}} # [[:en:Daugther]] - [[ɔbabaa]] # [[:en:Adopted child]] - [[Abanoma]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 12:19, 31 Kitawonsa 2022 (UTC) # [[:en:Orphan]] - [[Agyanka]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 23:58, 3 Ɔsanaa 2022 (UTC) # [[:en:Twins]] - [[Ntaafoɔ]][[Dwumadini:Gkagabby|Gkagabby]] ([[Dwumadini nkitahode:Gkagabby|Nkitahode beaɛ]]) 08:29, 3 Ɔsanaa 2022 (UTC) # [[:en:Triplet]] - [[Ahenasa]] # [[:en:Friendship]] - [[Adamfofa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:04, 31 Kitawonsa 2022 (UTC) # [[:en:Dating]] - [[Mpenatweɛ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:49, 3 Ɔsanaa 2022 (UTC) # [[:en:Royal]] - [[Dehyeɛ]] # [[:en:Old man]] - [[Akɔkora]] # [[:en:Old woman]] - [[Aberewa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 01:19, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks''' {{done}} # [[:en:Firstborn child]] - [[Piesie]] # [[:en:Lastborn child]] - [[Kaakyire]] # [[:en:Young woman]] - [[Ababaawa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:49, 3 Ɔsanaa 2022 (UTC) # [[:en:Young man]] - [[Abranteɛ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 01:08, 11 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] gets '''2marks''' {{done}} =='''Apɔmuden ho nsɛmfua (Health related terminologies)'''== # [[:en:Health]] - [[Apowmuden]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 15:09, 9 Ɔsanaa 2022 (UTC) # [[:en:Sickness]] - [[Yareɛ]] # [[:en:Diseases]] - [[Nyarewa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:53, 29 Kitawonsa 2022 (UTC) # [[:en:Hospital]] - [[Ayaresabea]][[Dwumadini:Antwiaa1996|Antwiaa1996]] ([[Dwumadini nkitahode:Antwiaa1996|Nkitahode beaɛ]]) 10:11, 13 Kitawonsa 2022 (UTC) # [[:en:Syringe]] - [[Paneɛ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 00:16, 4 Ɔsanaa 2022 (UTC) # [[:en:Medicine]] - [[Aduro]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 17:34, 3 Ɔsanaa 2022 (UTC) # [[:en:Herbalist]] - [[Odunsini]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:37, 24 Kitawonsa 2022 (UTC) # [[:en:Itch]] - [[Ahokeka]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 15:20, 2 Ɔsanaa 2022 (UTC) # [[:en:Whooping cough]] - [[Nsamanwa]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Headache]] - [[Tipayɛ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:53, 29 Kitawonsa 2022 (UTC) # [[:en:Stomach ache]] - [[Yafunu yareɛ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Constipation]] - [[Ayamtim]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:58, 11 Kitawonsa 2022 (UTC) # [[:en:Diabetes]] - [[Asikyireyareɛ]] # [[:en:Cholera]] - [[Ayamtunini/Kɔlera]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:53, 29 Kitawonsa 2022 (UTC) # [[:en:Goiter]] - [[Kɔmpɔ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:23, 22 Kitawonsa 2022 (UTC)[[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:22, 22 Kitawonsa 2022 (UTC) # [[:en:Gonorrhea]] - [[Babaso]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:02, 28 Kitawonsa 2022 (UTC) # [[:en:Cancer]] - [[Kokoram]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 15:19, 31 Kitawonsa 2022 (UTC) # [[:en:Rheumatism]] - [[Sasabrɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Convulsion]] - [[Asensene]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 18:31, 26 Kitawonsa 2022 (UTC) # [[:en:Asthma]] - [[Ntehyeewa]] # [[:en:Cripple]] - [[Bafan]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:37, 24 Kitawonsa 2022 (UTC) # [[:en:Muteness]] - [[Emum]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:55, 17 Kitawonsa 2022 (UTC) # [[:en:Blindness]] - [[Anifra]] # [[:en:Kwashiokor]] - [[Kwashiokor]] # [[:en:Malaria]] - [[Atiridii yare]] # [[:en:Paralysis]] - [[Mmubuo]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:09, 22 Kitawonsa 2022 (UTC) # [[:en:Vomitting]] - [[Ɛfeɛ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:09, 22 Kitawonsa 2022 (UTC) # [[:en:Hypertension]] - [[Mogyamorosoɔ]] # [[:en:Ulcer]] - [[Ayamkuro]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:09, 22 Kitawonsa 2022 (UTC) # [[:en:Stroke]] - [[Nnwodwoeɛ]] # [[:en:Measles]] - [[Ntoboro]] # [[:en:Eczema]] - [[Ɛkrɔ]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:34, 14 Kitawonsa 2022 (UTC) # [[:en:Rashes]] - [[Nsawansawa]][[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:58, 11 Kitawonsa 2022 (UTC) # [[:en:Ringworm]] - [[Kakawirewire]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:45, 17 Kitawonsa 2022 (UTC) =='''Atenaeɛ ho nsɛmfua (Environmental related terminologies)'''== Environmental related # [[:en:Buildings]] - [[Adan]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:10, 12 Kitawonsa 2022 (UTC) # [[:en:Trees]] - [[Nnua]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Flowers]] - [[Nhweren]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Animals]] - [[Mmoa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Humans]] - [[Nnipa]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:32, 12 Kitawonsa 2022 (UTC) # [[:en:Clouds]] - [[Ewiem]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 18:56, 28 Kitawonsa 2022 (UTC) # [[:en:Air]] - [[Nframa]] # [[:en:Machines]] - [[Afidie]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 05:03, 29 Kitawonsa 2022 (UTC) # [[:en:River]] - [[Nsutene]][[Dwumadini:Mbaidoo|Mbaidoo]] ([[Dwumadini nkitahode:Mbaidoo|Nkitahode beaɛ]]) 14:43, 14 Kitawonsa 2022 (UTC) # [[:en:Sea]] - [[Ɛpo]][[Dwumadini:Mbaidoo|Mbaidoo]] ([[Dwumadini nkitahode:Mbaidoo|Nkitahode beaɛ]]) 14:43, 14 Kitawonsa 2022 (UTC) # [[:en:Car]] - [[Ɛhyɛn]][[Dwumadini:Mbaidoo|Mbaidoo]] ([[Dwumadini nkitahode:Mbaidoo|Nkitahode beaɛ]]) 14:43, 14 Kitawonsa 2022 (UTC) # [[:en:Train]] - [[Keteke]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 23:01, 20 Kitawonsa 2022 (UTC) # [[:en:Canoe]] - [[Kudoɔ]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Ship ]] - [[Suhyɛn]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Aircraft/aeroplane]] - [[Wiemhyɛn]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:50, 19 Kitawonsa 2022 (UTC) # [[:en:Airport]] - [[Wiemhyɛn gyinabea]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:27, 17 Kitawonsa 2022 (UTC) # [[:en:Port/harbor]] - [[Suhyɛn gyinabea]] # [[:en:Train station]] - [[Keteke gyinabea]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:34, 14 Kitawonsa 2022 (UTC) # [[:en:Forest]] - [[Kwaeɛ]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 23:01, 20 Kitawonsa 2022 (UTC) # [[:en:Court]] - [[Asɛm dibea]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 08:51, 3 Ɔsanaa 2022 (UTC) # [[:en:Church building]] - [[Asɔre dan]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 23:34, 14 Kitawonsa 2022 (UTC) # [[:en:Church]] - [[Asɔre]] [[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 14:46, 9 Ɔsanaa 2022 (UTC) # [[:en:Mosque]] - [[Nkramosom dan]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:38, 24 Kitawonsa 2022 (UTC) # [[:en:Muslim]] - [[Nkramoni]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:38, 24 Kitawonsa 2022 (UTC) # [[:en:Islam]] - [[Nkramosom]] [[Dwumadini:AC Krah|AC Krah]] ([[Dwumadini nkitahode:AC Krah|Nkitahode beaɛ]]) 20:38, 24 Kitawonsa 2022 (UTC) # [[:en:Christian]] - [[Kristoni]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Christianity]] - [[Kristosom]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 13:48, 24 Kitawonsa 2022 (UTC) # [[:en:Rainbow]] - [[Nyankontɔn]] # [[:en:Gun]] - [[Etuo]][[Dwumadini:Nana Sintim|Nana Sintim]] ([[Dwumadini nkitahode:Nana Sintim|Nkitahode beaɛ]]) 03:21, 1 Ɔsanaa 2022 (UTC) # [[:en:Water]] - [[Nsuo]] # [[:en:Railway]] - [[Keteke kwan]] # [[:en:Road]] - [[Lɔre kwan]] # [[:en:Stadium]] - [[Agoprama]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 16:50, 19 Kitawonsa 2022 (UTC) # [[:en:Market]] - [[Aguaso]][[Dwumadini:Afriyie34|Afriyie34]] ([[Dwumadini nkitahode:Afriyie34|Nkitahode beaɛ]]) 13:20, 31 Kitawonsa 2022 (UTC) # [[:en:Land]] - [[Asaase]] # [[:en:Mountain]] - [[Bepɔ]] # [[:en:Sun]] - [[Awia]] # [[:en:Moon]] - [[Bosome]] # [[:en:Star]] - [[Nsoroma]][[Dwumadini:Ebensarfo|Ebensarfo]] ([[Dwumadini nkitahode:Ebensarfo|Nkitahode beaɛ]]) 16:50, 19 Kitawonsa 2022 (UTC) # [[:en:Birds]] - [[Nnomaa]][[Dwumadini:Ebensarfo|Ebensarfo]] ([[Dwumadini nkitahode:Ebensarfo|Nkitahode beaɛ]]) 15:39, 19 Kitawonsa 2022 (UTC) 6iqqv6tsqbcyg2jp1kk1mp8dhx95lb2 0 12382 133299 131959 2022-08-09T16:22:03Z 197.255.127.172 Put a space between afe and 1992 wikitext text/x-wiki {{Dialect|Asante}} '''National Independence Party''' (NIP) yɛ [[Amammuifo|amammuo]] bi a atwam wɔ [[Ghana]]. Yɛtee kuo no 1992 mmerɛ yɛrebue nnan Republik a ɛwɔ Ghana. Kuo no baa awieɛ wɔ afe 1993 mu Ɛnam nkabom bi a wɔne Nkrumahist kuo foforɔ bi nyae. {| class="wikitable" ! colspan="2" |National Independence Party |- ![[Party leader|Leader]] |[[Kwabena Darko]] |- !Founded |1992 |- !Merged into |[[People's Convention Party]] ne [[National Convention Party (Ghana)|National Convention Party]] |- !Headquarters |[[Accra]] |- ![[List of political ideologies|Ideology]] |[[Nkrumaism]] |} ==SƐDEƐ WƆTEE KUO NO== Wɔtee kuo NIP wɔ afe 1992 mu berɛ a [[Provisional National Defence Council]] baraa amammuo kuo biara wɔ kɔtonimaa, 1992 mu wɔ [[Jerry Rawlings]] mmerɛ so. Na saa kuo yi ka afoforɔ beberee a wɔyɛɛ sɛ wɔbɛdi [[Kwame Nkrumah|Nkrumah]] dwumadie no akyuli. Kuo afoforɔ te sɛ [[People's National Convention (Ghana)|People's National Convention]], [[People's Heritage Party]] <ref>https://en.m.wikipedia.org/wiki/National_Independence_Party_(Ghana)#cite_note-1</ref>ne [[National Convention Party (Ghana)|National Convention Party]]<nowiki/>nso kaa sɛ Nkrumah adeɛ a ɔde gyae no yɛ wɔn deɛ. ==1992 ABATOƆ NO MU NSƐM== NIP gyinaa wɔ 1992 Ghana abatoɔ kɛseɛ no mu wɔ Obubuo 3, 1992 mu. Deɛ ɔgyinaa manpanin akonnwa no ano ne [[Kwabena Darko]], a ɔyɛ adwumawura a wɔnnya ne ho. Kwabena Darko de 2.8% tɔɔ so nan wɔ abatoɔ ne nyinaa mu. <ref>https://en.m.wikipedia.org/wiki/National_Independence_Party_(Ghana)#cite_note-2</ref>Ɛwɔm sɛ amanɔnefoɔ no hunu sɛ na esisie biara nni abatoɔ no mu deɛ, nanso NIP ne nuo mmiensa bi a ɛyɛ [[New Patriotic Party]], People's National Convention ne People's Heritage Party kaa sɛ abatoɔ no deɛ yɛwia mu ma wɔn sane yii wɔn ho firi mmrahyɛbadwa abatoɔ a ɛkɔɔso Ɔpɛnimaa 29, 1992 mu.<ref>https://en.m.wikipedia.org/wiki/National_Independence_Party_(Ghana)#cite_note-3</ref> ==EKUO MMIENU NKABOM MU NSƐM== Wɔ afe a edikan wɔ 1993 a ɛyɛ nnan republik ma , Ghana no, NIP ne People's Heritage Party ne pro-Nkrumah party ka bom bɛyɛɛ [[People's Convention Party]].<ref>https://en.m.wikipedia.org/wiki/National_Independence_Party_(Ghana)#cite_note-4</ref> ==BEAƐ A MENYAA MMOA FIRIIƐ== sli7ldple5abi3d095dnusvqurp8fvc 0 12396 133338 126744 2022-08-10T10:59:03Z Robertjamal12 8680 /* Beaeɛ a menyaa mmoa firiiɛ */ wikitext text/x-wiki '''Ɛkrɔ''' yɛ honam a ɛhyehye, a ɛde ahoɔhene, nsaa a ayɛ kɔkɔɔ ba. <ref name=":0">https://books.google.com/books?id=egXPtnc4lssC&pg=PA1</ref>Sɛ ɛba mmerɛ tiawa bi a, ɛbɛbɔ mpumpunya na sɛ ɛba na ɛkyɛ a ɛbɛ dɔɔso.<ref name=":0" /> Baabi a nsaa no agu no bɛfiri baabi ketewa de akɔ nnipadua no nyinaa. <ref name=":0" /><ref name=":1">http://www.niams.nih.gov/health_info/Atopic_Dermatitis/default.asp</ref>Wɔfrɛ Dermatitis ɛkrɔ, na nsonsonoeɛ a ɛda ntam no nyɛ gyinapɛn. Nnoɔma a ɛde saa tebea no ba no mu nna hɔ.<ref name=":1" /> Nnoɔma a ɛde ba no bɛtumi ayɛ nnoɔma bi a ɛni sɛ ɔdi anaa ɔyɛ ne poor venous return. <ref name=":0" />Ɛkrɔ korɔ no gyina nnipa no abakɔsɛm ne baabi a nsaa no agu. Nhwɛsoɔ, ɛkrɔ a ɛyɛ hene taa ba nsa a mmerɛ biara afɔ. <ref name=":0" />Wɔn a wɔmpɛ nnoɔma bi a wɔyɛ saa adeɛ tumi ba sɛ wɔde wɔn ho ka allergen, a ɛma honam no ani foforo nsaa.<ref name=":0" /> Deɛ yɛde si atopic Dermatitis kwan yɛ fatty acids, na yɛde adeɛ bi a ayɛ sɛ nsuo ne steroid nkuu. <ref>https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA482</ref> Ɛwɔ sɛ steroid nkuu no yɛ ɛhɔ ne hɔ na wɔde sra bɛyɛ nnawɔtwe mmienu sɛ nsunsuansoɔ san ba a.<ref>https://books.google.com/books?id=N_D5CQAAQBAJ&pg=PA171</ref> Wobɛtumi de Antibiotics afa so sɛ nsɛnkyerɛnne no sane ba honam no so. <ref name=":1" />Ɛwɔ sɛ obi twe ne ho firi nnoɔma a ɛnni sɛ ɔde ne ho ka.<ref>Mowad CM, Anderson B, Scheinman P, Pootongkam S, Nedorost S, Brod B (June 2016). "Allergic contact dermatitis: Patient management and education". ''Journal of the American Academy of Dermatology''. '''74''' (6): 1043–1054. doi:10.1016/j.jaad.2015.02.1144</ref> Antihistamines tumi ma obi da na ɛte anadwo ahoɔhene so.<ref name=":1" /> Wɔsusu sɛ ɛkrɔ yɛɛ nnipa bɛyɛ mpem ahanu ne aduanan num wɔ mfeɛ mpem mmienu ne du num, anaa ɔhamu nkyekyɛmu mmiɛnsa akyiripɔ aduasa nan wɔ wiase afanaa nyinaa. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Dermatitis yɛ na na ɛhyɛ aseɛ firi mmɔfra.<ref name=":1" /> Dermatitis ɛba mmaa so mprenu te sɛ mmarima.<ref>https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA566</ref> Dermatitis tumi nya nnipa bɛyɛ ɔhamu nkyekyɛmu nson wɔ wɔn abrabɔ mu.<ref>https://books.google.com/books?id=EyypCwAAQBAJ&pg=SA99-PA868</ref> Dermatitis a ɛma ahoɔhene no yɛ na, ne titire wɔ nnipa a nnwuma bi mu, saa adeɛ no mu nna hɔ.<ref>https://books.google.com/books?id=hgXtCAAAQBAJ&pg=PA42</ref> == Ahodoɔ == Ɛkrɔ ahodoɔ no bi ne<ref>https://books.google.com/books?id=egXPtnc4lssC&pg=PA1</ref><ref name=":1" /> * Atopic dermatitis * Allergic contact dermatitis * Irritant contact dermatitis * Seborrhoeic dermatitis * Stasis dermatitis == Nsɛnkyerɛnne == Ɛkrɔ nsɛnkyerɛnne no da nso wɔ tebea a obi kɔ mu. Ɛwɔm sɛ ɛkrɔ ahodoɔ no nyinaa wɔ nsɛnkyerɛnne a ɛda nso, yɛwɔ ɛkrɔ nsɛnkyerɛnne bi a ne nyinaa yɛ pɛ, a nsa ho yɛ kɔkɔɔ, ɛhono, ɛyɛ hene na honam no huhura sane yɛ hu. Saa ara nso na baabi a ɛkrɔ no nsɛnkyerɛnne no gu no bɛda nso firi ɛkrɔ ahodoɔ biara, sɛ ɛwɔ kɔn, nsa, serɛ, nsa, nanpɔso ne bakɔn ho. Ɛwɔm sɛ baabi a ɛgu no da nso deɛ nanso nsɛnkyerɛnne a obiara nya no yɛ ahoɔhene. Ɛtumi ba yɛn agyapadeɛ so te sɛ hwoa anaa mmaa agyapadeɛ so.<ref>http://www.dermnetnz.org/topics/lichen-simplex</ref> <ref>http://www.mayoclinic.com/health/neurodermatitis/ds00712/dsection=symptoms</ref>Saa ɛkrɔ su yi nsɛnkyerɛnne bɛtumi ayɛ den na aba asane akɔ. Ɛkrɔ a ɛgyegye no yɛ hene sane yɛ ya. Ɛwɔm sɛ Atopic Dermatitis nsɛnkyerɛnne a ɛba nnipa so da nso firi afoforɔ ho deɛ, nsɛnkyerɛnne a ɛyɛ na ne ahoɔhene, honam a aho, honam yɛ kɔkɔɔ. Baabi a ɛkrɔ taa gu paa ara yɛ nsam, kotodwe,animu ne nsa ho. Perioral Dermatitis kyerɛ sɛ nsaa a ɛwɔ ano ho a ahura. <ref>http://www.dermnetnz.org/topics/periorificial-dermatitis/</ref>Dermatitis herpetiformis nsɛnkyerɛnne no bi ne ahoɔhene, nka ne ahohyehyeɛ. Papules ne vesicles yɛ adeɛ a ɛho yɛ na.<ref>http://www.dermnetnz.org/topics/dermatitis-herpetiformis</ref> Saa honam no a ahono a ayɛ kɔkɔɔ no kɛseɛ bɛyɛ 1cm, a aboa ne ho ano wɔ yɛn akyi wɔ soro ne fam, yɛ to, abrateɛ, kotodwe, kɔn ho, abatire ne tiri konkora. Seborrhoeic dermatitis nsɛnkyerɛnne nso ba nkakrankakra wɔ ti konkura no ho a aho(hoa) na ɛba anim, ɛtɔ mmerɛ bi a ɛyɛ hene wɔberɛ a wo tiriwii nku.<ref>http://www.dermnetnz.org/topics/seborrhoeic-dermatitis</ref> Wɔ mmɔfra a yɛawo wɔn foforɔ mu no, saa tebea no de tiriho a ahosuo no ayɛ sɛ akokɔsradeɛ a ɛyɛ te sɛ pampɛse a yɛde bɔ mmɔfra a nsaa gu wɔn. Sɛ ano yɛ den a nsɛnkyerɛnne no bɛba tiriwii no ase, aso ne nkyɛn, ani ntɔn, hwene ntam, hwene no ho, wobo so na wakyi.<ref>https://www.merckmanuals.com/home/skin-disorders/itching-and-dermatitis/seborrheic-dermatitis</ref> == Beaeɛ a menyaa mmoa firiiɛ == <references responsive="" /> ntit07wddbuywx1kkf5l19lvfxlegc0 0 12401 133297 133237 2022-08-09T15:52:21Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa". Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ [[eczema]], [[dermatitis]], [[urticaria]], [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ which conducts research on occupational health and safety, and the [[Occupational Safety and Health Administration]], which handles regulation and policy relating to worker safety and health. == History == The meaning of health has evolved over time. In keeping with the [[Biomedical model|biomedical]]<nowiki/>perspective, early definitions of health focused on the theme of the body's ability to function; health was seen as a state of normal function that could be disrupted from time to time by [[disease]]. An example of such a definition of health is: "a state characterized by anatomic, physiologic, and psychological integrity; ability to perform personally valued family, work, and community roles; ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == References == # '''[[Health#cite%20ref-WHO%20constitution%201-0|^]]''' [[World Health Organization]]. (2006). Constitution of the World Health Organization – Basic Documents, Forty-fifth edition, Supplement, October 2006. # '''[[Health#cite%20ref-2|^]]''' # '''[[Health#cite%20ref-3|^]]''' # '''[[Health#cite%20ref-4|^]]''' # ^ [[Health#cite%20ref-:0%205-0|^'''a''']] [[Health#cite%20ref-:0%205-1|^'''b''']] # '''[[Health#cite%20ref-6|^]]''' # '''[[Health#cite%20ref-7|^]]''' Federal Prevention InitiativesArchived 2016-06-15 at the [[Wayback Machine]]. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-8|^]]''' # '''[[Health#cite%20ref-9|^]]''' History & Development of Healthy People. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-10|^]]''' # '''[[Health#cite%20ref-11|^]]''' "How stressed are you?". Bbc. iuqdl1sebpab2y5m63fvogdbdbchk3c 133305 133297 2022-08-09T22:40:21Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa". Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == History == The meaning of health has evolved over time. In keeping with the [[Biomedical model|biomedical]]<nowiki/>perspective, early definitions of health focused on the theme of the body's ability to function; health was seen as a state of normal function that could be disrupted from time to time by [[disease]]. An example of such a definition of health is: "a state characterized by anatomic, physiologic, and psychological integrity; ability to perform personally valued family, work, and community roles; ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == References == # '''[[Health#cite%20ref-WHO%20constitution%201-0|^]]''' [[World Health Organization]]. (2006). Constitution of the World Health Organization – Basic Documents, Forty-fifth edition, Supplement, October 2006. # '''[[Health#cite%20ref-2|^]]''' # '''[[Health#cite%20ref-3|^]]''' # '''[[Health#cite%20ref-4|^]]''' # ^ [[Health#cite%20ref-:0%205-0|^'''a''']] [[Health#cite%20ref-:0%205-1|^'''b''']] # '''[[Health#cite%20ref-6|^]]''' # '''[[Health#cite%20ref-7|^]]''' Federal Prevention InitiativesArchived 2016-06-15 at the [[Wayback Machine]]. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-8|^]]''' # '''[[Health#cite%20ref-9|^]]''' History & Development of Healthy People. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-10|^]]''' # '''[[Health#cite%20ref-11|^]]''' "How stressed are you?". Bbc. lp5ufz8xz3gjliwd8tojql7iadb5jf1 133306 133305 2022-08-09T23:07:06Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa". Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == References == # '''[[Health#cite%20ref-WHO%20constitution%201-0|^]]''' [[World Health Organization]]. (2006). Constitution of the World Health Organization – Basic Documents, Forty-fifth edition, Supplement, October 2006. # '''[[Health#cite%20ref-2|^]]''' # '''[[Health#cite%20ref-3|^]]''' # '''[[Health#cite%20ref-4|^]]''' # ^ [[Health#cite%20ref-:0%205-0|^'''a''']] [[Health#cite%20ref-:0%205-1|^'''b''']] # '''[[Health#cite%20ref-6|^]]''' # '''[[Health#cite%20ref-7|^]]''' Federal Prevention InitiativesArchived 2016-06-15 at the [[Wayback Machine]]. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-8|^]]''' # '''[[Health#cite%20ref-9|^]]''' History & Development of Healthy People. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-10|^]]''' # '''[[Health#cite%20ref-11|^]]''' "How stressed are you?". Bbc. l8h0kjaou5faxslx56jkbn6ufx99gty 133307 133306 2022-08-09T23:26:19Z Nana Sintim 11223 I creat reference wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa". Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == Beaeɛ a menyaa mmoa == # '''[[Health#cite%20ref-WHO%20constitution%201-0|^]]''' [[World Health Organization]]. (2006). Constitution of the World Health Organization – Basic Documents, Forty-fifth edition, Supplement, October 2006. # '''[[Health#cite%20ref-2|^]]''' # '''[[Health#cite%20ref-3|^]]''' # '''[[Health#cite%20ref-4|^]]''' # ^ [[Health#cite%20ref-:0%205-0|^'''a''']] [[Health#cite%20ref-:0%205-1|^'''b''']] # '''[[Health#cite%20ref-6|^]]''' # '''[[Health#cite%20ref-7|^]]''' Federal Prevention InitiativesArchived 2016-06-15 at the [[Wayback Machine]]. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-8|^]]''' # '''[[Health#cite%20ref-9|^]]''' History & Development of Healthy People. U.S. Department of Health and Human Services # '''[[Health#cite%20ref-10|^]]''' # '''[[Health#cite%20ref-11|^]]''' "How stressed are you?". Bbc. 7rjcqoxa4odk7ehy4us94awusv2dfwr 133308 133307 2022-08-09T23:29:01Z Nana Sintim 11223 wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa". Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == Beaeɛ a menyaa mmoa firiiɛ == f2kb8fzddavisia3ylulvdxngyxxi2n 133309 133308 2022-08-09T23:31:46Z Nana Sintim 11223 wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa".<ref>https://en.m.wikipedia.org/wiki/Health#cite_note-WHO_constitution-1</ref> Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == Beaeɛ a menyaa mmoa firiiɛ == it84azkiokzut6lhlrqfqkllkunnb5j 133310 133309 2022-08-09T23:35:28Z Nana Sintim 11223 I add refrences wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa".<ref>https://en.m.wikipedia.org/wiki/Health#cite_note-WHO_constitution-1</ref> Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. <ref>https://en.m.wikipedia.org/wiki/Health#cite_note-2</ref>Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with [[Human body|physical]], [[biological]], [[Psychology|psychological]], and [[social stress]]".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to [[well-being]], in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == Beaeɛ a menyaa mmoa firiiɛ == bx1xq3mcvv1r6zrtdgrwf7ej7r2pj27 133311 133310 2022-08-09T23:38:59Z Nana Sintim 11223 I add refrences wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa".<ref>https://en.m.wikipedia.org/wiki/Health#cite_note-WHO_constitution-1</ref> Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. <ref>https://en.m.wikipedia.org/wiki/Health#cite_note-2</ref>Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. <ref>https://en.m.wikipedia.org/wiki/Health#cite_note-3</ref>Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with physical, biological, psychological, and social stress".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to well-being, in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == Beaeɛ a menyaa mmoa firiiɛ == 4u46ccnt4l5e649j4yy28m222cf0pe7 133312 133311 2022-08-09T23:42:09Z Nana Sintim 11223 I add refrences wikitext text/x-wiki '''Apowmuden''', sɛnea Wiase Nyinaa Akwahosan Ahyehyɛde no kyerɛ no, yɛ "tebea a nipadua, adwene ne asetra mu yiyedi koraa wom na ɛnyɛ yare ne mmerɛwyɛ a enni hɔ ara kwa".<ref>https://en.m.wikipedia.org/wiki/Health#cite_note-WHO_constitution-1</ref> Wɔde nkyerɛase ahorow adi dwuma wɔ atirimpɔw ahorow ho bere tenten. <ref>https://en.m.wikipedia.org/wiki/Health#cite_note-2</ref>Wobetumi ama akwahosan anya nkɔso denam dwumadi ahorow a ɛma ahoɔden, te sɛ apɔw-mu-teɛteɛ a wɔyɛ no daa ne nna a ɛfata a wɔbɛhyɛ ho nkuran, ne dwumadi anaa tebea horow a ɛnyɛ papa te sɛ sigaretnom anaa adwennwen a ɛboro so a wɔbɛtew so anaasɛ wɔbɛkwati so. Nneɛma bi a ɛka akwahosan no fi ankorankoro paw, te sɛ sɛ ebia wɔde wɔn ho bɛhyɛ suban a asiane kɛse wom mu, bere a afoforo nso fi nhyehyɛe mu nneɛma te sɛ sɛ ebia wɔahyehyɛ ɔmanfo no wɔ ɔkwan bi so a ɛbɛma ayɛ mmerɛw anaasɛ ɛbɛyɛ den ama nkurɔfo sɛ wobenya akwahosan ho nnwuma a ɛho hia. Nanso, nneɛma afoforo boro ankorankoro ne kuw nyinaa paw so, te sɛ awosu mu ɔhaw ahorow. == Adwuma == Deɛ ɛka ahobanbɔ ho, Nnwuma pii nso de yadeɛ ba,Nnyarewa ne apɔmuden ne mu haw. Nnwuma aka no nnyare name akwan hodoɔ so na ɛba ebi ne deɛ nadwumayɛni bɛtumi de ama no a Ɛyɛ berɛboɔ mu yadeɛ. Ntehyeewa nso yɛ aherawa mu yade a ɛyɛ nnwumafoɔ pii. Adwumafoɔ binom nso to me nya honam ani nnyarewa, ebi te sɛ eczema, dermatitis, urticaria, [[sunburn]], ne honam ani kokoram. Nnwuma mu nnyarewa no bi ne [[carpal tunnel syndrome]] ne deɛ ɛde adutoɔ ba. Nnwumakuo pii ama aman dodoɔ naa akɔ wɔn anim , ɛno de yadeɛ ahoɔdoɔ na ɛba kyɛn deɛ yɛankasa ɛyɛ. Yadeɛ a ɛtumi kɔ,ebi te sɛ kɛseɛ mmurosoɔ ne ɔbrɛ mmorosoɔ ne adwuma yɛ mmorosoɔ wɔ aman ahodoɔ. Aban ahodoɔ pii ayɛ nhyehyeɛ fa adwumayɛ ho ahyɛ aban no nnwuma sɛ wɔnhwɛ adumafoɔ ne wɔn apɔmuden ho banbɔ.Nhwɛsoɔ na edidi soɔ yi British apɔmuden ne banbɔ wɔ [[United States]], National Institute a ɛhwɛ nnwuma banbɔ ne apɔmuden a ɛyɛɛ nhwehwɛ mu . == Abakɔsɛm == Apɔmuden asekyerɛ wɔ mfeɛ pii ne. <ref>https://en.m.wikipedia.org/wiki/Health#cite_note-3</ref>Wɔ baalɔgye afa mu no, na apɔmuden kyerɛ sɛ nipadua no bɛyɛ adwuma yie wɔ ahyaseɛ no; Yɛhunu apɔmuden sɛ nipadua no reyɛ adwuma ne berɛ ano ne berɛa no abraa yadeɛ biara nha no. <ref>https://en.m.wikipedia.org/wiki/Health#cite_note-4</ref>Apɔmuden asekyerɛ nhwesoɔ ne sɛ sɛ nipadua no tumi yɛ adwuma yie, ability to deal with physical, biological, psychological, and social stress".Then, in 1948, in a radical departure from previous definitions, the [[World Health Organization]] (WHO) proposed a definition that aimed higher, linking health to well-being, in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition was welcomed by some as being innovative, it was also criticized for being vague and excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal, with most discussions of health returning to the practicality of the biomedical model. Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". In 1984, WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities." Thus, health referred to the ability to maintain [[homeostasis]] and recover from adverse events. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and [[independent living]].This opens up many possibilities for health to be taught, strengthened and learned. == Beaeɛ a menyaa mmoa firiiɛ == cwyryc2ai39pk6nwg867x5pbsd02egl 0 12406 133330 130200 2022-08-10T05:30:24Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} '''Wiemhyɛn'''({{Audio|tw-Wiemhyɛn.ogg|pronounciation of "Weimhyɛn"}}) gyinabea yɛ wiemhyɛn gyinabea a ɛwɔ nneɛma a wɔatrɛw mu, a ne fã kɛse no ara yɛ wiemhyɛn akwantu a wɔde di gua.<ref>http://www.merriam-webster.com/dictionary/airport</ref> Wiemhyɛn gyinabea taa yɛ beae a wɔde si fam, a ɛyɛ beae a ɛhɔ yɛ petee a wotumi fa wim a anyɛ yiye koraa no, beae biako a ɛyɛ adwuma te sɛ wiemhyɛn kwan a wiemhyɛn betumi atu na akɔ fam[3] anaasɛ helipad,[4] na ɛtaa ka nneɛma a ɛbɛn ho adan te sɛ control towers, hangers[5] ne terminals, de hwɛ wiemhyɛn so na wɔhwɛ so. Ebia wiemhyɛn gyinabea akɛse no benya wiemhyɛn gyinabea kyɛw, taksi akwan so abɔntenban, mmeae a wɔhwɛ wiemhyɛn akwantu so, mmeae a wɔde akwantufo te sɛ adidibea ne mmeae a wɔda mu, ne mmeae a wɔhwɛ nneɛma a egye ntɛmpɛ so. Wɔ aman bi mu, titiriw U.S. no, wiemhyɛn gyinabea ahorow nso taa nya wiemhyɛn gyinabea biako anaa nea ɛboro saa a wɔde di dwuma wɔ baabiara, a ɛsom wiemhyɛn a wɔde di dwuma wɔ ɔkwan a ɛkɔ akyiri so. 3tjb4a55a2gicxy4he09cmdnv0ny2d4 0 12407 133331 126668 2022-08-10T05:31:04Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} '''Wiemhyɛn''' '''gyinabea''' yɛ wiemhyɛn gyinabea a ɛwɔ nneɛma a wɔatrɛw mu, a ne fã kɛse no ara yɛ wiemhyɛn akwantu a wɔde di gua. <ref>http://www.merriam-webster.com/dictionary/airport</ref>Wiemhyɛn gyinabea taa yɛ beae a wɔde si fam, a ɛyɛ beae a ɛhɔ yɛ petee a wotumi fa wim a anyɛ yiye koraa no, beae biako a ɛyɛ adwuma te sɛ wiemhyɛn kwan a wiemhyɛn betumi atu na akɔ fam<ref>http://www.merriam-webster.com/dictionary/runway?show=0&t=1422938979</ref> anaasɛ helipad,<ref>http://www.merriam-webster.com/dictionary/helipad</ref> na ɛtaa ka nneɛma a ɛbɛn ho adan te sɛ control towers, hangers<ref>http://www.merriam-webster.com/dictionary/hangars</ref> ne terminals, de hwɛ wiemhyɛn so na wɔhwɛ so. Ebia wiemhyɛn gyinabea akɛse no benya wiemhyɛn gyinabea kyɛw, taksi akwan so abɔntenban, mmeae a wɔhwɛ wiemhyɛn akwantu so, mmeae a wɔde akwantufo te sɛ adidibea ne mmeae a wɔda mu, ne mmeae a wɔhwɛ nneɛma a egye ntɛmpɛ so. Wɔ aman bi mu, titiriw U.S. no, wiemhyɛn gyinabea ahorow nso taa nya wiemhyɛn gyinabea biako anaa nea ɛboro saa a wɔde di dwuma wɔ baabiara, a ɛsom wiemhyɛn a wɔde di dwuma wɔ ɔkwan a ɛkɔ akyiri so. wimhyɛn gyinabea ahorow a wɔde di dwuma no yɛ nea emu yɛ den yiye, na nhyehyɛe a ɛyɛ den a ɛfa wimhyɛn mmoa adwuma, akwantufo adwuma, ne wimhyɛn sohwɛ adwuma ho wɔ adwumayɛ no mu. Enti wimhyɛn gyinabea ahorow betumi ayɛ adwumawuranom atitiriw, ne mmeae a ɛho hia ma nsrahwɛ ne akwantu ahorow afoforo. Esiane sɛ ɛyɛ mmeae a wɔde mfiri a emu yɛ duru yɛ adwuma nti, wɔde mmara ne ahobammɔ ho nhyehyɛe ahorow bi adi dwuma wɔ wimhyɛn gyinabea ahorow, sɛnea ɛbɛyɛ a asiane ahorow no so bɛtew. Bio nso, wimhyɛn gyinabea ahorow wɔ mpɔtam hɔ nneɛma a atwa yɛn ho ahyia so nkɛntɛnso atitiriw, sɛ nneɛma akɛse a ɛde mframa mu efĩ, dede ne nneɛma afoforo a atwa yɛn ho ahyia ba no nyinaa, na ɛma ɛyɛ mmeae a wimhyɛn akwantu de ba nneɛma a atwa yɛn ho ahyia so no kɛse. Wimhyɛn gyinabea nso yɛ nnwuma a ɛyɛ mmerɛw sɛ wim tebea a ano yɛ den, wim nsakrae de po mu nsu kɔɔ soro ne asiane afoforo ba. == Nsɛmfua == Nsɛmfua wimhyɛn gyinabea, wimhyɛn gyinabea, ne wimhyɛn gyinabea nso kyerɛ wimhyɛn gyinabea, na nsɛmfua heliport, po so wimhyɛn gyinabea, ne STOLport kyerɛ wimhyɛn gyinabea a wɔahyira so ama helikopta, po so wimhyɛn, ne wimhyɛn a ɛtu ne nea ɛba bere tiaa mu nkutoo. Wɔ kasa mu a wɔde di dwuma wɔ mmeae bi no, wɔtaa sesa nsɛmfua wimhyɛn gyinabea ne wimhyɛn gyinabea. Nanso, mpɛn pii no, asɛmfua wimhyɛn gyinabea no betumi akyerɛ anaasɛ ɛbɛma wimhyɛn adwumayɛbea no ayɛ kɛse bi a ebia wimhyɛn gyinabea afoforo antumi annye. Wɔ tumidi ahorow bi mu no, wimhyɛn gyinabea yɛ mmara kwan so adwinni ho asɛmfua a wɔde asie ama saa wimhyɛn gyinabea ahorow a ɔmanfo wimhyɛn adwumayɛkuw a ɛfa ho no agye atom anaasɛ wɔama ho tumi krataa no nkutoo bere a wɔadi adansedi gyinapɛn pɔtee anaa mmara mu ahwehwɛde ahorow ho dwuma awie no. Ɛne sɛ, wimhyɛn gyinabea nyinaa yɛ wimhyɛn gyinabea, nanso ɛnyɛ wimhyɛn gyinabea nyinaa na ɛyɛ wimhyɛn gyinabea. Wɔ tumidi ahorow a mmara kwan so nsonsonoe biara nni wimhyɛn gyinabea ne wimhyɛn gyinabea ntam no, asɛmfua bɛn na wɔde bedi dwuma wɔ wimhyɛn gyinabea din mu no betumi ayɛ aguadi ho gyinaesi. Wɔ U.S. mfiridwuma/mmara kwan so dwumadie mu no, wɔde beaeɛ a wɔde si fam di dwuma sen sɛ wɔde wimhyɛn gyinabea bedi dwuma, na wimhyɛn gyinabea kyerɛ "beae a wimhyɛn de si fam a wimhyɛn de di dwuma daa de gye akwantufoɔ anaa nneɛma a wɔde fa mu anaa wɔde gu mu".[7] == Ntotoeɛ. == Wimhyɛn gyinabea nketewa anaa nea ennya nkɔso pii, a egyina hɔ ma dodow no ara no taa yɛ nea ɛyɛ tiaa sen mita 1,000 (anammɔn 3,300). Wimhyɛn gyinabea akɛse a wɔde wimhyɛn fa wimhyɛn mu no taa yɛ akwan a wɔabɔ so a ɛyɛ mita 2,000 (anammɔn 6,600) anaa nea ɛboro saa. Skyline wimhyɛn gyinabea a ɛwɔ Inkom no, Idaho wɔ wimhyɛn kwan a ne tenten yɛ mita 122 pɛ.[8] Wɔ United States no, wɔde mfuw a ɛyɛ kusuu a ɛyɛ den a ɛwɔ fam no nsusuwii a ɛba fam koraa no kyerɛ sɛnea mfuw no si fam akyirikyiri na ɛtu fi hɔ no. Eyinom bi ne nneɛma a ɛsɛ sɛ wosusuw ho wɔ ahobammɔ ho bere a wɔresi fam ne bere a wɔretu no. Wimhyɛn kwan a ɛware sen biara a wɔde di dwuma wɔ wiase nyinaa wɔ Qamdo Bamda Wimhyɛn Gyinabea wɔ [[China]]. ne tenten yɛ mita 5,500 (anammɔn 18,045). Wimhyɛn kwan a ɛtrɛw sen biara a wɔabɔ ho ban sen biara wɔ wiase no wɔ Ulmaunovsk Vostochny Wimhyɛn Gyinabea wɔ Russia na ne tɛtrɛtɛ yɛ mita 105 (anammɔn 344). Ɛde besi afe 2009 no, CIA no kae sɛ na "wimhyɛn gyinabea anaa wimhyɛn gyinabea a wotumi hu fi wim" bɛyɛ 44,000 na ɛwɔ wiase nyinaa, a 15,095 a wɔwɔ U.S. ka ho, na U.S. na ɛwɔ wiase no mu kɛse. == ^{<small>Wimhyɛn gyinabea wurayɛ ne wɔn dwumadie</small>} == Wiase wimhyɛn gyinabea akɛse no mu dodow no ara yɛ mpɔtam hɔ, ɔmantam, anaa ɔman no aban ahyehyɛde ahorow a afei wɔde wimhyɛn gyinabea no ma ankorankoro nnwumakuw a wɔhwɛ wimhyɛn gyinabea no dwumadi so no de. Sɛ nhwɛso no, wɔ UK no, ɔman no wimhyɛn gyinabea ahorow a ɔman no wɔ no mfiase no na ɛyɛ ɔman no mu aguadi wimhyɛn gyinabea atitiriw awotwe – akyiri yi wɔde hyɛɛ ankorankoro nsa wɔ 1980 mfe no awiei mu hɔ, na bere a Spainfo mmea a wɔyɛ mmea no gyee no wɔ 2006 mu no, wɔayi afi hɔ bio na wɔatew so . kosi sɛ ɛbɛyɛ adwuma wɔ Heathrow kɛkɛ. Germany wimhyɛn gyinabea a ɛwɔ Germany no, adwumakuw a ɛte sɛ nea ɛyɛ ankorankoro de no na ɛhwɛ so. Bere a wɔwɔ India GMR Kuw no mu no, ɛnam adwuma a wɔbom yɛ so no, Indira Gandhi Amanaman Ntam Wimhyɛn Gyinabea ne Rajiv Gandhi Amanaman Ntam Wimhyɛn Gyinabea. Bengaluru Amanaman Ntam Wimhyɛn Gyinabea ne Chhatrapati Shivaji Amanaman Ntam Wimhyɛn Gyinabea no yɛ nea GVK Kuw no na ɛhwɛ so. India wimhyɛn gyinabea ahorow a aka no, India Airports Authority na ɛhwɛ so. Wɔ Pakistan no, ɛkame ayɛ sɛ ɔmanfo wimhyɛn gyinabea nyinaa yɛ Pakistan Ɔmanfo Wimhyɛn Dwumadibea no de na wɔhwɛ so gye sɛ Sialkot Amanaman Ntam Wimhyɛn Gyinabea a ɛwɔ nsonsonoe a ɛne sɛ ɛyɛ ɔmanfo wimhyɛn gyinabea a edi kan a ankorankoro wɔ wɔ Pakistan ne Asia Kesee Fam[nsɛm a wɔde kyerɛw Wɔ U.S. no, mpɛn pii no, aban ahyehyɛde ahorow anaa wimhyɛn gyinabea mpanyimfo (a wɔsan frɛ no hyɛn gyinabea mpanyimfo) na ɛhwɛ aguadi wimhyɛn gyinabea ahorow so tẽẽ, te sɛ Los Angeles Wiase Wimhyɛn Gyinabea Tumi a ɛhwɛ wimhyɛn gyinabea ahorow pii so wɔ Los Angeles mpɔtam hɔ, a Los Angeles International ka ho wimhyɛn gyinabea[nkyerɛwde a ɛho hia]. == Beaɛ a me nya moa firiɛ == jgjqctfppanz10zlac5xlfnwdw13q5i 0 12519 133324 128871 2022-08-10T05:25:47Z Afriyie34 10662 Me de dialect wikitext text/x-wiki {{Dialect|Akuapem}} '''dermatophytosis''' a wɔsan frɛ no ringworm no yɛ fungal a ɛba honam ani.[2] Mpɛn pii no ɛde akisikuru kɔkɔɔ, ɛyaw, nsensanee, kurukuruwa ba.[1] Nwi betumi atɔ wɔ beae a ɛka no.[1] Nsɛnkyerɛnne no fi ase nnanan kosi dunan wɔ bere a wɔde ahyɛ mu no akyi.[1] Mmeae pii betumi aka wɔ bere pɔtee bi mu.[4] ntontom ahorow bɛyɛ 40 betumi ama ringworm aba.[2] Wɔtaa yɛ Trichophyton, Microsporum, anaa Epidermophyton ahorow.[2] Nneɛma a ɛde asiane ba no bi ne baguam aguaree, agumadi a wɔde wɔn ho hyɛ mu te sɛ akuturukubɔ, fifiri a ɛba dodo, mmoa a wɔde wɔn ho bɛbɔ, kɛseyɛ mmoroso, ne nipadua no mu tumi a ɛko tia nyarewa a entumi nyɛ adwuma yiye.[3][4] Ringworm tumi trɛw fi mmoa afoforo mu anaasɛ nnipa ntam.[3] Mpɛn pii no, wogyina sɛnea ɛte ne ne ho sɛnkyerɛnne so na ɛkyerɛ sɛ obi anya yare no.[5] Ebia wobetumi asi so dua denam aduru a wɔde yɛ honam ani anaasɛ wɔbɛhwɛ honam ani a wɔde afiri a wɔde hwɛ nneɛma nketenkete ase so.[5] Nea ɛma wosiw ano ne sɛ wɔbɛma honam ani ayɛ kusuu, worennantew baabi a wompa mpaboa, na worenkyɛ ankorankoro nneɛma.[3] Mpɛn pii no, wɔde nnuru a ekum fungal te sɛ clotrimazole anaa miconazole na ɛsa yare.[7] Sɛ ti nhwi no ka ho a, ebia ɛho behia sɛ wɔde nnuru a wɔde ko tia fungal a wɔde ano te sɛ fluconazole.[7] Wɔ wiase nyinaa no, nnipa dodow no mu bɛyɛ 20% betumi anya ringworm bere biara.[8] Nyarewa a ɛwɔ akyi berɛmo mu no taa ba mmarima mu, bere a nyarewa a ɛba ti nhwi ne nipadua mu no ba pɛpɛɛpɛ wɔ mmarima ne mmea nyinaa mu.[4] Nyarewa a ɛba ti nhwi mu no taa ba mmofra so bere a yare a ɛba wɔn ti nhwi mu no taa ba wɔn a wɔn mfe akɔ anim no so.[4] Nkyerɛkyerɛmu a ɛfa ringworm ho no fi tete abakɔsɛm mu.[9] == Nsɛnkyerɛnenye ne sɛnkyerɛnne ahorow == Ebia nyarewa a ɛwɔ nipadua no so no bɛma wɔanya ringworm nkaa kɔkɔɔ a ɛkɔ soro a ɛtaa yɛ kɛse. Nyarewa a ɛwɔ nan ho were so no betumi ama agumadifo nan ne ne hwene mu no, jock ayɛ no yaw. Wɔfrɛ nnadewa no a ɛka ho no onychomycosis, na ebetumi ayɛ kɛse, asakra ne kɔla, na awiei koraa no abubu na ahwe ase. Wɔtaa ba nnipa a wɔanyinyin dodow no ara mu, na nnipa dodow no ara mu bɛyɛ 20% na wonya saa nyarewa yi mu biako wɔ bere biara mu.[citation needed] Mmoa a akraman ne mpataa ka ho nso betumi anya ringworm, na yare no betumi akɔ mmoa ne nnipa ntam, na ama ayɛ yare a ɛhwɛ mmoa so. Nsɛnkyerɛnne pɔtee bi betumi ayɛ: nsensanee kɔkɔɔ, nsensanee, ɛyaw anaasɛ ɛkɔ soro ebia nsensanee no bɛyɛ kɔkɔɔ wɔ akyi anoano anaasɛ ɛte sɛ nkaa nsensanee a efi ase tu anaasɛ ɛyɛ akisikuru betumi ayɛ ti nhwi no bere a ɛka ti nhwi no nnadewa betumi ayɛ den, asakra ne kɔla anaasɛ afi ase apaapae[10] . == Nneɛma a ɛde ba == Fungi yɛ yiye wɔ mmeae a ɛhɔ yɛ nwini na ɛhɔ yɛ hyew, te sɛ adan a wɔde nneɛma gu mu, mpa a wɔde honam ani hwɛbea gu mu, asuguarebea, ne honam ani hwɛbea a wɔbobɔw; nea ɛne eyi hyia no, nea ɛde dermatophytosis ba no betumi atrɛw denam apɔw-mu-teɛteɛ mfiri a wɔmfaa nnuru nkum mmoawa bere a wɔde adi dwuma awie no a wɔde bedi dwuma no so, anaasɛ mpopaho, ntade, mpaboa, anaa ti nhwi a wɔde bɛkyɛ so. == Nhwehwɛmu a wɔyɛe == Wobetumi agyina abakɔsɛm, nipadua mu nhwehwɛmu, ne potassium hydroxide (KOH) microscopy so ahu dermatophyte yare no ntɛm ara.[11] 3gnluubf26i1hdndimbrjjuqj98e14r 0 12521 133333 128979 2022-08-10T05:32:45Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} '''Agumadibea''' (agumadibea dodow bi anaa agumadibea) <ref>http://dictionary.reference.com/browse/stadium</ref>yɛ beae anaa beae a wɔyɛ (dodow no ara) abɔnten agumadi, kɔnsɛt, anaa nsɛm afoforo na ɛyɛ afuw anaa agoprama a wɔde ɔdan a ɛwɔ ntoatoaso a wɔayɛ sɛ ɛbɛma bɛhwɛadefo agyina hɔ atwa ho ahyia no fã bi anaa ne nyinaa anaasɛ wobɛtra ase ahwɛ adeyɛ no.<ref>https://en.m.wikipedia.org/wiki/Nussli_Group</ref> pausanias kae sɛ bɛyɛ mfe ɔha fã no, adeyɛ biako pɛ a ɛkɔɔ so wɔ tete Helafo Olimpik afahyɛ no ase ne mmirikatu a na ɛyɛ agumadibea a ɛwɔ Olimpia no tenten biako, faako a asɛmfua "agumadibea" no fii ase no. Agumadibea ahorow a anyɛ yiye koraa no nnipa 10,000 betumi atra mu no mu dodow no ara yɛ fekuw bɔɔlbɔ. Agumadibea afoforo a agye din ne gridiron bɔɔlbɔ, baseball, kriket, rugby mmara ahorow, field lacrosse, bandy, ne anantwinini akodi. Wɔde agumadibea akɛse pii nso yɛ kɔnsɛt ahorow. == Edin no Farebaeɛ == stadium" yɛ Latin kasa mu Hela asɛmfua "stadion" (στάδιον), tenten susudua a ɛne nnipa anammɔn 600 tenten yɛ pɛ.<ref>CITATION ^[4] Στάδιον, Henry George Liddell, Robert Scott, ''A Greek-English Lexicon'', on Perseus</ref>Sɛnea nan tenten sesa no stadion tenten pɔtee gyina tenten pɔtee a wogye tom no so ma nan 1 wɔ beae ne bere bi mu Ɛwom sɛ wɔ nnɛyi nsɛm mu no, agumadibea 1 = anammɔn 600 (mita 180) de, nanso wɔ abakɔsɛm mu tebea bi mu no ebetumi akyerɛ ankasa tenten a ɛkɔ soro kodu 15% kɛse anaa ketewaa bi.<ref>''A Brief History of the Olympic Games'' by David C. Young, p. 20</ref> Romafo susudua a ɛne no sɛ, agumadibea no, wɔ tenten a ɛte saa ara – bɛyɛ mita 185 (anammɔn 607) – nanso sɛ́ anka wɔbɛkyerɛkyerɛ mu wɔ anammɔn mu no, wɔde Romafo gyinapɛn passsus dii dwuma de kyerɛkyerɛɛ mu sɛ ɛyɛ kwan a ɛyɛ 125 passūs (akwan abien). Engiresifo a wɔde agumadibea di dwuma no fi nneɛma a wɔayɛ no ntoatoaso a atwa Romafo kwan bi a ne tenten te saa ho ahyia no mu. Nsɛm asekyerɛ nhoma dodow no ara de agumadibea ne agumadibea nyinaa ma sɛ Engiresi kasa mu dodow kabea a ɛfata. == Abakɔsɛm. == agumadibea a akyɛ sen biara a wonim ne Agumadibea a ɛwɔ Olympia wɔ Greece, faako a na wɔyɛ tete Olimpik Agumadi no fi 776 A.Y.B. Mfiase no na Agumadi no yɛ adeyɛ biako, mmirikatu a wɔde tu mmirika wɔ agumadibea no tenten mu. Wɔahu Helafo ne Romafo agumadibea ahorow wɔ tete nkurow pii mu, ebia nea agye din sen biara ne Domitian Agumadibea a ɛwɔ Roma no. Tete Panathenaic Agumadibea a wɔatutu na wɔayɛ no foforo no yɛɛ Olimpik Agumadi no a wɔbɔɔ mmɔden sɛ wɔbɛsan akanyan no wɔ 1870[5] ne 1875 mu ansa na wɔreyɛ nnɛyi Olimpik Agumadi a edi kan wɔ 1896 mu, 1906 Intercalated Agumadi, ne nsɛm bi a esisii wɔ 2004 Awɔw Bere mu Olimpik Agumadi no mu. Ná agumadibea no a wotutuu na wosiesiee no yɛ Hela ɔman ayamyefo Evangelos Zappas agyapade no fã, na ɛno ne tete agumadibea a edi kan a wɔde dii dwuma wɔ nnɛ mmere yi mu. == Beaeɛ a me nya firiɛ == atgjibxk0say9mi7au8p3zr16js1i9l 0 12527 133332 130189 2022-08-10T05:31:54Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} '''Kwae''' yɛ asase a nnua wɔ so kɛse.<ref>http://dictionary.reference.com/browse/forest</ref>Wɔde kwaeɛ ho nkyerɛaseɛ ɔhaha pii di dwuma wɔ wiase nyinaa, a wɔde nneɛma te sɛ nnua dodoɔ, nnua no tenten, asase a wɔde di dwuma, mmara kwan so gyinabea, ne abɔdeɛ a nkwa wom dwumadie ka ho.<ref>http://www.efi.int/files/attachments/publications/ir_06.pdf</ref><ref>http://www.cbd.int/forest/definitions.shtml</ref><ref name=":0">https://web.archive.org/web/20100726140947/http://www.unep.org/vitalforest/Report/VFG-01-Forest-definition-and-extent.pdf</ref> Amanaman Nkabom no Aduan ne Kuadwuma Ahyehyɛde (FAO) kyerɛkyerɛ kwae mu sɛ, "Asase a ne kɛse boro hekta 0.5 a nnua a ɛkorɔn boro mita 5 ne ntama a ɛkata so bɛboro ɔha biara mu nkyem 10, anaa nnua a etumi du saa ahwehwɛde ahorow yi ho wɔ beae a ɛwɔ no. Ɛyɛ." nka asase a ɛwɔ kuayɛ anaa nkuropɔn mu dwumadie mu titire no ho."<ref>http://www.fao.org/3/I8661EN/i8661en.pdf</ref>Wɔde saa nkyerɛaseɛ yi dii dwuma no, Wiase Nyinaa Kwaeɛ Ahodeɛ Nhwehwɛmu 2020 (FRA 2020) hunuu sɛ kwaeɛ no yɛ hekta ɔpepepem 4.06 (acre ɔpepepem 10.0; kilomita ahinanan ɔpepem 40.6; ahinanan ɔpepem 15.7 akwansin), anaasɛ bɛyɛ wiase asase no ɔha biara mu nkyem 31 wɔ afe 2020 mu.<ref>https://doi.org/10.4060/ca8985en</ref> == Nkyerɛmu == ɛwom sɛ wɔtaa de asɛmfua kwae di dwuma de, nanso nkyerɛase pɔtee biara nni hɔ a wogye tom wɔ amansan nyinaa mu, na wɔde kwae ho nkyerɛase bɛboro 800 na edi dwuma wɔ wiase nyinaa.<ref name=":0" />Ɛwom sɛ wɔtaa kyerɛkyerɛ kwae mu denam nnua a ɛwɔ hɔ so de, nanso wɔ nkyerɛase pii ase no, ebia wɔbɛda so ara abu beae a nnua nni hɔ koraa sɛ kwae sɛ enyin nnua wɔ bere bi a atwam no mu, ebenyin nnua daakye,<ref>http://www.fao.org/docrep/017/ap862e/ap862e00.pdf</ref> anaasɛ mmara kwan so de too gua sɛ a kwae a afifide ahorow a ɛwɔ mu no mfa ho.[13] Nkyerɛase ahorow abiɛsa a ɛtrɛw wɔ kwae a wɔde di dwuma ho: adwumayɛ, asase a wɔde di dwuma, ne asase a wɔde kata so.[13] Nkyerɛkyerɛmu a ɛfa nnisoɔ ho no gyina mmara kwan so din a wɔde ama asase no so titire, na ɛtaa ne ne afifideɛ no nni abusuabɔ kɛseɛ: asase a wɔde ama wɔ mmara kwan so sɛ kwaeɛ no, wɔkyerɛkyerɛ mu sɛdeɛ ɛteɛ sɛ mpo nnua biara nnyin wɔ so a. Asase a wɔde di dwuma ho nkyerɛkyerɛmu ahorow gyina atirimpɔw titiriw a asase no di ho dwuma so. Sɛ nhwɛso no, wobetumi akyerɛ kwae ase sɛ asase biara a wɔde yɛ nnua titiriw. Wɔ asase a wɔde di dwuma ho nkyerɛkyerɛmu a ɛte saa ase no, wɔda so ara bu akwan anaa nneɛma a wɔatutu mu wɔ beae bi a wɔde yɛ kwae mu—anaa mmeae a otwa, nyarewa, anaa ogya atutu—no sɛ kwae, sɛ nnua biara nni mu mpo a. Asase a ɛkata so ho nkyerɛkyerɛmu ahorow no gyina afifide ahorow a enyin wɔ asase no so ne ne dodow so kyerɛkyerɛ kwae mu. Nkyerɛase ahorow a ɛtete saa no taa kyerɛkyerɛ kwae mu sɛ beae a nnua nyin sen aboboano bi. Saa aboboano yi taa yɛ nnua dodoɔ a ɛwɔ beaeɛ biara (density), asase a ɛwɔ dua no ase (canopy cover) anaa asase no fã a nnua no ntini no ntwemu no te (basal area).[13] Wɔ asase a ɛkata so ho nkyerɛase ahorow a ɛte saa ase no, sɛ ɛyɛ nnua a ɛrenyin nkutoo a, wobetumi ahu asase no fã bi sɛ kwae. Mmeae a entumi nni asase a ɛkata so nkyerɛase no so no, wobetumi akɔ so de aka ho bere a nnua a ennyinii wɔ hɔ a wɔhwɛ kwan sɛ ebedu nkyerɛase no ho bere a ɛrenyin no.[13] == Edin no Farebaeɛ == asɛmfua kwae no fi Franse Dedaw kwae (a ɛsan nso yɛ forès), a ɛkyerɛ "kwae, ntrɛwmu kɛse a nnua akata so"; wodii kan de kwae baa Borɔfo kasa mu sɛ asɛmfua a ɛkyerɛ wuram asase a wɔde asi hɔ ama abɔmmɔ a ɛho nhia sɛ nnua wɔ asase no so. Ebia ɛyɛ fɛm, ebia ɛnam Frank anaa German High Dedaw so, a ɛfa Mfinimfini Mmere mu Latin foresta ho, a ɛkyerɛ "nnua a wɔabue", Carolingian akyerɛwfo dii kan de foresta dii dwuma wɔ Charlemagne capitularies mu, titiriw de kyerɛɛ ɔhene no ahemfo abɔmmɔbea. Na asɛmfua no nyɛ Romance kasa ahorow no mu de, s.e., kurom hɔ nsɛmfua a wɔde gyina hɔ ma kwae wɔ Romance kasa ahorow mu a wonya fii Latin silva mu, a ɛkyerɛ "kwae" ne "nnua(asase)" (fa toto Engiresi kasa mu sylva ne sylvan ho; Italia kasa no, Spania kasa, ne Portugalfo selva, Romaniafo silvă, Fransefo Dedaw no ankasa). Kwae ho nsɛm a ɛne no hyia wɔ Romance kasa ahorow mu—sɛ nhwɛso no, Italiafo foresta, Spania ne Portugal kasa mu floresta, ne nea ɛkeka ho—ne nyinaa yɛ nea awiei koraa no wonya fii Franse kasa mu. == Beaeɛ a me nya firiɛ == 501texgbzeglw6aq3l5qbdpxkuk9o54 0 12528 133329 128993 2022-08-10T05:29:46Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} Wɔ '''keteke''' akwantu mu no, keteke yɛ kar ahorow a ɛka bom a ɛnam keteke kwan so na ɛde nnipa anaa nneɛma kɔ. Asɛmfua keteke no fi Franse Dedaw trahiner mu, a wonya fii Latin trahere a ɛkyerɛ "sɛ wobɛtwe, wobɛtwe".[1] Mpɛn pii no, keteke ahorow (a wɔtaa frɛ no "engine" ara kwa) na ɛtwe anaa ɛpia keteke ahorow, ɛwom sɛ ebinom na ɛnam ne ho, te sɛ mfiri ahorow pii de. Wɔde keteke kar ahorow a wɔsan frɛ no nteaseɛnam na ɛde akwantufo ne nneɛma kɔ. Wɔayɛ keteke ahorow no sɛnea ɛbɛyɛ a ɛbɛkyerɛ keteke kwan pɔtee bi, anaasɛ kwan a ɛda keteke kwan ntam. Keteke dodow no ara fa dade akwan a dade ntwahonan wɔ so so, na esiane sɛ ɛnyɛ den pii nti, ɛma ɛyɛ adwuma yiye sen akwantu afoforo. == Abakɔsɛm == keteke ahorow yɛ nteaseɛnam a ɛwɔ ntwahonan a ɛnam abo teaseɛnam akwan so no adannandi, na Babilon na edii kan yɛɛ no ​​bɛyɛ afe 2,200 A.Y.B. Efi 1500 mfe no mu no, wɔde nteaseɛnam akwan bae a wɔde twe nneɛma fi mmeae a wotu fam no; efi 1790 mfe no mu no, wɔde dade akwan a ɛyɛ den bae.[2] Wɔ nkɔso a edi kan wɔ 1700 mfe no fã a ɛto so abien no akyi no, wɔ 1804 mu no, keteke a ɛde nsu a ɛyɛ hyew yɛe a Britaniafo Richard Trevithick yɛe no na ɛmaa keteke a ɛde nsu a ɛyɛ hyew di kan yɛɛ adwuma.[3] Wɔ fango a wotu fam, baabi a na wobetumi anya pɛtro ntɛm ara no akyi no, wɔansɔ keteke a wɔde fango yɛ adwuma no anhwɛ kosii sɛ wobuee Stockton ne Darlington Keteke Kwan no wɔ 1825. Britania mfiridwumayɛfo George Stephenson de keteke a wɔde fango yɛ a wɔfrɛ no Locomotion No. 1 dii dwuma wɔ saa kilomita 40 (akwansin 25) yi so . line tenten, a ɛtwe akwantufo bɛboro 400 a ɛde mmirika bɛyɛ kilomita 13 dɔnhwerew biara (mph 8). Saa keteke yi nkonimdi, ne Stephenson's Rocket wɔ 1829 mu no maa nnipa pii gye dii sɛ ɛsom bo wɔ keteke a wɔde nsu a ɛyɛ hyew di dwuma no ho, na wɔ mfe du mu no, sikakorabea ahurututu a wɔfrɛ no "Railway Mania" no fii ase wɔ United Kingdom nyinaa. Asɛm a ɛfa sɛnea keteke a ɛde nsu a ɛyɛ hyew di yiye ho no duu United States ntɛm ara, faako a wobuee keteke kwan a edi kan a wɔde nsu a ɛyɛ hyew di dwuma wɔ 1829 mu no.[5] Ankyɛ na Amerika keteke akwan ho akwampaefo fii ase yɛɛ wɔn ankasa keteke ahorow, a wɔayɛ sɛ wɔde bedi akwan a ɛyɛ nnam ne keteke kwan a ɛyɛ den a ɛyɛ ɔman no keteke akwan ho nhwɛso no ho dwuma.[6] 7e5apaqzslvtzjlyfkm81741nel58y7 0 12540 133323 133003 2022-08-10T05:24:50Z Afriyie34 10662 Me de dialect ka ho wikitext text/x-wiki {{Dialect|Akuapem}} '''Akuru''' yɛ nipadua no mu ntini bi a ɛgyae anaasɛ ɛpaapae a esiw akwaa a ɛka no no dwumadi kwan sɛnea ɛsɛ. Sɛnea Robins yare no kyerɛ no, "akuru yɛ honam ani, epithelium anaa mucous membrane a ɛkɔ so no a ɛpaapae a ɛnam sloughing a efi necrotic tissue a ɛho ayɛ hyew no mu ba no." Akuru ahorow a wɔtaa hu wɔ nnuruyɛ mu no bi ne: Akuru (dermatology), honam ani a ɛmma ɛnkɔ so anaasɛ honam ani a ɛpaapae. Nhyɛso mu akuru, a wɔsan frɛ no mpa so akisikuru Genital ulcer, akuru a ɛwɔ ɔbarima ne ɔbea nna ho fã Ulcerative dermatitis, honam ani yare a ɛne ɔyare mmoawa nyin a ɛtaa fi ase denam ne ho a ɛyɛ hu so Anal fissure, a.k.a. akuru anaa atetew a ɛbɛn akyi anaa akyi berɛmo no mu Asikreyare nan akisikuru, ɔhaw kɛse a ɛwɔ asikreyare nan no mu Anim akisikuru, tebea a ɛma obi ho yɛ hyew anaasɛ ɛde ɔyare ba a ɛwɔ ani no mu Ano mu akisikuru, akisikuru a abue wɔ ano mu. Aphthous ulcer, anom akisikuru pɔtee bi a wɔsan frɛ no cancer sore Peptic ulcer, yafunu mu ntini a ɛgyae (yafunu mu akisikuru)[1] . Venous ulcer, kuru a wosusuw sɛ ɛba esiane ntini ahorow a ɛwɔ ntini no mu a ɛnyɛ adwuma yiye nti Stress ulcer, akuru a ɛwɔ yafunu no mu ne duodenum a ɛbɛn no mu Ulcerative sarcoidosis, honam ani yare a ɛka nnipa a wɔwɔ sarcoidosis Lichen planus a ɛyɛ kuru, a ɛyɛ lichen planus a ɛntaa nsi Ulcerative colitis, ɔyare bi a ɛma obi ho yɛ hyew (IBD). Ulcerative disposition, ɔhaw anaa ɔhaw a ɛde yafunu mu haw kɛse ba, a mpɛn pii no ɛne yafunu mu yare a enni sabea wɔ abusuabɔ 6s999hkhqx2sbhi3ugdf0oeu6xxsgle 0 12542 133321 131647 2022-08-10T05:22:53Z Afriyie34 10662 Me de dialect ka ho wikitext text/x-wiki {{Dialect|Akuapem}} '''Kɔmpɔ anaa Kɔmpɔ''', yɛ kɔn mu a ɛhoa a efi thyroid ntini a ɛyɛ kɛse mu ba.[1][2] Wobetumi de goitre abata thyroid a ɛnyɛ adwuma yiye ho. wɔ wiase nyinaa no, bɛboro 90% a wonya goitre no fi iodine a enni hɔ.[3] Asɛmfua no fi Latin kasa mu gutturia, a ɛkyerɛ menewam. Goitres dodow no ara nyɛ kokoram (benign), ɛwom sɛ ebetumi apira de. == Nsɛnkyerɛnne ne nsɛnkyerɛnne. == Goitre betumi ada adi sɛ thyroid ntini a ɛwɔ kɔn no ase a ɛyɛ kɛse a wotumi hu anaasɛ wotumi hu. Goitre, sɛ ɛne hypothyroidism anaa hyperthyroidism wɔ abusuabɔ a, ebia na ɔyare no ho sɛnkyerɛnne ahorow wɔ hɔ. Wɔ hyperthyroidism ho no, sɛnkyerɛnne a ɛtaa ba no ne adrenergic stimulation wɔ abusuabɔ: tachycardia (koma a ɛbɔ kɛse), koma a ɛbɔ, ehu, ahopopo, mogya mmoroso a ɛkɔ soro ne ɔhyew a ontumi nnyina ano. Mpɛn pii no, nea ɛda adi wɔ ayaresabea no fa nipadua mu nkwaadɔm a ɛsakra kɛse, ( nipadua mu nkwaadɔm a ɛkɔ soro), thyroid hormone a ɛboro so, oxygen a wɔde di dwuma a ɛkɔ soro, nipadua mu nsakrae a ɛba protein mu, nipadua no mu tumi a ɛko tia nyarewa a ɛkanyan goitre a ɛtrɛw, ne aniwa mu nsakrae (exophthalmos) ho. Nnipa a wɔwɔ hypothyroid no taa nya aduan ho akɔnnɔ bɔne, wontumi nnyina awɔw ano, wɔn ho yɛ wɔn yaw, wɔyɛ ɔbrɛ na ebia wɔn mu duru bɛyɛ kɛse. Nanso, saa sɛnkyerɛnne ahorow yi taa nyɛ nea ɛyɛ pɔtee na ɛma ɛyɛ den sɛ wobehu.[citation needed] Sɛnea WHO kyekyɛɛ goitre mu denam nsa a wɔde nsa ka so kyerɛ no, mprempren wɔde sɛnea goitre no mu yɛ den no toto ho sɛ grade 0, grade 1, grade 2.[5] == Nnea ɛdi ba == wɔ wiase nyinaa no, ade a ɛtaa de goitre ba ne iodine a enni hɔ, a wɔtaa hu wɔ aman a ɛkame ayɛ sɛ wɔmfa nkyene a iodide wom nni dwuma no mu. Wobu selenium a enni hɔ nso sɛ ade a ɛde ba. Wɔ aman a wɔde nkyene a iodized wom di dwuma mu no, Hashimoto thyroiditis na ɛtaa de ba.[6] Goitre nso betumi afi cyanide awuduru mu aba, a abu so titiriw wɔ aman a ɛhɔ yɛ hyew a nkurɔfo di cassava ntini a cyanide wom no sɛ aduan titiriw no mu.[7] == Ayaresa == Wɔsa goitre sɛnea nea ɛde ba no te. Sɛ thyroid ntini no reyɛ thyroid hormone ahorow (T3 ne T4) a ɛboro so a, wɔde iodine a ɛma mframa bɔ kɛse ma ɔyarefo no ma ɛtwetwe ntini no. Sɛ iodine a enni hɔ na ɛde goitre ba a, wɔde iodide nketenkete a ɛyɛ Lugol’s iodine anaa KI solution ma. Sɛ goitre no ne thyroid a ɛnyɛ adwuma yiye wɔ abusuabɔ a, wɔde nnuru a wɔde ka thyroid ho di dwuma sɛ ayaresa. Ɛtɔ da bi a ɛho hia sɛ wotwa thyroid no fã bi anaa ne nyinaa.[18] 7aidia7hralo3o49k5lpkwnd7zkc4pk 0 13610 133335 132465 2022-08-10T05:34:42Z Afriyie34 10662 Me de wikitext text/x-wiki {{Dialect|Akuapem}} '''Nyankontɔn''' yɛ wim tebea ho adeyɛ a ɛnam hann a ɛtwetwe, ɛbɔ ne nea ɛbɔ wɔ nsuo mu a ɛma hann ahodoɔ bi pue wɔ wim na ɛba. Ɛfa ɔkwan a ɛyɛ kurukuruwa a ɛwɔ kɔla ahorow pii so. Nyankontɔn a owia hann de ba no pue wɔ wim fã a ɛne Owia no di nhwɛanim tẽẽ no bere nyinaa. [[File:Double-alaskan-rainbow.jpg|Double-alaskan-rainbow]] nyankontɔn betumi ayɛ kurukuruwa a ɛyɛ ma. Nanso, mpɛn pii no, nea ɔhwɛ ade no hu arc bi a nsu a ɛtɔ gu fam a ɛhyerɛn ayɛ no nkutoo,[1] na ɛwɔ mfinimfini wɔ nsensanee bi a efi Owia no so kɔ nea ɔhwɛ no aniwa so. Wɔ nyankontɔn titiriw mu no, arc no kyerɛ kɔkɔɔ wɔ akyi fã na ɛyɛ violet wɔ mu fã no. Saa nyankontɔn yi fi hann a ɛpaapae bere a ɛhyɛn nsu a ɛtɔ gu mu no mu, afei ɛdannan wɔ mu wɔ nsu a ɛtɔ gu fam no akyi na ɛsan paapae bere a efi mu no. Wɔ nyankontɔn a ɛbɔ ho abien mu no, wohu ahama a ɛto so abien wɔ ahama titiriw no akyi, na wɔadan ne kɔla ahorow no nnidiso nnidiso, na kɔkɔɔ wɔ ahama no mu fã. Eyi fi hann a ɛdannan mprenu wɔ nsu a ɛtɔ gu fam no mu ansa na afi mu no. == Nsɛm a wɔaka abom == Nyankontɔn nni baabi pɔtee bi a ɛne nea ɔhwɛ no ntam kwan ware, na mmom efi aniwa mu nsusuwii hunu a nsu a ɛtɔ gu fam biara a wofi baabi pɔtee bi hwɛ bere a wɔde toto hann fibea bi ho no de ba no mu. Enti, nyankontɔn nyɛ ade na wontumi mfa honam fam nkɔ. Nokwarem no, ɛrentumi nyɛ yiye sɛ obi a ɔhwɛ ade no behu nyankontɔn bi a efi nsu a ɛtɔ gu fam mu wɔ baabi foforo biara a ɛnyɛ amanne kwan so de a ɛne hann fibea no bɔ abira no yɛ digrii 42 no. Sɛ obi a ɔhwɛ ade no hu obi foforo a ɔhwɛ ade mpo a ɛte sɛ nea nyankontɔn bi "ase" anaasɛ "wɔ "awiei" a, nea ɔto so abien a ɔhwɛ ade no behu nyankontɔn soronko bi—a ɛwɔ akyirikyiri—wɔ anim koro no ara a nea odi kan a ɔhwɛ ade no hu no. Nyankontɔn trɛw kɔla ahorow a ɛkɔ so daa mu. Nhama a ɛda nsow biara a wohu no yɛ ade a wɔde yɛ nnipa kɔla anisoadehu, na wonhu nhama biara a ɛyɛ fɛ wɔ nyankontɔn mfonini a ɛyɛ tuntum ne fitaa mu, na ɛyɛ den a ɛkɔ so ntɛmntɛm kosi nea ɛsen biara, afei ɛyera kɔ ɔfã foforo no nkutoo. Wɔ kɔla ahorow a onipa aniwa hu ho no, nea wɔtaa fa ka ho asɛm na wɔkae nnidiso nnidiso ne Isaac Newton kɔkɔɔ, borɔdɔma, kɔkɔɔ, ahabammono, bruu, indigo ne violet a ɛyɛ mpɛn ason,[2][a] a Richard Of York a ɔyɛ nkae ade no kae no , anaasɛ sɛ obi a ɔyɛ ayɛsɛm din (Roy G. Biv). Ɛtɔ mmere bi a wɔfrɛ mfiase no wɔ ɔkwan a ɛdannan so, sɛ VIBGYOR. Nnɛyi de, wɔtaa kyekyɛ nyankontɔn no mu yɛ kɔkɔɔ, borɔdɔma, kɔkɔɔ, ahabammono, cyan, bruu ne violet. == kɔla dodow a ɛwɔ spectrum anaa nyankontɔn mu == Spectrum a wonya denam glass prism ne point source so no yɛ asorɔkye tenten a ɛkɔ so a enni bands. Kɔla dodow a onipa aniwa tumi hu wɔ nsonsonoe bi mu no yɛ 100.[7] Nea ɛne eyi hyia no, Munsell kɔla nhyehyɛe (afeha a ɛto so 20 nhyehyɛe a wɔde akontaahyɛde kyerɛkyerɛ kɔla ahorow mu, a egyina anammɔn a ɛyɛ pɛ a wɔfa so hu ade a nnipa hu so) ma kɔla ahorow 100 da nsow. Kɔla atitiriw a ɛda adi sɛ ɛyɛ soronko no yɛ ade a nnipa hu na kɔla atitiriw dodow pɔtee no yɛ nea wɔpaw no ɔkwan bi so. Newton a ogye toom sɛ n’ani ntumi nkyerɛ nsonsonoe kɛse wɔ kɔla ahorow mu no,[8] mfiase no (1672) kyekyɛɛ spectrum no mu yɛɛ no ​​kɔla atitiriw anum: kɔkɔɔ, kɔkɔɔ, ahabammono, bruu ne violet. Akyiri yi ɔde borɔdɔma ne indigo kaa ho, na ɔde kɔla atitiriw ason mae denam nsɛso a ɛne nnyigyei dodow a ɛwɔ nnwom nsenia mu no so.[2][b][9] Newton paw sɛ ɔbɛkyekyɛ nsonsonoe a wotumi hu no mu ayɛ no kɔla ahorow ason afi gyidi bi a wonya fii gyidi ahorow no mu mu tete Helafo sophistfo no ho, a na wosusuwii sɛ abusuabɔ bi wɔ kɔla ahorow, nnwom nnyigyei ahorow, nneɛma a wonim wɔ Owia Nhyehyɛe no mu, ne dapɛn no mu nna ntam.[10][11][12] Nhomanimfo ahyɛ no nsow sɛ nea Newton buu no saa bere no sɛ "blue" no nnɛ wobebu no sɛ cyan, na nea Newton frɛɛ no ​​"indigo" no nnɛ wobebu no sɛ bruu.[3][13][14] tiyym8i0qdl5kkhfo28eme4jh0qhjxa 0 13619 133325 132639 2022-08-10T05:26:23Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} Wɔ afifide ho adesua mu no, '''dua''' yɛ afifide a ɛtra hɔ daa a ne dua anaa dua tenten, na ɛtaa gyina nkorabata ne nhaban akyi. Wɔ nneɛma bi a wɔde di dwuma mu no, dua ho nkyerɛase betumi ayɛ teateaa, a afifide a ɛyɛ nnua a enyin wɔ ɔkwan a ɛto so abien nkutoo so, afifide a wotumi de di dwuma sɛ nnua anaa afifide a ɛboro sorokɔ pɔtee bi ka ho. Wɔ nkyerɛase ahorow a ɛtrɛw mu no, nnua atenten, nnua a wɔfrɛ no fern, banana, ne bamboo nso yɛ nnua. Nnua nyɛ taxonomic kuw nanso ɛka afifide ahorow ahorow a wɔde wɔn ho ayɛ dua ne nkorabata sɛ ɔkwan a wɔfa so kɔ soro sen afifide afoforo de si akan wɔ owia hann ho. Nnua ahorow no mu dodow no ara yɛ angiosperms anaa nnua a ɛyɛ den; nea aka no mu pii yɛ gymnosperm anaa nnua a ɛyɛ mmerɛw. Nnua taa tra ase kyɛ, na ebinom adi mfe mpempem pii. Nnua atra hɔ mfe ɔpepem 370 ni. Wobu akontaa sɛ nnua a anyin bɛyɛ ɔpepepem abiɛsa na ɛwɔ wiase. dua bi taa wɔ nkorabata a ɛto so abien pii a dua no gyina akyi fi fam. Mpɛn pii no, nnua ntini a ɛma ahoɔden, ne ntini mu ntini a ɛde nneɛma fi dua no fã biako kɔ foforo wɔ saa dua yi mu. Wɔ nnua dodow no ara fam no, wɔde dua bi a ɛyɛ akwanside a ɛbɔ ho ban atwa ho ahyia. Wɔ fam ase no, ntini no yɛ nkorabata na ɛtrɛw kɛse; wɔsom sɛ wɔde hyɛ dua no mu na woyi nsu ne aduannuru fi asase no mu. Wɔ fam no, nkorabata no mu paapae yɛ nkorabata nketewa ne nkorabata. Mpɛn pii no, nhaban no sow nhaban, na ɛkyere hann ahoɔden na ɛdan asikre denam photosyntesis so, na ɛma dua no nyin na enyin. Nnua taa de aba na ɛwo. Ebia nhwiren ne nnuaba wɔ hɔ, nanso nnua bi te sɛ nnua a wɔfrɛ no conifers no wɔ pollen cones ne aba cones mmom. Nnua, banana, ne bamboo nso ma aba, nanso nnua mu fern ma spore mmom. Nnua di dwuma titiriw wɔ nsu a ɛtɔ gu fam no so tew na ɛma wim tebea yɛ mmerɛw no mu. Woyi carbon dioxide fi wim na wɔkora carbon pii so wɔ wɔn ntini mu. Nnua ne kwae ma mmoa ne afifide ahorow pii tra. Kwae a osu tɔ na owia bɔ kɛse wom no ka mmeae a abɔde a nkwa wom gu ahorow sen biara wɔ wiase no ho. Nnua ma sunsuma ne dabere, nnua a wɔde si adan, pɛtro a wɔde noa aduan ne ɔhyew, ne nnuaba a wɔde yɛ aduan ne nneɛma afoforo pii a wɔde di dwuma. Wɔ wiase no afã horow no, kwae ahorow so retew bere a wotutu nnua ma asase a wobetumi ayɛ kua no ayɛ kɛse no. Esiane sɛ nnua kyɛ na mfaso wɔ so nti, wɔabu nnua bere nyinaa, na ɛwɔ kwae kronkron wɔ amammerɛ ahorow mu, na edi dwuma wɔ wiase anansesɛm pii mu. == Nkyerɛaseɛ == ɛwom sɛ "dua" yɛ asɛmfua a wɔtaa ka de, nanso nkyerɛase pɔtee biara nni hɔ a wogye tom wɔ amansan nyinaa mu wɔ nea dua yɛ ho, wɔ afifide mu anaasɛ kasa a wɔtaa de di dwuma mu.[1][2] Wɔ ne ntease a ɛtrɛw mu no, dua yɛ afifide biara a ɛwɔ ɔkwan a ɛtrɛw te sɛ dua, anaa dua a ɛware, a ɛboa nhaban anaa nkorabata a ɛma hann no wɔ akyirikyiri bi wɔ fam no. Wɔtaa kyerɛkyerɛ nnua nso mu denam sorokɔ so,[4] a wɔfrɛ afifide nketewa a ne tenten fi mita 0.5 kosi 10 (anammɔn 1.6 kosi 32.8) sɛ nnuadewa,[5] enti wɔkyerɛkyerɛ dua bi sorokɔ a ɛba fam koraa no mu wɔ ɔkwan a ɛyɛ mmerɛw so nkutoo. Afifide akɛse a ɛyɛ nhabannuru te sɛ papaya ne banana yɛ nnua wɔ ntease a ɛtrɛw yi mu.[2][6] Nkyerɛase a ɛyɛ teateaa a wɔtaa de di dwuma ne sɛ dua bi wɔ dua bi a ɛyɛ dua a ɛnam nyin a ɛto so abien so na ɛba, a ɛkyerɛ sɛ dua no yɛ den afe biara denam nyin a ɛkɔ akyi no so, de ka onyin titiriw a ɛkɔ soro fi ano a enyin no ho. Wɔ nkyerɛase a ɛte saa ase no, wɔmfa afifide a ɛyɛ nhabannuru te sɛ mmɛw, banana ne papaya sɛ nnua ɛmfa ho sɛnea ne tenten, sɛnea enyin anaasɛ ne dua no te. Wobetumi abu monocots binom sɛ nnua wɔ nkyerɛase a ɛyɛ mmerɛw kakra ase;[8] bere a Yosua dua, bamboos ne palms nni nyin a ɛto so abien na ɛnsow nokware nnua a enyin nkaa da no,[9][10] wobetumi ayɛ "pseudo-wood." " denam nkwammoaa a ɛnam nyin a edi kan so hyehyɛ no so.[11] Nnua ahorow a ɛwɔ Dracaena abusua mu no, ɛmfa ho sɛ ɛyɛ monocots nso no, ɛwɔ nyin a ɛto so abien a meristem a ɛwɔ wɔn dua mu no de ba, nanso ɛyɛ soronko wɔ meristem a ɛyɛ den a wohu wɔ nnua a ɛwɔ dicotyledonous mu no ho.[12] Sɛ yɛde nhyehyɛe ho nkyerɛase ahorow to nkyɛn a, wɔtaa de di dwuma na ɛkyerɛkyerɛ nnua mu; sɛ nhwɛso no, sɛ saa afifide a ɛma nnua no.[13] == Nsɛm a Wɔaka abom == Nnua nyin su yɛ adannandi nsakrae a wohu wɔ afifide akuw ahorow mu: ɛdenam nyin a ɛware so no, nnua tumi si akan yiye wɔ owia hann ho.[14] Nnua taa yɛ atenten na ɛtra hɔ kyɛ,[15] ebinom di mfe mpempem pii.[16] Nnua pii ka abɔde a nkwa wom a akyɛ sen biara a wɔte ase mprempren no ho.[17] Nnua wɔ nhyehyɛe ahorow a wɔayɛ mu nsakrae te sɛ ntini a ɛyɛ den a nkwammoaa titiriw na ɛwom a ɛma ahoɔden ne nea ɛtra hɔ kyɛ ka ho, na ɛma enyin tenten sen afifide afoforo pii na ɛtrɛw wɔn nhaban mu. Ɛsono nnua, a ɛwɔ onyin kwan a ɛte saa ara, denam mpɛn pii no enyin kɛse na ɛwɔ dua titiriw biako so;[5] nanso nsonsonoe biara nni dua ne dua bi ntam daa,[18] a nokwasɛm a ɛyɛ sɛ nnua no ma ɛyɛ basaa kɛse ebia wɔbɛtew ne kɛse so wɔ nneɛma a atwa yɛn ho ahyia tebea horow a emu yɛ den te sɛ mmepɔw ne mmeae a ɛwɔ asase ase no mu. Dua no su no anya nkɔso wɔ ɔkwan soronko so wɔ afifide ahorow a ɛnyɛ abusuabɔ mu de bua nneɛma a atwa yɛn ho ahyia ho nsɛnnennen a ɛte saa ara, na ɛma ɛyɛ adannandi a ɛne ne ho di nsɛ ho nhwɛso a wɔagye din. Sɛ wobu akontaa sɛ nnua ahorow 60,000-100,000 na ɛwɔ hɔ a, nnua dodow a ɛwɔ wiase nyinaa no betumi ayɛ afifide ahorow a ɛte ase nyinaa mu ɔha biara mu nkyem aduonu anum.[19][20] Eyinom dodow a ɛsen biara no nyin wɔ mmeae a osu tɔ na owia bɔ kɛse; afifide ho animdefo nnya nyɛɛ mmeae yi pii ho nhwehwɛmu nwiei, na ɛma wonnim nnua ahorow ne mmeae a ɛwɔ hɔ no yiye.[21] i2wn7l9l4xc0lzt7b9hes9xgc5gm76p 0 13620 133326 132643 2022-08-10T05:26:50Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} '''Nhwiren''', a ɛtɔ mmere bi a wɔfrɛ no nhwiren anaa nhwiren, ne awo nhyehyɛe a wohu wɔ afifide a ɛsow nhwiren mu (afifide a ɛwɔ mpaapaemu Angiospermae mu). Abɔde mu dwumadi a nhwiren yɛ ne sɛ ɛbɛma awo ayɛ mmerɛw, mpɛn pii no denam ɔkwan bi a ɛma mmadwoa ne nkesua bom so. Nhwiren betumi ama outcrossing (nkwaboaa ne nkesua a efi ankorankoro ahorow mu a wɔde bɛka abom wɔ nnipa dodow bi mu) a efi cross-pollination mu ba no ayɛ mmerɛw anaasɛ ɛbɛma kwan ma selfing (nkwaboaa ne nkesua a efi nhwiren koro no ara mu a wɔde bɛka abom) bere a ankasa pollination ba no. pollination ahorow abien na ɛwɔ hɔ: ne ho pollination ne cross-pollination. Anther-pollination ba bere a pollen a efi anther no mu no gu nhwiren koro no ara stigma so, anaasɛ nhwiren foforo a ɛwɔ afifide koro no ara so no. Cross-pollination yɛ bere a wɔde pollen fi nhwiren biako anther mu kɔ nhwiren foforo stigma so wɔ ankorankoro soronko bi a ɔyɛ nhwiren koro no ara so no. Nhwiren a ɛtwetwe ne ho no si wɔ nhwiren a stamen ne carpel no nyin bere koro mu, na wɔde si hɔ sɛnea ɛbɛyɛ a pollen no betumi akɔ fam wɔ nhwiren no stigma no so. Saa pollination yi nhia sika a efi afifide no hɔ na ama nectar ne pollen ayɛ aduan ama pollinators.[1] Nhwiren binom ma diaspore ahorow ba a wɔmfa nnuru nhyɛ mu (parthenocarpy). Nhwiren wɔ sporangia na ɛhɔ na gametophytes nyin. Nhwiren pii adan a ɛyɛ fɛ ma mmoa, sɛnea ɛbɛyɛ a ɛbɛma ayɛ nneɛma a ɛde nsu mu nsu no kɔ baabi foforo. Sɛ nhwiren no hyɛ mu wie a, nhwiren no awotwaa no nyin bɛyɛ aba a aba wom. Nea ɛka nhwiren a ɛma ɛyɛ mmerɛw sɛ wɔbɛsan awo ho no, nnipa ani gye nhwiren ho fi bere tenten na wɔde di dwuma ma nneɛma a atwa yɛn ho ahyia no yɛ fɛ, na ɛsan nso yɛ nneɛma a wɔde yɛ ɔdɔ, amanne, ahintasɛm, abayisɛm, nyamesom, nnuru a wɔde di dwuma wɔ biribiara mu, ne aduan fibea . == etymology ho adesua == Nhwiren fi Mfinimfini Engiresi esiam mu, a na ɛkyerɛ aburow a wɔayam ne sɛnea afifide tumi awo no nyinaa ansa na ɛrepaapae wɔ afeha a ɛto so 17 mu. Mfiase no, efi Latin din a wɔde frɛ Italyfo nhwiren nyamewa Flora no mu. Asɛmfua a edi kan a wɔde frɛ nhwiren wɔ Borɔfo kasa mu ne nhwiren,[2] ɛwom sɛ mprempren ɛkyerɛ nhwiren a ɛyɛ nnua a ɛsow aba nkutoo de.[3] == dwumadie == Nhwiren atirimpɔw titiriw ne sɛ ɛbɛsan awo onipa no ne ne su no. Afifide a ɛsow nhwiren nyinaa yɛ heterosporous, kyerɛ sɛ, afifide biara a ɛwɔ hɔ no yɛ spore ahorow abien. Microspores nam meiosis a ɛwɔ anthers mu na ɛba na megaspores ba ovules a ɛwɔ ovary mu no mu. Anthers taa yɛ microsporangia anan na ovule yɛ megasporangium a ɛyɛ integumented. Nkwammoaa ahorow abien no nyinaa nyin bɛyɛ gametophytes wɔ sporangia mu. Sɛnea ɛte wɔ afifide a ɛwɔ heterosporous nyinaa ho no, gametophytes no nso nyin wɔ spores no mu, i. e., wɔyɛ endosporic. Wɔ afifide ahorow dodow no ara mu no, nhwiren ankorankoro wɔ carpels ne stamens a ɛyɛ adwuma nyinaa. Afifide ho animdefo ka nhwiren yi ho asɛm sɛ ɛyɛ pɛ anaasɛ ɛyɛ ɔbarima ne ɔbea nna, na nhwiren ahorow no ka ɔbarima ne ɔbea nna ho asɛm. Wɔ afifide ahorow kakraa bi mu no, wɔn nhwiren no nni awo akwaa biako anaa foforo na wɔka ho asɛm sɛ ɛnyɛ pɛ anaasɛ ɛyɛ ɔbarima ne ɔbea nna. Sɛ afifide ankorankoro a ɛwɔ ɔkwan bi so no mu biara wɔ nhwiren a ɛyɛ ɔbarima ne ɔbea nna biako a, ɛnde na afifide no yɛ nea ɛwɔ ɔbarima ne ɔbea nna biako. Sɛnea ɛbɛyɛ foforo no, sɛ afifide biara wɔ nhwiren a ɛyɛ ɔbarima ne ɔbea nna nkutoo a, ɛnde na afifide no yɛ dioecious. aiqv1bltpx71igqk6sbswwe7xgxr928 0 13621 133327 132645 2022-08-10T05:27:37Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} '''Mmoa''' yɛ mmoawa a wɔwɔ nkwammoaa pii, eukaryotic wɔ abɔde a nkwa wom ahemman Animalia mu. Sɛ mmoa kakraa bi na ɛka ho a, mmoa di nneɛma a nkwa wom, wɔhome mframa pa, wotumi keka wɔn ho, wotumi wo wɔ nna mu, na wɔfa ontogenetic fã bi a wɔn nipadua no yɛ nkwammoaa kurukuruwa bi a ɛyɛ tokuru, blastula, bere a awotwaa no nyin no. Wɔaka mmoa ahorow a wɔte ase bɛboro ɔpepem 1.5 ho asɛm—a emu bɛyɛ ɔpepem 1 yɛ nkoekoemmoa—nanso wɔabu akontaa sɛ sɛ wɔka ne nyinaa bom a, mmoa ahorow bɛboro ɔpepem 7 na ɛwɔ hɔ. Mmoa tenten fi micrometer 8.5 (0.00033 in) kosi mita 33.6 (anammɔn 110). Wɔne wɔn ho wɔn ho ne nneɛma a atwa wɔn ho ahyia no di nkitaho a ɛyɛ den, na ɛyɛ nnuan nhama a ɛyɛ nwonwa. Nyansahu mu nhwehwɛmu a wɔyɛ wɔ mmoa ho no, wɔfrɛ no mmoa ho adesua. mmoa ahorow a wɔte ase dodow no ara wɔ Bilateria, clade a emufo wɔ nipadua nhyehyɛe a ɛne ne ho hyia wɔ afã abien no mu. Bilateria no bi ne protostomes, a mmoa te sɛ nematodes, arthropods, flatworms, annelids ne molluscs wom, ne deuterostomes, a echinoderms ne chordates wom, a nea etwa to no ka vertebrates ho. Na nkwa ahorow a wɔkyerɛɛ ase sɛ mmoa a wodii kan bae no wɔ Ediacaran biota a ɛwɔ Precambrian awiei no mu. Nnɛyi mmoa phyla pii bɛyɛɛ nea wɔde sii hɔ pefee wɔ fossil kyerɛwtohɔ mu sɛ po mu mmoa ahorow wɔ Cambrian ɔtopae a efii ase bɛyɛ mfe ɔpepem 539 a atwam ni no mu. Wɔahu awosu mu nkwaadɔm akuw 6,331 a ɛne mmoa a wɔte ase nyinaa yɛ pɛ; ebia eyinom fi nana biako a ɔbom traa ase mfe ɔpepem 650 a atwam ni no mu. Abakɔsɛm mu no, Aristotle kyekyɛɛ mmoa mu yɛɛ no ​​wɔn a wɔwɔ mogya ne wɔn a wonni mogya. Carl Linnaeus de ne Systema Naturae yɛɛ abɔde a nkwa wom mu nkyekyem a edi kan a wɔahyehyɛ no nnidiso nnidiso wɔ 1758 mu, a Jean-Baptiste Lamarck trɛw mu yɛɛ no ​​phyla 14 wɔ 1809. Wɔ 1874 mu no, Ernst Haeckel kyekyɛɛ mmoa ahemman no mu yɛɛ no ​​Metazoa a ɛwɔ nkwammoaa pii (mprempren ɛne Animalia a ɛne no di nsɛ) no Protozoa, mmoawa a wɔwɔ nkwammoaa biako a wɔmfa mmoa bio. Wɔ nnɛyi mmere yi mu no, mmoa a wɔkyekyɛ wɔn mu wɔ abɔde mu no gyina akwan horow a ɛkɔ akyiri te sɛ molecule phylogenetics a etu mpɔn wɔ abusuabɔ a ɛda taxa ahorow ntam a ɛdannan ba no a wɔda no adi mu. Nnipa de mmoa ahorow pii te sɛ aduan (a nam, nufusu, ne nkesua ka ho), nneɛma (te sɛ aboa nhoma ne aboa nhoma), afieboa, ne mmoa a wɔyɛ adwuma a nea wɔde fa nneɛma ka ho di dwuma. Wɔde akraman adi dwuma wɔ abɔmmɔ mu, na wɔde nnomaa a wɔkyere mmoa we nso adi dwuma, bere a na wɔde mmoa a wɔwɔ asase so ne nsu mu pii abɔ abɔmmɔ de adi agoru no. Mmoa a wɔnyɛ nnipa apue wɔ adwinni mu fi teteete na wɔka ho asɛm wɔ anansesɛm ne nyamesom mu. == Etymology ho nsɛm == Asɛmfua "aboa" no fi Latin kasa mu animalis mu, a ɛkyerɛ sɛ 'ɔwɔ ahome', 'ɔwɔ ɔkra' anaa 'ɔteasefo'.[1] Abɔde a nkwa wom nkyerɛase no ka ahemman Animalia no mufo nyinaa ho.[2] Wɔ kasa mu no, wɔtaa de asɛmfua aboa di dwuma de kyerɛ mmoa a wɔnyɛ nnipa nkutoo.[3][4][5][6] Asɛmfua "metazoa" no fi Tete Hela kasa mu μετα (meta, a wɔde kyerɛ "akyiri yi") ne ζῷᾰ (zōia, dodow kabea a ɛkyerɛ ζῷον zōion "aboa").[7][8] qvis79aul2wv4ja2gz7p0ztydjhhwvk 0 13622 133328 132653 2022-08-10T05:28:45Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} Wɔ '''wim''' tebea ho adesua mu no, mununkum yɛ aerosol a ɛyɛ nsu nketenkete a ɛyɛ nsu a ɛyɛ nwini, ahwehwɛ a ayɛ nwini, anaa nneɛma nketenkete afoforo a ɛsensɛn okyinnsoromma bi anaa ahunmu a ɛte saa no wim. Nsu anaa nnuru afoforo ahorow betumi ayɛ nsu a ɛtɔ gu fam ne ahwehwɛ no. Wɔ Asase so no, mununkum ba esiane mframa a ɛhyɛ mu ma bere a ɛyɛ nwini kodu ne bosu no mu, anaasɛ bere a enya nsu a ɛdɔɔso (mpɛn pii no ɛyɛ nsu a ɛyɛ hyew) fi baabi a ɛbɛn hɔ ma obosu no kɔ soro kodu baabi a atwa ho ahyia no nti ahoɔhyeɛ. Wohu wɔn wɔ Asase no homosphere a troposphere, stratosphere, ne mesosphere ka ho no mu. Nephology yɛ mununkum ho nyansahu, a wɔyɛ wɔ wim tebea ho adesua mununkum ho adesua baa dwumadibea no mu. Akwan abien na wɔfa so to mununkum din wɔ wɔn homosphere no ntoatoaso ahorow mu, Latin ne common. genus ahorow a ɛwɔ troposphere, wim fã a ɛbɛn Asase ani sen biara no, wɔ Latin din ahorow esiane Luke Howard din a wɔde too gua wɔ ɔkwan a ɛfata so a wɔhyɛɛ ho nyansa wɔ 1802 mu no toom wɔ amansan nyinaa mu nti. Ɛbɛyɛɛ nnɛyi amanaman ntam nhyehyɛe bi a ɛkyekyɛ mununkum mu yɛ no honam fam nneɛma anum a wobetumi akyekyɛ mu bio anaasɛ wɔakyekyɛ mu ayɛ no mmeae a ɛkorɔn de anya mmusua atitiriw du. Mununkum ahorow a ɛyɛ ananmusifo titiriw ma saa ahorow yi mu biara ne stratiform, cumuliform, stratocumuliform, cumulonimbiform, ne cirriform. Mununkum a ɛba fam no nni nsɛmfua a wɔde di kan a ɛfa sorokɔ ho biara. Nanso wɔde mfinimfini gyinabea stratiform ne stratocumuliform ahorow no ma prefix alto- bere a high-level variants a ɛwɔ saa nsusuwii abien koro yi ara mu no kura prefix cirro-. Wɔ nsɛm abien no nyinaa mu no, wɔtow strato- fi ɔkwan a etwa to no so na wɔakwati sɛ wɔde nkyerɛwde abien bedi dwuma. Genus ahorow a ɛwɔ vertical extent a ɛdɔɔso a ebetumi agye bɛboro level biako no nkura prefixes biara a ɛfa ɔsorokɔ ho. Wɔkyekyɛ wɔn mu wɔ ɔkwan a ɛfata so sɛ nea ɛwɔ fam anaa mfinimfini a egyina sorokɔ a emu biara fi ase no so, na wɔsan nso kyerɛ wɔ ɔkwan a ɛfata so kɛse sɛ ɛwɔ ɔfã pii anaasɛ ɛda hɔ. Wobetumi akyekyɛ abusua du a wonya fi saa kwan yi so no mu dodow no ara mu ayɛ no ahorow ahorow na wɔasan akyekyɛ mu ayɛ no ahorow ahorow. Wɔde edin a wɔtaa de frɛ mununkum a ɛyɛ stratiform a ɛba fam yiye a ɛtrɛw kɔ Asase ani no fog ne mist, nanso enni Latin din biara. Wɔ stratosphere ne mesosphere mu no, mununkum wɔ din a wɔtaa de frɛ wɔn ahorow atitiriw no. Ebia wobenya nkatanim anaa ntama a ɛte sɛ nsensanee, wisps a ɛte sɛ kurukuruwa, anaasɛ nsensanee anaa asorɔkye a ɛte sɛ nsensanee. Wɔntaa nhu wɔn, na wɔn mu dodow no ara wɔ Asase no po so mmeae ahorow. Wɔahu mununkum wɔ okyinnsoromma ne ɔsram afoforo a ɛwɔ Owia Nhyehyɛe no mu ne akyirikyiri no wim. Nanso esiane sɛ ɛsono sɛnea ɛyɛ hyew nti, wɔtaa de nneɛma afoforo te sɛ methane, ammonia, ne sulphuric acid, ne nsu nso na ɛwom. Tropospheric mununkum betumi anya wim nsakrae so nkɛntɛnso tẽẽ wɔ Asase so. Ebia wɔbɛda hann a efi owia no mu ba a ebetumi aboa ma onwini aba baabi ne bere a mununkum yi ba, anaasɛ wɔbɛkyere asorɔkye mframa a ɛware a ɛsan kɔ soro fi Asase ani a ebetumi ama ɔhyew aba. Mununkum no sorokɔ, sɛnea ɛte, ne ne kɛse ne nneɛma atitiriw a ɛka Asase ne wim tebea a ɛyɛ hyew anaa ɛyɛ nwini wɔ mpɔtam hɔ no. Mununkum a ɛba wɔ troposphere no atifi no ho yɛ na dodo na ɛyɛ tratraa dodo sɛ ebenya wim nsakrae so nkɛntɛnso biara. Mununkum ne ade titiriw a wontumi nsi pi wɔ wim tebea ho nkate mu.[3] == Ɛpono ho asɛm == Table a ɛdi akyire no trɛw yiye wɔ scope mu te sɛ cloud template a ɛdi akyire no. Nsonsonoeɛ bi wɔ din ahodoɔ a wɔde frɛ no ntam wɔ nkyekyɛmu nhyehyɛeɛ a wɔde di dwuma ma troposphere (Latin a ɛyɛ den gye sɛ aerosol a ɛgyina soro) ne homosphere a ɛkorɔn (nsɛmfua a wɔtaa de di dwuma, a ebi wɔ hɔ wɔ ɔkwan a ɛnyɛ ɔkwan pa so a ɛfiri Latin kasa mu). Nanso, nhyehyɛe ahorow a wɔde ama wɔ ha no kyɛ honam fam nsusuwii ne sorokɔ gyinabea ahorow a wɔde cross-classification di dwuma de nya tropospheric genera 10 no,[4] sum ne nsuyiri a ɛba wɔ sorosoro, ne troposphere ahorow pii a ɛwɔ soro. Cumulus abusua no mu bi ne mmoa ahorow anan a ɛkyerɛ sɛ ne kɛse gyina hɔ a ebetumi aka sorokɔ dodow. == Etymology ne abakɔsɛm a ɛfa mununkum nyansahu ne edin == '''Nsɛmfua a wɔde kyerɛw nsɛm''' Wobetumi ahu asɛmfua "mununkum" mfiase wɔ Engiresi kasa dedaw mu nsɛmfua clud anaa clod mu, a ɛkyerɛ koko anaa ɔbo kɛse bi. Bɛyɛ afeha a ɛto so 13 mfiase no, wɔde asɛmfua no dii dwuma sɛ kasakoa a ɛkyerɛ osutɔ mununkum, esiane sɛnea ɔbotan kɛse bi ne cumulus heap mununkum no di nsɛ wɔ sɛnea ɛte no mu nti. Bere kɔɔ so no, asɛmfua no a wɔde dii dwuma wɔ kasakoa mu no besii Engiresi Dedaw weolcan a na ɛyɛ asɛmfua ankasa a wɔde gyina hɔ ma mununkum wɔ ɔkwan a ɛkɔ akyiri so no ananmu.[9][10] '''Aristotle''' Wɔanyɛ tete mununkum ho nhwehwɛmu ahorow no wɔ baabi a ɛyɛ soronko, na mmom wohui sɛ wɔde wim nneɛma afoforo ne abɔde ho nyansahu afoforo mpo kaa ho. Bɛyɛ afe 340 A.Y.B. Nea edi kan no, wɔfrɛɛ osutɔ ne mununkum a osu tɔ fii mu no meteors, a efi Hela asɛmfua meteoros a ɛkyerɛ ‘korɔn wɔ wim’ no mu. Saa asɛmfua no mu na nnɛyi asɛmfua wim tebea ho adesua, mununkum ne wim tebea ho adesua no bae. Ná meteorologica gyina adwene a wotumi hu ne nneɛma a wotumi hu a ɛnyɛ den so, nanso na ɛnyɛ nea mprempren wobu no sɛ nyansahu kwan no so. Ne nyinaa mu no, ɛyɛ adwuma a edi kan a wonim a ɛbɔɔ mmɔden sɛ ɛbɛdi wim tebea ho nsɛmti ahorow pii ho dwuma wɔ nhyehyɛe kwan so, titiriw nsu ho kyinhyia no.[11] jko48ciyequ30t5t5ghutdabwcciz4v 0 13650 133334 132951 2022-08-10T05:33:25Z Afriyie34 10662 wikitext text/x-wiki {{Dialect|Akuapem}} Gua yɛ asɛmfua a wɔde kyerɛkyerɛ nsusuwii ahorow te sɛ: Guadidan (sikasɛm) . Guadi mu sikasɛm Guadidan, gua a ɛwɔ hɔ ankasa anaa ɔmanfo gua == Asase ho nsɛm == Märket, supɔw a Finland ne Sweden kyɛ Adwinni, anigyede, ne nsɛm ho amanneɛbɔ == Sini ahorow == Market (1965 sini), 1965 South Korea sini Market (2003 sini), 2003 Hindi sini The Market: A Tale of Trade, Turkeyfo sini bi == Television so hwɛ == The Market (TV so dwumadi ahorow), New Zealand television so drama Nneɛma a wɔde yɛ nneɛma anaa nnwuma ahorow The Market (adwumakuw), Farm Fresh Supermarket adwene sotɔɔ The Market, Safeway sotɔɔ titiriw bi Sikasɛm mu gua ahorow Kuadwuma ho aguadi Guadidan a ɛrenya nkɔso Ahoɔden ho gua Sikasɛm ho gua so Amannɔne sikasesɛw ho gua Gray gua so Nsɛm ho amanneɛbɔfo gua Niche gua so Guadidan a wɔabue mu, sikasɛm a wɔde di gua a wɔde wɔn ho to so; asɛmfua a ɛne gua a wɔato mu no bɔ abira Nkɔmhyɛ gua so Adan ne afie ho gua Sikakorabea ahorow Nneɛma a wɔtɔn no kɛse == Sikasɛm mu gua ahorow no afã horow == Efficient-market hypothesis a ɛyɛ adwuma yiye Mark-to-market akontaabu ho akontaabu Guadi mu sika a wɔde di dwuma Guadi mu sikasɛm Guadi mu huammɔdi Guadidan mu adwumayɛfo Guadidan mu nhyehyɛe nketenkete Guadi ho nhwehwɛmu Guadi fã bi Guadi mu kyɛfa Guadi mu su a ɛrekɔ so Bo a ɛsom wɔ gua so Guadidan biako pɛ Fa w’ani si gua so Honam fam gua ahorow ahorow Bazaar a ɛwɔ hɔ Bazaar Titiriw Akuafo gua, a wɔde wɔn adwene si nnuan a wɔayɛ no foforo so Mpataa gua so Flea gua so Guadi a ɛsensɛn nsu so Adetɔnbea a wɔtɔn nneɛma wom Guadidan mu abɔnten so Guadidan mu kurow Guadibea Anadwo gua so Ɔmanfo gua (disambiguation) . Souq na ɛwɔ hɔ Mmɔnten so gua, a aguadidan ahorow wɔ ɔmanfo mmɔnten biako anaa nea ɛboro saa so Adetɔnbea kɛse bi Guadi a ɛyɛ nsu, a wɔde wɔn adwene si nam a wɔayɛ no foforo, mpataa, nneɛma a wɔyɛ, ne nneɛma afoforo a ɛporɔw so == Hwɛ nso == Wikiquote wɔ nsɛm a wɔafa aka a ɛfa Market ho. Nkratafa a ɛwɔ asɛmti ahorow a Market wom nyinaa Guadibea (disambiguation), asɛmfua a ɛtɔ da bi a wotumi sesa ne "gua so". Markt (asɛm a wɔka no pefee) . Marquette (nsɛm a wɔde kyerɛkyerɛ mu) . Mercado (disambiguation), Spania ne Portugal asɛmfua a wɔde gyina hɔ ma gua Marketts no The Title Market (1909), nhoma a Emily Post kyerɛwee 461tsqo62lbeprjuqifxlk1shlg9y8k 0 13652 133313 133015 2022-08-10T04:43:40Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba[28] . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.[28][29] == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse."[30] Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.[31] '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.[30] '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.[32] Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia.[33] Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.[30] Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru.[34] Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.[3] 5–10% a aka no fi awosu mu nneɛma.[3] Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa.[38] Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.[3][39] Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,[40][41] ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de.[40] Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,[42] nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba.[43] Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.[44] Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho.[45] Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaa[45] ne bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.[46] Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 .[47][48] Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram.[49] Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%,[50] anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.[51] Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.[51] Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba.[52][53] '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M h35szgngug7izeqgsa74qd55lzuvphb 133314 133313 2022-08-10T04:46:50Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse."[30] Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.[31] '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.[30] '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.[32] Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia.[33] Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.[30] Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru.[34] Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.[3] 5–10% a aka no fi awosu mu nneɛma.[3] Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa.[38] Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.[3][39] Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,[40][41] ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de.[40] Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,[42] nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba.[43] Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.[44] Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho.[45] Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaa[45] ne bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.[46] Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 .[47][48] Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram.[49] Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%,[50] anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.[51] Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.[51] Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba.[52][53] '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M 81r48innp7g10qkkwqp7vxms05xnyr7 133315 133314 2022-08-10T04:51:41Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.[31] '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.[32] Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia.[33] Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru.[34] Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.[3] 5–10% a aka no fi awosu mu nneɛma.[3] Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa.[38] Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.[3][39] Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,[40][41] ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de.[40] Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,[42] nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba.[43] Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.[44] Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho.[45] Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaa[45] ne bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.[46] Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 .[47][48] Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram.[49] Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%,[50] anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.[51] Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.[51] Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba.[52][53] '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M ks2uiiwmb1vnvl3f3hss2e7u4m3olwy 133316 133315 2022-08-10T04:54:50Z Afriyie34 10662 wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.<ref>https://doi.org/10.1097%2FNCC.0b013e31822fc76c</ref> '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.[32] Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia.[33] Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru.[34] Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.[3] 5–10% a aka no fi awosu mu nneɛma.[3] Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa.[38] Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.[3][39] Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,[40][41] ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de.[40] Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,[42] nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba.[43] Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.[44] Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho.[45] Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaa[45] ne bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.[46] Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 .[47][48] Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram.[49] Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%,[50] anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.[51] Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.[51] Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba.[52][53] '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M sqp8l1y91ub9ws7pwvjrx5oqogy0lg8 133317 133316 2022-08-10T04:57:50Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.<ref>https://doi.org/10.1097%2FNCC.0b013e31822fc76c</ref> '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia. Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru. Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.<ref name=":8">https://www.cancer.gov/types/metastatic-cancer</ref>Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo. Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.<ref name=":8" /> == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.[3] 5–10% a aka no fi awosu mu nneɛma.[3] Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa.[38] Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.[3][39] Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,[40][41] ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de.[40] Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,[42] nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba.[43] Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.[44] Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho.[45] Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaa[45] ne bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.[46] Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 .[47][48] Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram.[49] Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%,[50] anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.[51] Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.[51] Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba.[52][53] '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M i5z4css3lbtng8oj5jo7y9r1belnroi 133318 133317 2022-08-10T05:03:12Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.<ref name=":9">https://doi.org/10.1097%2FNCC.0b013e31822fc76c</ref> '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia. Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru. Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.<ref name=":8">https://www.cancer.gov/types/metastatic-cancer</ref>Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo. Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.<ref name=":8" /> == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.<ref name=":2" /> 5–10% a aka no fi awosu mu nneɛma.<ref name=":2" /> Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa. Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.<ref>https://doi.org/10.3322%2Fcaac.21440</ref> <ref name=":9" />Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de. Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,[42] nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba.[43] Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.[44] Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho.[45] Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaa[45] ne bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.[46] Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 .[47][48] Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram.[49] Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%,[50] anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.[51] Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.[51] Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba.[52][53] '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M mqkrq1onw99xl0rov481li0ftde9idq 133319 133318 2022-08-10T05:10:00Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.<ref name=":9">https://doi.org/10.1097%2FNCC.0b013e31822fc76c</ref> '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia. Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru. Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.<ref name=":8">https://www.cancer.gov/types/metastatic-cancer</ref>Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo. Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.<ref name=":8" /> == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.<ref name=":2" /> 5–10% a aka no fi awosu mu nneɛma.<ref name=":2" /> Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa. Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.<ref>https://doi.org/10.3322%2Fcaac.21440</ref> <ref name=":9" />Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de. Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba. Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho. Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaane bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 . Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram. Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%, anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.<ref name=":10">https://web.archive.org/web/20071012202014/http://www.who.int/mediacentre/news/notes/2007/np19/en/index.html</ref>Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.<ref name=":10" /> Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba. '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.<ref name=":2" />[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.[3] Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.[3] Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma).[61] '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba.[62][63][64] Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.[63] Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa.[63] Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.[65] Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.[65] Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu.[66] Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo.[67] Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no.[67] Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.[69] [62] Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam.[70] '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba.[71] Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho,[71] ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,[72] ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.[73] Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,[74] ne 1.9 ma prostate kokoram.[75] Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no.[76] Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu.[77] '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru.[78] Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[78] Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite).[78] Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba.[78] Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.[79] Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.[79] Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.[79] Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a.[79] Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.[79] Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ.[79][80] Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.[81][82] Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew.[83] '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu.[85] Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.[84] Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no.[84] Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.[84] Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M o4jn3xsf8nrejr5gdyo4tnim8oo7pxy 133320 133319 2022-08-10T05:17:38Z Afriyie34 10662 Me de reference ka ho wikitext text/x-wiki '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.<ref name=":9">https://doi.org/10.1097%2FNCC.0b013e31822fc76c</ref> '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia. Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru. Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.<ref name=":8">https://www.cancer.gov/types/metastatic-cancer</ref>Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo. Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.<ref name=":8" /> == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.<ref name=":2" /> 5–10% a aka no fi awosu mu nneɛma.<ref name=":2" /> Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa. Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.<ref>https://doi.org/10.3322%2Fcaac.21440</ref> <ref name=":9" />Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de. Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba. Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho. Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaane bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 . Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram. Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%, anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.<ref name=":10">https://web.archive.org/web/20071012202014/http://www.who.int/mediacentre/news/notes/2007/np19/en/index.html</ref>Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.<ref name=":10" /> Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba. '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.<ref name=":2" />[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.<ref name=":2" />Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.<ref name=":2" /> Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma). '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba. Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa. Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu. Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo. Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no. Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam. '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba. Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho, ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,ne 1.9 ma prostate kokoram. Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no. Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu. '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru. Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[ Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite). Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba. Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ. Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew. '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu. Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.<ref name=":11">https://www.ncbi.nlm.nih.gov/books/NBK20759/</ref> Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no. Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.<ref name=":11" /> Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M nzjarew6gprc149gs84ph4sjar5ls2q 133322 133320 2022-08-10T05:23:38Z Afriyie34 10662 Me de dialect ka ho wikitext text/x-wiki {{Dialect|Akuapem}} '''Kokoram'''({{Audio|tw-Kokoram.ogg|pronounciation of "kokoram"}}) yɛ nyarewa kuw bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":0">https://www.who.int/en/news-room/fact-sheets/detail/cancer</ref> <ref name=":1">https://www.cancer.gov/about-cancer/understanding/what-is-cancer</ref>Eyinom ne akisikuru a ɛnyɛ hu a ɛntrɛw no bɔ abira.<ref name=":1" />Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ebetumi aba no bi ne akisikuru, mogya a ɛnteɛ, ɔfe a ɛtra hɔ kyɛ, ne mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu, ne nsakrae a ɛba wɔ ne dwensɔtwaa mu.<ref name=":2" />Bere a saa sɛnkyerɛnne ahorow yi betumi akyerɛ sɛ kokoram de, nanso ebetumi de nneɛma afoforo nso aba.<ref name=":2">http://www.nhs.uk/Conditions/Cancer/Pages/Symptoms.aspx</ref>Kokoram ahorow bɛboro 100 na ɛka nnipa.<ref name=":1" /> Tawa a wɔde di dwuma no na ɛde kokoram wuwu bɛyɛ 22% ba.<ref name=":0" />10% foforo nso fi kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wonnya anaasɛ nsa a wɔnom boro so.<ref>http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3</ref><ref name=":0" /> <ref name=":3">https://doi.org/10.1093%2Falcalc%2Fagv110</ref>Nneɛma afoforo a ɛde ba ne ɔyare mmoawa bi, mframa a ɛma ɛyɛ ion a wɔde wɔn ho hyɛ mu, ne nneɛma a atwa yɛn ho ahyia a ɛde efĩ ba.<ref name=":2" /> Wɔ aman a afei na wɔrenya nkɔso mu no, kokoram 15% fi nyarewa te sɛ Helicobacter pylori, mmerɛbo mu yare B, mmerɛbo mu yare C, nnipa papillomavirus yare mmoawa, Epstein–Barr mmoawa ne nnipa nipadua mu tumi a ɛko tia nyarewa (HIV).<ref name=":0" />Anyɛ yiye koraa no, saa nneɛma yi yɛ adwuma, ne fã bi, denam nkwammoaa bi awosu mu nkwaadɔm a wɔsakra no so.<ref name=":4">https://en.m.wikipedia.org/wiki/Cancer#cite_note-WCR2014Bio-10</ref>Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae pii wɔ awosu mu ansa na kokoram aba.Bɛyɛ kokoram 5–10% fi awosu mu sintɔ ahorow a wonya fi awo mu.<ref name=":5">http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer</ref>Wobetumi de nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bi anaa nhwehwɛmu a wɔde hwehwɛ kokoram mu ahu kokoram.Afei wɔtaa de nnuruyɛ mu mfoniniyɛ hwehwɛ mu bio na wɔde nipadua mu nhwehwɛmu si so dua. Wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya kokoram ahorow bi so denam sigaretnom a wɔrennom, ne mu duru a ɛfata a wɔbɛkɔ so atra mu, nsa a wɔnom ano hye, nhabannuru, nnuaba, ne aburow a wɔayam no yiye a wobedi, nyarewa bi a wɔde yare mmoawa ba a wɔbɛbɔ wɔn ho ban, nam a wɔayɛ ho adwuma ne nam kɔkɔɔ a wɔbɛtow ano hye, ne nea wɔbɛto ano hye so owia hann a ɛba tẽẽ.Sɛ wohu ntɛm denam nhwehwɛmu so a, ɛho wɔ mfaso ma awotwaa ne akyi berɛmo mu kokoram. Mfaso a ɛwɔ nufu mu kokoram a wɔhwehwɛ mu no yɛ nea akyinnyegye wom.Wɔtaa de mframa bɔne a wɔde sa yare, oprehyɛn, nnuru a wɔde sa yare ne ayaresa a wɔde wɔn ani asi so a wɔaka abom bi sa kokoram.<ref name=":2" /><ref name=":3" /> Ɛyaw ne sɛnkyerɛnne ahorow a wɔde di dwuma no yɛ ɔhwɛ no fã titiriw.<ref name=":0" />Ayaresa a ɛma obi ho dwo no ho hia titiriw wɔ nnipa a wɔwɔ yare a emu yɛ den no mu.<ref name=":1" />Hokwan a ɛwɔ hɔ sɛ obi benya nkwa no gyina kokoram ko a ɛwɔ ne baabi a yare no kodu bere a wɔrefi ayaresa ase no so.[10] Wɔ mmofra a wonnii mfe 15 mu bere a wohu yare no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase wɔ aman a wɔanya nkɔso no mu no yɛ 80%Wɔ kokoram ho wɔ United States no, sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum a wɔde tra ase no yɛ 66%.<ref name=":3" /> Wɔ afe 2015 mu no, nnipa bɛyɛ ɔpepem 90.5 wɔ wiase nyinaa nyaa kokoram.[18] Wɔ afe 2019 mu no, kokoram a ɛba afe biara no nyaa nkɔanim nnipa ɔpepem 23.6 na nnipa ɔpepem 10 na wowuwui wɔ wiase nyinaa, a ɛkyerɛ wɔ mfe du a atwam no mu no, nkɔanim 26% ne 21%, sɛnea ɛte biara.<ref name=":4" /> Kokoram ahorow a ɛtaa ba mmarima so ne ahurututu mu kokoram, prostate kokoram, akyi berɛmo mu kokoram, ne yafunu mu kokoram.Wɔ mmea mu no, nea ɛtaa ba ne nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, ahurututu mu kokoram, ne awotwaa mu kokoram.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055577</ref> Sɛ wɔde honam ani kokoram a ɛnyɛ melanoma ka kokoram foforo a ɛba nyinaa ho afe biara a, anka ɛbɛyɛ nea ɛba no mu bɛyɛ 40%.Wɔ mmofra mu no, lymphoblastic leukemia a emu yɛ den ne amemene mu akisikuru na abu so kɛse, gye Afrika, baabi a lymphoma a ɛnyɛ Hodgkin taa ba no.Wɔ afe 2012 mu no, mmofra bɛyɛ 165,000 a wonnii mfe 15 na wohui sɛ wɔwɔ kokoram. Kokoram ho asiane no kɔ soro kɛse bere a obi nyin no, na kokoram pii taa ba aman a wɔanya nkɔso ne mu .<ref>https://doi.org/10.3322%2Fcaac.20107</ref>Nneɛma dodow rekɔ soro bere a nnipa pii tra ase kosi wɔn nkwakoraa ne mmerewa ne asetra mu nsakrae ba wɔ aman a afei na wɔrenya nkɔso no mu no.Wɔbuu akontaa sɛ wiase nyinaa sikasɛm mu ka a wɔbɔ wɔ kokoram ho nyinaa yɛ U.S. dɔla ɔpepepem 1.16 afe biara de besi afe 2010.<ref>https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/</ref> == Etymology ne nkyerɛase ahorow == Asɛmfua no fi tete Hela asɛmfua καρκίνος, a ɛkyerɛ krak ne akisikuru mu. Helafo nnuruyɛfo Hippocrates ne Galen, ne afoforo, hui sɛ krak ne akisikuru bi a ntini a ahonhon no di nsɛ. Wɔde asɛmfua no baa Borɔfo kasa mu wɔ nnɛyi aduruyɛ mu ntease mu bɛyɛ afe 1600 mu.<ref>https://www.etymonline.com/word/cancer</ref> Kokoram yɛ nyarewa abusua kɛse bi a ɛfa nkwammoaa nyin a ɛnteɛ a ebetumi akɔ nipadua no afã afoforo so anaasɛ ɛbɛtrɛw mu.<ref name=":1" /><ref name=":5" />Wɔyɛ neoplasm ahorow no fã ketewaa bi. Neoplasm anaa tumor yɛ nkwammoaa kuw bi a wɔanyinyin a wɔanhyɛ da na ɛbɛtaa ayɛ mass anaa akisikuru, nanso ebetumi akyekyɛ wɔ ɔkwan a ɛtrɛw so. Nkwammoaa a ɛwɔ akisikuru no nyinaa da kokoram agyiraehyɛde ahorow asia adi. Saa su ahorow yi ho hia na ama wɔanya akisikuru a ɛyɛ hu. Nea ɛka ho ne:<ref>https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref>. Nkwammoaa nyin ne mpaapaemu nni nsɛnkyerɛnne a ɛfata Nkɔso a ɛkɔ so ne mpaapaemu a wɔde nsɛnkyerɛnne a ɛne no bɔ abira mpo ama Nkwammoaa a wɔayɛ ho nhyehyɛe a wobewuwu a wɔbɛkwati Nkwammoaa mu mpaapaemu dodow a anohyeto nni mu Mogya ntini a wɔyɛ no ho nkuranhyɛ Ntini mu ntua ne metastases a ɛba<ref name=":6">https://en.m.wikipedia.org/wiki/Douglas_Hanahan</ref> . Nkɔso a efi nkwammoaa a ɛteɛ mu kɔ nkwammoaa a ebetumi ayɛ kɛse a wotumi hu mu kɔ kokoram koraa mu no fa anammɔn pii a wɔfrɛ no nkɔso a ɛyɛ hu ho.<ref name=":6" /> == Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow == Sɛ kokoram fi ase a, ɛmma yare no ho sɛnkyerɛnne biara mma. Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow da adi bere a aduru no nyin anaasɛ ɛyɛ kurukuruwa no. Nea ebefi mu aba no gyina kokoram no su ne faako a ɛwɔ so. Nsɛnkyerɛnne kakraa bi na ɛwɔ hɔ pɔtee. Pii taa ba ankorankoro a wɔwɔ tebea afoforo mu. Kokoram betumi ayɛ den sɛ wobehu na wobetumi abu no sɛ "ɔsuasua kɛse.<ref name=":7">Holland Chp. 1</ref> Nkurɔfo betumi ayɛ basaa anaa adwenemhaw bere a wɔahu yare no akyi. Asiane a ɛwɔ hɔ sɛ nnipa a wɔwɔ kokoram bekum wɔn ho no bɛyɛ mmɔho abien.<ref name=":9">https://doi.org/10.1097%2FNCC.0b013e31822fc76c</ref> '''Nsɛnkyerɛnne a ɛwɔ mpɔtam hɔ''' Mpɔtam hɔ sɛnkyerɛnne ahorow betumi aba esiane akisikuru no kɛse anaasɛ ne kuru nti. Sɛ nhwɛso no, nneɛma pii a efi ahurututu mu kokoram mu ba no betumi asiw ahurututu no ano na ɛde ɔfe anaa ahurututu mu yare aba; esophageal cancer betumi ama esophagus no ayɛ teateaa, na ama ayɛ den anaasɛ ɛyɛ yaw sɛ wɔbɛmene; na kokoram a ɛba akyi berɛmo mu no betumi ama dwensɔtwaa no ayɛ ketewaa anaasɛ asiw, na aka dwensɔtwaa no su ahorow. Nneɛma a ɛdɔɔso wɔ nufu anaa awotwaa mu no betumi ama akuru a wotumi hu aba. Akuru betumi ama mogya atu a ebetumi ama woanya sɛnkyerɛnne ahorow te sɛ mogya a ɛbɛfe (ahurututu mu kokoram), mogya a ɛtɔ obi nipadua mu anaasɛ mogya a ɛtɔ obi akyi berɛmo mu (kokoram a ɛba obi akyi berɛmo mu), mogya a ɛba nsuo mu (akisikuru mu kokoram), anaa mogya a ɛtɔ obi awotwaa mu a ɛnteɛ (endometrial anaa awotwaa mu kokoram). Ɛwom sɛ ɛyaw a ɛwɔ baabiara betumi aba wɔ kokoram a ɛkɔ anim mu de, nanso mpɛn pii no akisikuru a edi kan no nyɛ yaw. Kokoram ahorow bi betumi ama nsu aboaboa ano wɔ koko anaa yafunu mu.<ref name=":7" /> '''Nsɛnkyerɛnne a ɛwɔ nhyehyɛe mu''' Nneɛma a ɛwɔ nipadua no mu no betumi aba esiane sɛnea nipadua no yɛ n’ade wɔ kokoram no ho nti. Ebia nea ɛka eyi ho ne ɔbrɛ, mu duru a wɔanhyɛ da a ɛso tew, anaasɛ honam ani a ɛbɛsakra.Kokoram ahorow bi betumi ama nipadua no mu ɔhyew tebea bi a ɛma ntini ahorow no kɔ so hwere na ɛyɛ mmerɛw, a wɔfrɛ no cachexia. Kokoram ahorow bi te sɛ Hodgkin yare, mogya mu kokoram, ne mmerɛbo anaa asaabo mu kokoram betumi ama obi anya atiridii a ɛkɔ so daa.<ref name=":7" /> Kokoram ho sɛnkyerɛnne ahorow bi a ɛba nipadua no mu no fi hormone anaa molecule afoforo a akisikuru no de ba, a wɔfrɛ no paraneoplastic syndromes no. Paraneoplastic syndromes a ɛtaa ba no bi ne hypercalcemia, a ebetumi ama adwene mu tebea asakra, akisikuru ne nsu a ɛho ayɛ fĩ, anaasɛ hyponatremia, a ɛno nso betumi ama adwene mu tebea asakra, ɔfe, tiyɛ, anaa akisikuru. Nneɛma a ɛtrɛw kɔ mmeae afoforo '''Asɛm titiriw: Metastasis''' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.<ref name=":8">https://www.cancer.gov/types/metastatic-cancer</ref>Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo. Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.<ref name=":8" /> == Nneɛma a ɛde ba == Kokoram dodow no ara, bɛyɛ 90–95% wɔ nsɛm no mu, fi awosu mu nsakrae a efi nneɛma a atwa yɛn ho ahyia ne asetra kwan mu nneɛma mu ba.<ref name=":2" /> 5–10% a aka no fi awosu mu nneɛma.<ref name=":2" /> Nneɛma a atwa yɛn ho ahyia kyerɛ biribiara a ɛde ba a ɛnyɛ agyapade, te sɛ asetra kwan, sikasɛm, ne suban mu nneɛma na ɛnyɛ efĩ ara kwa. Nneɛma a atwa yɛn ho ahyia a ɛtaa ma kokoram wuwu no bi ne tawa a wɔnom (25–30%), aduan ne kɛseyɛ mmoroso (30–35%), ɔyare mmoawa (15–20%), mframa bɔne (a ɛma ɛyɛ ion ne nea ɛnyɛ ion nyinaa, ɛkɔ 10%) . , nipadua mu dwumadi a wonnya, ne efĩ.<ref>https://doi.org/10.3322%2Fcaac.21440</ref> <ref name=":9" />Ɛte sɛ nea adwene mu nhyɛso nyɛ asiane a ɛma kokoram fi ase,ɛwom sɛ ebetumi ama nea efi mu ba no asɛe wɔ wɔn a wɔwɔ kokoram dedaw no mu de. Mpɛn pii no, wontumi nkyerɛ nea ɛde kokoram pɔtee bi bae efisɛ nneɛma ahorow a ɛde ba no nni nsateaa pɔtee bi. Sɛ nhwɛso no, sɛ obi a ɔnom tawa pii nya ahurututu mu kokoram a, ɛnde ɛbɛyɛ sɛ tawa nom no na ɛde bae, nanso esiane sɛ obiara wɔ hokwan ketewaa bi sɛ obenya ahurututu mu kokoram esiane mframa a wɔsɛe no anaa mframa a wɔde ma nti, ebia kokoram no nyaa nkɔso maa saa nneɛma no mu biako. Sɛ yɛyi ɔyare mmoawa a ɛntaa nsi a ɛba wɔ nyinsɛn ne akwaa a wɔde ma bere ne bere mu no nkutoo ho a, mpɛn pii no kokoram nyɛ yare a wɔde kɔ nnipa mu,nanso nneɛma a ebia ɛmaa kokoram bae no betumi ayɛ nea wɔde kɔ nnipa mu; te sɛ oncovirus te sɛ hepatitis B, Epstein-Barr mmoawa ne HIV. '''Nnuru a wɔde yɛ nnuru''' Nsɛm foforo: Nsã ne kokoram ne Sigaretnom ne kokoram Ahurututu mu kokoram a ɛba no ne sigaretnom wɔ abusuabɔ kɛse. Wɔde nneɛma pɔtee bi a wɔde di dwuma no bata kokoram ahorow pɔtee bi ho. Wɔfrɛ saa nneɛma yi nnuru a ɛma obi nya kokoram. Sɛ nhwɛso no, tawa wusiw na ɛde ahurututu mu kokoram 90% ba. Ɛsan nso de kokoram ba anom, ti, kɔn, yafunu, akisikuru, asaabo, ɛwo ne dwensɔtwaa mu.Tawa wusiw wɔ nneɛma bɛboro aduonum a wonim sɛ ɛde kokoram ba, a nitrosamines ne polycyclic aromatic hydrocarbons ka ho. Tawa na ɛde kokoram wuwu bɛyɛ nnipa baanum biara mu biako wɔ wiase nyinaane bɛyɛ baasa biara mu biako wɔ aman a wɔanya nkɔso no mu.Nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ United States no ada sigaretnom kwan no adi, na sigaretnom dodow a ɛkɔ soro na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no kɔ soro kɛse, na nnansa yi ara, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu no so atew fi 1950 mfe no mu na ɛno akyi no, nnipa dodow a wowuwu wɔ ahurututu mu kokoram mu wɔ mmarima mu no so atew fi 1990 . Ɔde ne nsa kyerɛɛ ne so. Wɔ Europa Atɔe Fam no, kokoram a ɛba mmarima mu 10% ne mmea mu kokoram 3% fi nsa a wɔnom, titiriw mmerɛbo ne aduan mu kokoram. Kokoram a efi nnuru a wɔde di dwuma wɔ adwuma mu mu ba no betumi ama wɔanya nsɛm no mu 2 kosi 20%, anyɛ yiye koraa no, ebetumi ama nnipa 200,000 awuwu.<ref name=":10">https://web.archive.org/web/20071012202014/http://www.who.int/mediacentre/news/notes/2007/np19/en/index.html</ref>Kokoram te sɛ ahurututu mu kokoram ne mesothelioma betumi afi tawa wusiw anaa asbestos nhama a wɔhome mu, anaasɛ mogya mu kokoram a efi benzene a wɔde wɔn ho hyɛ mu no mu aba.<ref name=":10" /> Wonim sɛ sɛ obi nya perfluorooctanoic acid (PFOA) a wɔde di dwuma titiriw wɔ Teflon a wɔyɛ mu a, ɛde kokoram ahorow abien ba. '''Adidi ne apɔw-mu-teɛteɛ''' Asɛm titiriw: Aduandi ne kokoram Adidi, nipadua mu dwumadi ne kɛseyɛ mmoroso ne kokoram a wowuwu no mu bɛyɛ 30–35% wɔ abusuabɔ.<ref name=":2" />[3][54] Wɔ United States no, nipadua mu duru a ɛboro so no ne kokoram ahorow pii a ɛba no wɔ abusuabɔ na ɛyɛ ade a ɛma kokoram wuwu 14–20% ba.[54] UK nhwehwɛmu bi a nnipa bɛboro ɔpepem 5 ho nsɛm ka ho kyerɛe sɛ anyɛ yiye koraa no nipadua mu duru a ɛkɔ soro no ne kokoram ahorow 10 wɔ abusuabɔ na ɛde nsɛm bɛyɛ 12,000 ba afe biara wɔ saa ɔman no mu. Wogye di sɛ apɔw-mu-teɛteɛ a wɔnyɛ no boa ma kokoram ho asiane ba, ɛnyɛ nkɛntɛnso a enya wɔ nipadua mu duru so nko so na mmom nkɛntɛnso bɔne a enya wɔ nipadua no mu tumi a ɛko tia nyarewa ne nipadua no mu ntini a ɛma nipadua no mu yɛ den so nso.[54] Nkɛntɛnso a efi aduan mu ba no bɛboro fã fi aduan pa a wodi boro so (adidi pii), sen sɛ ebefi nhabannuru kakraa bi anaa nnuan afoforo a ahoɔden wom a wodi mu. Nnuan pɔtee bi ne kokoram pɔtee bi wɔ abusuabɔ. Aduan a nkyene pii wom no ne yafunu mu kokoram wɔ abusuabɔ.[56] Aflatoxin B1, a ɛtaa de efĩ gu aduan mu no de mmerɛbo mu kokoram ba.[56] Betel nut a wɔwe no betumi ama obi anya kokoram wɔ anom.[56] Ebia nsonsonoe a ɛwɔ ɔman no aduan mu nneyɛe mu no bɛkyerɛkyerɛ nsonsonoe a ɛwɔ kokoram a ɛba mu no mu fã bi. Sɛ nhwɛso no, yafunu mu kokoram abu so kɛse wɔ Japan esiane nkyene pii a wodi nti[57] bere a akyi berɛmo mu kokoram abu so kɛse wɔ United States. Atubrafo kokoram ho nsɛm no te sɛ wɔn man foforo no de, mpɛn pii no wɔ awo ntoatoaso biako mu.[58] '''Nsaneɛ''' Asɛm titiriw: Nneɛma a ɛde kokoram ba a ɛde ɔyare mmoawa ba Wɔ wiase nyinaa no, nnipa a kokoram kunkum wɔn no mu bɛyɛ 18% fa nyarewa a wɔde yare mmoawa ba ho.<ref name=":2" />Saa dodow yi fi 25% a ɛkorɔn wɔ Afrika kosi nea ennu 10% wɔ aman a wɔanya nkɔso no mu.<ref name=":2" /> Virus ne nneɛma a wɔtaa de nyarewa ba a ɛde kokoram ba nanso kokoram mmoawa ne mmoawa a wɔsɛe nnɔbae nso betumi adi dwuma. Oncovirus (mmoawa a ebetumi de kokoram aba) no bi ne nnipa papillomavirus (awotwaa mu kokoram), Epstein–Barr mmoawa (B-cell lymphoproliferative disease ne nasopharyngeal carcinoma), Kaposi sarcoma herpesvirus (Kaposi sarcoma ne primary effusion lymphomas), hepatitis B ne hepatitis C mmoawa ( hepatocellular carcinoma) ne nnipa T-nkwaboaa mu kokoram mmoawa-1 (T-nkwaboaa mu kokoram). Mmoawa a wɔde nyarewa ba no nso betumi ama kokoram ho asiane no ayɛ kɛse, sɛnea wohu wɔ yafunu mu kokoram a Helicobacter pylori de ba no mu no.[59][60] Nkwammoaa a wɔde nyarewa ba a ɛne kokoram wɔ abusuabɔ no bi ne Schistosoma haematobium (squamous cell carcinoma a ɛwɔ akisikuru mu) ne mmerɛbo mu flukes, Opisthorchis viverrini ne Clonorchis sinensis (cholangiocarcinoma). '''Mframa a wɔde yɛ adwuma''' Asɛm titiriw: Kokoram a mframa bɔne de ba Mframa a wɔde di dwuma te sɛ ultraviolet mframa ne nneɛma a ɛma mframa bɔ kɛse no yɛ asiane a ɛde kokoram ba. Honam ani kokoram pii a ɛnyɛ melanoma no fi mframa a ano yɛ den a ɛbɔ, a ne fã kɛse no ara fi owia hann mu.Nneɛma a ɛma mframa bɔne a ɛma ɛyɛ hyew ba no bi ne aduruyɛ mu mfoninitwa ne radon mframa. Ionizing radiation nyɛ mutagen a ɛyɛ den titiriw.Sɛ nhwɛso no, radon gas a wɔde di dwuma wɔ atrae no wɔ kokoram ho asiane te sɛ sigaretnom a wɔnyɛ hwee.[65] Mframa a wɔde ma no yɛ kokoram fibea a ano yɛ den kɛse bere a wɔde ka nneɛma afoforo a ɛde kokoram ba te sɛ radon ne tawa wusiw ho ka ho no.Mframa a ɛbɔ no betumi de kokoram aba nipadua no afã dodow no ara, mmoa nyinaa mu ne mfe biara mu. Mmofra taa nya mogya mu kokoram a mframa bɔne de ba no mmɔho abien sen mpanyimfo; mframa a wɔde ma ansa na wɔawo no nya nkɛntɛnso no mmɔho du.[65] Mframa a ɛma ɛyɛ hyew a wɔde di dwuma wɔ aduruyɛ mu no yɛ kokoram a mframa bɔne de ba no fibea ketewaa bi nanso ɛrenya nkɔanim. Wobetumi de mframa a ɛma ɛyɛ ion adi dwuma de asa kokoram afoforo, nanso eyi betumi, wɔ tebea horow bi mu no, ama kokoram a ɛto so abien aba.[65] Wɔde di dwuma nso wɔ aduruyɛ mu mfonini ahorow bi mu. Sɛ obi nya ultraviolet mframa a efi owia mu bere tenten a, ebetumi ama wanya melanoma ne honam ani yare afoforo. Adanse a emu da hɔ kyerɛ sɛ mframa a ɛbɔ denneennen, titiriw UVB a ɛnyɛ ionizing medium wave no, na ɛde honam ani kokoram dodow no ara a ɛnyɛ melanoma ba, a ɛyɛ kokoram ahorow a abu so sen biara wɔ wiase no. Wiase Akwahosan Ahyehyɛde no Amanaman Ntam Dwumadibea a Ɛhwɛ Kokoram Ho Nhwehwɛmu So no aka radio frequency radiation a ɛnyɛ ionizing a efi telefon a wokura kyin mu, anyinam ahoɔden a wɔde fa nneɛma ne nneɛma afoforo a ɛtete saa mu no ho asɛm sɛ ebetumi ayɛ kokoram. Nanso, adanse ntumi nkyerɛɛ biribi a ɛhaw adwene.Nea ɛka eyi ho ne sɛ nhwehwɛmu ahorow nhuu abusuabɔ a ɛkɔ so daa wɔ telefon a wokura kyin mframa ne kokoram ho asiane ntam. '''Agyapade''' Asɛm titiriw: Kokoram yare Kokoram dodow no ara nyɛ nea wonya fi awo mu (ɛba bere ne bere mu). Kokoram a wonya fi awo mu no fi awosu mu sintɔ bi a wonya fi awo mu titiriw. Nnipa dodow a ennu 0.3% na wɔde awosu mu nsakrae a ɛwɔ nkɛntɛnso kɛse wɔ kokoram ho asiane so na eyinom de kokoram a ennu 3–10% ba. Saa nsɛnkyerɛnne yi bi ne: nkwaadɔm mu nsakrae ahorow bi a wonya fi awo mu wɔ awosu mu nkwaadɔm BRCA1 ne BRCA2 mu a asiane bɛboro 75% wɔ nufu mu kokoram ne awotwaa mu kokoram ho, ne awosu mu kokoram a ɛnyɛ polyposis colorectal cancer (HNPCC anaa Lynch syndrome), a ɛwɔ bɛyɛ 3 mu % nnipa a wɔwɔ kokoram a ɛwɔ akyi berɛmo mu,ne afoforo. Akontaabu mu wɔ kokoram ahorow a ɛma nnipa dodow no ara wuwu no ho no, asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu bere a wɔahu sɛ obusuani bi a odi kan (ɔwofo, onua anaa abofra) wɔ bi no bɛyɛ 2.Asiane a ɛne no hyia no yɛ 1.5 ma ahurututu mu kokoram,ne 1.9 ma prostate kokoram. Wɔ nufu mu kokoram ho no, asiane a ɛwɔ hɔ no yɛ 1.8 a obusuani a odi kan anya bi bere a wadi mfe 50 anaa nea ɛboro saa, ne 3.3 bere a obusuani no nyaa bi bere a na onnii mfe 50 no. Nnipa a wɔware no wɔ asiane kɛse sɛ wobenya kokoram efisɛ wɔwɔ nkwammoaa pii sen nnipa a wɔyɛ tiaa. Esiane sɛ awosu mu nneɛma na ɛkyerɛ ɔsorokɔ kɛse nti, nnipa a wɔware no wɔ kokoram ho asiane a ɛkɔ soro fi awo mu. '''Honam fam nneɛma a wɔde yɛ nneɛma''' Nneɛma bi de kokoram ba titiriw denam ne honam fam nkɛntɛnso so, sen sɛ ɛbɛyɛ nnuru. Eyi ho nhwɛso titiriw ne asbestos a wɔde wɔn ho hyɛ mu bere tenten, mineral fibers a ɛwɔ abɔde mu a ɛyɛ ade titiriw a ɛde mesothelioma (kokoram a ɛwɔ serous membrane mu) ba mpɛn pii no serous membrane a atwa ahurututu no ho ahyia no. Wogye di sɛ nneɛma afoforo a ɛwɔ saa kuw yi mu, a nhama a ɛte sɛ asbestos a ɛwɔ abɔde mu ne nea wɔayɛ no nyinaa ka ho, te sɛ wollastonite, attapulgite, ahwehwɛ nwi ne abotan nwi no wɔ nkɛntɛnso a ɛte saa ara.[ Nneɛma nketenkete a ɛnyɛ fibrous a ɛde kokoram ba no bi ne powder metallic cobalt ne nickel ne crystalline silica (quartz, cristobalite ne tridymite). Mpɛn pii no, ɛsɛ sɛ honam fam nneɛma a ɛde kokoram ba no kɔ nipadua no mu (te sɛ nea ɛnam ɔhome so) na ɛhwehwɛ sɛ wɔde di dwuma mfe pii na ama kokoram aba. Nipadua mu apirakuru a ɛde kokoram ba no ntaa mma.Sɛ nhwɛso no, wonnya nkyerɛɛ nsɛm a wɔka sɛ nnompe a ebubui no maa nnompe mu kokoram bae.Saa ara nso na wonnye nipadua mu apirakuru ntom sɛ ɛde awotwaa mu kokoram, nufu mu kokoram anaa amemene mu kokoram ba.Fibea biako a wogye tom ne nneɛma a ɛyɛ hyew a wɔtaa de gu nipadua no so bere tenten. Ebetumi aba sɛ nipadua no fã koro no ara a ɛhyew mpɛn pii, te sɛ nea kanger ne kairo a wɔde yɛ ɔhyew (fango nsa a wɔde yɛ hyew) de ba no betumi ama obi anya honam ani kokoram, titiriw sɛ nnuru a ɛde kokoram ba nso wɔ hɔ a Sɛ wɔtaa nom tii a ɛyɛ hyew a ɛyɛ hyew a, ebetumi ama woanya kokoram wɔ aduan mu.Mpɛn pii no, wogye di sɛ kokoram sɔre, anaasɛ wɔhyɛ kokoram a na ɛwɔ hɔ dedaw ho nkuran, wɔ ayaresa no mu, sen sɛ ɛbɛba tẽẽ denam ahodwiriw no so.[79] Nanso, sɛ obi pira ntini koro no ara mpɛn pii a, ebetumi ama nkwammoaa no adɔɔso dodo, na afei ebetumi ama asiane a ɛwɔ hɔ sɛ obi bɛsakra kokoram no ayɛ kɛse. Wɔasusuw sɛ ɔfe a enni sabea no de nkwaadɔm mu nsakrae ba tẽẽ. Ɔfe betumi aboa ma kokoram nkwammoaa no adɔɔso, atra ase, angiogenesis ne atutra denam nkɛntɛnso a enya wɔ tumor microenvironment no so.Oncogenes no kyekye pro-tumorigenic microenvironment a ɛma ɔhyew. '''Nkwammoaa a ɛwɔ nipadua mu''' Nkwammoaa bi di dwuma wɔ kokoram a ɛba no mu denam nkwammoaa a ɛdɔɔso no so.[84] Nneɛma a ɛte sɛ insulin a ɛma onyin ne protein ahorow a ɛkyekyere wɔn no di dwuma titiriw wɔ kokoram nkwammoaa a ɛdɔɔso, nsonsonoe ne apoptosis mu, na ɛkyerɛ sɛ ebetumi aba sɛ wɔde wɔn ho ahyɛ kokoram a ɛba mu. Hormone yɛ nneɛma a ɛho hia wɔ kokoram a ɛfa nna ho mu, te sɛ nufu, endometrium, prostate, ovary ne testis kokoram ne thyroid kokoram ne nnompe mu kokoram nso.<ref name=":11">https://www.ncbi.nlm.nih.gov/books/NBK20759/</ref> Sɛ nhwɛso no, mmea a wɔwɔ nufu mu kokoram mmabea wɔ estrogen ne progesterone dodow a ɛkɔ soro kɛse sen mmea a wonni nufu mu kokoram mmabea. Saa hormone dodow a ɛkɔ soro yi betumi akyerɛkyerɛ asiane kɛse a ɛwɔ hɔ sɛ wobenya nufu mu kokoram no mu, bere mpo a nufu mu kokoram awosu mu abɔde biara nni hɔ no. Saa ara nso na mmarima a wofi Afrika nananom no wɔ testosterone dodow a ɛkɔ soro kɛse sen mmarima a wofi Europa nananom na wɔwɔ prostate kokoram dodow a ɛne no hyia.<ref name=":11" /> Mmarima a wofi Asia, a androstanediol glucuronide a ɛma testosterone yɛ adwuma no sua koraa no, na wɔwɔ prostate kokoram a ɛba fam koraa.[84] Nneɛma afoforo nso fa ho: nnipa a wɔayɛ kɛse mmoroso no wɔ hormone ahorow bi a ɛne kokoram wɔ abusuabɔ no dɔɔso na saa kokoram ahorow no dodow kɔ soro.[84] Mmea a wɔnom nnuru a wɔde si hormone ananmu no wɔ asiane kɛse sɛ wobenya kokoram a ɛne saa hormone ahorow no wɔ abusuabɔ.[84] Ɔkwan foforo so no, nnipa a wɔteɛteɛ wɔn apɔw mu sen sɛ wɔkyekyem pɛpɛɛpɛ no, saa hormone ahorow yi sua na asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.[84] Ebia nkwaadɔm a ɛma obi nyin no na ɛma osteosarcoma nya nkɔso.[84] Ayaresa ne akwan horow bi a wɔfa so siw ano no de nea ɛde ba yi di dwuma denam hormone dodow a wɔtew so wɔ ɔkwan a wɔde nsa ayɛ so na ɛnam so ma kokoram ahorow a ɛyɛ hormone no yɛ mmerɛw no abam bu so.[84] '''Nyarewa a nipadua no tumi ko tia nyarewa''' Abusuabɔ bi wɔ celiac yare ne kokoram nyinaa ho asiane a ɛkɔ soro no ntam. Nnipa a wɔwɔ celiac yare a wɔansa wɔn yare no wɔ asiane kɛse, nanso asiane yi so tew bere a bere kɔ so bere a wɔahu sɛ wɔwɔ coeliac yare no akyi no, ebia esiane aduan a gluten nnim a wogye tom nti, a ɛte sɛ nea ɛwɔ dwuma a ɛbɔ ho ban fi ɔyare bɔne a ɛbɛba nnipa a wɔwɔ celiac yare no mu no ho . Nanso, ɛte sɛ nea bere a wɔkyɛ wɔ yare a wohu ne aduan a gluten nnim a wofi ase di no ma asiane a ɛwɔ hɔ sɛ wobenya nyarewa bɔne no yɛ kɛse.[86] Nnipa a wɔwɔ Crohn yare ne akisikuru a ɛma obi nya yafunu mu kokoram dodow kɔ soro, esiane ɔfe a enni sabea nti. Afei nso, nnuru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa nyarewa yi betumi ama wɔanya nyarewa bɔne a ɛwɔ dwensɔtwaa no akyi.[87] == Pathophysiology ho adesua == '''Awosu mu nneɛma''' Asɛm titiriw: ''Oncogenomics'' Kokoram yɛ yare titiriw a ɛma ntini ahorow nyin. Sɛnea ɛbɛyɛ a nkwammoaa a ɛteɛ bɛdan kokoram nkwammoaa no, ɛsɛ sɛ wɔsesa awosu mu nkwaadɔm a ɛhwɛ nkwammoaa nyin ne nsonsonoe so no.[88] Wɔakyekyɛ awosu mu nkwaadɔm a ɛka wɔn no mu akuw abien a ɛtrɛw. Oncogenes yɛ awosu mu nkwaadɔm a ɛma nkwammoaa nyin na wɔwo. Tumor suppressor genes yɛ awosu mu nkwaadɔm a esiw nkwammoaa mu mpaapaemu ne nkwa ano. Nsakrae a ɛyɛ hu betumi aba denam oncogenes foforo a ɛba, oncogenes a ɛfata a wɔda no adi boro so a ɛmfata, anaasɛ awosu mu nkwaadɔm a esiw akisikuru ano a wɔda no adi yiye anaasɛ ɛma ɛyɛ adwuma no so. Mpɛn pii no, ɛho hia sɛ wɔyɛ nsakrae wɔ awosu mu nkwaadɔm pii mu na ama wɔadan nkwammoaa a ɛteɛ no ayɛ no kokoram nkwammoaa.[89] Awosu mu nsakrae betumi aba wɔ gyinabea ahorow ne akwan horow so. Nkwammoaa a wonya anaasɛ ɛyera wɔ chromosome mũ no nyinaa mu no betumi aba denam mfomso ahorow a ɛba wɔ mitosis mu no so. Nea ɛtaa ba ne nkwaadɔm mu nsakrae, a ɛyɛ nsakrae a ɛba wɔ genomic DNA no nucleotide ahorow a ɛtoatoa so no mu. Nkwammoaa mu nsakrae akɛse no fa chromosome bi fã bi a wɔpopa anaasɛ wonya ho. Genomic amplification ba bere a nkwammoaa bi nya chromosomal locus ketewaa bi mfonini ahorow (mpɛn pii no 20 anaa nea ɛboro saa), a mpɛn pii no oncogenes biako anaa nea ɛboro saa ne awosu mu nneɛma a ɛbɛn ho wom no. Translocation ba bere a chromosomal mmeae abien a ɛsono emu biara no bom wɔ ɔkwan a ɛnteɛ so, mpɛn pii no wɔ beae a ɛda nsow no. Eyi ho nhwɛso a wonim no yiye ne Philadelphia chromosome, anaasɛ chromosome 9 ne 22 a ɛkɔ baabi foforo, a ɛba wɔ myelogenous leukemia a enni sabea mu na ɛma wɔyɛ BCR-abl fusion protein, oncogenic tyrosine kinase. Nkwammoaa mu nsakrae nketenkete bi ne point mutations, deletions, ne insertions, a ebetumi aba wɔ awosu mu nkwaadɔm bi promoter region na aka ne nkyerɛkyerɛmu, anaasɛ ebetumi aba wɔ gene no coding sequence mu na asakra ne protein product no dwumadi anaasɛ egyina pintinn. Awosu mu nkwaadɔm biako a wɔbɛsɛe no nso betumi afi genomic nneɛma a efi DNA mmoawa anaa retrovirus mu a wɔaka abom no mu aba, na ama wɔada ɔyare mmoawa no oncogenes adi wɔ nkwammoaa a ɔyare no ne n’asefo mu. Nsɛm a ɛwɔ nkwammoaa a nkwa wom DNA mu no a wɔbɛsan ayɛ no foforo no bɛma mfomso ahorow bi aba (nsakrae a ɛsakra). Wɔde mfomso a wɔteɛteɛ ne nea wosiw ano a ɛyɛ den ahyɛ adeyɛ no mu na ɛbɔ nkwammoaa no ho ban fi kokoram ho. Sɛ mfomso kɛse bi ba a, nkwammoaa a asɛe no betumi asɛe ne ho denam nkwammoaa a wɔayɛ ho nhyehyɛe a wowuwu, a wɔfrɛ no apoptosis no so. Sɛ mfomso a wɔhwɛ so no di nkogu a, ɛnde nkwaadɔm mu nsakrae no bɛkɔ so atra ase na wɔde akɔ nkwammoaa a wɔyɛ mmabea no mu. Nneɛma bi a atwa yɛn ho ahyia no ma mfomso ahorow taa ba na ɛtrɛw. Nneɛma a atwa yɛn ho ahyia a ɛte saa no betumi ayɛ nneɛma a ɛhaw adwene a wɔfrɛ no carcinogens a ɛwɔ hɔ, nipadua mu opira a ɛba mpɛn pii, ɔhyew, ionizing radiation anaasɛ hypoxia.[90] Mfomso ahorow a ɛde kokoram ba no yɛ nea ɛma ne ho yɛ kɛse na ɛma ɛyɛ kɛse, sɛ nhwɛso no: Nkwammoaa bi mfiri a wɔde siesie mfomso ahorow no mu nsakrae betumi ama saa nkwammoaa no ne ne mma aboaboa mfomso ano ntɛmntɛm. Nsakrae foforo a ɛbɛba oncogene mu no betumi ama nkwammoaa no awo ntɛmntɛm na ayɛ mpɛn pii asen ne mfɛfo a ɛteɛ no. Nkwammoaa mu nsakrae foforo betumi ama awosu mu abɔde bi a esiw akisikuru ano no ayera, na asɛe apoptosis sɛnkyerɛnne kwan no na ama nkwammoaa no anwu. Ebia nsakrae foforo a ɛbɛba nkwammoaa no mfiri a ɛma nsɛnkyerɛnne no mu no de nsɛnkyerɛnne a ɛde mfomso ba no bɛkɔ nkwammoaa a ɛbɛn hɔ no mu. Nkwammoaa a ɛteɛ a ɛdan kokoram no te sɛ nkɔnsɔnkɔnsɔn a mfomso ahorow a edi kan no de ba, a ɛyɛ kɛse ma ɛyɛ mfomso a emu yɛ den kɛse, na emu biara ma nkwammoaa no guan nkakrankakra wɔ nneɛma pii a wɔde di dwuma a ɛma ntini ahorow a ɛfata nyin no ano hye. Saa tebea a ɛte sɛ atuatew yi yɛ wɔn a wɔyɛ den sen biara no nkwa a wɔmpɛ, baabi a tumi horow a ɛkanyan adannandi no yɛ adwuma tia nipadua no nhyehyɛe ne nhyehyɛe a ɛma ɛyɛ adwuma no. Sɛ kokoram fi ase reba a, saa adeyɛ a ɛkɔ so yi a wɔfrɛ no clonal evolution no ma nkɔso kɔ mmeae a ɛyɛ hu kɛse.[91] Clonal adannandi de intra-tumour heterogeneity (kokoram nkwammoaa a ɛwɔ heterogeneous mutations) a ɛma ɛyɛ den sɛ wɔbɛyɛ ayaresa akwan a etu mpɔn na ɛhwehwɛ sɛ wɔfa ɔkwan a ɛyɛ adannandi so de yɛ ayaresa ho nhyehyɛe. Wɔakyekyɛ su tumi ahorow a kokoram ahorow nya no mu akuw ahorow, titiriw no, apoptosis a wɔkwati, onyin ho sɛnkyerɛnne a obi tumi yɛ ne ho, sɛnkyerɛnne a ɛko tia onyin ho nkate, ntini a ɛkɔ so tra hɔ, tumi a ɛsan yɛ bio a anohyeto nni mu, metastasis, ahoɔden a ɛsakra ho nhyehyɛe a wɔsan yɛ ne nipadua no mu tumi a ɛko tia nyarewa a wɔkwati ][29] na ɛwɔ hɔ. '''Epigenetics ho nimdeɛ''' Adwene a wɔtaa kura wɔ kokoram ho no yɛ nyarewa ahorow bi a awosu mu nkwaadɔm a ɛnteɛ a ɛkɔ so nkakrankakra a nea ɛka ho ne nsakrae a ɛba wɔ awosu mu nkwaadɔm a esiw akisikuru ano ne oncogenes ne nkwaboaa mu nneɛma a ɛnteɛ so na ɛba. Akyiri yi epigenetic nsakrae ahorow no di dwuma.[92] Epigenetic nsakrae yɛ nsakrae a ɛfa dwumadi ho wɔ genome no mu a ɛnsakra nucleotide ntoatoaso no. Nsakraeɛ a ɛte saa ho nhwɛsoɔ ne nsakraeɛ a ɛba DNA methylation (hypermethylation ne hypomethylation), histone nsakraeɛ[93] ne nsakraeɛ a ɛba wɔ chromosomal architecture mu (a ɛnam protein te sɛ HMGA2 anaa HMGA1 a wɔda no adi a ɛmfata so na ɛba).[94] Saa nsakrae yi mu biara hwɛ awosu mu nkwaadɔm a wɔda no adi no so a ɛnsakra DNA a ɛwɔ ase no. Ebia nsakrae yi bɛkɔ so atra hɔ denam nkwammoaa mu mpaapaemu so, ɛbɛtra hɔ awo ntoatoaso pii na wobetumi abu no sɛ ɛyɛ epimutations (a ɛne nkwaadɔm mu nsakrae yɛ pɛ). Epigenetic nsakrae taa ba wɔ kokoram ahorow mu. Sɛ nhwɛso no, nhwehwɛmu bi kaa awosu mu nkwaadɔm a ɛkyerɛw protein a wɔtaa sesa wɔ wɔn methylation mu a ɛne kokoram wɔ akyi berɛmo mu no din. Nea ɛka eyinom ho ne awosu mu nkwaadɔm 147 a wɔde hypermethylated ayɛ ne 27 a wɔayɛ no hypomethylated. Wɔ hypermethylated genes no mu no, 10 yɛɛ hypermethylated wɔ 100% a ɛwɔ akyi berɛmo mu kokoram mu na afoforo pii nso yɛɛ hypermethylated wɔ bɛboro 50% mu wɔ akyi berɛmo mu kokoram mu.[95] Bere a wohu epigenetic nsakrae wɔ kokoram ahorow mu no, ebia epigenetic nsakrae a ɛba DNA asiesie awosu mu nkwaadɔm mu, a ɛma DNA asiesie protein ahorow a wɔda no adi so tew no ho hia titiriw. Wosusuw sɛ nsakrae a ɛte saa no ba ntɛm wɔ kokoram mu nkɔso mu na ɛbɛyɛ sɛ ɛno na ɛde awosu mu nkwaadɔm a entumi nnyina pintinn a ɛyɛ kokoram no su ba.[96][97][98] DNA a wosiesie no awosu mu nkwaadɔm a wɔda no adi so tew no sɛe DNA a wosiesie no. Eyi na wɔakyerɛ wɔ mfonini no mu wɔ 4th level no so fi soro. (Wɔ mfonini no mu no, nsɛmfua kɔkɔɔ kyerɛ dwuma titiriw a DNA a wɔsɛe no ne sintɔ ahorow a ɛwɔ DNA a wosiesie mu no di wɔ kokoram mu nkɔso mu.) Sɛ DNA a wosiesie no yɛ nea enni mu a DNA a wɔsɛe no kɔ so tra nkwammoaa mu wɔ dodow a ɛkorɔn sen sɛnea ɛtaa ba (ɔfa a ɛto so 5) na ɛma mpɛn dodow a ɛkɔ soro mutation ne/anaasɛ epimutation (6th level). Nkwammoaa mu nsakrae dodow kɔ soro kɛse wɔ nkwammoaa a asɛe wɔ DNA a ɛne ne ho nhyia asiesie mu[99][100] anaasɛ homologous recombinational repair (HRR) mu.[101] Nkwammoaa a wɔsan hyehyɛ wɔn ho ne aneuploidy nso kɔ soro wɔ nkwammoaa a HRR asɛe no mu.[102] DNA a wɔsɛe no kɛse no ma nkwaadɔm mu nsakrae kɔ soro (mfonini no fã nifa so) na ɛma nipadua no mu nkwaadɔm mu nsakrae kɔ soro. Bere a wɔresiesie DNA nhama abien a abubu, anaasɛ wɔresiesie DNA afoforo a asɛe no, mmeae a wosiesie no a wɔansiesie no yiye no betumi ama epigenetic gene silencing.[103][104] DNA a esiesie protein ahorow a wɔankyerɛ no yiye esiane nkwaadɔm mu nsakrae a wonya fi awo mu nti no betumi ama kokoram ho asiane ahorow no ayɛ kɛse. Ankorankoro a wɔwɔ DNA a wosiesie awosu mu nkwaadɔm 34 no mu biara mu ɔhaw a wonya fi awo mu (hwɛ asɛm DNA a wosiesie-a enni hɔ) no anya kokoram ho asiane a ɛkɔ soro, a sintɔ ahorow bi hwɛ hu sɛ wobenya kokoram hokwan 100% wɔ wɔn nkwa nna nyinaa mu (e.g. p53 mutations).[105] Wɔahyɛ DNA a esiesie nipadua no mu nsakrae a ɛba wɔ nipadua no mu no nsow wɔ mfonini no benkum so. Nanso, mmoawa mu nkwaadɔm mu nsakrae a ɛte saa (a ɛde kokoram a ɛkɔ nipadua no mu kɛse ba) na ɛde kokoram bɛyɛ ɔha biara mu nkyem 1 pɛ ba.[106] Wɔ kokoram ahorow a ɛba bere ne bere mu mu no, ɛtɔ mmere bi a DNA a wosiesie no mu sintɔ ahorow no fi DNA a wosiesie awosu mu abɔde mu nkwaadɔm mu nsakrae a ɛba nanso ɛtaa fi epigenetic nsakrae a ɛtew DNA a wosiesie awosu mu nkwaadɔm a wɔda no adi no so anaasɛ ɛma ɛyɛ komm no so. Eyi na wɔakyerɛ wɔ mfonini a ɛwɔ 3rd level no mu. Nhwehwɛmu pii a wɔyɛe wɔ kokoram a dade a emu yɛ duru de ba ho no kyerɛ sɛ dade a emu yɛ duru a ɛte saa no ma DNA a esiesie enzyme ahorow a wɔda no adi no so tew, na ebinom nam epigenetic akwan horow so. Wɔkyerɛ sɛ DNA a wosiesie no a wosiw ano no ne ɔkwan titiriw a wɔfa so de kokoram ba a dade a emu yɛ duru de ba no mu. Nea ɛka ho no, nsakrae a ɛtaa ba wɔ DNA ntoatoaso no mu wɔ epigenetic mu no kyerɛ RNA nketewa a wɔfrɛ no microRNAs (anaa miRNAs). miRNA ahorow no nkyerɛw protein ahorow, na mmom ebetumi "de wɔn ani asi" protein-coding genes so na ɛtew wɔn nkyerɛkyerɛmu so. Kokoram taa fi nkwaadɔm mu nsakrae ne epimutations a wɔaboaboa ano a ɛma wonya mfaso a wɔpaw a ɛde clonal ntrɛwmu ba (hwɛ Field defects in progression to cancer). Nanso, ebia nkwaadɔm mu nsakrae ntaa mma wɔ kokoram ahorow mu te sɛ epigenetic nsakrae no. Sɛ wɔkyekyem pɛpɛɛpɛ a, nufu anaa akyi berɛmo mu kokoram betumi anya nkwaadɔm mu nsakrae bɛyɛ 60 kosi 70 a ɛsakra protein, a emu bɛyɛ abiɛsa anaa anan betumi ayɛ "draiver" mu nsakrae na nea aka no betumi ayɛ "akwantufo" mu nsakrae.[107] '''Nneɛma a ɛtrɛw kɔ mmeae afoforo''' Asɛm titiriw: ''Metastasis'' Metastasis yɛ kokoram a ɛtrɛw kɔ mmeae afoforo wɔ nipadua no mu. Wɔfrɛ akisikuru a apete no metastatic tumors, bere a wɔfrɛ nea edi kan no akisikuru titiriw. Ɛkame ayɛ sɛ kokoram nyinaa tumi kɔ mmeae afoforo.[35] Kokoram a wowuwu dodow no ara fi kokoram a akɔ mmeae afoforo.[36] Metastasis taa ba wɔ kokoram no fã a etwa to no mu na ebetumi afa mogya anaa ntini a ɛma mogya tu no anaa n’abien nyinaa so aba. Anamɔn a ɛtaa ba wɔ metastasis mu ne mpɔtam hɔ ntua, ntini a ɛkɔ mogya anaa ntini mu, mogya a ɛkɔ nipadua no mu, ntini a ɛkɔ ntini foforo no mu, ntini a ɛdɔɔso ne ntini a ɛma mogya tu. Kokoram ahorow taa kɔ akwaa pɔtee bi mu, nanso ne nyinaa mu no, mmeae a ɛtaa kɔ mmeae afoforo ne ahurututu, mmerɛbo, amemene ne nnompe.[35] '''Nneɛma a ɛma nipadua no yɛ adwuma''' Asɛm titiriw: ''Tumor metabolome'' Nkwammoaa a ɛyɛ daa no taa nya ahoɔden bɛyɛ 30% pɛ fi glycolysis mu,[108] bere a kokoram dodow no ara de ne ho to glycolysis so ma ahoɔden yɛ (Warburg nkɛntɛnso).[109][110][111] Nanso kokoram ahorow kakraa bi de wɔn ho to oxidative phosphorylation so sɛ ahoɔden fibea titiriw, a lymphoma, mogya mu kokoram, ne endometrial kokoram ka ho.[112] Nanso, wɔ saa nsɛm yi mu mpo no, glycolysis a wɔde di dwuma sɛ ahoɔden fibea no ntaa ntra 60%.[108] Kokoram kakraa bi de glutamine di dwuma sɛ ahoɔden fibea titiriw, ne fã bi ne sɛ ɛma nitrogen a ɛho hia ma nucleotide (DNA,RNA) a wɔyɛ no.[113][108] Kokoram ntini mu nkwammoaa taa de oxidative phosphorylation anaa glutamine di dwuma sɛ ahoɔden fibea titiriw.[114] Nhwehwɛmu pii akyerɛ sɛ wɔpaw enzyme sirtuin 6 no adwuma wɔ oncogenesis mu wɔ akisikuru ahorow ahorow mu denam glycolysis a ɛma ɛba no so.[111] Sirtuin foforo, sirtuin 3 siw kokoram a egyina glycolysis so ano, nanso ɛhyɛ kokoram a egyina oxidative phosphorylation so no ho nkuran.[115] Ɛtɔ mmere bi a wɔkamfo aduan a carbohydrate kakraa bi na ɛwom (ketogenic diet) kyerɛ sɛ aduru a ɛboa ma kokoram sa.[116][117] == Nhwehwɛmu a wɔyɛe == Wohu kokoram dodow no ara mfiase no esiane sɛnkyerɛnne anaa sɛnkyerɛnne ahorow a ɛda adi anaasɛ ɛnam nhwehwɛmu so nti.[118] Eyinom mu biara mma wonhu yare no yiye, a ɛhwehwɛ sɛ ɔyare ho ɔbenfo hwehwɛ ntini bi mu nhwehwɛmu mu. Wɔde nnuruyɛ mu nhwehwɛmu hwehwɛ nnipa a wosusuw sɛ wɔwɔ kokoram no mu. Eyinom taa bi ne mogya mu nhwehwɛmu, X-ray, (contrast) CT scan ne endoscopy. Ntini a wohu fi biopsy no mu no kyerɛ nkwammoaa ko a ɛredɔɔso, ne nipadua mu nkwaadɔm mu gyinabea, awosu mu nneɛma a ɛnteɛ ne nneɛma afoforo. Sɛ wɔka nsɛm yi bom a, mfaso wɔ so sɛ wɔde bɛhwehwɛ nea ɛbɛba daakye no mu na wɔapaw ayaresa a eye sen biara. Cytogenetics ne immunohistochemistry yɛ ntini mu nhwehwɛmu ahorow afoforo. Saa nhwehwɛmu ahorow yi ma wonya nsɛm a ɛfa molecule nsakrae (te sɛ nkwaadɔm mu nsakrae, fusion genes ne akontaahyɛde mu nsakrae a ɛba wɔ chromosome mu) ho na ɛnam so betumi akyerɛ nkɔmhyɛ ne ayaresa a eye sen biara nso. Kokoram a wohu no betumi de adwene mu haw aba na adwene mu nneyɛe te sɛ kasa mu ayaresa betumi aboa nkurɔfo wɔ eyi mu.[119] == Nkyekyɛmu == Nsɛm foforo: Kokoram ahorow a wɔahyehyɛ ne Nsɛmfua a ɛfa oncology ho a wɔahyehyɛ Wɔkyekyɛ kokoram ahorow mu sɛnea nkwammoaa a akisikuru no te sɛ wɔn no te ma enti wosusuw sɛ ɛno na ɛde akisikuru no bae. Saa ahorow yi bi ne: Carcinoma: Kokoram a wonya fi nkwammoaa a ɛwɔ nipadua no mu no mu. Kokoram a ɛtaa ba no pii ka saa kuw yi ho na ɛkame ayɛ sɛ nea ɛwɔ nufu, prostate, ahurututu, dwensɔtwaa ne akyi berɛmo mu nyinaa ka ho. Sarcoma: Kokoram a efi ntini a ɛka bom (i.e. nnompe, ntini, srade, ntini), a emu biara fi nkwammoaa a efi mesenchymal nkwammoaa a ɛwɔ nnompe mu ntini no akyi mu ba. Lymphoma ne leukemia: Saa akuw abien yi fi nkwammoaa a ɛma mogya yɛ adwuma (a ɛyɛ mogya) a efi ntini no mu na ɛtaa nyin wɔ ntini a ɛma mogya tu ne mogya mu, sɛnea ɛte biara.[120] Nkwammoaa mu akisikuru: Kokoram a efi nkwammoaa a ɛwɔ tumi pii mu ba, na ɛtaa ba awotwaa anaa awotwaa no mu (seminoma ne dysgerminoma, sɛnea ɛte biara). Blastoma: Kokoram a efi "precursor" nkwammoaa a ennyinii anaasɛ awotwaa mu ntini mu ba. Wɔtaa de -carcinoma, -sarcoma anaa -blastoma di dwuma de to kokoram din sɛ akyi, a Latin anaa Hela asɛmfua a ɛkyerɛ akwaa anaa ntini a efi mu no yɛ ntini. Sɛ nhwɛso no, wɔfrɛ mmerɛbo mu ntini mu kokoram a efi nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ hu mu ba no hepatocarcinoma, bere a wɔfrɛ ɔyare bɔne a efi mmerɛbo mu nkwammoaa a edi kan a edi kan mu ba no hepatoblastoma na wɔfrɛ kokoram a efi srade nkwammoaa mu ba no liposarcoma. Wɔ kokoram ahorow bi a abu so ho no, wɔde Engiresi akwaa din no na edi dwuma. Sɛ nhwɛso no, wɔfrɛ nufu mu kokoram a ɛtaa ba no. Ɛha no, asɛmfua a wɔde gyina hɔ ma ductal no kyerɛ sɛnea kokoram no da adi wɔ afiri a wɔde hwɛ nneɛma nketenkete mu, a ɛkyerɛ sɛ efi ase wɔ nufusu ntini ahorow no mu. Wɔde -oma di dwuma sɛ akyigyina a akwaa no din yɛ ntini no na ɛto akisikuru a ɛnyɛ hu (a ɛnyɛ kokoram) din. Sɛ nhwɛso no, wɔfrɛ ntini mu nkwammoaa a ɛyɛ mmerɛw akisikuru a ɛnyɛ hu no leiomyoma (din a wɔtaa de frɛ saa akisikuru a ɛnyɛ hu a ɛtaa ba wɔ awotwaa no mu yi ne fibroid). Nea ɛyɛ ahodwiriw no, kokoram ahorow bi de -noma akyigyinafo di dwuma, nhwɛso ahorow a melanoma ne seminoma ka ho. Wɔto kokoram ahorow bi din esiane sɛnea nkwammoaa no kɛse ne sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu nti, te sɛ nkwammoaa akɛse mu kokoram, spindle cell carcinoma ne nkwammoaa nketewa kokoram. == Siw a wosiw ano == Wɔkyerɛkyerɛ kokoram ano aduru mu sɛ nneɛma a ɛyɛ nnam a wɔde bɛtew kokoram ho asiane so.[121] Kokoram dodow no ara fi nneɛma a atwa yɛn ho ahyia a asiane wom. Nneɛma a atwa yɛn ho ahyia yi mu pii yɛ asetra kwan a wotumi di so. Enti, mpɛn pii no, wotumi siw kokoram ano.[122] Kokoram a ɛtaa ba no mu 70% kosi 90% fi nneɛma a atwa yɛn ho ahyia mu ma enti wobetumi asiw ano.[123] Wobetumi asiw kokoram a wowuwu no mu bɛboro 30% ano denam asiane ahorow a wɔbɛkwati a nea ɛka ho ne: tawa, mu duru a ɛboro so/kɛseyɛ mmoroso, aduan pa a wonni, apɔw-mu-teɛteɛ a wɔnyɛ, nsa, nyarewa a wonya fi nna mu ne mframa a wɔsɛe no no so. Bio nso, wobetumi abu ohia sɛ asiane a ɛnteɛ a ɛde nnipa kokoram ba.[125] Ɛnyɛ nneɛma a atwa yɛn ho ahyia a ɛde ba nyinaa na wotumi di so, te sɛ mframa a efi abɔde mu a ɛba akyi ne kokoram a ɛnam awosu mu nyarewa so de ba na enti wontumi mfa ankorankoro nneyɛe nsiw ano. '''Aduan a wodi''' Asɛm titiriw: Aduandi ne kokoram Bere a wɔahyɛ nyansahyɛ ahorow pii a ɛfa aduan ho ho nyansa sɛ ɛbɛtew kokoram ho asiane so no, adanse a ɛfoa so no nyɛ nea edi mũ.[13][126] Nneɛma atitiriw a ɛma asiane no yɛ kɛse ne kɛseyɛ mmoroso ne nsa a wɔnom. Wɔde nnuan a nnuaba ne nhabannuru kakraa bi na ɛwom ne nam kɔkɔɔ pii wom no aka ho nanso nhwehwɛmu ne meta-nhwehwɛmu ahorow no nnya nsɛm a ɛkɔ so daa.[127][128] Afe 2014 meta-analysis anhu abusuabɔ biara a ɛda nnuaba ne nhabannuru ne kokoram ntam.[129] Kafe ne mmerɛbo mu kokoram ho asiane a ɛso tew no wɔ abusuabɔ.[130] Nhwehwɛmu ahorow akyerɛ sɛ nam kɔkɔɔ anaa wɔayɛ no foforo a wodi boro so no ne asiane a ɛkɔ soro a ɛne sɛ wobenya nufu mu kokoram, akyi berɛmo mu kokoram ne dwensɔtwaa mu kokoram, adeyɛ a ebetumi afi nneɛma a ɛde kokoram ba a ɛwɔ nam a wɔanoa wɔ ɔhyew a ɛkɔ soro mu no mu. Wɔ afe 2015 mu no IARC bɔɔ amanneɛ sɛ nam a wɔayɛ no foforo a wodi (e.g., bacon, ham, hot dogs, soseji) ne, wɔ ɔkwan ketewaa bi so no, nam kɔkɔɔ a wodi no ne kokoram ahorow bi wɔ abusuabɔ.[133][134] Mpɛn pii no, aduan ho nyansahyɛ ahorow a wɔde siw kokoram ano no bi ne sɛ wobesi nhabannuru, nnuaba, aburow a wɔayam ne mpataa so dua na wɔakwati nam a wɔayɛ ho adwuma ne nam kɔkɔɔ (nantwinam, mprako nam, oguammaa nam), mmoa srade, nnuan a wɔayam ne carbohydrates a wɔayɛ no yiye. '''Nnuru a wɔde di dwuma''' Wobetumi de nnuru adi dwuma de asiw kokoram ano wɔ tebea horow kakraa bi mu.[135] Wɔ nnipa dodow no ara mu no, NSAID ahorow no ma asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ akyi berɛmo mu no so tew; nanso esiane koma ne ntini ne yafunu mu nsunsuanso nti, sɛ wɔde di dwuma de siw ano a, ɛde ɔhaw nyinaa ba.[136] Wɔahu sɛ aspirin tew asiane a ɛwɔ hɔ sɛ kokoram betumi awu no so bɛyɛ 7%.[137] Ebia nnuru a esiw COX-2 ano no bɛtew sɛnea polyp a ɛba nnipa a wɔwɔ abusua mu adenomatous polyposis mu no so; nanso, ɛne nsunsuanso bɔne koro no ara a NSAIDs de ba no wɔ abusuabɔ.[138] Tamoxifen anaa raloxifene a wɔde di dwuma da biara da no ma asiane a ɛwɔ hɔ sɛ mmea a asiane kɛse wom benya nufu mu kokoram no so tew.[139] Mfaso a ɛwɔ so ne ɔhaw a ɛwɔ 5-alpha-reductase inhibitor te sɛ finasteride so no mu nna hɔ.[140] Ɛte sɛ nea vitamin a wɔde ma no ntumi nsiw kokoram ano.[141] Bere a vitamin D a ɛba fam wɔ mogya mu no ne kokoram ho asiane a ɛkɔ soro no wɔ abusuabɔ no,[142][143][144] sɛ ebia saa abusuabɔ yi de ba na vitamin D a wɔde ma no yɛ ahobammɔ no, wonhu. Nhwehwɛmu bi a wɔyɛe wɔ afe 2014 mu no kyerɛe sɛ nnuru a wɔde ka aduan ho no nni nkɛntɛnso kɛse biara wɔ kokoram ho asiane so.[146] Nhwehwɛmu foforo a wɔyɛe wɔ afe 2014 mu no de baa awiei sɛ ebia vitamin D3 bɛtew asiane a ɛwɔ hɔ sɛ kokoram bewuwu no so (owu kakraa bi wɔ nnipa 150 a wɔsa wɔn yare wɔ mfe 5 mu), nanso wɔhyɛɛ dadwen wɔ nsɛm a wɔde ama no yiye ho no nsow.[147] Beta-Carotene a wɔde ma no ma ahurututu mu kokoram dodow kɔ soro wɔ wɔn a asiane kɛse wom no mu.[148] Folic acid a wɔde ma no ntumi nsiw kokoram a ɛwɔ akyi berɛmo mu no ano na ebetumi ama akyi berɛmo mu polyps akɔ soro.[149] Wɔnkyerɛe sɛ selenium a wɔde ka ho no brɛ asiane a ɛwɔ hɔ sɛ obi benya kokoram no ase.[150] '''Abota''' Wɔayɛ nnuru a wɔde bɔ nkurɔfo ho ban a ɛmma mmoawa bi a wɔde kokoram ba no ntumi nnya ɔyare mmoawa.[151] Nnipa papillomavirus vaccine (Gardasil ne Cervarix) ma asiane a ɛwɔ hɔ sɛ wobenya awotwaa mu kokoram no so tew.[151] Hepatitis B vaccine no siw hepatitis B mmoawa a wobenya no ano na ɛnam so ma asiane a ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram no so tew.[151] Wɔkamfo nnipa papillomavirus ne hepatitis B nnuru a wɔde bɔ nkurɔfo ho ban no kyerɛ wɔ baabi a nneɛma ma kwan.[152] == Nhwehwɛmu a wɔyɛ == Nea ɛnte sɛ mmɔden a wɔbɔ sɛ wobehu kokoram a sɛnkyerɛnne ne nnuruyɛ mu sɛnkyerɛnne ahorow kanyan no, kokoram nhwehwɛmu hwehwɛ sɛ wɔbɔ mmɔden sɛ wobehu kokoram bere a ayɛ basaa akyi, nanso ansa na sɛnkyerɛnne biara a wobehu no ada adi.[153] Eyi betumi ayɛ nipadua mu nhwehwɛmu, mogya anaa nsu mu nhwehwɛmu anaa aduruyɛ mu mfoninitwa.[153] Wɔntumi nyɛ kokoram nhwehwɛmu wɔ kokoram ahorow pii ho. Sɛ wotumi yɛ nhwehwɛmu mpo a, ebia wɔrenkamfo nkyerɛ obiara. Amansan nyinaa nhwehwɛmu anaa nhwehwɛmu a wɔyɛ wɔ nnipa pii mu no fa obiara ho nhwehwɛmu ho.[154] Nhwehwɛmu a wɔpaw no kyerɛ nnipa a wɔwɔ asiane kɛse mu, te sɛ nnipa a wɔwɔ abusua abakɔsɛm.[154] Wosusuw nneɛma pii ho de kyerɛ sɛ ebia mfaso a ɛwɔ nhwehwɛmu so no dɔɔso sen asiane ne ɛka a wɔbɔ wɔ nhwehwɛmu no ho anaa.[153] Nneɛma yi bi ne: Nneɛma a ebetumi apira obi wɔ sɔhwɛ a wɔde hwehwɛ nneɛma mu no mu: sɛ nhwɛso no, X-ray mfonini ahorow no fa mframa a ɛyɛ ionizing a ebetumi apira obi ho Sɛnea ɛbɛyɛ yiye sɛ sɔhwɛ no bɛkyerɛ kokoram no yiye Sɛnea ɛbɛyɛ yiye sɛ kokoram wɔ hɔ: Mpɛn pii no, nhwehwɛmu nyɛ mfaso wɔ kokoram a ɛntaa nsi ho. Ɔhaw a ebetumi afi akwan horow a wɔfa so di akyi no mu aba Sɛ ebia ayaresa a ɛfata wɔ hɔ anaa Sɛ ebia sɛ wohu no ntɛm a, ɛma nea efi ayaresa mu ba no tu mpɔn anaa Sɛ ebia kokoram no behia ayaresa da bi anaa Sɛ ebia sɔhwɛ no yɛ nea nkurɔfo no gye tom anaa: Sɛ nhwehwɛmu a wɔde hwehwɛ nneɛma mu no yɛ adesoa dodo (sɛ nhwɛso no, ɛyɛ yaw kɛse) a, ɛnde nkurɔfo bɛpow sɛ wɔde wɔn ho bɛhyɛ mu.[154] Ɛka '''Nyansahyɛ ahorow''' U.S. Nnwumakuw a Wɔde Siw Ano Dwumadibea U.S. Preventive Services Task Force (USPSTF) de nyansahyɛ ahorow ma wɔ kokoram ahorow ho: Kamfo kyerɛ denneennen sɛ wɔnyɛ awotwaa mu kokoram nhwehwɛmu wɔ mmea a wɔde wɔn ho hyɛ nna mu na anyɛ yiye koraa no wɔwɔ awotwaa mu kosi sɛ wobedi mfe 65.[155] Kamfo kyerɛ sɛ wɔnhwɛ Amerikafo mu sɛ ebia wɔwɔ kokoram wɔ akyi berɛmo mu denam mogya a wɔde yɛ asumansɛm mu nhwehwɛmu a wɔyɛ wɔ nsu mu, sigmoidoscopy, anaa colonoscopy so mfi ase fi mfe 50 kosi mfe 75 so.[156] Adanse nnɔɔso a ɛbɛkamfo akyerɛ sɛ ɛsɛ sɛ wɔyɛ honam ani kokoram,[157] anom kokoram,[158] ahurututu mu kokoram,[159] anaasɛ prostate kokoram wɔ mmarima a wonnii mfe 75 mu anaasɛ wɔkasa tia.[160] Wɔnkamfo nhwehwɛmu a wɔyɛ no daa nkyerɛ wɔ akisikuru mu kokoram,[161] awotwaa mu kokoram,[162] awotwaa mu kokoram,[163] dwensɔtwaa mu kokoram,[164] anaa prostate kokoram ho.[165] Kamfo kyerɛ sɛ wɔnyɛ nufu mu kokoram nhwehwɛmu mfe abien biara fi mfe 50–74, nanso ɛnkamfo kyerɛ sɛ wɔnyɛ nufu mu nhwehwɛmu anaasɛ wɔnyɛ nufu mu nhwehwɛmu wɔ ayaresabea.[166] Cochrane nhwehwɛmu bi a wɔyɛe wɔ afe 2013 mu no de baa awiei sɛ nufu mu kokoram nhwehwɛmu a wɔde mammography yɛe no nni nkɛntɛnso biara wɔ owu a wɔtew so esiane sɛ wohu yare no boro so ne ayaresa a ɛboro so nti.[167] Japan Screens a wɔde hwehwɛ yafunu mu kokoram a wɔde photofluorography di dwuma esiane sɛ ɛdɔɔso wɔ hɔ nti.[23] '''Awosu mu nhwehwɛmu''' Awosu mu nhwehwɛmu a wɔbɛyɛ ama ankorankoro a wɔwɔ asiane kɛse mu sɛ wobenya kokoram ahorow bi no, akuw a ɛnyɛ aban de kamfo kyerɛ.[152][168] Afei wɔn a wokura saa nkwaadɔm mu nsakrae yi betumi ayɛ nhwehwɛmu kɛse, nnuru a wɔde siw ano, anaa oprehyɛn a wɔde besiw ano na ama asiane a ɛbɛba akyiri yi no so atew.[168] == Ntotoeɛ == Ayaresa ahorow pii wɔ hɔ a wɔde sa kokoram. Nea ɛho hia titiriw ne oprehyɛn, nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone a wɔde sa yare, ayaresa a wɔde wɔn ani asi so ne ayaresa a wɔde ma obi ho brɛ ase. Ayaresa ahorow a wɔde di dwuma no gyina kokoram no ko, beae ne ne gyinabea ne ɔyarefo no akwahosan ne nea ɔpɛ so. Ebia ayaresa atirimpɔw no bɛyɛ nea ɛbɛsa yare anaasɛ ɛrenyɛ saa. '''Nnuru a wɔde sa yare''' Nnuru a wɔde sa yare no yɛ kokoram a wɔde nnuru biako anaa nea ɛboro saa a ekum ɔyare mmoawa (nnuru a wɔde sa yare) a wɔde sa kokoram sɛ nhyehyɛe a wɔahyɛ da ayɛ no fã. Asɛmfua no fa nnuru ahorow ho, a wɔakyekyɛ mu ayɛ no akuw a ɛtrɛw te sɛ alkylating agents ne antimetabolites.[169] Nnuru a wɔde sa yare a wɔde di dwuma wɔ amanne kwan so no yɛ adwuma denam nkwammoaa a ɛpaapae ntɛmntɛm a ekunkum wɔn no so, na ɛyɛ kokoram nkwammoaa dodow no ara su titiriw. Wohui sɛ nnuru a wɔde kum nkwaboaa a wɔaka abom a wɔde bɛma no ye sen aduru biako, adeyɛ a wɔfrɛ no ayaresa a wɔaka abom, a ɛwɔ mfaso wɔ akontaabu a ɛfa nkwa a wonya ne sɛnea wɔyɛ wɔn ade wɔ akisikuru no ho ne sɛnea yare no kɔ so no mu. Cochrane nhwehwɛmu bi de baa awiei sɛ ayaresa a wɔaka abom no tu mpɔn kɛse de sa nufu mu kokoram a ɛkɔ mmeae afoforo no. Nanso, mpɛn pii no ɛnyɛ nea ɛyɛ nokware sɛ ebia nnuru a wɔde ka bom no ma akwahosan pa ba, bere a wosusuw nkwa ne awuduru nyinaa ho no.[171] Ayaresa a wɔde wɔn ani asi so yɛ nnuru a wɔde sa yare a wɔde wɔn ani si molecule mu nsonsonoe pɔtee a ɛwɔ kokoram ne nkwammoaa a ɛteɛ ntam so. Ayaresa ahorow a edi kan a wɔde wɔn ani sii so no siw estrogen receptor molecule no kwan, na esiw nufu mu kokoram no nyin ano. Nhwɛso foforo a wɔtaa yɛ ne Bcr-Abl inhibitors kuw no, a wɔde sa myelogenous leukemia a enni sabea (CML).[4] Mprempren, ayaresa ahorow a wɔde wɔn ani asi so wɔ hɔ ma kokoram ahorow a ɛtaa ba no pii, a nea ɛka ho ne akisikuru, nufu mu kokoram, kokoram a ɛwɔ akyi berɛmo mu, asaabo mu kokoram, mogya mu kokoram, mmerɛbo mu kokoram, ahurututu mu kokoram, lymphoma, dwensɔtwaa mu kokoram, prostate kokoram, honam ani kokoram, ne thyroid kokoram sɛ ne kokoram ahorow afoforo nso.[172] Sɛnea nnuru a wɔde sa yare no tumi yɛ adwuma no gyina kokoram ko a ɛba ne ne fã a ɛkɔ so no so. Sɛ wɔde oprehyɛn ka ho a, nnuru a wɔde sa yare no ada adi sɛ mfaso wɔ so wɔ kokoram ahorow a nufu mu kokoram, akyi berɛmo mu kokoram, dwensɔtwaa mu kokoram, nnompe mu sarcoma, awotwaa mu kokoram, mmadwoa mu kokoram ne ahurututu mu kokoram ahorow bi ka ho mu. Nnuru a wɔde sa yare no sa kokoram ahorow bi, te sɛ mogya mu kokoram binom,[174][175] entumi nyɛ adwuma wɔ amemene mu akisikuru binom mu,[176] na ɛho nhia wɔ afoforo mu, te sɛ honam ani kokoram dodow no ara a ɛnyɛ melanoma.[177] Mpɛn pii no, awuduru a ɛwɔ nipadua no mu ntini afoforo mu no na ɛma nnuru a wɔde sa yare no tu mpɔn no. Bere a nnuru a wɔde sa yare no mma wonnya ayaresa a ɛtra hɔ daa mpo no, ebetumi ayɛ nea mfaso wɔ so sɛ wɔbɛtew sɛnkyerɛnne ahorow te sɛ ɛyaw so anaasɛ wɔbɛtew akisikuru a wontumi nyɛ oprehyɛn no kɛse so a wɔwɔ anidaso sɛ wɔbɛyɛ oprehyɛn daakye. '''Mframa a wɔde yɛ adwuma''' Mframa a wɔde sa yare no fa mframa a ɛma ɛyɛ hyew a wɔde di dwuma de bɔ mmɔden sɛ wɔbɛsa yare no ho sɛnkyerɛnne ahorow no yare anaasɛ wɔbɛma atu mpɔn ho. Ɛyɛ adwuma denam DNA a ɛwɔ kokoram ntini mu a ɛsɛe no so, na ekum no. Nea ɛbɛyɛ na wɔakwati ntini a ɛteɛ (te sɛ honam ani anaa akwaa ahorow, a ɛsɛ sɛ mframa fa mu na ɛsa akisikuru no) no, wɔde mframa a wɔayɛ no sɛnea ɛte no fi mmeae pii a wɔde wɔn ho hyɛ mu no si hɔ ma ɛne akisikuru no hyia, na ɛma wonya dodow kɛse wɔ hɔ sen ntini a atwa ho ahyia a ɛwɔ apɔwmuden no mu . Sɛnea ɛte wɔ nnuru a wɔde sa yare ho no, ɛsono sɛnea kokoram yɛ wɔn ade wɔ mframa a wɔde sa yare no ho.[178][179][180] Wɔde mframa bɔne a wɔde sa yare di dwuma wɔ nsɛm no mu bɛyɛ fã mu. Mframa a ɛbɔ no betumi afi nneɛma a ɛwɔ mu (brachytherapy) anaasɛ afi mu. Mframa a wɔde ma no taa yɛ X-ray a ahoɔden nnim a wɔde sa honam ani kokoram, bere a wɔde X-ray a ahoɔden wom kɛse di dwuma ma kokoram a ɛwɔ nipadua no mu.[181] Wɔtaa de mframa bɔne di dwuma de ka oprehyɛn ne anaasɛ nnuru a wɔde sa yare ho. Wɔ kokoram ahorow bi te sɛ ti ne kɔn mu kokoram a ɛba ntɛm ho no, wobetumi de adi dwuma nkutoo.[182] Wɔ nnompe a ɛtrɛw a ɛyɛ yaw ho no, wɔahu sɛ ɛyɛ adwuma yiye wɔ ayarefo bɛyɛ 70% mu.[182] '''Sɛɛgyiri''' Oprehyɛn ne ɔkwan titiriw a wɔfa so sa kokoram dodow no ara a atew ne ho a ɛyɛ den no yare na ebetumi adi dwuma wɔ nkwa a wɔma ɛyɛ mmerɛw na ɛma ɛyɛ tenten no mu. Mpɛn pii no, ɛyɛ ade titiriw a ɛma wotumi hu akisikuru no yiye na wɔde si baabi a ɛsɛ sɛ wɔyɛ no, efisɛ mpɛn pii no ɛho hia sɛ wɔyɛ nipadua no mu nhwehwɛmu. Wɔ kokoram a ɛwɔ baabi a ɛwɔ no mu no, oprehyɛn taa bɔ mmɔden sɛ wobeyi aduru no nyinaa aka ho, wɔ tebea horow bi mu no, ntini a ɛwɔ mpɔtam hɔ no. Wɔ kokoram ahorow bi ho no eyi dɔɔso sɛ ebeyi kokoram no afi hɔ.[173] '''Ayaresa a ɛma obi ho dwo no''' Palliative care yɛ ayaresa a ɛbɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma ne ho atɔ no na ebia wɔde bɛka mmɔden a wɔbɔ sɛ wɔbɛsa kokoram no ho. Nea ɛka ayaresa a ɛma obi ho dwo no ho ne adeyɛ a ɛbɛtew honam fam, nkate fam, honhom fam ne adwene ne asetram haw so. Nea ɛnte sɛ ayaresa a ne botae ne sɛ ebekum kokoram nkwammoaa tẽẽ no, botae titiriw a ɛwɔ ayaresa a ɛma obi ho dwo no mu ne sɛ ɛbɛma asetra atu mpɔn. Mpɛn pii no, nnipa a wɔwɔ kokoram ayaresa no fã ahorow nyinaa nya ayaresa bi a ɛma obi ho brɛ ase. Wɔ tebea horow bi mu no, nnuruyɛ ho adwumayɛfo ahyehyɛde ahorow kamfo kyerɛ sɛ ayarefo ne nnuruyɛfo de ayaresa a ɛma obi ho dwo nkutoo na ɛyɛ wɔn ade wɔ kokoram ho.[183] Eyi fa ayarefo a:[184] . da adwumayɛ tebea a ɛba fam adi, a ɛkyerɛ sɛ wontumi nhwɛ wɔn ho yiye[183] ​​. annya mfaso biara amfi ayaresa ahorow a egyina adanse so a wɔadi kan de ama no mu[183] ​​. mfata sɛ wɔde wɔn ho hyɛ ayaresabea sɔhwɛ biara a ɛfata mu[183]. adanse a emu yɛ den biara nni hɔ a ɛkyerɛ sɛ ayaresa bɛyɛ nea etu mpɔn[183] ​​. Ebia wɔde ayaresa a ɛma obi ho dwo no frafra ayaresabea a wɔhwɛ wɔn a wɔyare no mu ma enti bere a nkurɔfo bɛn nkwa awiei nkutoo na wɔbɛkyerɛ. Te sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no bɔ mmɔden sɛ ɛbɛboa ɔyarefo no ma wadi n’ahiade ahorow a ehia ntɛm ara no ho dwuma na ama awerɛkyekye ayɛ kɛse. Nea ɛnte sɛ ayaresabea a wɔhwɛ wɔn a wɔyare no, ayaresa a ɛma obi ho dwo no nhwehwɛ sɛ nkurɔfo gyae ayaresa a wɔde wɔn ani asi kokoram no so no. Ɔman no aduruyɛ ho akwankyerɛ pii kamfo kyerɛ sɛ wɔmfa ayaresa a ɛma obi ho dwo no ntɛm mma ayarefo a wɔn kokoram no ama wɔanya sɛnkyerɛnne ahorow a ɛhaw adwene anaasɛ wohia mmoa a wɔde begyina wɔn yare no ano. Wɔ ayarefo a wodii kan hui sɛ wɔwɔ yare a ɛtrɛw kɔ mmeae afoforo no mu no, wobetumi akyerɛ sɛ wɔmfa ayaresa a ɛma obi ho brɛ ase ntɛm ara. Wɔkyerɛ sɛ wɔhwɛ ayarefo a wɔn nkwa nna nnu asram 12 a wɔde ayaresa a ano yɛ den mpo ama wɔn no yare a ɛma obi ho brɛ ase.[185][186][187] '''Nneɛma a ɛko tia nyarewa''' Asɛm titiriw: Kokoram a wɔko tia nyarewa Ayaresa ahorow a wɔde nipadua no mu tumi a ɛko tia nyarewa di dwuma, a ɛkanyan anaa ɛboa nipadua no mu tumi a ɛko tia nyarewa ma ɛko tia kokoram no, wɔde adi dwuma fi 1997. Akwan a wɔfa so yɛ no bi ne nipadua mu nkwammoaa a wɔko tia nyarewa, ayaresa a wɔde hwɛ nneɛma mu, ne nkwammoaa a wɔde wɔn kɔ baabi foforo.[188] '''Laser ayaresa''' Asɛm titiriw: Laser a wɔde sa kokoram Laser ayaresa de hann a ano yɛ den kɛse di dwuma de sa kokoram denam akisikuru anaa nea enyin ansa na kokoram reba no a ɛtew so anaasɛ ɛsɛe no so. Wɔtaa de laser sa kokoram a ɛwɔ nipadua no ani anaa akwaa a ɛwɔ nipadua no mu no so kɛse. Wɔde sa basal cell honam ani kokoram ne afoforo te sɛ awotwaa, ɔbarima akyi berɛmo, ɔbea awotwaa mu, awotwaa mu kokoram a ɛnyɛ nkwammoaa nketewa no mfiase pɛɛ. Wɔtaa de ka ayaresa afoforo te sɛ oprehyɛn, nnuru a wɔde sa yare, anaa mframa a wɔde sa yare ho. Laser-induced interstitial thermotherapy (LITT), anaasɛ interstitial laser photocoagulation, de laser di dwuma de sa kokoram ahorow bi denam hyperthermia a ɛde ɔhyew di dwuma de tew akisikuru so denam kokoram nkwammoaa a ɛsɛe anaasɛ ekum so no so. Laser yɛ pɛpɛɛpɛ sen oprehyɛn na ɛmma nneɛma nsɛe pii, ɛnyɛ ɛyaw, mogya tu, ɛho ahon, na ɛnyɛ akuru pii. Ade a enye wɔ ho ne sɛ ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn nya ntetee titiriw. Ebia ne bo yɛ den sen ayaresa afoforo.[189] '''Nnuru a wɔde si ananmu''' Kokoram ayaresa a wɔde ka ho ne nea wɔde si ananmu yɛ ayaresa ahorow, nneyɛe ne nneɛma ahorow a ɛnyɛ nnuru a wɔde di dwuma daa no fã.[190] "Aduru a wɔde ka ho" kyerɛ akwan ne nneɛma a wɔde di dwuma ka nnuru a wɔde di dwuma ho, bere a "aduru foforo" kyerɛ nnuru a wɔde di dwuma sen sɛ wɔde nnuru a wɔde di dwuma daa bedi dwuma.[191] Wɔnyɛɛ nnuru a wɔde ka kokoram ho ne nea wɔde si ananmu dodow no ara ho nhwehwɛmu anaasɛ wɔmfa akwan horow a wɔtaa fa so te sɛ nnuruyɛ mu sɔhwɛ ahorow nsɔ nhwɛ. Wɔayɛ ayaresa foforo bi ho nhwehwɛmu na wɔada no adi sɛ entu mpɔn nanso wɔda so ara da so ara di gua na wɔhyɛ ho nkuran. Kokoram ho nhwehwɛmufo Andrew J. Vickers kae sɛ, "Ahyɛnsode a ɛne sɛ 'wɔnkyerɛ sɛ ɛyɛ nokware' no mfata mma ayaresa a ɛtete saa; ɛyɛ bere a ɛsɛ sɛ yɛka sɛ kokoram ayaresa foforo pii 'wɔakyerɛ sɛ ɛnyɛ nokware'."[192] == Nsɛm a Wɔka Kyerɛ == Nnipa dodow a wonya nkwa no gu ahorow sɛnea kokoram kokoram no te ne baabi a wohu no, efi nnipa dodow no ara a wonya nkwa so kosi wɔn a wowuwu koraa wɔ mfe anum akyi bere a wɔahu sɛ wɔanya bi no so. Sɛ kokoram bi kɔ mmeae afoforo wie a, mpɛn pii no, nkɔmhyɛ no mu yɛ den kɛse. Ayarefo a wɔrenya kokoram a ɛba nipadua no mu ayaresa (a carcinoma in situ ne honam ani kokoram a ɛnyɛ melanoma nka ho) no mu bɛyɛ fã wuwu wɔ saa kokoram no anaa n’ayaresa no mu.[23] Kokoram a wowuwu no mu dodow no ara fi akisikuru titiriw no a ɛkɔ mmeae afoforo.[194] Nkwa a wonya no nye koraa wɔ aman a afei na wɔrenya nkɔso no mu,[23] ne fã bi ne sɛ kokoram ahorow a abu so wɔ hɔ no yɛ den sɛ wɔbɛsa sen nea ɛne aman a wɔanya nkɔso wɔ abusuabɔ no.[195] Wɔn a wonya nkwa wɔ kokoram mu no nya kokoram titiriw a ɛto so abien a ɛyɛ bɛyɛ wɔn a wonhu da no mmɔho abien.[196] Wogye di sɛ asiane a ɛkɔ soro no fi hokwan a ɛwɔ hɔ sɛ obi benya kokoram biara kwa, sɛnea ebetumi aba sɛ obenya nkwa wɔ kokoram a edi kan no mu, asiane koro no ara a ɛde kokoram a edi kan no bae, nneɛma bɔne a wɔmpɛ a efi kokoram a edi kan a wɔsa mu (titiriw mframa a wɔde sa yare), ne sɛ wobedi nhwehwɛmu a wɔyɛ no so yiye.[196] Nkwa a wobenya bere tiaa anaa bere tenten a wɔbɛka ho asɛm no gyina nneɛma pii so. Nea ɛho hia sen biara ne kokoram no su ne ɔyarefo no mfe ne n’akwahosan nyinaa. Wɔn a wɔayɛ mmerɛw wɔ akwahosan ho haw afoforo ho no nya nkwa dodow a ɛba fam sen nnipa a anka wɔwɔ apɔwmuden no. Ɛnyɛ den koraa sɛ wɔn a wɔadi mfe ɔha no bɛtra ase mfe anum sɛ ayaresa no kɔ yiye mpo a. Nnipa a wɔbɔ amanneɛ sɛ wɔn asetra yɛ papa no taa tra ase kyɛ.[197] Nnipa a wɔn asetra nyɛ papa no betumi anya adwenemhaw ne nsɛnnennen afoforo ne/anaasɛ yare no nkɔso a ɛsɛe asetra pa ne dodow no nyinaa. Bio nso, ayarefo a wɔn nkɔmhyɛ a enye koraa no betumi anya adwenemhaw anaasɛ wɔbɛbɔ amanneɛ sɛ wɔn asetra nyɛ papa efisɛ wohu sɛ ɛda adi sɛ wɔn tebea no betumi akum wɔn. Nnipa a wɔwɔ kokoram no wɔ asiane kɛse sɛ mogya bɛtɔ wɔn ntini mu a ebetumi de wɔn nkwa ato asiane mu.[198] Nnuru a ɛma mogya tew te sɛ heparin a wɔde di dwuma no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew nanso wɔankyerɛ sɛ ɛma nnipa a wɔwɔ kokoram no nkwa nna yɛ kɛse.[198] Nnipa a wɔnom nnuru a ɛma mogya tu no nso wɔ asiane kɛse sɛ mogya bɛtɔ wɔn.[198] Ɛwom sɛ kokoram ahorow bi ntaa mma koraa de, nanso efi bere a ɛkɔ anim mpo no betumi asa ara kwa. Saa adeyɛ yi na wɔfrɛ no fafiri a ɛba ara kwa.[199] == Nyarewa a Ɛtrɛw Ho Adesua == Akontabuo kyerɛ sɛ wɔ afe 2018 mu no, nnipa foforɔ ɔpepem 18.1 na wɔanya kokoram na nnipa ɔpepem 9.6 wuwu wɔ wiase nyinaa.[201] Mmarima bɛyɛ 20% ne mmea 17% benya kokoram wɔ bere bi mu bere a mmarima 13% ne mmea 9% bewuwu wɔ ho.[201] Wɔ afe 2008 mu no, wɔhunuu kokoram bɛyɛ ɔpepem 12.7 (a honam ani kokoram a ɛnyɛ melanoma ne kokoram afoforo a ɛnyɛ nea ɛkɔ nipadua mu nka ho)[23] na wɔ afe 2010 mu no, ɛkame ayɛ sɛ nnipa ɔpepem 7.98 wuwui.[202] Kokoram na ɛma nnipa wuwu no mu bɛyɛ 16%. Nea ɛtaa ba wɔ afe 2018 mu ne ahurututu mu kokoram (awuwu ɔpepem 1.76), akyi berɛmo mu kokoram (860,000) yafunu mu kokoram (780,000), mmerɛbo mu kokoram (780,000), ne nufu mu kokoram (620,000).[2] Eyi ma kokoram a ɛba no yɛ nea ɛde owu ba kɛse wɔ aman a wɔanya nkɔso no mu na ɛto so abien wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nsɛm no mu bɛboro fã na ɛba wɔ aman a afei na wɔrenya nkɔso no mu.[23] Nnipa a kokoram kunkum wɔn no dodow yɛ ɔpepem 5.8 wɔ 1990 mu.[202] Owu akɔ soro titiriw esiane nkwa tenten ne asetra mu nsakrae a aba wɔ aman a afei na wɔrenya nkɔso no mu nti.[23] Asiane a ɛho hia sen biara a ɛma obi nya kokoram ne mfe a obi adi.[203] Ɛwom sɛ ebetumi aba sɛ kokoram bɛba wɔ mfe biara mu de, nanso ayarefo dodow no ara a wɔwɔ kokoram a ɛba nipadua no mu no adi boro mfe 65.[203] Sɛnea kokoram ho nhwehwɛmufo Robert A. Weinberg kyerɛ no, "Sɛ yɛtra ase kyɛ a, anka yɛn nyinaa benya kokoram."[204] Wɔkyerɛ sɛ abusuabɔ a ɛda onyin ne kokoram ntam no bi fi immunosenescence,[205] mfomso ahorow a ɛboaboa ano wɔ DNA mu boro so nkwa nna nyinaa[206] ne nsakrae a ɛfa mfe a obi adi ho wɔ endocrine nhyehyɛe no mu.[207] Nkɛntɛnso a onyin nya wɔ kokoram so no yɛ den esiane nneɛma te sɛ DNA a ɛsɛe ne ɔfe a ɛhyɛ ho nkuran ne nneɛma te sɛ ntini mu onyin ne endocrine nsakrae a esiw ano nti.[208] Kokoram ahorow bi a enyin nkakrankakra no abu so titiriw, nanso mpɛn pii no enkum nnipa. Nhwehwɛmu a wɔyɛe wɔ amu ho nhwehwɛmu a wɔyɛe wɔ Europa ne Asia kyerɛe sɛ nnipa bɛyɛ 36% wɔ thyroid kokoram a wonnya nhui na ɛda adi sɛ ɛnyɛ asiane biara bere a wowuwui no na mmarima 80% nya prostate kokoram bere a wɔadi mfe 80.[209][210] Esiane sɛ saa kokoram ahorow yi mma ɔyarefo no nwu nti, anka sɛ wohu no a, ɛbɛgyina hɔ ama ɔyarefo a wɔahu no boro so sen sɛ wobenya ayaresa a mfaso wɔ so. Mmofra mu kokoram abiɛsa a ɛtaa ba ne mogya mu kokoram (34%), amemene mu akisikuru (23%) ne lymphomas (12%).[211] Wɔ United States no, kokoram ka mmofra 285 biara mu bɛyɛ 1.[212] Mmofra mu kokoram dodow kɔɔ soro 0.6% afe biara wɔ 1975 ne 2002 ntam wɔ United States[213] ne 1.1% afe biara wɔ 1978 ne 1997 ntam wɔ Europa.[211] Mmofra mu kokoram a wowuwui no so tew fã wɔ afe 1975 ne 2010 ntam wɔ United States.[212] == Abakɔsɛm == Kokoram atra hɔ wɔ nnipa abakɔsɛm nyinaa mu.[214] Kyerɛwtohɔ a edi kan a wɔakyerɛw afa kokoram ho no fi bɛyɛ afe 1600 A.Y.B. Hippocrates (bɛyɛ 460 A.Y.B. – bɛyɛ 370 A.Y.B.) kaa kokoram ahorow pii ho asɛm, na ɔde Hela asɛmfua καρκίνος karkinos (krak anaa krak) frɛɛ wɔn.[214] Saa din yi fi sɛnea akisikuru bɔne a ɛyɛ den a wɔatwa no anim no te, a "ntini no trɛw wɔ afã nyinaa sɛnea aboa a krak no wɔ ne nan, baabi a onyaa ne din no".[215] Galen kae sɛ "wɔfrɛ nufu no mu kokoram saa esiane sɛ wɔsusuw sɛ ɛte sɛ krak a ɛnam akisikuru no akyi tenten ne ntini a ɛtrɛw a ɛbɛn hɔ no so de ma nti".[216]: 738 Celsus (c. 25 BC – 50 AD) a wɔkyerɛɛ ase karkinos kɔ Latin kokoram mu, a ɛsan kyerɛ krak na wɔkamfo oprehyɛn kyerɛ sɛ ayaresa.[214] Galen (afeha a ɛtɔ so mmienu Y.B.) ne oprehyɛn a wɔde bedi dwuma no annye antom na ɔkamfoo nnuru a wɔde tew nneɛma ho mmom kyerɛe.[214] Saa nyansahyɛ ahorow yi gyinaa hɔ kɛse mfe 1000.[214] Wɔ afeha a ɛto so 15, 16 ne 17 mu no, ɛbɛyɛɛ nea wogye tom sɛ nnuruyɛfo bɛtetew nipadua mu de ahu nea ɛde owu ba.[217] Germanni ɔbenfo Wilhelm Fabry gye di sɛ nufu mu kokoram fi nufusu mu ntini bi mu. Ná Dutchni ɔbenfo Francois de la Boe Sylvius a odi Descartes akyi no gye di sɛ yare nyinaa fi nnuru a wɔde di dwuma mu ba na nsu a ɛwɔ ntini mu a ɛyɛ acid no na ɛde kokoram ba. Ne bere sofo Nicolaes Tulp gye dii sɛ kokoram yɛ awuduru a ɛtrɛw nkakrankakra na ɔde baa awiei sɛ ɛyɛ ɔyare mmoawa.[218] Oduruyɛfo John Hill kaa tawa ho asɛm sɛ ɛno na ɛde hwene mu kokoram ba wɔ afe 1761 mu.[217] Eyi akyi no, amanneɛbɔ a Britania oduruyɛfo Percivall Pott de mae wɔ 1775 mu sɛ chimney sweeps’ carcinoma, a ɛyɛ kokoram a ɛwɔ akyi berɛmo mu no yɛ yare a abu so wɔ chimney sweeps mu bae.[219] Esiane sɛ wɔde afiri a wɔde hwɛ nneɛma nketenkete no dii dwuma kɛse wɔ afeha a ɛto so 18 mu nti, wohui sɛ ‘kokoram awuduru’ no trɛw fi akisikuru titiriw no mu fa ntini a ɛma mogya tu no mu kɔ mmeae afoforo ("metastasis"). Engiresini oduruyɛfo Campbell De Morgan na odii kan hyehyɛɛ yare no ho adwene yi wɔ 1871 ne 1874 ntam.[220] == Ɔmanfo ne amammerɛ == Ewom sɛ ebia nyarewa pii (te sɛ koma a entumi nyɛ adwuma yiye) bɛkɔ so ayɛ bɔne sen kokoram dodow no ara de, nanso kokoram yɛ nea ehu ne ahyɛde ahorow a abu so. Wɔda so ara de "yare tenten" a wɔde kyerɛkyerɛ kokoram ahorow a ɛde owu ba no mu nsɛm a ɛyɛ dɛ no di dwuma wɔ owu ho nsɛm mu, sen sɛ wɔbɛbɔ yare no din pefee, a ɛda animtiaabu bi a ɛda adi sɛ ɛyɛ animtiaabu adi.[221] Wɔsan nso ka kokoram ho asɛm sɛ "C-asɛmfua";[222][223][224] Macmillan Kokoram Mmoa de asɛmfua no di dwuma de bɔ mmɔden sɛ ɛbɛtew ehu a ɛwɔ yare no ho no so.[225] Wɔ Nigeria no, ɛhɔnom din biako a wɔde frɛ kokoram no kyerɛ ase kɔ Borɔfo kasa mu sɛ "yare a wontumi nsa".[226] Saa gyidi a emu dɔ yi a ɛne sɛ ɛho hia sɛ kokoram yɛ yare a emu yɛ den na ɛtaa kum nnipa no da adi wɔ nhyehyɛe ahorow a ɔmanfo paw de boaboa kokoram ho akontaabu ano no mu: kokoram a abu so sen biara—honam ani kokoram a ɛnyɛ melanoma, a ɛyɛ kokoram a ɛba wiase nyinaa no mu bɛyɛ nkyem abiɛsa mu biako, . nanso owu kakraa bi pɛ[227][228]—wɔayi afi kokoram akontaabu mu titiriw efisɛ ɛnyɛ den sɛ wɔbɛsa na ɛkame ayɛ sɛ bere nyinaa wɔsa, mpɛn pii no wɔ ayaresa biako, tiawa, a wɔde kɔ ayaresabea.[229] Atɔe fam adwene ahorow a ɛfa hokwan ahorow a ayarefo wɔ ma nnipa a wɔwɔ kokoram ho no bi ne asɛyɛde a ɛne sɛ wɔbɛda ayaresa tebea no adi akyerɛ onipa no koraa, ne hokwan a wɔwɔ sɛ wɔde wɔn ho hyɛ gyinaesi ahorow a wɔkyɛ mu wɔ ɔkwan a ɛkyerɛ obu ma onipa no ankasa gyinapɛn ahorow so. Wɔ amammerɛ afoforo mu no, wɔpɛ hokwan ne gyinapɛn afoforo. Sɛ nhwɛso no, Afrikafo amammerɛ dodow no ara bu mmusua mũ nyinaa sɛ ɛsom bo sen sɛ wobebu ankorankoro ho adwene. Wɔ Afrika mmeae bi no, wɔtaa hu yare no akyiri yi araa ma wontumi nsa, na sɛ wonya ayaresa koraa a, ɛbɛma abusua no asɛe ntɛm. Esiane saa nneɛma yi nti, Afrika akwahosan ho adwumayɛfo taa ma abusua mufo si gyinae sɛ ebia, bere ne ɔkwan a wɔbɛfa so ada ɔyare no adi, na wɔtaa yɛ saa nkakrankakra na wɔkyinkyin, bere a onipa no kyerɛ anigye ne tumi a ɔde gyina nsɛm a ɛyɛ awerɛhow no ano no .[226] . Nnipa a wofi Asia ne Amerika Kesee Fam aman mu nso taa pɛ ɔkwan a wɔfa so da no adi brɛoo na ɛnyɛ pefee sen sɛnea wɔpɛ wɔ United States ne Europa Atɔe Fam no, na wogye di sɛ ɛtɔ mmere bi a ɛbɛyɛ papa sɛ wɔrenka kokoram a wɔahu ho asɛm nkyerɛ wɔn ] . Mpɛn pii no, yare no a wɔda no adi no abu so sen sɛnea na ɛte wɔ afeha a ɛto so 20 no mu no, nanso wɔmfa nkɔmhyɛ no ho asɛm a edi mũ mma ayarefo pii wɔ wiase nyinaa.[226] Wɔ United States ne amammerɛ afoforo bi mu no, wobu kokoram sɛ yare a ɛsɛ sɛ "wɔko" na ama "ɔmanfo atuatew" no aba awiei; wɔde Ɔko a Wɔde Ko Tia Kokoram too gua wɔ U.S. Asraafo kasakoa abu so titiriw wɔ nkɛntɛnso a kokoram nya wɔ nnipa so ho nkyerɛkyerɛmu mu, na esi ɔyarefo no akwahosan tebea ne hia a ehia sɛ n’ankasa yɛ nneɛma a ɛyɛ gyinaesi ntɛm ara sen sɛ ɔbɛtwentwɛn ne nan ase, abu n’ani agu so anaasɛ ɔde ne ho ato afoforo so koraa no nyinaa so dua. Asraafo kasakoa ahorow no nso boa ma ntease ba ayaresa a emu yɛ den, a ɛsɛe ade.[230][231] Wɔ 1970 mfe no mu no, na kokoram ayaresa foforo a agye din kɛse wɔ U.S. no yɛ ɔkasa ayaresa titiriw bi, a egyina adwene a ɛne sɛ kokoram fi adwene bɔne so.[232] Na wogye di sɛ nnipa a wɔwɔ "kokoram nipasu"—wɔn adwenemhaw, wɔahyɛ wɔn so, wɔtan wɔn ho na wosuro sɛ wɔbɛda wɔn nkate adi—nam akɔnnɔ a wɔwɔ wɔ wɔn adwene mu so daa kokoram adi. Adwene ne nneyɛe ho animdefo binom kae sɛ ayaresa a wɔde bɛsakra ɔyarefo no adwene wɔ asetra ho no bɛsa kokoram no.[232] Nea ɛka nneɛma afoforo ho ne sɛ, saa gyidi yi maa ɔmanfo kwan ma wɔde asodi no too nea wɔayɛ no bɔne no so sɛ ɔno na ɔde kokoram no bae (denam "ɔpɛ" no so) anaasɛ osiw n'ayaresa ano (denam sɛ wannyɛ obi a ɔwɔ anigye, onsuro ne ɔdɔ sɛnea ɛsɛ so).[233] Ɛsan nso maa ayarefo dadwen yɛɛ kɛse, efisɛ wogye dii wɔ ɔkwan a ɛnteɛ so sɛ abɔde mu nkate a ɛne awerɛhow, abufuw anaa ehu ma wɔn nkwa nna yɛ tiaa.[233] Susan Sontag dii adwene no ho fɛw, a otintim Illness sɛ Metaphor bere a na ɔrenya ahoɔden afi nufu mu kokoram ayaresa mu wɔ 1978 mu no.[232] Ɛwom sɛ mprempren wɔtaa bu mfitiase adwene no sɛ nkwaseasɛm de, nanso adwene no fã bi kɔ so tra hɔ wɔ ɔkwan a wɔatew so so a gyidi a ɛtrɛw, nanso ɛnteɛ, a ɛne sɛ sɛ wɔhyɛ da nya adwene pa ho su a, ɛbɛma nkwa a wobenya no ayɛ kɛse. Saa adwene yi mu yɛ den titiriw wɔ nufu mu kokoram amammerɛ mu.[233] Adwene biako a ɛfa nea enti a wɔde asodi to nnipa a wɔwɔ kokoram so anaasɛ wɔbɔ wɔn animtiaa, a wɔfrɛ no wiase atɛntrenee ho adwene a ɛne sɛ kokoram ho asodi a wɔde to ɔyarefo no nneyɛe anaa ne suban so no ma wɔn a wɔde asodi no to wɔn so no tumi san nya tumidi ho adwene. Eyi gyina asodifo no gyidi so sɛ wiase no yɛ nea ɛteɛ titiriw na enti ɛsɛ sɛ yare biara a ɛyɛ hu, te sɛ kokoram, yɛ asotwe bi a wɔde ma wɔ nneɛma bɔne a wɔpaw ho, efisɛ wɔ wiase a ɛteɛ mu no, nneɛma bɔne rensi nnipa pa ] . '''Sikasɛm mu nkɛntɛnso''' Wɔbuu akontaa sɛ sika a wɔsɛee no nyinaa wɔ akwahosan ho wɔ kokoram ho wɔ U.S. no yɛ dɔla ɔpepepem 80.2 wɔ afe 2015 mu.[235] Ɛwom mpo sɛ akwahosan ho sika a wɔsɛe wɔ kokoram ho no akɔ soro koraa wɔ mfe du du a atwam no mu de, nanso akwahosan ho sika a wɔsɛe no wɔ kokoram ayaresa ho no mu kyɛfa no akɔ so abɛn 5% wɔ 1960 ne 2004 ntam.[236][237] Wɔahu nhyehyɛe a ɛte saa ara wɔ Europa baabi a wɔsɛe akwahosan ho sika nyinaa mu bɛyɛ 6% wɔ kokoram ayaresa ho.[238][239] Wɔ akwahosan ho ka ne sikasɛm mu awuduru akyi no, kokoram de ɛka a ɛnteɛ ba wɔ adwumayɛ mu a wɔhwere esiane nna a wɔyare, tumi a wontumi nyɛ daa ne dɛmdi ne owu a ɛba ntɛm wɔ mfe a wɔde yɛ adwuma mu nti. Kokoram de ka nso ba wɔ ɔhwɛ a wɔmfa nhyehyɛe mu ho. Wɔtaa bu akontaa sɛ ɛka a wɔbɔ wɔ ɔkwan a ɛnteɛ so ne ɔhwɛ a ɛnyɛ ɔkwan pa so ho ka no boro anaasɛ ɛne kokoram ho ka a wɔbɔ wɔ akwahosan ho no yɛ pɛ.[240][239] '''Adwumayɛbea''' Wɔ United States no, wɔde kokoram ka ho sɛ tebea a wɔabɔ ho ban denam Equal Employment Opportunity Commission (EEOC) so, titiriw esiane sɛ kokoram betumi anya nkɛntɛnso a ɛyɛ nyiyim wɔ adwumayɛfo so nti.[241] Nyiyim wɔ adwumam betumi aba sɛ adwumawura bi kura atoro gyidi sɛ obi a ɔwɔ kokoram ntumi nyɛ adwuma bi yiye, na ebetumi abisa akwamma a wɔde yare pii sen adwumayɛfo afoforo a. Adwumawuranom nso betumi agyina adwene a ɛnteɛ a wɔwɔ wɔ kokoram mu dɛmdi ho so asi gyinae sɛ wɔbɛfa wɔn adwuma mu anaasɛ wobeyi wɔn afi adwumam, sɛ ɛwɔ hɔ a. EEOC de nsɛmbisa akwankyerɛ ma adwumawuranom, ne ano aduru a ɛbɛtumi aba a wɔde bɛsɔ adwumayɛfoɔ a wɔwɔ kokoram ahwɛ na wɔagye wɔn atom.[241] == Hwehwɛ mu == Esiane sɛ kokoram yɛ nyarewa kuw bi nti,[242][243] ɛnyɛ nea ɛbɛyɛ yiye sɛ "kokoram aduru" biako bɛba da bi sɛnea ayaresa biako bɛba ama nyarewa a wɔde yare mmoawa ba nyinaa.[244] Bere bi na wosusuw sɛ angiogenesis inhibitors wɔ ɔkwan a ɛnteɛ so sɛ ebetumi ayɛ "dwetɛ tuo" ayaresa a wɔde di dwuma wɔ kokoram ahorow pii ho.[245] Wɔde nnuru a esiw angiogenesis ano ne nnuru afoforo a wɔde sa kokoram bom di dwuma de tew kokoram yare ne owu so.[246] Wɔyɛ kokoram ayaresa a wɔsɔ hwɛ ho nhwehwɛmu wɔ ayaresabea sɔhwɛ ahorow mu de toto ayaresa a wɔahyɛ ho nyansa no ho ne ayaresa a eye sen biara a ɛwɔ hɔ dedaw no. Wobetumi asɔ ayaresa ahorow a edii nkonim wɔ kokoram ahorow biako mu no ahwɛ wɔ ahorow afoforo ho.[247] Wɔreyɛ nhwehwɛmu a wɔde hu yare no sɛnea ɛbɛyɛ a wɔde ayaresa a ɛfata bɛma ayarefo a wɔfata no yiye, a egyina wɔn ankorankoro abɔde a nkwa wom so.[248] Kokoram ho nhwehwɛmu twe adwene si nsɛm a edidi so yi so: Nneɛma (sɛ nhwɛso no, mmoawa) ne nsɛm a esisi (sɛ nhwɛso no, nkwaadɔm mu nsakrae) a ɛde awosu mu nsakrae ba anaasɛ ɛma ɛyɛ mmerɛw wɔ nkwammoaa a wɔahyɛ sɛ wɔbɛyɛ kokoram no mu. Sɛnea awosu mu nneɛma a ɛsɛe ade no te pɔtee ne awosu mu nkwaadɔm a ɛka no. Nea efi saa awosu mu nsakrae ahorow no mu ba wɔ nkwammoaa no abɔde a nkwa wom so, wɔ kokoram nkwammoaa bi su ahorow a ɛkyerɛkyerɛ mu a ɛma ɛba ne awosu mu nsɛm afoforo a ɛma kokoram no kɔ so kɔ so no yɛ mmerɛw no mu. Ntease a ɛkɔ anim wɔ molecule biology ne cellular biology ho esiane kokoram ho nhwehwɛmu nti no ama wɔanya kokoram ho ayaresa foforo fi bere a U.S. Ɔmampanyin Richard Nixon de "Kokoram Ko" too gua wɔ 1971. Efi saa bere no, ɔman no asɛe bɛboro dɔla ɔpepepem 200 wɔ kokoram ho nhwehwɛmu ho, a nea ɛka ho ne nneɛma a efi ɔman ne ankorankoro nnwuma mu.[249] Nnipa dodow a wowuwu wɔ kokoram mu (sɛ wɔyɛ nsakrae wɔ nnipa dodow ne mfe a wɔadi ho a) so tew ɔha biara mu nkyem anum wɔ 1950 ne 2005 ntam hɔ.[250] Ɛte sɛ nea sikasɛm mu ahonyade ho akansi no asiw adebɔ, biakoyɛ, asiane a wɔde wɔn ho to so ne mfitiase nsusuwii a ɛho hia na wɔahu nneɛma atitiriw no ano, na ɛmaa nhwehwɛmu a asiane kakraa bi na ɛwɔ mu a ɛfa nkɔso nketenkete a ɛkɔ soro ho no ani gye ho sɛnea ɛnsɛ sen nhwehwɛmu a asiane wom, a ɛyɛ foforo kɛse. Ɛte sɛ nea nea efi akansi mu ba afoforo ne nhwehwɛmu pii a wɔka nsɛm a ɛyɛ nwonwa a wontumi nsan nyɛ nea efi mu ba no ne nkannyan a ɛnteɛ a ɛhyɛ ahyehyɛde ahorow a wɔde mmoa ma no nkuran ma wonnyin a wɔmfa sika a ɛdɔɔso nsi wɔn ankasa adesuabea ne adwumayɛbea ahorow mu. ''Wɔreyɛ'' virotherapy a wɔde convert virus di dwuma no ho nhwehwɛmu. Wɔ COVID-19 ɔyaredɔm no akyi no, adwennwene aba sɛ kokoram ho nhwehwɛmu ne ayaresa no rebrɛ ase.[255][256] == Nyinsɛn == Kokoram ka mmea a wɔyem 1,000 biara mu bɛyɛ 1. Kokoram a ɛtaa hu wɔ nyinsɛn mu no ne kokoram a ɛtaa hu wɔ mmea a wɔnnyinsɛn mu wɔ awo mfe mu no yɛ pɛ: nufu mu kokoram, awotwaa mu kokoram, kokoram, mogya mu kokoram, lymphoma, melanoma, ovarian kokoram ne kokoram a ɛwɔ akyi berɛmo mu. Ɛyɛ den sɛ wobehu kokoram foforo wɔ ɔbea a onyinsɛn mu, a ne fã bi ne sɛ wɔtaa fa no sɛ yare no ho sɛnkyerɛnne biara yɛ ɔhaw a ɛfata a ɛbata nyinsɛn ho. Ne saa nti, wɔtaa hu kokoram no akyiri kakra sen sɛ wɔkyekyem pɛpɛɛpɛ a. Wobu mfoninitwa akwan bi te sɛ MRI (magnetic resonance imaging), CT scans, ultrasounds ne mammograms a wɔde awotwaa no bɔ ho ban no sɛ asiane biara nni ho bere a wɔyem no; afoforo binom te sɛ PET scans no nyɛ saa.[257] Mpɛn pii no, ayaresa no yɛ nea wɔde ma mmea a wonnyinsɛn no ara pɛ. Nanso, mpɛn pii no, wɔkwati mframa bɔne ne nnuru a ɛma anyinam ahoɔden bere a wɔyem no, titiriw sɛ ebia akokoaa no dodow boro 100 cGy a. Wɔ tebea horow bi mu no, sɛ wohu kokoram no akyiri yi wɔ nyinsɛn no mu a, wɔtwentwɛn ayaresa ahorow bi anaa ne nyinaa ase kosi sɛ wɔbɛwo no akyi. Wɔtaa de awo ntɛm di dwuma de ma ayaresa no mfiase nya nkɔso. Mpɛn pii no, asiane nnim oprehyɛn, nanso oprehyɛn a wɔyɛ wɔ akyi berɛmo mu wɔ ɔsram abiɛsa a edi kan no mu no betumi ama nyinsɛn atu. Ayaresa ahorow bi, titiriw nnuru bi a wɔde sa yare a wɔde ma wɔ ɔsram abiɛsa a edi kan no mu no ma asiane a ɛwɔ hɔ sɛ wobenya awo mu dɛmdi ne nyinsɛn a wɔbɛhwere (nyinsɛn a woyi gu a ɛba ara kwa ne awo a wowuwu) no yɛ kɛse.[257] Ɛho nhia sɛ woyi nyinsɛn gu a wɔpaw no, na wɔ kokoram ahorow ne ne fã ahorow a ɛtaa ba no fam no, ɛmma ɛna no nkwa nna nkɔ anim. Wɔ nsɛm kakraa bi mu, te sɛ awotwaa mu kokoram a ɛkɔ anim no, wontumi ntoa nyinsɛn no so na wɔ afoforo mu no, ɔyarefo no betumi ama nyinsɛn no aba awiei sɛnea ɛbɛyɛ a obetumi afi ase ayɛ nnuru a ano yɛ den.[257] Ayaresa ahorow bi betumi asiw ɛna no kwan sɛ ɔbɛwo wɔ ɔbea no awotwaa mu anaasɛ ɔbɛma nufu.[257] Ebia awotwaa mu kokoram bɛhwehwɛ sɛ wɔwo no ''denam'' oprehyɛn a wɔde yɛ oprehyɛn so. Mframa a wɔde kɔ nufu no mu no ma tumi a saa nufu no tumi yɛ nufusu no so tew na ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu yare no yɛ kɛse. Afei nso, sɛ wɔde nnuru a wɔde sa yare ma wɔ awo akyi a, nnuru no pii pue wɔ nufusu mu, na ebetumi apira akokoaa no.[257] == Beaɛ a Menye firiɛ == M b8z40w3lioxe43wip4sphot33a5cu98 0 13653 133303 133022 2022-08-09T22:17:20Z AC Krah 10338 wikitext text/x-wiki Nkran pupuni mantam mantam du nsia a ɛwɔ Ghana no mu ketewa,a ɛgye asaase bɛyɛ mpem mmiɛnsa,ahanu ne aduanan num.<ref>http://www.ghanahealthservice.org/ghs-region.php?ghs&ghsrid=1</ref> Wei yɛ asaase a ɛwɔ Ghana no mu ɔhamu nkyekyɛmu baako akyiripɔ nan. Ɛyɛ mantam a ɛtɔso mmienu a ɛwɔ nnipa dɔm paa ara, ɛkyɛn Asante Mantam a ɛwɔ nnipa bɛyɛ ɔpepem num, ahanan ne aduonum num, ahansia aduokron mmienu wɔ mfeɛ mpem mmienu ne aduonu baako a ɛyɛ ɔhamu nkyekyɛmu du nson akyiripɔ nson.<ref>http://statsghana.gov.gh/docfiles/2010phc/Census2010_Summary_report_of_final_results.pdf</ref> Nkran pupuni mantam yɛ mantam a ɛwɔ kurom wɔ ɔman no mu a wɔn dodoɔ yɛ ɔhamu nkyekyɛmu aduowɔtwe nson akyiripɔ nan a wɔte kurom.<ref>http://pubs.iied.org/pdfs/G02540.pdf</ref>Nkran pupuni mantam ahenkuro ne Nkran a ɛno ara na ɛyɛ Ghana ahenkuro. == Abakɔsɛm == Wɔ afe apem ahankron ne aduosia mu no, Nkran pupuni mantam a na wɔfrɛ no Accra capital District, na ɛka apueɛ mantam ho. Ɔsoafoɔ a ɔhwɛ nkurase so no tee mu. Ɛhyɛɛ aseɛ firii ɔsanaa bosome da a ɛtɔ so aduonu mmienu mu no, Greater Accra Region Law(PNDCL 26) na ɔtee nkran mantam sɛ mantam a wɔnam mmara kwan so ate mu.<ref name=":0" /> <ref name=":0">https://web.archive.org/web/20101102185900/http://www.ghanadistricts.com/region/?r=1&sa=26</ref> == Geography == '''Location and size''' Nkran pupuni mantam ne apueɛ mantam North, Fram mantam wɔ East, Gulf of Gyinae wɔ south na mfimfini mantam wɔ west na ɛbɔ ahyeɛ. Ɛyɛ mantam a ɛsua wɔ Ghana na ɛwɔ mmaeɛ du nsia == Nsrahwɛ == === Parks === * Shai Reserve * Lakeside Marina Park<ref>https://beautifulghana.com/listing/lakeside-marina-park/</ref> * Kwame Nkrumah Memorial Park * Efua Sutherland Children's Park === Recreation areas === * National Museum * La Pleasure Beach * Kokrobite Beach * Coco Beach Resort * Cocoloco Beach * Korle Beach Resort * Next Door Beach Resort * Manet Paradise * Ada Paradise Beach * Ningo-Prampram Beach * Rufus Green Parks * Labadi Beach * Laboma Beach * Titanic Beach * Bojo Beach * Sandbox beach Club * Afrikiko * Bloombar === National monuments === * National Theater * Independence Square * Accra International Conference Center * Center for National Culture === National historic sites === * Kwame Nkrumah Mausoleum * Osu Castle * National Museum of Ghana === Afahyɛ === Nkranfoɔ di afayɛ bi a wato din Homowo a ase kyerɛ ne sɛ <nowiki>''ɔkɔm huro''</nowiki>. Saa [[afahyɛ]] yi fii ase mfie pii a atwam. Wɔhyɛ saa fa yi de kae ɛkɔm kɛseɛ bi esii wɔ Nkranfoɔ mu mfie bebree bi. Afahyɛ no yɛ aduane afahyɛ a wɔde hyɛ fa ma nkrafo kɔm abokosem no. Wodi saa afahyɛ yi wɔ Ɔsanaa bosome no mu na Nkran abusuakuo nyinaa hyɛ saa fa yi. Adangbefo yɛ wɔn a wofi Ada na wɔn afahyɛ a wodi ne Asafotu afahyɛ a wɔnsan nso frɛ no 'Asafotufiam'. ɛyɛ afahyɛ a wodi de kae akofo ne nkunim a wodii wɔ wɔ ako ahorow mu. Wɔhyɛ saa fa yi ase wɔ yawada wɔ Kitawonsa bosome no mu kɔsi nnawɔtwe a edi kan wɔ Ɔsanaa bosome no mu. sɛnea wɔbɛ kae nnoɔma nti, sɛ edu afahyɛ yi a, akofo no hyɛ wɔn ako ntadeodoɔ a w na wɔde agorɔ asi anni. Saa bere yi nsɛ yɛ bre wɔde ntetee ma mmabun wɔ ɔko ho. Saa afahyɛ yi ne otwa afahyɛ no hyia ma nti wɔyɛ amaneɛ ahorɔw a ahotew amammerɛ ka ho. Afahyɛ no du ne mpɔnpɔn so bre a ahenfo fura wɔn tam ahorɔw tenatena wɔn apankan mu,na wɔn manfoɔ de twenebɔ, osebɔ , nnwom ne asaw di wɔn akyi . Ahenfo no de nkyea ma wɔn ho wɔn ho, gu nsa na wɔhye wɔn ho wɔn ho den. === Nsrahwɛ ahodoɔ === * Fishing port at Jamestown * Du Bois Memorial Center for Pan-African Culture * George Padmore Research Library on African Affairs * Agblobloshie dwadibea * Makola dwadibea * Trade Fair dwadibea Asoeɛ a ɛhwɛ nnipa akekan so wo Nkran mantam no mu. Nkran mantam no wo mpesua a edidi so yi; La Nkwantanang Madina Mantam mu, Ashaiman Mantam mu Ledzokuku-krowor Mantam muAdenta Mantam ,Ga apuei Mantam . Nnipa akenkan a ɛkɔɔ so wɔ afe 2010 mu no kyerɛ sɛ, emu nnipa dodoɔ yɛ 4,010,054 ,ɛma no bɛyɛɛ mantam a ɛtɔ so mmienu a wɔn mu nnipa dɔɔso yi paa. Asante mantam na edikan ma Nkramantam to so mienu. Nea nti a ɛte saa ne sɛ nkrufo di mu atukotena paa. === Mmusuakuo === Ga-Dangmefo no yɛ Nkranfoɔ kuo a wɔdɔɔso paa wɔ Nkran mmusuakuo no nyinaa mu. wɔn dodoɔ yɛ ɔha mu nkyekyɛm du nnwɔtwe akyiripɔ nkron (18.9). Nkranfo nhenkuro no gu ahodoɔ nsia; Ga Mashie, Osu , La, Tshie Nungua ne Tema. Wɔn mu biara wɔ ahengua a woyi so apaeɛ. La kurow no wɔ Sika korabea a ɛsom La manfoɔ no. Nkran bɛyɛɛ titire wɔ Ga-Dangme nkuro no mu ma nnɛ, abɛyɛ Ghana Ahenkuro. Na Nkranfoɔ no adwuma ne kuayɛ nanso nnɛ, apopo dwuma ne adetɔn ne nwuma a agye nkran man no afa. Mmaa no pii yɛ dwadifoɔ na wɔn kununom nni wɔn yerenom sika so tumi. Nkranfoɔ di ɛna adeɛ nti mmaa pii yɛ adedifo. Mmarima no yɛ ade a wodi agya ade ma nti wɔtena wɔn agyanom fie, Nanso sɛ mmea no ware mpo a, wɔn ne wɔn maamenon ne wɔn mma tena wɔn na fie. Efie biara mu wɔ nkranfoɔ fie wɔ wɔn abosom a wɔyɛ nyankomade ma wɔn na afahyɛ pii nso na ɛwɔ hɔ. Adangmefo no yɛ wɔn a wɔte bɛn Ghana mpoano ɛfiri Kpone kosi Ada, nsuo Frao ne Gulf of Guinea. Adangmefo no ne Ada, Kpone, Krobo, Ningo, Osuduku, Prampram ne Shai, wɔn nyinaa ka Adangme a ne fibea ne Kwa,a ɛwɔ Congo mmusua mu. Adangmefo ne wɔn a wɔ dɔɔso wɔ nkranfo mu na nkran nsase ɔha mu nkyekyemu aduoson yɛ wɔn dea 7cxq64nloqe5ixtzd1uz4k4od4gc0aw 133304 133303 2022-08-09T22:21:46Z AC Krah 10338 /* Nsrahwɛ ahodoɔ */ wikitext text/x-wiki Nkran pupuni mantam mantam du nsia a ɛwɔ Ghana no mu ketewa,a ɛgye asaase bɛyɛ mpem mmiɛnsa,ahanu ne aduanan num.<ref>http://www.ghanahealthservice.org/ghs-region.php?ghs&ghsrid=1</ref> Wei yɛ asaase a ɛwɔ Ghana no mu ɔhamu nkyekyɛmu baako akyiripɔ nan. Ɛyɛ mantam a ɛtɔso mmienu a ɛwɔ nnipa dɔm paa ara, ɛkyɛn Asante Mantam a ɛwɔ nnipa bɛyɛ ɔpepem num, ahanan ne aduonum num, ahansia aduokron mmienu wɔ mfeɛ mpem mmienu ne aduonu baako a ɛyɛ ɔhamu nkyekyɛmu du nson akyiripɔ nson.<ref>http://statsghana.gov.gh/docfiles/2010phc/Census2010_Summary_report_of_final_results.pdf</ref> Nkran pupuni mantam yɛ mantam a ɛwɔ kurom wɔ ɔman no mu a wɔn dodoɔ yɛ ɔhamu nkyekyɛmu aduowɔtwe nson akyiripɔ nan a wɔte kurom.<ref>http://pubs.iied.org/pdfs/G02540.pdf</ref>Nkran pupuni mantam ahenkuro ne Nkran a ɛno ara na ɛyɛ Ghana ahenkuro. == Abakɔsɛm == Wɔ afe apem ahankron ne aduosia mu no, Nkran pupuni mantam a na wɔfrɛ no Accra capital District, na ɛka apueɛ mantam ho. Ɔsoafoɔ a ɔhwɛ nkurase so no tee mu. Ɛhyɛɛ aseɛ firii ɔsanaa bosome da a ɛtɔ so aduonu mmienu mu no, Greater Accra Region Law(PNDCL 26) na ɔtee nkran mantam sɛ mantam a wɔnam mmara kwan so ate mu.<ref name=":0" /> <ref name=":0">https://web.archive.org/web/20101102185900/http://www.ghanadistricts.com/region/?r=1&sa=26</ref> == Geography == '''Location and size''' Nkran pupuni mantam ne apueɛ mantam North, Fram mantam wɔ East, Gulf of Gyinae wɔ south na mfimfini mantam wɔ west na ɛbɔ ahyeɛ. Ɛyɛ mantam a ɛsua wɔ Ghana na ɛwɔ mmaeɛ du nsia == Nsrahwɛ == === Parks === * Shai Reserve * Lakeside Marina Park<ref>https://beautifulghana.com/listing/lakeside-marina-park/</ref> * Kwame Nkrumah Memorial Park * Efua Sutherland Children's Park === Recreation areas === * National Museum * La Pleasure Beach * Kokrobite Beach * Coco Beach Resort * Cocoloco Beach * Korle Beach Resort * Next Door Beach Resort * Manet Paradise * Ada Paradise Beach * Ningo-Prampram Beach * Rufus Green Parks * Labadi Beach * Laboma Beach * Titanic Beach * Bojo Beach * Sandbox beach Club * Afrikiko * Bloombar === National monuments === * National Theater * Independence Square * Accra International Conference Center * Center for National Culture === National historic sites === * Kwame Nkrumah Mausoleum * Osu Castle * National Museum of Ghana === Afahyɛ === Nkranfoɔ di afayɛ bi a wato din Homowo a ase kyerɛ ne sɛ <nowiki>''ɔkɔm huro''</nowiki>. Saa [[afahyɛ]] yi fii ase mfie pii a atwam. Wɔhyɛ saa fa yi de kae ɛkɔm kɛseɛ bi esii wɔ Nkranfoɔ mu mfie bebree bi. Afahyɛ no yɛ aduane afahyɛ a wɔde hyɛ fa ma nkrafo kɔm abokosem no. Wodi saa afahyɛ yi wɔ [[Ɔsanaa]] bosome no mu na [[Nkran]] abusuakuo nyinaa hyɛ saa fa yi. Adangbefo yɛ wɔn a wofi Ada na wɔn afahyɛ a wodi ne Asafotu afahyɛ a wɔnsan nso frɛ no 'Asafotufiam'. ɛyɛ afahyɛ a wodi de kae akofo ne nkunim a wodii wɔ wɔ ako ahorow mu. Wɔhyɛ saa fa yi ase wɔ [[yawoada]] wɔ [[Kitawonsa]] bosome no mu kɔsi nnawɔtwe a edi kan wɔ [[Ɔsanaa]] bosome no mu. sɛnea wɔbɛ kae nnoɔma nti, sɛ edu afahyɛ yi a, akofo no hyɛ wɔn ako ntade dodoɔ a wɔde agorɔ asi anni. Saa bere yi osyɛ berɛ a e wɔde ntetee ma mmabu n wɔ ɔko ho. Saa afahyɛ yi ne otwa afahyɛ no hyia ma nti wɔyɛ amaneɛ adoɔɔw a ahoɛ w amammerɛ ka ho. Afahyɛ no du ne mpɔnpɔn so bre a ahenfo fura wɔn tam adoɔ w tenatena wɔn apankan mu,na wɔn manfoɔ de twenebɔ, osebɔ , nnwom ne a w di wɔn akyi . Ahenfo no de nkyea ma wɔn ho wɔn ho, gu nsa na wɔhye wɔn ho wɔn ho den. === Nsrahwɛ ahodoɔ === * Fishing port at Jamestown * Du Bois Memorial Center for Pan-African Culture * George Padmore Research Library on African Affairs * Agblobloshie dwadibea * Makola dwadibea * Trade Fair dwadibea Asoeɛ a ɛhwɛ nnipa akekan so wo [[Nkran Mantam|Nkran mantam]] no mu. [[Nkran Mantam|Nkran mantam]] no wo mpesua a edidi so yi; La Nkwantanang Madina Mantam mu, Ashaiman Mantam mu Ledzokuku-krowor Mantam mu, Adenta Mantam ,Ga apuei Mantam . Nnipa akenkan a ɛkɔɔ so wɔ mfeɛ mpem mmienu ne du ( 2010) mu no kyerɛ sɛ, emu nnipa dodoɔ yɛ 4,010,054 ,ɛma no bɛyɛɛ mantam a ɛtɔ so mmienu a wɔn mu nnipa dɔɔso yi paa. Asante mantam na edikan ma Nkramantam to so mienu. Nea nti a ɛte saa ne sɛ nkrufo di mu atukotena paa. === Mmusuakuo === Ga-Dangmefo no yɛ Nkranfoɔ kuo a wɔdɔɔso paa wɔ Nkran mmusuakuo no nyinaa mu. wɔn dodoɔ yɛ ɔha mu nkyekyɛm du nnwɔtwe akyiripɔ nkron (18.9). Nkranfo nhenkuro no gu ahodoɔ nsia; Ga Mashie, Osu , La, Tshie Nungua ne Tema. Wɔn mu biara wɔ ahengua a woyi so apaeɛ. La kurow no wɔ Sika korabea a ɛsom La manfoɔ no. Nkran bɛyɛɛ titire wɔ Ga-Dangme nkuro no mu ma nnɛ, abɛyɛ Ghana Ahenkuro. Na Nkranfoɔ no adwuma ne kuayɛ nanso nnɛ, apopo dwuma ne adetɔn ne nwuma a agye nkran man no afa. Mmaa no pii yɛ dwadifoɔ na wɔn kununom nni wɔn yerenom sika so tumi. Nkranfoɔ di ɛna adeɛ nti mmaa pii yɛ adedifo. Mmarima no yɛ ade a wodi agya ade ma nti wɔtena wɔn agyanom fie, Nanso sɛ mmea no ware mpo a, wɔn ne wɔn maamenon ne wɔn mma tena wɔn na fie. Efie biara mu wɔ nkranfoɔ fie wɔ wɔn abosom a wɔyɛ nyankomade ma wɔn na afahyɛ pii nso na ɛwɔ hɔ. Adangmefo no yɛ wɔn a wɔte bɛn Ghana mpoano ɛfiri Kpone kosi Ada, nsuo Frao ne Gulf of Guinea. Adangmefo no ne Ada, Kpone, Krobo, Ningo, Osuduku, Prampram ne Shai, wɔn nyinaa ka Adangme a ne fibea ne Kwa,a ɛwɔ Congo mmusua mu. Adangmefo ne wɔn a wɔ dɔɔso wɔ nkranfo mu na nkran nsase ɔha mu nkyekyemu aduoson yɛ wɔn dea kaldvlab7048ick5y42ys3uu0i17x45 0 13660 133295 133157 2022-08-09T14:53:19Z Nana Sintim 11223 Mede atwerɛ no bi kaa ho ne haperlink wikitext text/x-wiki Paneɛ yɛ adeɛ a yɛntumi de twe adeɛ firi biribi mu a biribiara sɔ so. (Ɛwom sɛ abɛɛfo deɛ no ayɛ piston ɛsɔ mu denenden airi [[Ahomatrofoɔ|ahoma]] abuadeɛ a wɔfrɛ no ankorɛ anaa "barrel"rel.<ref>http://www.thefreedictionary.com/dental+syringe {{cite web|url=https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|title=Disposable Needles & Syringes &#124; Trigiene Dental &#124; Quality Dental Supplies UK|access-date=2017-08-25|url-status=live|archive-url=https://web.archive.org/web/20180511135451/https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|archive-date=2018-05-11}}</ref>adeɛ no a ɛsɔ so tumi twe ba abɔntene na ɛsan tumi twe kɔ ɛmu , ama paneɛ no kwan ama atwe mframa anaa nsuo afa ahoma tokuro no mu be.Paneɛ no beaeɛ a abue no bua ma nsuo no fa paneɛ no mu kɔ gu adeɛ no a ayɛ sɛ [[ankorɛ]] no mu. Paneɛ taa di dwuma wɔ abɛɛfo [[ayaresabea]] mu pa ara, a ɛboa ma wɔwɔ [[paneɛ]], wɔde [[nsuo]] asi ayarefoɔ so, wɔde mogya nso fa [[paneɛ]] mu na ɛde wɔ ayarefoɔ, na nnoɔma bi te sɛ glue ne lubricants aka ho. Edin paneɛ firi Greekifoɔ kasa mu a ɛkyerɛ sɛ σύριγξ (''syrinx'', meaning "Pan flute", "tube") == Medical syringes == {{see also|Hypodermic needle}} [[File:Syringe.jpg|link=https://en.wikipedia.org/wiki/File:Syringe.jpg|thumb|The threads of the [[Luer taper|Luer lock]] tip of this 12mL disposable syringe keep it securely connected to a tube or other apparatus.]] [[File:SyringeAllGlass.jpg|link=https://en.wikipedia.org/wiki/File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, with no parts made from metal, nor any other material.]] [[File:Rekord-Spritze.jpg|link=https://en.wikipedia.org/wiki/File:Rekord-Spritze.jpg|thumb|An antique glass and metal syringe]] Sectors in the syringe and needle market include disposable and [[Safety syringe|safety syringes]], injection pens, needleless injectors, insulin pumps, and specialty needles.<ref>{{cite web|title=Disposable Syringe Markets|publisher=TriMark Publications, LLC|date=June 2013|url=http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140911154606/http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|archive-date=2014-09-11}}</ref> Hypodermic syringes are used with [[Hypodermic needle|hypodermic needles]] to [[Injection (medicine)|inject]] [[liquid]] or gases into body tissues, or to remove from the [[Human body|body]]. Injecting of [[air]] into a [[blood vessel]] is hazardous, as it may cause an [[air embolism]]; preventing embolisms by removing [[air]] from the syringe is one of the reasons for the familiar image of holding a hypodermic syringe pointing upward, tapping it, and expelling a small amount of liquid before an injection into the [[bloodstream]]. The [[barrel]] of a syringe is made of [[plastic]] or [[glass]], usually has graduated marks indicating the volume of [[fluid]] in the syringe, and is nearly always transparent. Glass syringes may be [[Sterilization (microbiology)|sterilized]] in an [[autoclave]]. Plastic syringes can be constructed as either two-part or three-part designs. A three-part syringe contains a plastic plunger/[[piston]] with a [[rubber]] tip to create a seal between the piston and the [[barrel]], where a two-part syringe is manufactured to create a perfect fit between the plastic plunger and the barrel to create the seal without the need for a separate synthetic rubber piston. Two-part syringes have been traditionally used in [[Europe|European countries]] to prevent introduction of additional materials such as silicone oil needed for lubricating three-part plungers.<ref>{{cite web|title=The Anatomy of the Hypodermic Needle and Syringe|url=https://www.exchangesupplies.org/article_the_anatomy_of_a_hypodermic_needle_and_syringe.php|website=www.exchangesupplies.org|access-date=18 May 2021}}</ref> Most modern medical syringes are plastic because they are cheap enough to dispose of after being used only once, reducing the risk of spreading [[Blood-borne disease|blood-borne diseases]]. Reuse of needles and syringes has caused spread of diseases, especially [[HIV]] and [[hepatitis]], among intravenous drug users. Syringes are also commonly reused by diabetics, as they can go through several in a day with multiple daily insulin injections, which becomes an affordability issue for many. Even though the syringe and needle are only used by a single person, this practice is still unsafe as it can introduce bacteria from the skin into the bloodstream and cause serious and sometimes lethal infections.<ref>{{cite web|url=http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|title=Is it safe to reuse an insulin syringe? - CNN.com|first=Asked by|last=Bethany|website=[[CNN]]|url-status=live|archive-url=https://web.archive.org/web/20170710123054/http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|archive-date=2017-07-10}}</ref> In medical settings, single-use needles and syringes effectively reduce the risk of cross-contamination.<ref>{{cite web|title=Disposable Medical Supplies Markets|publisher=TriMark Publications, LLC|date=July 2014|url=http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140224004233/http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|archive-date=2014-02-24}}</ref> Medical syringes are sometimes used without a needle for orally administering liquid medicines to young children or animals, or milk to small young animals, because the dose can be measured accurately and it is easier to squirt the medicine into the subject's mouth instead of coaxing the subject to drink out of a measuring spoon. === Standard U-100 insulin syringes === [[File:Standard_insulin_syringe.JPG|link=https://en.wikipedia.org/wiki/File:Standard_insulin_syringe.JPG|thumb|Insulin syringes are marked in insulin "units".]] Syringes for [[insulin]] users are designed for standard U-100 insulin. The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "units" of insulin.<ref>{{cite journal|pmid=12060790|title=Making the unit of insulin: standards, clinical work, and industry, 1920–1925|date=2010-12-08|volume=76|issue=2|journal=Bull Hist Med|pages=231–70|author=Sinding C|doi=10.1353/bhm.2002.0097|s2cid=44334307}}</ref> Since insulin vials are typically 10 mL, each vial has 1000 units. Insulin syringes are made specifically for self injections and have friendly features: * shorter needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> as insulin injections are [[Subcutaneous injection|subcutaneous]] (under the skin) rather than intramuscular, * finer gauge needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> for less pain, * markings in insulin units to simplify drawing a measured dose of insulin, and<ref>{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|title=BD Diabetes-Syringe Capacity and Dose Size|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110707095615/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|archive-date=2011-07-07}}</ref> * [[Low dead space syringe|low dead space]] to reduce complications caused by improper drawing order of different insulin strengths.{{citation needed|date=March 2017}} {| class="wikitable" ! colspan="2" |'''U-100 Syringe Sizes and Markings''' |- ! colspan="2" |1cc (1 mL) Syringe |- !Holds maximum: !100 units<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 2 units:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> (all but 31 gauge needle) |- !Smallest line measures 1 unit: !Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringe demonstration-their syringes all measure in 1 unit increments|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |1/2cc (0.5 mL) Syringe |- !Holds maximum: !50 units<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Ulti-Care<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref>{{cite web|url=http://www.ulti-care.com/ultiguard_insulinsyringes.html|title=Ulti-Care U100 Syringes-Product Information|publisher=Ulti-care.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110717150302/http://www.ulti-care.com/ultiguard_insulinsyringes.html|archive-date=2011-07-17}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes demonstration-all syringes with 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |3/10cc (0.3 mL) Syringe |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD Micro Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> BD Ultra Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> (standard length only) Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes-all products measure in 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> UltiCare<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |Half-unit scale 3/10cc (0.3 mL) Syringe<ref>{{cite web|url=http://www.bd.com/resource.aspx?IDX=7917|title=Comparison of 3/10 cc syringe marks—half unit and whole unit scale-BD|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121135/http://www.bd.com/resource.aspx?IDX=7917|archive-date=2011-09-28}}</ref> |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1/2 unit: !BD Ultra Fine II (short)<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref><ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |} {{clear right}} === Oral === An oral syringe is a [[measuring instrument]] used to accurately measure doses of liquid [[medication]], expressed in [[Millilitre#SI%20prefixes%20applied%20to%20the%20litre|millilitres]](mL). They do not have threaded tips, because no needle or other device needs to be screwed onto them. The contents are simply squirted or sucked from the syringe directly into the mouth of the person or animal. Oral syringes are available in various sizes, from 1–10 mL and larger. The sizes most commonly used are 1 mL, 2.5 mL and 5 mL.<ref>{{cite web|url=http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|title=How to use your oral syringe|work=Netdoctor|url-status=live|archive-url=https://web.archive.org/web/20110104083118/http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|archive-date=2011-01-04|date=2012-11-23}}</ref> === Dose-sparing syringes === [[File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|link=https://en.wikipedia.org/wiki/File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|thumb|A dose-sparing syringe and needle being used to draw up a Covid-19 vaccine]] A dose-sparing syringe is one which minimises the amount of liquid remaining in the barrel after the plunger has been depressed. These syringes feature a combined needle and syringe, and a protrusion on the face of the plunger to expel liquid from the needle hub. Such syringes were particularly popular during the [[COVID-19 pandemic]] as vaccines were in short supply.<ref>{{Cite web|title=Government orders 65m syringes ahead of potential Covid-19 vaccine|url=https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/|url-status=live|access-date=2021-04-15|website=www.pulsetoday.co.uk}}</ref> Beaeɛ a menyaa mmoa firiiɛ {{anchor|Medical syringe}} 919zs2lg1nhmws9927zv4wp8m2ry8fl 133298 133295 2022-08-09T16:13:32Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki Paneɛ yɛ adeɛ a yɛntumi de twe adeɛ firi biribi mu a biribiara sɔ so. (Ɛwom sɛ abɛɛfo deɛ no ayɛ piston ɛsɔ mu denenden airi [[Ahomatrofoɔ|ahoma]] abuadeɛ a wɔfrɛ no ankorɛ anaa "barrel"rel.<ref>http://www.thefreedictionary.com/dental+syringe {{cite web|url=https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|title=Disposable Needles & Syringes &#124; Trigiene Dental &#124; Quality Dental Supplies UK|access-date=2017-08-25|url-status=live|archive-url=https://web.archive.org/web/20180511135451/https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|archive-date=2018-05-11}}</ref>adeɛ no a ɛsɔ so tumi twe ba abɔntene na ɛsan tumi twe kɔ ɛmu , ama paneɛ no kwan ama atwe mframa anaa nsuo afa ahoma tokuro no mu be.Paneɛ no beaeɛ a abue no bua ma nsuo no fa paneɛ no mu kɔ gu adeɛ no a ayɛ sɛ [[ankorɛ]] no mu. Paneɛ taa di dwuma wɔ abɛɛfo [[ayaresabea]] mu pa ara, a ɛboa ma wɔwɔ [[paneɛ]], wɔde [[nsuo]] asi ayarefoɔ so, wɔde mogya nso fa [[paneɛ]] mu na ɛde wɔ ayarefoɔ, na nnoɔma bi te sɛ glue ne lubricants aka ho. Edin paneɛ firi Greekifoɔ kasa mu a ɛkyerɛ sɛ σύριγξ (''syrinx'', meaning "Pan flute", "tube") == AYAREHWƐ HO PANEƐM == {{see also|Hypodermic needle}} [[File:Syringe.jpg|link=https://en.wikipedia.org/wiki/File:Syringe.jpg|thumb|The threads of the [[Luer taper|Luer lock]] tip of this 12mL disposable syringe keep it securely connected to a tube or other apparatus.]] [[File:SyringeAllGlass.jpg|link=https://en.wikipedia.org/wiki/File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, with no parts made from metal, nor any other material.]] [[File:Rekord-Spritze.jpg|link=https://en.wikipedia.org/wiki/File:Rekord-Spritze.jpg|thumb|An antique glass and metal syringe]] Beaeɛ a ɛwɔ paneɛ konko ho ne mpaneɛ adwasuo bi ne Sectors in the syringe and needle market include disposable and [[Safety syringe|safety syringes]], injection pens, needleless injectors, insulin pumps, and specialty needles.<ref>{{cite web|title=Disposable Syringe Markets|publisher=TriMark Publications, LLC|date=June 2013|url=http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140911154606/http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|archive-date=2014-09-11}}</ref> Hypodermic syringes are used with [[Hypodermic needle|hypodermic needles]] to [[Injection (medicine)|inject]] [[liquid]] or gases into body tissues, or to remove from the [[Human body|body]]. Injecting of [[air]] into a [[blood vessel]] is hazardous, as it may cause an [[air embolism]]; preventing embolisms by removing [[air]] from the syringe is one of the reasons for the familiar image of holding a hypodermic syringe pointing upward, tapping it, and expelling a small amount of liquid before an injection into the [[bloodstream]]. The [[barrel]] of a syringe is made of [[plastic]] or [[glass]], usually has graduated marks indicating the volume of [[fluid]] in the syringe, and is nearly always transparent. Glass syringes may be [[Sterilization (microbiology)|sterilized]] in an [[autoclave]]. Plastic syringes can be constructed as either two-part or three-part designs. A three-part syringe contains a plastic plunger/[[piston]] with a [[rubber]] tip to create a seal between the piston and the [[barrel]], where a two-part syringe is manufactured to create a perfect fit between the plastic plunger and the barrel to create the seal without the need for a separate synthetic rubber piston. Two-part syringes have been traditionally used in [[Europe|European countries]] to prevent introduction of additional materials such as silicone oil needed for lubricating three-part plungers.<ref>{{cite web|title=The Anatomy of the Hypodermic Needle and Syringe|url=https://www.exchangesupplies.org/article_the_anatomy_of_a_hypodermic_needle_and_syringe.php|website=www.exchangesupplies.org|access-date=18 May 2021}}</ref> Most modern medical syringes are plastic because they are cheap enough to dispose of after being used only once, reducing the risk of spreading [[Blood-borne disease|blood-borne diseases]]. Reuse of needles and syringes has caused spread of diseases, especially [[HIV]] and [[hepatitis]], among intravenous drug users. Syringes are also commonly reused by diabetics, as they can go through several in a day with multiple daily insulin injections, which becomes an affordability issue for many. Even though the syringe and needle are only used by a single person, this practice is still unsafe as it can introduce bacteria from the skin into the bloodstream and cause serious and sometimes lethal infections.<ref>{{cite web|url=http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|title=Is it safe to reuse an insulin syringe? - CNN.com|first=Asked by|last=Bethany|website=[[CNN]]|url-status=live|archive-url=https://web.archive.org/web/20170710123054/http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|archive-date=2017-07-10}}</ref> In medical settings, single-use needles and syringes effectively reduce the risk of cross-contamination.<ref>{{cite web|title=Disposable Medical Supplies Markets|publisher=TriMark Publications, LLC|date=July 2014|url=http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140224004233/http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|archive-date=2014-02-24}}</ref> Medical syringes are sometimes used without a needle for orally administering liquid medicines to young children or animals, or milk to small young animals, because the dose can be measured accurately and it is easier to squirt the medicine into the subject's mouth instead of coaxing the subject to drink out of a measuring spoon. === Standard U-100 insulin syringes === [[File:Standard_insulin_syringe.JPG|link=https://en.wikipedia.org/wiki/File:Standard_insulin_syringe.JPG|thumb|Insulin syringes are marked in insulin "units".]] Syringes for [[insulin]] users are designed for standard U-100 insulin. The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "units" of insulin.<ref>{{cite journal|pmid=12060790|title=Making the unit of insulin: standards, clinical work, and industry, 1920–1925|date=2010-12-08|volume=76|issue=2|journal=Bull Hist Med|pages=231–70|author=Sinding C|doi=10.1353/bhm.2002.0097|s2cid=44334307}}</ref> Since insulin vials are typically 10 mL, each vial has 1000 units. Insulin syringes are made specifically for self injections and have friendly features: * shorter needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> as insulin injections are [[Subcutaneous injection|subcutaneous]] (under the skin) rather than intramuscular, * finer gauge needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> for less pain, * markings in insulin units to simplify drawing a measured dose of insulin, and<ref>{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|title=BD Diabetes-Syringe Capacity and Dose Size|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110707095615/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|archive-date=2011-07-07}}</ref> * [[Low dead space syringe|low dead space]] to reduce complications caused by improper drawing order of different insulin strengths.{{citation needed|date=March 2017}} {| class="wikitable" ! colspan="2" |'''U-100 Syringe Sizes and Markings''' |- ! colspan="2" |1cc (1 mL) Syringe |- !Holds maximum: !100 units<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 2 units:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> (all but 31 gauge needle) |- !Smallest line measures 1 unit: !Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringe demonstration-their syringes all measure in 1 unit increments|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |1/2cc (0.5 mL) Syringe |- !Holds maximum: !50 units<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Ulti-Care<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref>{{cite web|url=http://www.ulti-care.com/ultiguard_insulinsyringes.html|title=Ulti-Care U100 Syringes-Product Information|publisher=Ulti-care.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110717150302/http://www.ulti-care.com/ultiguard_insulinsyringes.html|archive-date=2011-07-17}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes demonstration-all syringes with 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |3/10cc (0.3 mL) Syringe |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD Micro Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> BD Ultra Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> (standard length only) Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes-all products measure in 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> UltiCare<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |Half-unit scale 3/10cc (0.3 mL) Syringe<ref>{{cite web|url=http://www.bd.com/resource.aspx?IDX=7917|title=Comparison of 3/10 cc syringe marks—half unit and whole unit scale-BD|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121135/http://www.bd.com/resource.aspx?IDX=7917|archive-date=2011-09-28}}</ref> |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1/2 unit: !BD Ultra Fine II (short)<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref><ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |} {{clear right}} === Oral === An oral syringe is a [[measuring instrument]] used to accurately measure doses of liquid [[medication]], expressed in [[Millilitre#SI%20prefixes%20applied%20to%20the%20litre|millilitres]](mL). They do not have threaded tips, because no needle or other device needs to be screwed onto them. The contents are simply squirted or sucked from the syringe directly into the mouth of the person or animal. Oral syringes are available in various sizes, from 1–10 mL and larger. The sizes most commonly used are 1 mL, 2.5 mL and 5 mL.<ref>{{cite web|url=http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|title=How to use your oral syringe|work=Netdoctor|url-status=live|archive-url=https://web.archive.org/web/20110104083118/http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|archive-date=2011-01-04|date=2012-11-23}}</ref> === Dose-sparing syringes === [[File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|link=https://en.wikipedia.org/wiki/File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|thumb|A dose-sparing syringe and needle being used to draw up a Covid-19 vaccine]] A dose-sparing syringe is one which minimises the amount of liquid remaining in the barrel after the plunger has been depressed. These syringes feature a combined needle and syringe, and a protrusion on the face of the plunger to expel liquid from the needle hub. Such syringes were particularly popular during the [[COVID-19 pandemic]] as vaccines were in short supply.<ref>{{Cite web|title=Government orders 65m syringes ahead of potential Covid-19 vaccine|url=https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/|url-status=live|access-date=2021-04-15|website=www.pulsetoday.co.uk}}</ref> Beaeɛ a menyaa mmoa firiiɛ {{anchor|Medical syringe}} dyh83yhaykdde5bjtf8hkjecnaxzc0p 133300 133298 2022-08-09T21:00:22Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki Paneɛ yɛ adeɛ a yɛntumi de twe adeɛ firi biribi mu a biribiara sɔ so. (Ɛwom sɛ abɛɛfo deɛ no ayɛ piston ɛsɔ mu denenden airi [[Ahomatrofoɔ|ahoma]] abuadeɛ a wɔfrɛ no ankorɛ anaa "barrel"rel.<ref>http://www.thefreedictionary.com/dental+syringe {{cite web|url=https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|title=Disposable Needles & Syringes &#124; Trigiene Dental &#124; Quality Dental Supplies UK|access-date=2017-08-25|url-status=live|archive-url=https://web.archive.org/web/20180511135451/https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|archive-date=2018-05-11}}</ref>adeɛ no a ɛsɔ so tumi twe ba abɔntene na ɛsan tumi twe kɔ ɛmu , ama paneɛ no kwan ama atwe mframa anaa nsuo afa ahoma tokuro no mu be.Paneɛ no beaeɛ a abue no bua ma nsuo no fa paneɛ no mu kɔ gu adeɛ no a ayɛ sɛ [[ankorɛ]] no mu. Paneɛ taa di dwuma wɔ abɛɛfo [[ayaresabea]] mu pa ara, a ɛboa ma wɔwɔ [[paneɛ]], wɔde [[nsuo]] asi ayarefoɔ so, wɔde mogya nso fa [[paneɛ]] mu na ɛde wɔ ayarefoɔ, na nnoɔma bi te sɛ glue ne lubricants aka ho. Edin paneɛ firi Greekifoɔ kasa mu a ɛkyerɛ sɛ σύριγξ (''syrinx'', meaning "Pan flute", "tube") == AYAREHWƐ HO PANEƐM == {{see also|Hypodermic needle}} [[File:Syringe.jpg|link=https://en.wikipedia.org/wiki/File:Syringe.jpg|thumb|The threads of the [[Luer taper|Luer lock]] tip of this 12mL disposable syringe keep it securely connected to a tube or other apparatus.]] [[File:SyringeAllGlass.jpg|link=https://en.wikipedia.org/wiki/File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, with no parts made from metal, nor any other material.]] [[File:Rekord-Spritze.jpg|link=https://en.wikipedia.org/wiki/File:Rekord-Spritze.jpg|thumb|An antique glass and metal syringe]] Beaeɛ a ɛwɔ paneɛ konko ho ne mpaneɛ adwasuo bi ne disposable and [[Safety syringe|safety syringes]], injection pens, needleless injectors, insulin pumps, and specialty needles.<ref>{{cite web|title=Disposable Syringe Markets|publisher=TriMark Publications, LLC|date=June 2013|url=http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140911154606/http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|archive-date=2014-09-11}}</ref> Hypodermic syringes yɛde ɛne [[Hypodermic needle|hypodermic paneɛ]] [[Injection (medicine)|na yɛde twe nsuo anaa mframa,]] dekɔ nnipa dua no mu anaa sɛ yɛde twe firi nipadia no mu. Mframa a yɛtwe dekɔ mogya ntini mu no yɛ adeɛ ɛhu yie, sɛ ɛbɛtumi de [[air embolism]] aba, sɛ yɛbɛbɔ embolisms ho ban no, sɛ yɛretwe mframa afiri paneɛ konkora mu no yɛ ɔkwan baako a sɛ wohwɛ mfonin a ɛwɔ hɔ yi bi a yɛde ano ahwɛ soro, a yɛretwetwe no, a yɛrepia nsuo kakra bi afiri mu ansana yɛde awɔ mogya ntini no. The [[barrel]] of a syringe is made of [[plastic]] or [[glass]], usually has graduated marks indicating the volume of [[fluid]] in the syringe, and is nearly always transparent. Glass syringes may be [[Sterilization (microbiology)|sterilized]] in an [[autoclave]]. Plastic syringes can be constructed as either two-part or three-part designs. A three-part syringe contains a plastic plunger/[[piston]] with a [[rubber]] tip to create a seal between the piston and the [[barrel]], where a two-part syringe is manufactured to create a perfect fit between the plastic plunger and the barrel to create the seal without the need for a separate synthetic rubber piston. Two-part syringes have been traditionally used in [[Europe|European countries]] to prevent introduction of additional materials such as silicone oil needed for lubricating three-part plungers.<ref>{{cite web|title=The Anatomy of the Hypodermic Needle and Syringe|url=https://www.exchangesupplies.org/article_the_anatomy_of_a_hypodermic_needle_and_syringe.php|website=www.exchangesupplies.org|access-date=18 May 2021}}</ref> Most modern medical syringes are plastic because they are cheap enough to dispose of after being used only once, reducing the risk of spreading [[Blood-borne disease|blood-borne diseases]]. Reuse of needles and syringes has caused spread of diseases, especially [[HIV]] and [[hepatitis]], among intravenous drug users. Syringes are also commonly reused by diabetics, as they can go through several in a day with multiple daily insulin injections, which becomes an affordability issue for many. Even though the syringe and needle are only used by a single person, this practice is still unsafe as it can introduce bacteria from the skin into the bloodstream and cause serious and sometimes lethal infections.<ref>{{cite web|url=http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|title=Is it safe to reuse an insulin syringe? - CNN.com|first=Asked by|last=Bethany|website=[[CNN]]|url-status=live|archive-url=https://web.archive.org/web/20170710123054/http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|archive-date=2017-07-10}}</ref> In medical settings, single-use needles and syringes effectively reduce the risk of cross-contamination.<ref>{{cite web|title=Disposable Medical Supplies Markets|publisher=TriMark Publications, LLC|date=July 2014|url=http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140224004233/http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|archive-date=2014-02-24}}</ref> Medical syringes are sometimes used without a needle for orally administering liquid medicines to young children or animals, or milk to small young animals, because the dose can be measured accurately and it is easier to squirt the medicine into the subject's mouth instead of coaxing the subject to drink out of a measuring spoon. === Standard U-100 insulin syringes === [[File:Standard_insulin_syringe.JPG|link=https://en.wikipedia.org/wiki/File:Standard_insulin_syringe.JPG|thumb|Insulin syringes are marked in insulin "units".]] Syringes for [[insulin]] users are designed for standard U-100 insulin. The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "units" of insulin.<ref>{{cite journal|pmid=12060790|title=Making the unit of insulin: standards, clinical work, and industry, 1920–1925|date=2010-12-08|volume=76|issue=2|journal=Bull Hist Med|pages=231–70|author=Sinding C|doi=10.1353/bhm.2002.0097|s2cid=44334307}}</ref> Since insulin vials are typically 10 mL, each vial has 1000 units. Insulin syringes are made specifically for self injections and have friendly features: * shorter needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> as insulin injections are [[Subcutaneous injection|subcutaneous]] (under the skin) rather than intramuscular, * finer gauge needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> for less pain, * markings in insulin units to simplify drawing a measured dose of insulin, and<ref>{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|title=BD Diabetes-Syringe Capacity and Dose Size|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110707095615/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|archive-date=2011-07-07}}</ref> * [[Low dead space syringe|low dead space]] to reduce complications caused by improper drawing order of different insulin strengths.{{citation needed|date=March 2017}} {| class="wikitable" ! colspan="2" |'''U-100 Syringe Sizes and Markings''' |- ! colspan="2" |1cc (1 mL) Syringe |- !Holds maximum: !100 units<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 2 units:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> (all but 31 gauge needle) |- !Smallest line measures 1 unit: !Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringe demonstration-their syringes all measure in 1 unit increments|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |1/2cc (0.5 mL) Syringe |- !Holds maximum: !50 units<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Ulti-Care<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref>{{cite web|url=http://www.ulti-care.com/ultiguard_insulinsyringes.html|title=Ulti-Care U100 Syringes-Product Information|publisher=Ulti-care.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110717150302/http://www.ulti-care.com/ultiguard_insulinsyringes.html|archive-date=2011-07-17}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes demonstration-all syringes with 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |3/10cc (0.3 mL) Syringe |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD Micro Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> BD Ultra Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> (standard length only) Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes-all products measure in 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> UltiCare<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |Half-unit scale 3/10cc (0.3 mL) Syringe<ref>{{cite web|url=http://www.bd.com/resource.aspx?IDX=7917|title=Comparison of 3/10 cc syringe marks—half unit and whole unit scale-BD|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121135/http://www.bd.com/resource.aspx?IDX=7917|archive-date=2011-09-28}}</ref> |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1/2 unit: !BD Ultra Fine II (short)<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref><ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |} {{clear right}} === Oral === An oral syringe is a [[measuring instrument]] used to accurately measure doses of liquid [[medication]], expressed in [[Millilitre#SI%20prefixes%20applied%20to%20the%20litre|millilitres]](mL). They do not have threaded tips, because no needle or other device needs to be screwed onto them. The contents are simply squirted or sucked from the syringe directly into the mouth of the person or animal. Oral syringes are available in various sizes, from 1–10 mL and larger. The sizes most commonly used are 1 mL, 2.5 mL and 5 mL.<ref>{{cite web|url=http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|title=How to use your oral syringe|work=Netdoctor|url-status=live|archive-url=https://web.archive.org/web/20110104083118/http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|archive-date=2011-01-04|date=2012-11-23}}</ref> === Dose-sparing syringes === [[File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|link=https://en.wikipedia.org/wiki/File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|thumb|A dose-sparing syringe and needle being used to draw up a Covid-19 vaccine]] A dose-sparing syringe is one which minimises the amount of liquid remaining in the barrel after the plunger has been depressed. These syringes feature a combined needle and syringe, and a protrusion on the face of the plunger to expel liquid from the needle hub. Such syringes were particularly popular during the [[COVID-19 pandemic]] as vaccines were in short supply.<ref>{{Cite web|title=Government orders 65m syringes ahead of potential Covid-19 vaccine|url=https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/|url-status=live|access-date=2021-04-15|website=www.pulsetoday.co.uk}}</ref> Beaeɛ a menyaa mmoa firiiɛ {{anchor|Medical syringe}} 6chvr0xz1k678grumyd73ndyw4w80mn 133301 133300 2022-08-09T21:29:51Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki Paneɛ yɛ adeɛ a yɛntumi de twe adeɛ firi biribi mu a biribiara sɔ so. (Ɛwom sɛ abɛɛfo deɛ no ayɛ piston ɛsɔ mu denenden airi [[Ahomatrofoɔ|ahoma]] abuadeɛ a wɔfrɛ no ankorɛ anaa "barrel"rel.<ref>http://www.thefreedictionary.com/dental+syringe {{cite web|url=https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|title=Disposable Needles & Syringes &#124; Trigiene Dental &#124; Quality Dental Supplies UK|access-date=2017-08-25|url-status=live|archive-url=https://web.archive.org/web/20180511135451/https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|archive-date=2018-05-11}}</ref>adeɛ no a ɛsɔ so tumi twe ba abɔntene na ɛsan tumi twe kɔ ɛmu , ama paneɛ no kwan ama atwe mframa anaa nsuo afa ahoma tokuro no mu be.Paneɛ no beaeɛ a abue no bua ma nsuo no fa paneɛ no mu kɔ gu adeɛ no a ayɛ sɛ [[ankorɛ]] no mu. Paneɛ taa di dwuma wɔ abɛɛfo [[ayaresabea]] mu pa ara, a ɛboa ma wɔwɔ [[paneɛ]], wɔde [[nsuo]] asi ayarefoɔ so, wɔde mogya nso fa [[paneɛ]] mu na ɛde wɔ ayarefoɔ, na nnoɔma bi te sɛ glue ne lubricants aka ho. Edin paneɛ firi Greekifoɔ kasa mu a ɛkyerɛ sɛ σύριγξ (''syrinx'', meaning "Pan flute", "tube") == AYAREHWƐ HO PANEƐM == {{see also|Hypodermic needle}} [[File:Syringe.jpg|link=https://en.wikipedia.org/wiki/File:Syringe.jpg|thumb|The threads of the [[Luer taper|Luer lock]] tip of this 12mL disposable syringe keep it securely connected to a tube or other apparatus.]] [[File:SyringeAllGlass.jpg|link=https://en.wikipedia.org/wiki/File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, with no parts made from metal, nor any other material.]] [[File:Rekord-Spritze.jpg|link=https://en.wikipedia.org/wiki/File:Rekord-Spritze.jpg|thumb|An antique glass and metal syringe]] Beaeɛ a ɛwɔ paneɛ konko ho ne mpaneɛ adwasuo bi ne disposable and [[Safety syringe|safety syringes]], injection pens, needleless injectors, insulin pumps, and specialty needles.<ref>{{cite web|title=Disposable Syringe Markets|publisher=TriMark Publications, LLC|date=June 2013|url=http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140911154606/http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|archive-date=2014-09-11}}</ref> Hypodermic syringes yɛde ɛne [[Hypodermic needle|hypodermic paneɛ]] [[Injection (medicine)|na yɛde twe nsuo anaa mframa,]] dekɔ nnipa dua no mu anaa sɛ yɛde twe firi nipadia no mu. Mframa a yɛtwe dekɔ mogya ntini mu no yɛ adeɛ ɛhu yie, sɛ ɛbɛtumi de [[air embolism]] aba, sɛ yɛbɛbɔ embolisms ho ban no, sɛ yɛretwe mframa afiri paneɛ konkora mu no yɛ ɔkwan baako a sɛ wohwɛ mfonin a ɛwɔ hɔ yi bi a yɛde ano ahwɛ soro, a yɛretwetwe no, a yɛrepia nsuo kakra bi afiri mu ansana yɛde awɔ mogya ntini no. Ankorɛ a ɛsɔ paneɛ so no yɛ ruba anaa glaase, a ahyɛnson deɛ wɔ ho a ɛkyerɛ nsuo dodoɔ anaa aduro dodoɔ a ɛwɔ mu, aberɛ biara no ɛyɛ adeɛ a ɛmu da hɔ a wotumi hunu mu. Ahwehwɛ paneɛ we tumi yɛ [[Sterilization (microbiology)|sterilized]] wɔ [[autoclave]]. Ruba deɛ no deɛ yɛtumi yɛ no afa mmienu anaa mmiɛnsa. Ruba deɛ no a ɛkura afa mmienu no deɛ mpɛn pii no ɛwɔ nsɔ ano a yɛde ruba ayɛ yɛasi ano wɔ ɛne ankorɛ no ntem, three-part syringe contains a plastic plunger/[[piston]] with a [[rubber]] tip to create a seal between the piston and the [[barrel]], where a two-part syringe is manufactured to create a perfect fit between the plastic plunger and the barrel to create the seal without the need for a separate synthetic rubber piston. Two-part syringes have been traditionally used in [[Europe|European countries]] to prevent introduction of additional materials such as silicone oil needed for lubricating three-part plungers.<ref>{{cite web|title=The Anatomy of the Hypodermic Needle and Syringe|url=https://www.exchangesupplies.org/article_the_anatomy_of_a_hypodermic_needle_and_syringe.php|website=www.exchangesupplies.org|access-date=18 May 2021}}</ref> Most modern medical syringes are plastic because they are cheap enough to dispose of after being used only once, reducing the risk of spreading [[Blood-borne disease|blood-borne diseases]]. Reuse of needles and syringes has caused spread of diseases, especially [[HIV]] and [[hepatitis]], among intravenous drug users. Syringes are also commonly reused by diabetics, as they can go through several in a day with multiple daily insulin injections, which becomes an affordability issue for many. Even though the syringe and needle are only used by a single person, this practice is still unsafe as it can introduce bacteria from the skin into the bloodstream and cause serious and sometimes lethal infections.<ref>{{cite web|url=http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|title=Is it safe to reuse an insulin syringe? - CNN.com|first=Asked by|last=Bethany|website=[[CNN]]|url-status=live|archive-url=https://web.archive.org/web/20170710123054/http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|archive-date=2017-07-10}}</ref> In medical settings, single-use needles and syringes effectively reduce the risk of cross-contamination.<ref>{{cite web|title=Disposable Medical Supplies Markets|publisher=TriMark Publications, LLC|date=July 2014|url=http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140224004233/http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|archive-date=2014-02-24}}</ref> Medical syringes are sometimes used without a needle for orally administering liquid medicines to young children or animals, or milk to small young animals, because the dose can be measured accurately and it is easier to squirt the medicine into the subject's mouth instead of coaxing the subject to drink out of a measuring spoon. === Standard U-100 insulin syringes === [[File:Standard_insulin_syringe.JPG|link=https://en.wikipedia.org/wiki/File:Standard_insulin_syringe.JPG|thumb|Insulin syringes are marked in insulin "units".]] Syringes for [[insulin]] users are designed for standard U-100 insulin. The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "units" of insulin.<ref>{{cite journal|pmid=12060790|title=Making the unit of insulin: standards, clinical work, and industry, 1920–1925|date=2010-12-08|volume=76|issue=2|journal=Bull Hist Med|pages=231–70|author=Sinding C|doi=10.1353/bhm.2002.0097|s2cid=44334307}}</ref> Since insulin vials are typically 10 mL, each vial has 1000 units. Insulin syringes are made specifically for self injections and have friendly features: * shorter needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> as insulin injections are [[Subcutaneous injection|subcutaneous]] (under the skin) rather than intramuscular, * finer gauge needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> for less pain, * markings in insulin units to simplify drawing a measured dose of insulin, and<ref>{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|title=BD Diabetes-Syringe Capacity and Dose Size|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110707095615/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|archive-date=2011-07-07}}</ref> * [[Low dead space syringe|low dead space]] to reduce complications caused by improper drawing order of different insulin strengths.{{citation needed|date=March 2017}} {| class="wikitable" ! colspan="2" |'''U-100 Syringe Sizes and Markings''' |- ! colspan="2" |1cc (1 mL) Syringe |- !Holds maximum: !100 units<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 2 units:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> (all but 31 gauge needle) |- !Smallest line measures 1 unit: !Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringe demonstration-their syringes all measure in 1 unit increments|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |1/2cc (0.5 mL) Syringe |- !Holds maximum: !50 units<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Ulti-Care<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref>{{cite web|url=http://www.ulti-care.com/ultiguard_insulinsyringes.html|title=Ulti-Care U100 Syringes-Product Information|publisher=Ulti-care.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110717150302/http://www.ulti-care.com/ultiguard_insulinsyringes.html|archive-date=2011-07-17}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes demonstration-all syringes with 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |3/10cc (0.3 mL) Syringe |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD Micro Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> BD Ultra Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> (standard length only) Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes-all products measure in 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> UltiCare<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |Half-unit scale 3/10cc (0.3 mL) Syringe<ref>{{cite web|url=http://www.bd.com/resource.aspx?IDX=7917|title=Comparison of 3/10 cc syringe marks—half unit and whole unit scale-BD|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121135/http://www.bd.com/resource.aspx?IDX=7917|archive-date=2011-09-28}}</ref> |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1/2 unit: !BD Ultra Fine II (short)<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref><ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |} {{clear right}} === Oral === An oral syringe is a [[measuring instrument]] used to accurately measure doses of liquid [[medication]], expressed in [[Millilitre#SI%20prefixes%20applied%20to%20the%20litre|millilitres]](mL). They do not have threaded tips, because no needle or other device needs to be screwed onto them. The contents are simply squirted or sucked from the syringe directly into the mouth of the person or animal. Oral syringes are available in various sizes, from 1–10 mL and larger. The sizes most commonly used are 1 mL, 2.5 mL and 5 mL.<ref>{{cite web|url=http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|title=How to use your oral syringe|work=Netdoctor|url-status=live|archive-url=https://web.archive.org/web/20110104083118/http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|archive-date=2011-01-04|date=2012-11-23}}</ref> === Dose-sparing syringes === [[File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|link=https://en.wikipedia.org/wiki/File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|thumb|A dose-sparing syringe and needle being used to draw up a Covid-19 vaccine]] A dose-sparing syringe is one which minimises the amount of liquid remaining in the barrel after the plunger has been depressed. These syringes feature a combined needle and syringe, and a protrusion on the face of the plunger to expel liquid from the needle hub. Such syringes were particularly popular during the [[COVID-19 pandemic]] as vaccines were in short supply.<ref>{{Cite web|title=Government orders 65m syringes ahead of potential Covid-19 vaccine|url=https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/|url-status=live|access-date=2021-04-15|website=www.pulsetoday.co.uk}}</ref> Beaeɛ a menyaa mmoa firiiɛ {{anchor|Medical syringe}} 91bbv18qa9w0ejmddflvqia85q19ubs 133336 133301 2022-08-10T05:54:11Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki Paneɛ yɛ adeɛ a yɛntumi de twe adeɛ firi biribi mu a biribiara sɔ so. (Ɛwom sɛ abɛɛfo deɛ no ayɛ piston ɛsɔ mu denenden airi [[Ahomatrofoɔ|ahoma]] abuadeɛ a wɔfrɛ no ankorɛ anaa "barrel"rel.<ref>http://www.thefreedictionary.com/dental+syringe {{cite web|url=https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|title=Disposable Needles & Syringes &#124; Trigiene Dental &#124; Quality Dental Supplies UK|access-date=2017-08-25|url-status=live|archive-url=https://web.archive.org/web/20180511135451/https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|archive-date=2018-05-11}}</ref>adeɛ no a ɛsɔ so tumi twe ba abɔntene na ɛsan tumi twe kɔ ɛmu , ama paneɛ no kwan ama atwe mframa anaa nsuo afa ahoma tokuro no mu be.Paneɛ no beaeɛ a abue no bua ma nsuo no fa paneɛ no mu kɔ gu adeɛ no a ayɛ sɛ [[ankorɛ]] no mu. Paneɛ taa di dwuma wɔ abɛɛfo [[ayaresabea]] mu pa ara, a ɛboa ma wɔwɔ [[paneɛ]], wɔde [[nsuo]] asi ayarefoɔ so, wɔde mogya nso fa [[paneɛ]] mu na ɛde wɔ ayarefoɔ, na nnoɔma bi te sɛ glue ne lubricants aka ho. Edin paneɛ firi Greekifoɔ kasa mu a ɛkyerɛ sɛ σύριγξ (''syrinx'', meaning "Pan flute", "tube") == AYAREHWƐ HO PANEƐM == {{see also|Hypodermic needle}} [[File:Syringe.jpg|link=https://en.wikipedia.org/wiki/File:Syringe.jpg|thumb|The threads of the [[Luer taper|Luer lock]] tip of this 12mL disposable syringe keep it securely connected to a tube or other apparatus.]] [[File:SyringeAllGlass.jpg|link=https://en.wikipedia.org/wiki/File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, with no parts made from metal, nor any other material.]] [[File:Rekord-Spritze.jpg|link=https://en.wikipedia.org/wiki/File:Rekord-Spritze.jpg|thumb|An antique glass and metal syringe]] Beaeɛ a ɛwɔ paneɛ konko ho ne mpaneɛ adwasuo bi ne disposable and [[Safety syringe|safety syringes]], injection pens, needleless injectors, insulin pumps, and specialty needles.<ref>{{cite web|title=Disposable Syringe Markets|publisher=TriMark Publications, LLC|date=June 2013|url=http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140911154606/http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|archive-date=2014-09-11}}</ref> Hypodermic syringes yɛde ɛne [[Hypodermic needle|hypodermic paneɛ]] [[Injection (medicine)|na yɛde twe nsuo anaa mframa,]] dekɔ nnipa dua no mu anaa sɛ yɛde twe firi nipadia no mu. Mframa a yɛtwe dekɔ mogya ntini mu no yɛ adeɛ ɛhu yie, sɛ ɛbɛtumi de [[air embolism]] aba, sɛ yɛbɛbɔ embolisms ho ban no, sɛ yɛretwe mframa afiri paneɛ konkora mu no yɛ ɔkwan baako a sɛ wohwɛ mfonin a ɛwɔ hɔ yi bi a yɛde ano ahwɛ soro, a yɛretwetwe no, a yɛrepia nsuo kakra bi afiri mu ansana yɛde awɔ mogya ntini no. Ankorɛ a ɛsɔ paneɛ so no yɛ ruba anaa glaase, a ahyɛnson deɛ wɔ ho a ɛkyerɛ nsuo dodoɔ anaa aduro dodoɔ a ɛwɔ mu, aberɛ biara no ɛyɛ adeɛ a ɛmu da hɔ a wotumi hunu mu. Ahwehwɛ paneɛ we tumi yɛ [[Sterilization (microbiology)|sterilized]] wɔ [[autoclave]]. Ruba deɛ no deɛ yɛtumi yɛ no afa mmienu anaa mmiɛnsa. Ruba deɛ no a ɛkura afa mmienu no deɛ mpɛn pii no ɛwɔ nsɔ ano a yɛde ruba ayɛ yɛasi ano wɔ ɛne ankorɛ no ntem, beaeɛ a wayɛ no mmienu kyerɛ sedeɛ ɛbɛyɛ a ɛbɛkye ruba no ne ankorɛ no a ɛsɔ so no a wasi ano sedeɛ ɛbɛyɛ a ɛho nhia sɛ wobɛtete paneɛ no ne ankorɛ no ntem ansa na wode adi dwuma.Two-part syringes yɛ adeɛ a wɔde de dwuma Amanɔne nkuro so [[Europe|European countries]] sedeɛ ɛbɛyɛ a wɔbɛtumi abera silicone oil a wɔde ngo serasera three-part plungers.<ref>{{cite web|title=The Anatomy of the Hypodermic Needle and Syringe|url=https://www.exchangesupplies.org/article_the_anatomy_of_a_hypodermic_needle_and_syringe.php|website=www.exchangesupplies.org|access-date=18 May 2021}}</ref> Abɛɛfo mpaeɛ aba no modern medical syringes are plastic because they are cheap enough to dispose of after being used only once, reducing the risk of spreading [[Blood-borne disease|blood-borne diseases]]. Reuse of needles and syringes has caused spread of diseases, especially [[HIV]] and [[hepatitis]], among intravenous drug users. Syringes are also commonly reused by diabetics, as they can go through several in a day with multiple daily insulin injections, which becomes an affordability issue for many. Even though the syringe and needle are only used by a single person, this practice is still unsafe as it can introduce bacteria from the skin into the bloodstream and cause serious and sometimes lethal infections.<ref>{{cite web|url=http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|title=Is it safe to reuse an insulin syringe? - CNN.com|first=Asked by|last=Bethany|website=[[CNN]]|url-status=live|archive-url=https://web.archive.org/web/20170710123054/http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|archive-date=2017-07-10}}</ref> In medical settings, single-use needles and syringes effectively reduce the risk of cross-contamination.<ref>{{cite web|title=Disposable Medical Supplies Markets|publisher=TriMark Publications, LLC|date=July 2014|url=http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140224004233/http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|archive-date=2014-02-24}}</ref> Medical syringes are sometimes used without a needle for orally administering liquid medicines to young children or animals, or milk to small young animals, because the dose can be measured accurately and it is easier to squirt the medicine into the subject's mouth instead of coaxing the subject to drink out of a measuring spoon. === Standard U-100 insulin syringes === [[File:Standard_insulin_syringe.JPG|link=https://en.wikipedia.org/wiki/File:Standard_insulin_syringe.JPG|thumb|Insulin syringes are marked in insulin "units".]] Syringes for [[insulin]] users are designed for standard U-100 insulin. The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "units" of insulin.<ref>{{cite journal|pmid=12060790|title=Making the unit of insulin: standards, clinical work, and industry, 1920–1925|date=2010-12-08|volume=76|issue=2|journal=Bull Hist Med|pages=231–70|author=Sinding C|doi=10.1353/bhm.2002.0097|s2cid=44334307}}</ref> Since insulin vials are typically 10 mL, each vial has 1000 units. Insulin syringes are made specifically for self injections and have friendly features: * shorter needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> as insulin injections are [[Subcutaneous injection|subcutaneous]] (under the skin) rather than intramuscular, * finer gauge needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> for less pain, * markings in insulin units to simplify drawing a measured dose of insulin, and<ref>{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|title=BD Diabetes-Syringe Capacity and Dose Size|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110707095615/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|archive-date=2011-07-07}}</ref> * [[Low dead space syringe|low dead space]] to reduce complications caused by improper drawing order of different insulin strengths.{{citation needed|date=March 2017}} {| class="wikitable" ! colspan="2" |'''U-100 Syringe Sizes and Markings''' |- ! colspan="2" |1cc (1 mL) Syringe |- !Holds maximum: !100 units<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 2 units:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> (all but 31 gauge needle) |- !Smallest line measures 1 unit: !Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringe demonstration-their syringes all measure in 1 unit increments|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |1/2cc (0.5 mL) Syringe |- !Holds maximum: !50 units<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Ulti-Care<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref>{{cite web|url=http://www.ulti-care.com/ultiguard_insulinsyringes.html|title=Ulti-Care U100 Syringes-Product Information|publisher=Ulti-care.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110717150302/http://www.ulti-care.com/ultiguard_insulinsyringes.html|archive-date=2011-07-17}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes demonstration-all syringes with 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |3/10cc (0.3 mL) Syringe |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD Micro Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> BD Ultra Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> (standard length only) Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes-all products measure in 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> UltiCare<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |Half-unit scale 3/10cc (0.3 mL) Syringe<ref>{{cite web|url=http://www.bd.com/resource.aspx?IDX=7917|title=Comparison of 3/10 cc syringe marks—half unit and whole unit scale-BD|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121135/http://www.bd.com/resource.aspx?IDX=7917|archive-date=2011-09-28}}</ref> |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1/2 unit: !BD Ultra Fine II (short)<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref><ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |} {{clear right}} === Oral === An oral syringe is a [[measuring instrument]] used to accurately measure doses of liquid [[medication]], expressed in [[Millilitre#SI%20prefixes%20applied%20to%20the%20litre|millilitres]](mL). They do not have threaded tips, because no needle or other device needs to be screwed onto them. The contents are simply squirted or sucked from the syringe directly into the mouth of the person or animal. Oral syringes are available in various sizes, from 1–10 mL and larger. The sizes most commonly used are 1 mL, 2.5 mL and 5 mL.<ref>{{cite web|url=http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|title=How to use your oral syringe|work=Netdoctor|url-status=live|archive-url=https://web.archive.org/web/20110104083118/http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|archive-date=2011-01-04|date=2012-11-23}}</ref> === Dose-sparing syringes === [[File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|link=https://en.wikipedia.org/wiki/File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|thumb|A dose-sparing syringe and needle being used to draw up a Covid-19 vaccine]] A dose-sparing syringe is one which minimises the amount of liquid remaining in the barrel after the plunger has been depressed. These syringes feature a combined needle and syringe, and a protrusion on the face of the plunger to expel liquid from the needle hub. Such syringes were particularly popular during the [[COVID-19 pandemic]] as vaccines were in short supply.<ref>{{Cite web|title=Government orders 65m syringes ahead of potential Covid-19 vaccine|url=https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/|url-status=live|access-date=2021-04-15|website=www.pulsetoday.co.uk}}</ref> Beaeɛ a menyaa mmoa firiiɛ {{anchor|Medical syringe}} j538m5myz8hvf8swoi63epehe71bkcc 133337 133336 2022-08-10T06:50:09Z Nana Sintim 11223 Mede atwerɛ no bi aka ho wikitext text/x-wiki Paneɛ yɛ adeɛ a yɛntumi de twe adeɛ firi biribi mu a biribiara sɔ so. (Ɛwom sɛ abɛɛfo deɛ no ayɛ piston ɛsɔ mu denenden airi [[Ahomatrofoɔ|ahoma]] abuadeɛ a wɔfrɛ no ankorɛ anaa "barrel"rel.<ref>http://www.thefreedictionary.com/dental+syringe {{cite web|url=https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|title=Disposable Needles & Syringes &#124; Trigiene Dental &#124; Quality Dental Supplies UK|access-date=2017-08-25|url-status=live|archive-url=https://web.archive.org/web/20180511135451/https://www.trigienedental.co.uk/Disposable_Needles__Syringes--category--417.html|archive-date=2018-05-11}}</ref>adeɛ no a ɛsɔ so tumi twe ba abɔntene na ɛsan tumi twe kɔ ɛmu , ama paneɛ no kwan ama atwe mframa anaa nsuo afa ahoma tokuro no mu be.Paneɛ no beaeɛ a abue no bua ma nsuo no fa paneɛ no mu kɔ gu adeɛ no a ayɛ sɛ [[ankorɛ]] no mu. Paneɛ taa di dwuma wɔ abɛɛfo [[ayaresabea]] mu pa ara, a ɛboa ma wɔwɔ [[paneɛ]], wɔde [[nsuo]] asi ayarefoɔ so, wɔde mogya nso fa [[paneɛ]] mu na ɛde wɔ ayarefoɔ, na nnoɔma bi te sɛ glue ne lubricants aka ho. Edin paneɛ firi Greekifoɔ kasa mu a ɛkyerɛ sɛ σύριγξ (''syrinx'', meaning "Pan flute", "tube") == AYAREHWƐ HO PANEƐM == {{see also|Hypodermic needle}} [[File:Syringe.jpg|link=https://en.wikipedia.org/wiki/File:Syringe.jpg|thumb|The threads of the [[Luer taper|Luer lock]] tip of this 12mL disposable syringe keep it securely connected to a tube or other apparatus.]] [[File:SyringeAllGlass.jpg|link=https://en.wikipedia.org/wiki/File:SyringeAllGlass.jpg|thumb|Syringe made entirely of glass, with no parts made from metal, nor any other material.]] [[File:Rekord-Spritze.jpg|link=https://en.wikipedia.org/wiki/File:Rekord-Spritze.jpg|thumb|An antique glass and metal syringe]] Beaeɛ a ɛwɔ paneɛ konko ho ne mpaneɛ adwasuo bi ne disposable and [[Safety syringe|safety syringes]], injection pens, needleless injectors, insulin pumps, and specialty needles.<ref>{{cite web|title=Disposable Syringe Markets|publisher=TriMark Publications, LLC|date=June 2013|url=http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140911154606/http://www.trimarkpublications.com/products/Disposable-Syringe-Markets.html|archive-date=2014-09-11}}</ref> Hypodermic syringes yɛde ɛne [[Hypodermic needle|hypodermic paneɛ]] [[Injection (medicine)|na yɛde twe nsuo anaa mframa,]] dekɔ nnipa dua no mu anaa sɛ yɛde twe firi nipadia no mu. Mframa a yɛtwe dekɔ mogya ntini mu no yɛ adeɛ ɛhu yie, sɛ ɛbɛtumi de [[air embolism]] aba, sɛ yɛbɛbɔ embolisms ho ban no, sɛ yɛretwe mframa afiri paneɛ konkora mu no yɛ ɔkwan baako a sɛ wohwɛ mfonin a ɛwɔ hɔ yi bi a yɛde ano ahwɛ soro, a yɛretwetwe no, a yɛrepia nsuo kakra bi afiri mu ansana yɛde awɔ mogya ntini no. Ankorɛ a ɛsɔ paneɛ so no yɛ ruba anaa glaase, a ahyɛnson deɛ wɔ ho a ɛkyerɛ nsuo dodoɔ anaa aduro dodoɔ a ɛwɔ mu, aberɛ biara no ɛyɛ adeɛ a ɛmu da hɔ a wotumi hunu mu. Ahwehwɛ paneɛ tumi yɛ [[Sterilization (microbiology)|sterilized]] wɔ [[autoclave]]. Ruba deɛ no deɛ yɛtumi yɛ no afa mmienu anaa mmiɛnsa. Ruba deɛ no a ɛkura afa mmienu no deɛ mpɛn pii no ɛwɔ nsɔ ano a yɛde ruba ayɛ yɛasi ano wɔ ɛne ankorɛ no ntem, beaeɛ a wayɛ no mmienu kyerɛ sedeɛ ɛbɛyɛ a ɛbɛkye ruba no ne ankorɛ no a ɛsɔ so no a wasi ano sedeɛ ɛbɛyɛ a ɛho nhia sɛ wobɛtete paneɛ no ne ankorɛ no ntem ansa na wode adi dwuma.Two-part syringes yɛ adeɛ a wɔde de dwuma Amanɔne nkuro so sedeɛ ɛbɛyɛ a wɔbɛtumi abera silicone oil a wɔde ngo serasera three-part plungers.<ref>{{cite web|title=The Anatomy of the Hypodermic Needle and Syringe|url=https://www.exchangesupplies.org/article_the_anatomy_of_a_hypodermic_needle_and_syringe.php|website=www.exchangesupplies.org|access-date=18 May 2021}}</ref> Abɛɛfo mpaeɛ a ba no yɛ ruba ɛfiri sɛ ne boɔ nyɛ den koraa a sɛ wode yɛ adwuma wei wobɛtumi ato atwene wɔ aberɛ a womfa nkɔ wɔ nipa foforo a ɛbɛte ɛhu a ɛwom sɛ ɛbɛtrɛtrɛ wɔ [[Blood-borne disease|blood-borne diseases]]. Paneɛ baako a yɛde di dwuma bebree no na ama yareɛ bi te sɛ [[HIV]] ne [[hepatitis]], ɛne nnuro a yɛde yɛ adwuma a wɔnhwɛ no yie. Syringes are also commonly reused by diabetics, as they can go through several in a day with multiple daily insulin injections, which becomes an affordability issue for many. Even though the syringe and needle are only used by a single person, this practice is still unsafe as it can introduce bacteria from the skin into the bloodstream and cause serious and sometimes lethal infections.<ref>{{cite web|url=http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|title=Is it safe to reuse an insulin syringe? - CNN.com|first=Asked by|last=Bethany|website=[[CNN]]|url-status=live|archive-url=https://web.archive.org/web/20170710123054/http://www.cnn.com/2011/HEALTH/expert.q.a/09/28/insulin.syringe.brawley/index.html|archive-date=2017-07-10}}</ref> In medical settings, single-use needles and syringes effectively reduce the risk of cross-contamination.<ref>{{cite web|title=Disposable Medical Supplies Markets|publisher=TriMark Publications, LLC|date=July 2014|url=http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|url-status=live|archive-url=https://web.archive.org/web/20140224004233/http://www.trimarkpublications.com/products/Disposable-Medical-Supplies-Markets.html|archive-date=2014-02-24}}</ref> Medical syringes are sometimes used without a needle for orally administering liquid medicines to young children or animals, or milk to small young animals, because the dose can be measured accurately and it is easier to squirt the medicine into the subject's mouth instead of coaxing the subject to drink out of a measuring spoon. === Standard U-100 insulin syringes === [[File:Standard_insulin_syringe.JPG|link=https://en.wikipedia.org/wiki/File:Standard_insulin_syringe.JPG|thumb|Insulin syringes are marked in insulin "units".]] Syringes for [[insulin]] users are designed for standard U-100 insulin. The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "units" of insulin.<ref>{{cite journal|pmid=12060790|title=Making the unit of insulin: standards, clinical work, and industry, 1920–1925|date=2010-12-08|volume=76|issue=2|journal=Bull Hist Med|pages=231–70|author=Sinding C|doi=10.1353/bhm.2002.0097|s2cid=44334307}}</ref> Since insulin vials are typically 10 mL, each vial has 1000 units. Insulin syringes are made specifically for self injections and have friendly features: * shorter needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> as insulin injections are [[Subcutaneous injection|subcutaneous]] (under the skin) rather than intramuscular, * finer gauge needles,<ref name="autogenerated1">{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|title=BD Diabetes-Insulin Syringe Needle Sizes|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121119/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7253|archive-date=2011-09-28}}</ref> for less pain, * markings in insulin units to simplify drawing a measured dose of insulin, and<ref>{{cite web|url=http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|title=BD Diabetes-Syringe Capacity and Dose Size|publisher=Bd.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110707095615/http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252|archive-date=2011-07-07}}</ref> * [[Low dead space syringe|low dead space]] to reduce complications caused by improper drawing order of different insulin strengths.{{citation needed|date=March 2017}} {| class="wikitable" ! colspan="2" |'''U-100 Syringe Sizes and Markings''' |- ! colspan="2" |1cc (1 mL) Syringe |- !Holds maximum: !100 units<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 2 units:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetes1">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|title=Close-up of BD 1cc Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083626/http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> (all but 31 gauge needle) |- !Smallest line measures 1 unit: !Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringe demonstration-their syringes all measure in 1 unit increments|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |1/2cc (0.5 mL) Syringe |- !Holds maximum: !50 units<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !10 unit increments<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD<ref name="childrenwithdiabetescc">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|title=Close-up of BD 1/2 cc Syringes—UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS05cc.jpg|archive-date=2016-02-15}}</ref> Precision Sure Dose<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Ulti-Care<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref>{{cite web|url=http://www.ulti-care.com/ultiguard_insulinsyringes.html|title=Ulti-Care U100 Syringes-Product Information|publisher=Ulti-care.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110717150302/http://www.ulti-care.com/ultiguard_insulinsyringes.html|archive-date=2011-07-17}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes demonstration-all syringes with 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref> Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |3/10cc (0.3 mL) Syringe |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1 unit:<ref name="autogenerated2">{{cite web|url=http://www.vetmed.wsu.edu/clientED/diabetes.asp|title=Diabetes Mellitus-Washington State University|publisher=Vetmed.wsu.edu|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110103175134/http://www.vetmed.wsu.edu/ClientED/diabetes.asp|archive-date=2011-01-03}}</ref> !BD Micro Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> BD Ultra Fine<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> (standard length only) Monoject<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> Easy Touch<ref>{{cite web|url=http://www.easytouchsyringes.com/quality.htm|title=Easy Touch Syringes-all products measure in 1 unit increment markings|publisher=Easytouchsyringes.com|access-date=2010-12-30|url-status=dead|archive-url=https://web.archive.org/web/20110710164413/http://www.easytouchsyringes.com/quality.htm|archive-date=2011-07-10}}</ref> UltiCare<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |- ! colspan="2" |Half-unit scale 3/10cc (0.3 mL) Syringe<ref>{{cite web|url=http://www.bd.com/resource.aspx?IDX=7917|title=Comparison of 3/10 cc syringe marks—half unit and whole unit scale-BD|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110928121135/http://www.bd.com/resource.aspx?IDX=7917|archive-date=2011-09-28}}</ref> |- !Holds maximum: !30 units<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Numbered in: !5 unit increments<ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> |- !Smallest line measures 1/2 unit: !BD Ultra Fine II (short)<ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref><ref name="childrenwithdiabetes2">{{cite web|url=http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|title=Close-up of BD 3/10 Syringes-UltraFine-30 Gauge-1/2", UltraFine II Short-31 Gauge-5/16", UltraFine Short-Half Unit Markings-31 Gauge-5/16" & MicroFine-28 Gauge-1/2"|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20160215083627/http://www.childrenwithdiabetes.com/gifs/products/BDUFS03cc.jpg|archive-date=2016-02-15}}</ref> ReliOn<ref name="relion1">{{cite web|url=http://www.relion.com/information/faq-insulin_delivery.htm#4|title=ReliOn Insulin Syringe Markings|publisher=Relion.com|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20101128234003/http://relion.com/information/faq-insulin_delivery.htm#4|archive-date=2010-11-28}}</ref><ref name="diabeteshealth1">{{cite web|url=http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|title=Diabetes Health Syringe Listings|access-date=2010-12-30|url-status=live|archive-url=https://web.archive.org/web/20110710123551/http://www.diabeteshealth.com/media/pdfs/PRG0107/Syringes-PRG-0107.pdf|archive-date=2011-07-10}}</ref> |} {{clear right}} === Oral === An oral syringe is a [[measuring instrument]] used to accurately measure doses of liquid [[medication]], expressed in [[Millilitre#SI%20prefixes%20applied%20to%20the%20litre|millilitres]](mL). They do not have threaded tips, because no needle or other device needs to be screwed onto them. The contents are simply squirted or sucked from the syringe directly into the mouth of the person or animal. Oral syringes are available in various sizes, from 1–10 mL and larger. The sizes most commonly used are 1 mL, 2.5 mL and 5 mL.<ref>{{cite web|url=http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|title=How to use your oral syringe|work=Netdoctor|url-status=live|archive-url=https://web.archive.org/web/20110104083118/http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm|archive-date=2011-01-04|date=2012-11-23}}</ref> === Dose-sparing syringes === [[File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|link=https://en.wikipedia.org/wiki/File:Oxford_AstraZeneca_COVID-19_vaccine_(2021)_D.jpeg|thumb|A dose-sparing syringe and needle being used to draw up a Covid-19 vaccine]] A dose-sparing syringe is one which minimises the amount of liquid remaining in the barrel after the plunger has been depressed. These syringes feature a combined needle and syringe, and a protrusion on the face of the plunger to expel liquid from the needle hub. Such syringes were particularly popular during the [[COVID-19 pandemic]] as vaccines were in short supply.<ref>{{Cite web|title=Government orders 65m syringes ahead of potential Covid-19 vaccine|url=https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/|url-status=live|access-date=2021-04-15|website=www.pulsetoday.co.uk}}</ref> Beaeɛ a menyaa mmoa firiiɛ {{anchor|Medical syringe}} cnb7beyzkdeqatqg4wzmc4robq5bx2p