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Indian Journal of Community Medicine

Cancer Morbidity and Mortality Profile in Jabalpur - A Hospital Based Study

Author(s): A. Sinha, P.K. Kasar, R. Tiwari, A. Sharma, T.R. Jadhav, H.B. Kalikoty, B.K. Kori, D.K. Pal

Vol. 31, No. 1 (2006-01 - 2006-03)

A. Sinha, P.K. Kasar, R. Tiwari, A. Sharma, T.R. Jadhav, H.B. Kalikoty, B.K. Kori, D.K. Pal

Introduction

There are over 20 million people living with cancer in the world today. The estimated number of new cases each year is expected to increase from 10 million in 2000 to 15 million in 2020. Some 60% of all these new cases will occur in the less developed world. Cancer is currently the cause of 12% of all deaths worldwide. In approximately 20 years time, the number of cancer deaths annually will increase from about 6 million to about 10 million1. Cancer has now become the third leading cause of death in South East Asia Region Countries2. Cancer becomes a major cause of death once the individual survives the first 5 years of life. Age is the single most risk factor for cancers3. There is an urgent need to generate authentic sitespecific date from various parts of the country.

The objective of the present study was to study the distribution pattern of different types of cancers in and related mortality in different age groups of the patients attending the OPD.

Material and Methods

The study was conducted at the SJB Cancer Hospital attached to the Netaji Subhash Chandra Bose Medical College, Jabalpur (MP), India. The study is an observational (cross-sectional) study of the patients who were registered in the SJB Cancer Hospital from January 01 to December 31, 2001. The available data of all the patients attending the Cancer Hospital during the study period of 1 year was entered into a pre-designed and pre-tested proforma. The patients who attended the OPD or admitted more than once during the study period were counted only once, that is, multiple OPD/admissions were excluded from the study. The data so collected was fed into a computer, analyzed and presented in the form of suitable figures, rates and percentages. The different sites of cancers were classified according to the International Classification of Diseases (ICD-10) given by the WHO.

Results and Discussion

A total of 1509 patients were registered in the OPD registers out of which 873 patients were admitted and 33 died. Mean age for cancers was 48.69 years. For males it is 50.75 years and for females it is 47.3 years. The male to female ratio comes out to be 0.66 which is nearly same as that reported from other parts of India4. Top 5 cancers in males in our study were:

Oral cavity – 19.56%, Reticulo-endothelial system (RES) - 12.21%, Secondaries – 9.61%, Esophagus – 7.79% and Larynx – 6.30%. Whereas it is lungs followed by stomach for developing countries5. Similarly, top 5 cancers in females in our study were: Cervix – 54.70%, Breast – 15.23%, Oral cavity – 5.62%, Ovary – 3.20% and Retiulo-endothelial System – 2.98%. Whereas it is Ca-Breast followed by Ca-Cervix for developing countries5.

Table I: Commonest Cancers in Different Age Groups

Age Groups Cancers
  MALES (n = 32) FEMALES (n = 14)
0-15 Years (n = 46) 1. RES (43.7%) 1. Eye (35.5%)
  2. Connective tissue (21.8%) 2. Connective tissue (21.4%)
  3. Brain (9.3%) 3. RES (14.2%)
  MALES (n = 56) FEMALES (n = 86)
16-30 years (n – 142) 1. RES (30.3%) 1. Cervix (55.8%)
  2. Bones (12.5%) 2. Breast (13.9%)
  3. Oral Cavity (12.5%) 3. RES (9.3%)
  MALES (n = 130) FEMALES
31-45 Years (n = 471) 1. Oral Cavity (22.3%) 1. Cervix (58.6%)
  2. RES (13.07%) 2. Breast (17%)
  3. Secondaries (7.6%) 3. Ovary (4.6%)
  MALES (n =204 ) FEMALES (n =336 )
46-60 Years (n = 540) 1. Oral Cavity (24%) 1. Cervix (56.87%)
  2. Secondaries (11.7%) 2. Breast (15.47%)
  3. RES (8.3%) 3. Oral Cavity ( %)
  MALES (n = 183) FEMALES ( = 127)
>60 Years (n = 310) 1. Oral Cavity (18%) 1. Cervix (44.8%)
  2. Esophagus (13.2%) 2. Breast (12.5%)
  3. Larynx (10.9%) 3. Escophagus (7.8%)

Top 3 cancers requiring admissions in males (n = 382) were: Oral Cavity – 16.23%, RES – 14.92% and Esophagus – 9.94% and in females (n = 491) were: Cervix – 51.93%, Breast - 16.49%, Ovary – 5.70%. Of the total cancer patients admitted, 43.7% were males and 56.3% were females, giving the male to female ratio of 0.77. About 2% of all OPD and 4% of admitted cancer patients during the study period died. (Table I) Among the total deaths, 51.5% were male and 48.4% were females giving a male-female ratio of 1.06. Mean age for death was 50.6 years (males = 56.5 and females = 44.5 years) Top 5 cancers leading to death in males (n = 17) were: Oral Cavity, RES, Larynx, Secondaries and Esophagus. Top 5 cancers leading to death in females (n = 16) were: Cervix, Breast, RES, Secondaries, and Lung. Case fatality rates for different and admission rate for cancers were 1.17%, 3.73% and death rate 2.10% respectively.

Conclusion

In India, a large (55%) of cancers occur in easily accessible parts of the body, This highlights the possibility of easy and early detection of a large percentage of cancers in the population thus decreasing the cancer burden in the community.

Acknowledgements

  1. Dr. A S Rathore, MD (Radiotherapy), Professor and Head, Department of Radiotherapy, Smt. Jadao Ba Cancer Hospital attached to NSCB Medical College, Jabalpur (MP) INDIA.
  2. Dr. Sanjay Jain, MD (Radiotherapy), Department of Radiotherapy, Smt. Jadao Ba Cancer Hospital attached to NSCB Medical College, Jabalpur (MP) INDIA.
  3. Dr. Mathew, MD (Radiotherapy), Department of Radiotherapy, Smt. Jadao Ba Cancer Hospital attached to NSCB Medical College, Jabalpur (MP) INDIA.

References

  1. WHO National Cancer Control Programs. Policies and Managerial Guidelines. Second edition. WHO Geneva 2002.
  2. WHO World Health Report – 2001, Geneva, WHO, 2002.
  3. WHO World Health Report – 1999, Geneva, WHO, 2000.
  4. ICMR Cancer prevalence from urban areas of India. National Cancer Registry Program (NCRP). Indian Council of Medical Research Report 2002.
  5. Ferlay J. et. al. GLOBOCAN 2000: Cancer incidence, Mortality and Prevalence worldwide. IARC.

Department of Community Medicine, NSCB Medical College,
Jabalpur (MP) 482003 INDIA
E-mail: [email protected]

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