Neoplasia literally means new growth and is commonly used to describe malignancies. Hyperplasia reflects an increase in cell number. This can be seen in both normal and neoplastic tissues. Transformation of hyperplastic tissue into frank neoplasia is rare. Metaplasia represents a reversible transformation of one cell type to another. This is seen with Barrett's mucosa with a change from normal squamous epithelium to an intestinal columnar type. This is frequently the result of chronic irritation and inflammation of the epithelium. Dysplasia refers to an alteration in size, shape and organization of adult cells.

The dominant feature of a carcinoma is its ability to invade the basement membrane and metastasize to surrounding and distant tissues. Local disease is restricted to the primary site, regional disease to the surrounding tissues including lymph nodes and distant disease is metastatic to distant organ sites.

Table 8.1. Relative frequency of cancer by sex

Cancer Men Women

Lung 32 25

Prostate 14 -

Colon 9 10

Leukemia/lymphoma 9 8

Pancreas 5 5

Tumor cells typically require 30 doublings to acquire a size of 1 cm and thereby become palpable.

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