An Alternative Approach to Study the Changes in the Cancer Pattern of Women in India (1988-2005)

Background: The changes in the cancer pattern are often studied with the help of changes in the rank ofleading sites, changes in the Age Adjusted Rates of the sites over the time or with the help of time trends. However,these methods do not quantify the changes in relation to overall changes that occurred in the total cancer casesover the period of time. An alternative approach was therefore used to assess the changes in cancer pattern inrelation to overall changes in time and also an attempt was made to identify the most emerging new cancers inIndia.
Methods: The cancer incidence data of various sites for women, over the periods 1988-90 and 2003-05 inIndia, for five urban registries namely Bangalore, Bhopal, Chennai, Delhi and Mumbai, functioning under thenetwork of National Cancer Registry Programme (ICMR), formed the sources of data for the present analysis.The changes in incidence cases by various cancer sites for women were assessed by calculating the differences inincidence cases over the two period of time. Based on the contribution of each site to total change, the ten mostleading sites were identified separately for each registry. The relative changes in the sites with time were takento identify the most emerging new cancer cases over the period of time.
Results: The pooled cancer cases forwomen among five urban registries increased from 29447 cases in 1988-90 to 48472 cases in 2003-05 registeringan increased of about 63.3%. The lowest percentage of increase was observed in the registry of Chennai (41.5%)and the maximum in Bhopal (102.0%). Based on the pooled figures, the breast cancer contributed to the maximum% change (38%), followed by ovarian (8.0%), gallbladder (5.1%), corpus uteri (4.9%) and cervix uteri (4.1%).Based on the pooled data and relative changes, the emerging new cancers were corpus uteri (187%), gallbladder(162.1%) and lung cancer (136.1%). The % change by sites and the emerging new cancers varied between theregistries.