Polity & Governance Prelims cum Mains

Cancer rate static but number of cases rising as India age

The News

  • According to a study ‘India State-Level Disease Burden Initiative Cancer Collaborators’, the age-standardised incidence of the most common cancers, except breast cancer, has remained static between 1990 and 2016.

 

Need for study

  • While there have been efforts to estimate cancer incidences and mortality previously, state-wise compilation of data was not available.
  • Beside cancer is the second leading cause of death globally after cardiovascular diseases.
  • Given that health is a state subject, it is important to study the cancer incidence and mortality state-wise in order to attack the problem.
  • Thus the cancer burden and variations in states were studied as a part of Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 done recently.
  • The heterogeneity in the state-level cancer incidence rate should be taken into account while designing strategies for cancer prevention and control.

 

About the Study

  • The study was a made using data from the following:
    • National Cancer Registry Programme Reports
    • Sample Registration System cause of death findings
    • Cancer Incidence in Five Continents Series
    • GLOBOCAN
  • The study presents following data for 28 types of cancers:
  1. Trends of incidence over years
  2. Mortality due to cancer in every state from 1990-2016
  3. Leading types of cancers
  • Reason why DALY is the main measure for disease burden:
    • Because it includes both mortality and morbidity
    • It is recommended by the National Health Policy of India for tracking disease burden

 

Key Results

  1. Trends of incidence of Cancer
  • Cancer in general contributed 5.0% of the total DALYs and 8.3% of the total deaths in India in 2016.
  • The estimated number of incident cancer cases in India increased from 548 000 in 1990 to 1 069 000 in 2016.
  • The crude cancer incidence rate in India increased by 28·2% from 63·4 per 100 000 in 1990 to 81·2 per 100 000 in 2016.
  • However there was no change in the age-standardised incidence rate.
  • Crude cancer incidence rate was highest in Kerala and Mizoram, followed by Haryana, Delhi, Karnataka, Goa, Himachal Pradesh, Uttarakhand, and Assam.
  • Age-standardised incidence rates were highest in the northeast states of Mizoram, Meghalaya, Arunachal Pradesh, and Assam.

 

 

  1. Mortality due to cancer in every state from 1990-2016
  • The number of deaths due to cancer in India increased from 382 000 in 1990 to 813 000 in 2016.
  • The crude cancer death rate in India in 2016 was 61·8 per 100 000, as compared with 44·2.
  • While male cancer patients had a 12·3% increase in age-standardised death rate, no substantial changes were found in female cancer patients.
  • The crude death rate was highest in Mizoram, Kerala, and Haryana in 2016, followed by
  • Assam, Karnataka, Odisha, Uttarakhand, Meghalaya, and Himachal.
  • The age-standardised death rates were highest in the northeast states of Mizoram, Meghalaya, Arunachal Pradesh, and Assam.

 

  1. Leading types of cancers
  • The main types of cancer in India in 2016 which are responsible for more than 5% of the total cancer DALYs were
  • Stomach cancer (9·0%), breast cancer (8·2%), lung cancer (7·5%), lip and oral cavity cancer (7·2%), pharynx cancer other than nasopharynx (6·8%), colon and rectum cancer (5·8%), leukaemia (5·2%), and cervical cancer (5·2%).
  • While the age-adjusted incidence of most common cancers remained static, that of breast cancer increased in India by 39.1% from 1990 to 2016.

 

 

Breast cancer

  • The number of breast cancer cases in India in 2016 was 118 000 with 98.1% in females.
  • Breast cancer was the first or second leading cause of cancer deaths among females in 28 Indian states in 2016.
  • Reasons for high incidence of breast cancer are
    • Rising abdominal obesity
    • Late age of child bearing
    • High use of oral contraceptives
    • Genetic susceptibility

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