Rural-urban disparity in cancer burden and care: findings from an Indian cancer registry.

BACKGROUND: Cancer incidence and mortality vary across the globe, with nearly two-thirds of cancer-related deaths occurring in low- and middle-income countries. The rural-urban disparity in socio-demographic, behavioural, and lifestyle-related factors, as well as in access to cancer care, is one of the contributing factors. Population-based cancer registries serve as a measure for understanding the burden of cancer. We aimed to evaluate the rural-urban disparity in cancer burden and care of patients registered by an Indian population-based cancer registry. METHODS: This study collected data from Varanasi, Uttar Pradesh, India, between 2017 and 2019. Sex and site-specific age-standardised rates for incidence and mortality per 100,000 population were calculated. Rural-urban disparities in cancer incidence and mortality were estimated through rate differences and standardised rate ratios (with 95% confidence intervals). Univariable and multivariable regressions were applied to determine any significant differences in socio-demographic and cancer-related variables according to place of residence (rural/urban). Crude and adjusted odds ratios with 95% confidence intervals were calculated. RESULTS: 6721 cancer patients were registered during the study duration. Urban patients were older and had better literacy and socioeconomic levels, while rural patients had higher odds of having unskilled or semi-skilled professions. Diagnostic and clinical confirmation for cancer was significantly higher in urban patients, while verbal autopsy-based confirmation was higher in rural patients. Rural patients were more likely to receive palliative or alternative systems of medicine, and urban patients had higher chances of treatment completion. Significantly higher incidence and mortality were observed for oral cancer among urban men and for cervical cancer among rural women. Despite the higher incidence of breast cancer in urban women, significantly higher mortality was observed in rural women. CONCLUSIONS: Low- and middle-income countries are facing dual challenges for cancer control and prevention. Their urban populations experience unhealthy lifestyles, while their rural populations lack healthcare accessibility. The distinctness in cancer burden and pattern calls for a re-evaluation of cancer control strategies that are tailor-made with an understanding of urban-rural disparities. Context-specific interventional programmes targeting risk-factor modifications, cancer awareness, early detection, and accessibility to diagnosis and care are essential.

Coablator-Assisted Excision of an Obstructing Mass in Congenital Hemifacial Hypertrophy.

A case of congenital hemifacial hypertrophy is described. This rare condition is more prevalent in males, and it is characterized by facial asymmetry. Sometimes, Hemifacial hypertrophy can lead to obstruction of the respiratory airway which may prove lethal. Here we made an attempt to present a complicated female case of true congenital hemifacial hypertrophy with its clinical, radiological presentation and surgical treatment. No single theory for hemifacial hypertrophy explains the etiology adequately. A 19-month-old female child was referred to our hospital with difficulty in breathing. She had Hemifacial hypertrophy presents with neck swelling, enlarged ear pinna with hyperpigmentation, and hypertrichosis. Radiological imaging was done, and it was diagnosed as congenital hemifacial hypertrophy. A mass obstructing the oropharynx with tonsillar enlargement was noted. Transoral endoscopic coablator-assisted excision of the oropharyngeal mass with tonsillar excision was done and the airway was secured. The neck fatty mass was excised externally. Follow-up was done for two years. Congenital Hemifacial hypertrophy is a rare congenital condition and has a good prognosis. Generally, Hemifacial hypertrophy presents with neck swelling, enlarged ear pinna with hyperpigmentation, and hypertrichosis. sometimes when presented with respiratory obstruction it can prove fatal which can be managed by securing the airway immediately. Here this case was managed with endoscopic surgical excision of obstruction and no further complications were noted. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04525-x.

Endoscopic Excision of Optic Nerve Schwannoma.

Optic nerve schwannoma (ONS) is an exception in that it does not possess the typical Schwann cells. Instead, it is believed to possibly originate from ectopic neural crest Schwann cells and perivascular Schwann cells. There are very few cases of Optic Nerve Schwannoma reported in literature. The patient is a 68-year-old male who presented with progressive left eye loss of vision. The patient's treatment encompassed Trans Nasal Endoscopic Excision of the mass with simultaneous Orbital Decompression. Laryngoscope, 134:3102-3104, 2024.