Abstract
Background
To provide a comprehensive assessment of women cancer in India utilizing the systematically collected data on all cancers by the National Cancer Registry Programme (NCRP).
Methods
The study examined 10,2287 cancer cases among women cancers providing cancer burden for major anatomical sites. Aggregated data of 28 PBCRs and 58 HBCRs under NCRP for 2012–16 was analysed for incidence rates, trends, cumulative risk of developing cancer, stage at detection and treatments offered.
Results
Study results have found region –wide variation of women cancers by indicating highest proportions in western followed by southern region of India. North-Eastern region had lowest proportion. It was observed that breast is highest ranking cancer in most registry areas of urban agglomerations of country while cancer cervix was leading site in registries of rural areas like Barshi (15.3) and Osmanabad &Beed (13.1). States of Mizoram (23.2) and Tripura (9.5) along with Pasighat, Cachar and Nagaland. Median age of occurrence for women for these anatomical sites ranged from 45 to 60 years of age. For cancer breast, cervix and ovary –most cases were detected with regional spread. These findings were different for cancer corpus uteri where registries have reported higher proportions (49.3 %) of localized stage at detection. Loco regional cancers had higher proportions of multimodality treatments.
Conclusion
Study provides a foundation for assessing the status of women cancers in the country. Variations between geographies would guide appropriate support for action to strengthen efforts to improve cancer prevention and control in underserved areas of the country. This would facilitate advocacy for better investments and research on women cancers.
Highlights
- • Higher age specific rates with increasing age are observed for all female reproductive cancers.
- • A significant decline in trend for cervical cancer was seen in registries.
- • Increase in breast cancer incidence rates shows that rates have overtaken cancer cervix during 2000-03.
- • Most of the cases of cancers of breast, cervix and ovary were detected at loco regional stage.
1Introduction
Morbidity and mortality due to cancer are well known globally across continents which are conglomerations of countries of various economies, cultures and geographies. Additive effect of aging population in background of increased life expectancy has made cancer a leading cause of mortality . Women constitute more than half of ageing population in the world . Consistent scientific recordings on cancer occurrences by cancer registries have drawn our attention towards gender-related risk of cancer.
In Indian women,factors attributable towards higher risk of cancer are increasing – dietary changes, physical inactivity, occupation, infections, tobacco usage and alcohol are some of the examples . Consequential risk factors such as delayed child births, low parity and reproductive factors further contribute to burden of cancer . Many of these cancers are related to reproductive organs while some other organs i.e. cancers of gall bladder, thyroid have also shown higher rates in women .
A rapid change in the social status of women,either economic or behavioral (caregiver to caretaker) makes it even more relevant to study cancers in women in Indian scenario . A large scale launch of cancer screening in India by the Ministry of Health and Family Welfare for three cancers under National programme of control and prevention of Cancer, Diabetes, Cardiovascular Diseases and Stroke has two leading cancers in women viz. breast and cervix. A National Cancer Registry Programme (NCRP) is in existence since 1981 which is involved in systematic data collection and covers part of population of the country (11%).
The present study aims to describe the clinicoepidemiological profile of cancers among women in India.The study would focus on incidence, lifetime cumulative risk of developing cancer, median age at occurrence,trends over time, extent of disease at presentation and treatment modalities given in case of reproductive cancers of women.
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