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A landmark analysis of cancer cases in Delhi, Mumbai, Chennai and Bangalore between 1982-2005 (24 years) by the Indian Council of Medical Research (ICMR) has found that while cervical cancer cases dipped, in some cases by almost 50%, the incidence of breast cancer doubled. And, the trends contained in ICMR’s yet-to-be-released report `Time Trends in Cancer Incidence Rates (1982-2005)’, were universal in all four cities.
In case of cervical cancer, this is how the cases have dropped: In 1982, Bangalore reported 32.4 new cases of cervical cancer in women per 100,000 population every year. The number dipped to 27.2 in 1991, 17 in 2001 and 18.2 in 2005.
Delhi, whose records are available from 1988, saw 25.9 new cases of cervical cancer per 100,000 population the same year. It then dipped to 19.1 in 1998 and then to 18.9 in 2005.
Mumbai, which recorded 17.9 new cases of cervical cancer per 100,000 population in 1982, recorded 12.7 new cases in 2005.
Chennai recorded a fall of almost 50% in cases of cervical cancer in this period of 24 years. In 1982, Chennai recorded 41 cases per 100,000 population; nearly a decade later, in 1991, Chennai’s figure of new cases dipped to 33.4. In 2005, new cases fell further to 22 per 100,000 population.
Caused by the Human Papiloma Virus (HPV), cervical cancer is often called the poor woman’s disease. It was earlier believed that cervical cancer was most common in India, with more than 1.3 lakh new cases reported each year and 74,000 women dying annually from the disease.
While Bangalore saw breast cancer cases more than double since 1982 – 15.8 in a population of one lakh in 1982 to 32.2 in 2005 – Chennai recorded 33.5 new cases of breast cancer in 2005 against 18.4 in 1982.
Delhi recorded 24.8 new cases of breast cancer a year per 100,000 women which rose to 32.2 in 2005. Mumbai recorded 20.8 new cases of breast cancer per 100,000 population in 1982 which increased by almost 10% in 2005.
ICMR director general and secretary of the department of health research Dr V M Katoch told TOI, “The decline in cases of cancer cervix has been seen across all cancer registries. Factors like late age of marriage and fewer children could be responsible for the decline.”
Chief of medical oncology at AIIMS and head of the Delhi Cancer Registry Dr Vinod Raina told TOI, “Increasing number of women are now delivering in institutions which has greatly improved their personal hygiene. Women now marry late and give birth to fewer children, all of which have led to a dip in cervical cancer cases.”
Ironically, these are the same factors, according to Dr Raina, which has increased breast cancer rates in India.
“Western lifestyle, increased consumption of fat products, obesity, late marriages, delayed child bearing and less number of children being conceived leading to reduced breastfeeding and use of some contraceptives, are all believed to be behind this increased risk of breast cancer. This cancer is also inevitable with an ageing population,” he added.
Dr Raina, however, was quick to say that breast cancer rate in India was much less than that in the West which records around 100 new cases per 100,000 population every year.
According to Dr Katoch, the report depicts changes in the incidence rates of cancer and is the first for any chronic disease in India.
Certain anatomical sites of cancer have shown a significantly steady increase across all registries, breast cancer being one of them. “This data will now help galvanize India’s health system and tell us how we can improve diagnostic capabilities and specialists in some types of cancer affecting Indians most,” Dr Katoch said.
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