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BRIEF RESEARCH ARTICLE
Year : 2018  |  Volume : 62  |  Issue : 3  |  Page : 221-223  

Cancer trends in India: A review of population-based cancer registries (2005–2014)


1 Research Intern, Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India
2 Scientist D, Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India
3 Scientist G, Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh, India
4 Fellow -Head and Neck Surgical Oncology, Department of Surgical Oncology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India

Date of Web Publication12-Sep-2018

Correspondence Address:
Satyanarayana Labani
Division of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_115_17

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   Abstract 


There is a constant rise in cancer cases, but the trends and pattern vary according to the geographical region. The aim of this brief research was to present an update of all cancer incidences through age-adjusted rates and their changes in different regions of the country. The data for this study were obtained from published reports of 28 population-based cancer registries (2005–2014) in India. Among males, currently, East/Northeast region ranked first, on the basis of incidence of cancer cases. Out of 28 registries, 11 registries encountered lung cancer as the leading site. Currently, East/Northeast regions were ranked first on the basis of incidence of cancer cases among females. Our study showed that 20 registries among the 28 had breast cancer as the leading one. Thus, the present overview revealed that all cancers in both males and females are consistent and had a high incidence in East/Northeast region of the country.

Keywords: India, incidence, leading cancer, population-based cancer registries


How to cite this article:
Mohan S, Asthana S, Labani S, Popli G. Cancer trends in India: A review of population-based cancer registries (2005–2014). Indian J Public Health 2018;62:221-3

How to cite this URL:
Mohan S, Asthana S, Labani S, Popli G. Cancer trends in India: A review of population-based cancer registries (2005–2014). Indian J Public Health [serial online] 2018 [cited 2018 Dec 16];62:221-3. Available from: http://www.ijph.in/text.asp?2018/62/3/221/241088



The World Health Organization estimates for 2011 states that, more deaths occur due to cancer than all coronary heart disease or all stroke.[1] According to GLOBOCAN 2012,[2] an estimated of 14.1 million new cancer cases and 8.2 million cancer deaths were reported. Cancer load is on the rise in both developed and economically developing countries, due to population aging and growth and adoption of cancer-linked lifestyle selections such as smoking and physical inactivity.[3] Trend and pattern of cancer cases differ with geographical region. India has come out as a fast-growing economy with changes in lifestyle-related behavior partly accountable for the increasing cancer load.[4],[5]

The cancer incidence data are collected by the population-based cancer registries (PBCR) in India. The National Cancer Registry Programme (NCRP) of India compiles PBCR data from time to time and publishes cancer statistics from registries. Certain studies have evaluated the reliability and completeness of cancer registration in India.[6] Synopsis of such cancer statistics is supportive for researchers and clinicians as quick reference for cancer load in the country. To have a quick summary of cancer statistics on the recent cancer trends, this study attempts to report an overview of the incidence from the NCRP [7] reports by highlighting the cancer load of all sites for various registries. Our objective was to present all cancer incidences from PBCR till date.

The data for this study were obtained from a secondary source of published reports of 28 PBCRs in India. The reports are accumulated by NCRP of Indian Council of Medical Research. The PBCRs in different parts across the country were divided into six regions for the purpose of the present study. The regions were as follows: North: Delhi, Patiala; South: Bengaluru, Chennai, Kollam, Thiruvananthapuram; Central: Bhopal; East/Northeast: Kolkata, Cachar District, Dibrugarh, Kamrup urban District, Manipur, Mizoram, Sikkim, Meghalaya, Tripura, Nagaland, Naharlagun, Pasighat; West: Barshi (Expanded), Mumbai, Ahmedabad (Urban), Aurangabad, Nagpur, Pune, Wardha; and Rural: Barshi (Rural) and Ahmedabad (Rural).

The cancer incidence is computed using the age-specific rate (ASpR) formula:



Taking the data on the incidence of cancer of six major sites among men and women, we summarized the age-adjusted rates (AARs) of incidence. The probability of the incidence of such a risk is presented in terms of one in a number of persons likely to develop cancer in his/her lifetime. AAR or Age-Standardized Rate is computed by using the formula:



Another epidemiological measure to understand cancer load was computed. One out of the total number of persons who develop cancer was calculated as 100/cumulative risk, where cumulative risk = 100 × (1 – exp [cum.rate/100]) and cumulative rate = (5 × ∑[ASpR] × 100)/100,000; ASpR was the age-specific incidence rate. The age-specific incidence rates of cancer of various sites and the AARs are available in the NCRP reports for every site and registry. The site-specific statistics of one out of the total number of persons developing cancer were computed by us for every registry and presented as ranges in each region. One out of the total number of persons who develop cancer is an easily understandable statistics and used for public health messages. The probability of one out of the total number of persons who developed cancer in the lifetime up to 64 years of age was also collected and presented for different registries.

The data for incidence are available since 1982 but only for major registries. As our aim was to study and compare data for all registries, so we started from 2005 to 2014, to maintain data consistency for most of the registries. We also studied the change in the pattern of leading cancer among male and females over a period from 2005 to 2014 for different registries.

Age-adjusted incidence rates and one out of the total number of persons who develop cancer at any site throughout their lifetime of 0–64 years of age, for both gender populations are presented for the different regions in [Table 1] and [Table 2]. In males, the highest incidence of cancer at all sites was seen in East/Northeast region, and the lowest incidence was seen in the rural region for all years. In females, the highest incidence of cancer at all sites was also seen in East/Northeast, and the lowest incidence was seen in the rural region of country for all years.
Table 1: Cancer incidence (all sites) in males for the year (2005-2014) from various regions in India

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Table 2: Cancer incidence (all sites) in females for the year (2005-2014) from various regions in India

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In North region, the leading cancer sites were lung and esophagus for Delhi and Patiala, respectively. Lung remained the leading cancer site for all the registries, under South region. In Bengaluru registry, the leading cancer sites were stomach and lung. In Bhopal registry, lung and mouth were the leading cancer sites. In the rural region, hypopharynx, liver, and mouth were the leading cancer sites in Barshi rural registry. Whereas in Ahmedabad rural, the leading cancer sites were tongue and mouth.

In East/Northeast region of the country, the leading cancer sites varied from the registry to registry. Lung was the leading cancer site for Kolkata and Tripura registry. In Dibrugarh, Kamrup Urban, Cachar, and Meghalaya registries, the leading cancer site was esophagus. Stomach was the leading cancer site for Mizoram, Sikkim, Naharlagun, and Pasighat registry. In Nagaland registry, nasopharynx was the leading cancer site. In West region, lung remained the leading cancer for all registries. In Mumbai and Aurangabad, mouth and lung both were the leading cancer sites.

In North, South, and Central regions of the country, the breast was the leading cancer site, for all the registries under these regions. In West and Rural region both breast and cervix uteri were the leading cancer sites. Variation in cancer sites was seen in East/Northeast region of the country for different registries. In Dibrugarh, breast and esophagus both were the leading cancer sites. Only breast was the leading cancer site at Kamrup Urban, Kolkata, and Cachar. In Sikkim, both breast and cervix uteri were the leading cancer sites. In Manipur, both breast and lung were the leading cancer site. Only cervix uteri were the leading cancer site at Tripura, Nagaland, and Pasighat. Cervix uteri and lung, both were the leading cancer sites in Mizoram. In Meghalaya, esophagus was the leading cancer site. Stomach was the leading cancer site in Naharlagun.

In the present study, the analysis of NCRP data revealed that East/Northeast region experienced the highest incidence of cancer for both genders. Recent data (2012–2014) highlighted Lung as the leading cancer site among males followed by mouth. However, females still encounter breast cancer as leading cancer followed by cervix uteri. Current registries present a rationally fair account of the trends and pattern of cancer in the country.

Among males, currently, East/Northeast region ranked first, on the basis of cancer incidence cases. The lowest incidence is seen in rural region of the country. According to GLOBOCAN 2012,[2] lung cancer is the most common cancer worldwide among males. Similar results were observed by our study, which shows that 11 out of 28 registries encountered lung cancer as the leading Site. The second place was captured by mouth cancer, which was the leading one in 10 registries out of 28. This suggests that tobacco control must be the priority for cancer control in India as smoke or smokeless tobacco is the prime etiological factor for the lung and mouth cancer. The previous time trend prevalence study shows a significant rise of lung cancer in Delhi, Chennai, and Bengaluru [8] and of mouth cancer in Bhopal and Mumbai.

Among females, currently, East/Northeast region ranked first, on the basis of cancer incidence cases. The lowest incidence is seen in the rural region. According to GLOBOCAN 2012,[2] breast cancer is the most common cancer worldwide among females. The same results were observed by our study which shows that 20 registries among the 28 had breast cancer as the leading one. The second most leading site was cervix uteri. This pattern has consistently remained same from 2005 to 2014. This is likely to result due to the prevalence of risk factors that are associated to reproductive, dietary, and other lifestyle factors.[9] However, we observed an unorthodox incidence rate in the Meghalaya registry as esophagus cancer has outnumbered the breast and cervix cancer, suggesting of some concealed risk factor which needs to be investigated.

It has been seen that cancer incidence in India is highest in North-East region of the country. Lack of awareness, socioeconomic conditions, and difficulty of access to the facilities has led to a wide disparity in both diagnosis and treatment of cancers in these regions of the country.[10] All these factors have put North-East region to the forefront as the leading area in cancer incidence. Ranking of other registries basically reflects the urbanized demographic and epidemiologic cancer transition, due to upgradation of the education, lifestyle and access to health care.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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National Cancer Registry Programme. Reports of Population Based Cancer Registries, Bangalore: National Cancer Registry Prorgamme (Indian Council of Medical Research) for the years 2004-2006, 2006-2008, 2009-2011 and 2012-2014. Available from: http://www.icmr.nic.in/ncrp/pbcr_2012-14/ALL_CONTENT/Printed_Version.htm. [Last accessed on 2016 May 25].  Back to cited text no. 7
    
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Malik PS, Raina V. Lung cancer: Prevalent trends & emerging concepts. Indian J Med Res 2015;141:5-7.  Back to cited text no. 8
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Murray CJ, Lopez AD. Global burden of disease and injury series. Global Health Statistics. Boston MA: Harvard School of Public Health; 1996.  Back to cited text no. 9
    
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Krishnatreya M, Kataki AC. A way forward to address the cancer burden in North-East India. Int J Health Allied Sci 2016;5:61-2.  Back to cited text no. 10
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