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Home News and Update Year 2010 Prevention and Control of Cancers in Indian Women

Prevention and Control of Cancers in Indian Women

Times of India
27 March 2010

Dr Rajendra Badwe, Director, Tata Memorial Centre
As India transits from a developing to a developed country, new challenges in the healthcare sector are emerging in the form of non communicable diseases like cancer, cardiovascular and diabetes, while older ones like malaria, tuberculosis and other infections remain uncontrolled. Since women constitute half of India’s population and have been somewhat unequal partners in its development, the challenge of providing equitable and universal healthcare to them is even greater.

Among the non-communicable diseases, cancer is one of the most important causes of death and suffering. There is hardly a family without a close relative with this disease. The single most important risk factor for cancer, often under appreciated by both health professionals and public, is increasing age. As India ages, the number of cancer cases is going to sharply increase even if age specific incidence remains the same. On the other hand with a change in lifestyle, the incidence itself is increasing for some of the important cancers. Both these facts mean that the healthcare system should be ready to deliver care to a large number of patients in the coming years.

Prevention, however, should be the primary goal of any disease control programme including cancer. Data on cancer occurrence is gathered under the National Cancer Registry Programme of ICMR. This data has given some important leads in cancer prevention and control. There is a difference in the pattern of cancers in rural versus urban regions of the country. In numbers cervical cancer and breast cancer are the two commonest cancers in Indian women – with approximately 132000 and 100000 estimated new cases every year respectively. For breast cancer, it is likely that aspects of urban lifestyle like obesity, later age at first childbirth, diet etc. are responsible. On the other hand cervical cancer continues to be the commonest cancer in rural women. Again, although the exact reasons are unclear, it is likely that a number of factors related to rural residence and lifestyle like early marriages and childbirths, higher number of pregnancies and poor hygiene including sexual hygiene may be responsible for this difference. In this context the role of human papilloma virus (HPV) in cervical cancer is well established.

With changing lifestyle and lesser physical activity for work and household purposes, obesity is an increasingly important risk factor especially for breast cancer in postmenopausal women. In addition obesity has been linked to a number of other cancers in women like those that occur in the uterus, large intestine, lower esophagus, gall bladder and ovaries.

The data from the Indian Cancer Registries and Cancer Atlas Project clearly indicates that major cancer types in India are related to tobacco consumption and are a preventable tragedy. Although less common, the incidence of tobacco related cancers in women ranges from 9 to 15 per cent. According to the results of a recent study published in New England Journal of Medicine, the risk of death in female Indian smokers is twice that of female non-smokers and the average life span is 8 years shorter.

The opportunity before Indian scientists, healthcare workers and public is to preserve some of those aspects of our lifestyle that have led to cancer incidence that is only a small fraction of the western rate. The challenge before us is to research and propagate the most healthful lifestyles that synthesize the best aspects of Indian and western cultures.

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