Quality assessment and improvement of cancer registration system in Kamrup Urban District: A report.

INTRODUCTION: The global burden of cancer incidence and mortality are rising continuously worldwide. As per the GLOBOCAN 2012 estimates, about 14.1 million cancer cases and 8.2 million cancer deaths occurred and 32.6 million people living with cancer (within 5 years of diagnosis) in 2012 worldwide. Reliable data on the magnitude and the pattern of cancer are essential for monitoring the health of the community, assessing the performance of the health care system. Cancer registries should pay great attention to quality of their data. The completeness of cancer registry data- the extent to which all of the incident cancers occurring in the population are included in the registry database- is an extremely important attribute of a cancer registry. There are mainly four aspects influencing the quality of data namely, comparability, completeness, validity and timeliness. MATERIALS AND METHODS: Data regarding incidence and mortality with methods of diagnosis for individual years were obtained from the National Cancer Registry Program database of the Indian Council of Medical Research for 2009 to 2014 periods and recalculated for combined years (2009-2014). RESULTS: In males in 2009-11, 77.1% were microscopically confirmed cases which are improved in the later years and for the year 2012-2014, it is 81.4%. In females also the percentage of microscopically confirmed cases were increased from 80.2% to 82.9%. An improvement in mortality to incidence ratio was observed over the years. MI ratio in males was improved to 32.9%. for the year 2012-14 as compared to 28.6% for the year 2009-11 while in female MI ratio is also increased from 18.8% to 21.8% over the period from 2009-11 to 2012-14. Whereas DCO was decreased from 12% to 10.7% in males and 7.3% to 6.6% in females respectively from the period 2009-11 to 2012-14. CONCLUSION: Although there is a slight improvement in data quality till date, there is an enormous scope for population based cancer registry Guwahati to improve the data quality.

Cancer statistics in Kamrup urban district: Incidence and mortality in 2007-2011.

PURPOSE: The aim of this study was to report cancer statistics in Kamrup Urban District, including incidence and, mortality. INTRODUCTION: In the last five year PBCR-Guwahati witnessed a remarkable growth in cancer incidence cases. The number of new cases of all cancer was increased from 155.3 to 188.5 and 102.7 to 165.3 per 100,000 men and women respectively from the year 2007 to 2011 in KUD. The data from KUD also have shown that for some of the specific types of cancer are highest or some of the highest incidence in rates in the world; particularly cancers of upper aero-digestive tract consist of anatomical sites such as oral cavity, hypopharynx, larynx gallbladder, stomach, lung, prostate and oesophageal cancer. MATERIALS AND METHODS: Age-standardized rates (ASR) (per 100,000 person-years) for incidence, mortality were calculated using the World Standard Population as proposed by Segi and modified by Doll et al. Descriptive statistics were presented by tables and figures. RESULTS: A total of 6623 number of cases (male = 3809, female = 2814) were diagnosed with cancer in the last five years (2007-2011) period of time. The overall age standardized cancer incidence rate is almost 21% higher in men than in women. The pooled ASR for the five year period is 175.2 and 144.7 per 100,000 men and women. CONCLUSION: Overall cancer incidence and mortality rates have increased since 2007.

Patterns of upper aero-digestive tract cancers in Kamrup Urban District of Assam: a retrospective study.

BACKGROUND: The incidence of upper aero-digestive tract (UADT) cancers, including C00-C14, C30-C32, C15 and C16, is increasing rapidly in Kamrup Urban District (KUD) of Assam, North East (NE) India. According to the NCRP (2013) report 37.6% of all cancers in both sexes are UADT cancers in the NE region, accounting for 53.3% in males and about 27.5% in females of the total cases MATERIALS AND METHODS: A retrospective study was conducted for patient information from the period of 2008-2011. Age-standardized or age-adjusted rates (ASR or AAR) (per 100,000 person-years) were calculated using the World Standard Population as proposed by Segi and modified by Doll et al. The registry population area at risk was estimated using the 1991 and 2001 census population by sex, as well as the growth rate during that interval using the difference distribution method. RESULTS: There were 5,638 cases registered during the last four years of the study (2008-2011) accounting for 56.7% (3,198/5,638) of the total in males and 43.3% (2,440/5,638) in females. The male: female ratio was 1.31: 1.00. The overall age adjusted rates (AAR) were 179.4 and 153.8 per 100 000 males and females respectively. Cancer of the oesophagus was most common in both sexes, with most appreciable gender variation for tongue and hypopharynx, presumably reflecting differential exposure to risk factors.

Descriptive report on pattern of variation in cancer cases within selected ethnic groups in Kamrup Urban District of Assam, 2009-2011.

BACKGROUND: The global burden of cancer is continuously increasing. According to recent report of the National Cancer Registry Programme (NCRP) on time trends it is estimated that future burden of cancer cases for India in 2020 will be 1,320,928. It is well known that knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. It would help health planners to formulate public health policy if relevant ethnic groups were considered. North East-India alone contains over 160 Scheduled Tribes and 400 other sub-tribal communities and groups, whose cancer incidence rates are high compared to mainland India. As since no previous study was done focusing on ethnicity, the present investigation was performed. MATERIALS AND METHODS: In this paper PBCR-Guwahati data on all cancer registrations from January 2009 to December 2011 for residents of the Kamrup Urban District, comprising an area of 261.8 sq. km with a total population of 900,518, including individual records with information on sex, age, ethnicity and cancer site are provided. Descriptive statistics including age adjusted rates (AARs) were taken as provided by NCRP. For comparison of proportional incidence ratios (PIR) the Student's t test was used, with p<0.05 considered as statistically significant. RESULTS AND CONCLUSIONS: Differences in leading sites of Kamrup Urban District since from the beginning of the PBCR-Guwahati were revealed among different ethnic groups by this study. The results should help policy makers to formulate different strategies to control the level of burden as well as for treatment planning. This study also suggests that age is an important factor of cancer among different ethnic populations as well as for overall population of Kamrup District of Assam.

Cancer: scenario and relationship of different geographical areas of the globe with special reference to North East-India.

BACKGROUND: Cancer is becoming the most important public health burden around the globe. As per the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths were estimated to have occurred in 2008. The burden of cancer cases for India in the year 2020 is calculated to be 1,148,757 (male 534,353; female 614,404) compared to 979,786 in 2010. The pattern of cancer incidence is varying among geographical regions, esophageal cancer for example being high in China, lung cancer in USA, and gallbladder cancer in Chile. The question remains why? Is it due to the diversity in genome pool, food habits, risk factor association and role of genetic susceptibility or some other factors associated with it? In India, the North East (NE)-India region is seeing a marked increase in cancer incidence and deaths, with a very different cancer incidence pattern compared to mainland India. The genome pool of the region is also quite distinct from the rest of India. Northeastern tribes are quite distinct from other groups; they are more closely related to East Asians than to other Indians. In this paper an attempt was made to see whether there is any similarity among the pattern of cancer incidence cases for different sites of NE-India region to South or East-Asia. MATERIALS AND METHODS: Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA), Pearson Correlation coefficient test was assessed to evaluate the linkage of North-East India region to other regions. A p value <0.05 was considered as statistically significant. RESULTS: The results clearly shows that there are similarities in occurrence of cancer incidence patterns for various cancer sites of NE-India with South and East-Asian regions, which may lead to the conclusion that there might be a genetic linkage between these regions.