Abstract
Objective: Cancer patterns and incidence rates for a rural population (359,674) resident in 384 villages spread over 2058 km2 in Palani and Oddanchathram taluks of Dindigul District, Tamil Nadu, in South India, are described in this paper.
Methods: A population-based cancer registry was established in 1995 to register incident invasive and in-situ cancers. Cases were found and details abstracted by cancer registry staff visiting 26 data sources, comprising cancer hospitals, tertiary and secondary care hospitals, pathology laboratories and death registration offices. A customized version of CANREG-3 software was used for data entry and analysis.
Results: During the period 1996–1998, 783 invasive cancers (310 male and 473 females) were registered, yielding an all-cancer crude incidence rate of 56.8/100,000 males and 88.5/100,000 females; the corresponding age standardized incidence rates (ASR) were 83.3 and 122.3 respectively. In males, mouth cancer (ASR 11.5) was the most frequently recorded malignancy followed by tongue (ASR 8.6), hypopharynx (ASR 7.8), esophagus (ASR 7.8) and larynx (ASR 7.8). Thus head and neck cancers accounted for half of the male cases. In females, cervical cancer (ASR 65.4) accounted for more than half of the cancers followed by breast (ASR 14.2) and mouth (ASR 10.2). Ambillikai Cancer Registry (ACR) reports the second highest incidence of cervical cancer in the world. More than four-fifths of cervical cancer cases were diagnosed in stages II B and III B; a third of these cancer patients either did not have, or did not complete, treatment.
Conclusions: The observed cancer patterns in this population establish that measures directed at prevention and early detection (linked with treatment) of cervix and head and neck cancers are of paramount importance for cancer control in this and other rural populations of India where three-fourths of the total population live.
Similar content being viewed by others
References
Jayant K, Rao RS, Nene BM, Dale PS (1991) A Report of the Rural Cancer Registry. Bombay, India: Tata Memorial Centre.
Jayant K, Rao RS, Nene BM, Dale PS (1997) Cancer incidence in Barshi, Paranda and Bhum, India, 1988-1992. In: Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J, eds. Cancer Incidence in Five Continents. Vol. VII (IARC Scientific Publications 143). Lyon: International Agency for Research on Cancer, pp. 342–345.
Hermanek P, Sobin LH, eds (1987) TNM Classification of Malignant Tumours, 4th edn. International Union Against Cancer. Geneva: Springer-Verlag, pp. 104–106.
Jensen OM, Parkin DM, MacLennan R, Muir CS, Skeet RG (1991) Cancer Registration: Principles and Methods (IARC Scientific Publications 95). Lyon: International Agency for Research on Cancer.
WHO (1990) International Classification of Diseases for Oncology, 2nd edn. Geneva: World Health Organization.
Cooke A (1998) CanReg3 Manual. Internal Report 98/03. Lyon: International Agency for Research on Cancer.
(1995) Census of India: Dindigul District, Tamil Nadu (1991) Madras: Directorate of Census Operations, Madras.
WHO (1992) International Classification of Diseases, 10th edn. Geneva: World Health Organization.
Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J Jr, eds (1997) Cancer Incidence in Five Continents. Vol. VII (IARC Scientific Publications 143). Lyon: International Agency for Research on Cancer.
Parkin DM, Chen VW, Ferlay J, Galceran J, Storm HH, Whelan SL (1996) Comparability and Quality Control in Cancer Registration. IARC Technical Report No. 19. Lyon: International Agency for Research on Cancer.
Sankaranarayanan R, Black RJ, Parkin DM, eds (1998) Cancer Survival in Developing Countries (IARC Scientific Publications 145) Lyon: International Agency for Research on Cancer.
Sankaranarayanan R, Wesley R, Somanathan T, et al. (1998) Performance of visual inspection after acetic acid application (VIA) in the detection of cervical cancer precursors. Cancer 83: 2150–2156.
University of Zimbabwe/JHPIEGO Cervical Cancer Project (1999) Visual inspection with acetic acid for cervical-cancer screening: test qualities in a primary-care setting. Lancet 353: 869–873.
Sankaranarayanan R, Duffy SW, Day NE, Krishnan Nair M, Padmakumari G (1989) A case control investigation of cancer of the oral tongue and the floor of the mouth in southern India. Int J Cancer 44: 617–621.
Sankaranarayanan R, Duffy SW, Krishnan Nair M, Padmakumari G, Day NE (1990) Tobacco and alcohol as risk factors in cancer of the larynx in Kerala, India. Int J Cancer 45: 879–882.
Sankaranarayanan R, Duffy SW, Padmakumari G, Day NE, Krishnan Nair M (1990) Risk factors for cancer of the buccal and labial mucosa in Kerala, India. J Epidemiol Commun Health 44: 286–292.
Mathew B, Sankaranarayanan R, Sunilkumar KB, Binu K, Pisani P, Krishnan Nair M (1997) Reproducibility and validity of oral visual inspection by trained health workers in the detection of oral precancer and cancer. Br J Cancer 76: 390–394.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rajkumar, R., Sankaranarayanan, R., Esmi, A. et al. Leads to cancer control based on cancer patterns in a rural population in South India. Cancer Causes Control 11, 433–439 (2000). https://doi.org/10.1023/A:1008900425151
Issue Date:
DOI: https://doi.org/10.1023/A:1008900425151