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Age-wise cancer incidence in western Uttar Pradesh in India: An observational study


1 Department of Radiotherapy and Clinical Oncology, Jawaharlal Nehru Medical College Aligarh Muslim University, Aligarh, Uttar Pradesh, India
2 Department of Pathology, Jawaharlal Nehru Medical College Aligarh Muslim University, Aligarh, Uttar Pradesh, India

Date of Submission29-Jun-2022
Date of Decision05-Aug-2022
Date of Acceptance14-Aug-2022
Date of Web Publication27-Oct-2022

Correspondence Address:
Mahbooba Khazir,
Jamia Urdu Medical Road, Aligarh, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_1339_22

 > Abstract 


Context: According to the World Health Organization report of 2011, the main cause of death was cancer rather than heart diseases. 14.1 million new cases and about 8.2 million deaths occur due to cancer according to the report given by GLOBOCAN 2012.
Aims: This study was conducted to highlight the age-wise cancer incidence in western Uttar Pradesh.
Materials and Methods: This was a cross-sectional study conducted in the department of radiotherapy from 2018-2020. Data were collected from the hospital records of histopathologically confirmed cases of malignancies from 2018 to 2020. Details regarding age, sex and site of the tumor were collected from the clinical records.
Statistical analysis used: Descriptive statistics were used for data calculation as well as summarization, Mean ± SD, percentage, and proportions were calculated.
Results: Age-wise cancer incidence in the head and neck region among both the genders shows that the highest percentage of mouth cancer of 23.19% (409) was found among males above 40 years of age as compared to females with 4.76% (84), the prevalence of breast cancer was increasing with increasing age reaching 42.79% (603) prevalence above the age of 40 years. The highest percentage of lung cancer was found above the age of 40 years 32.57% (459) in the case of males. Gallbladder carcinoma in females was 37.882% (161) and liver malignancies in males were found at 9.41% (40). In the case of the female reproductive system, highest percentage of cervical malignancies having 56.85% (485) next to the cervix it was the ovarian malignancy with a significant percentage of 19.22% (164).

Keywords: Epidemiology, incidence, Uttar Pradesh



How to cite this URL:
Akram M, Khazir M, Khan M, Afrose R. Age-wise cancer incidence in western Uttar Pradesh in India: An observational study. J Can Res Ther [Epub ahead of print] [cited 2022 Dec 9]. Available from: https://www.cancerjournal.net/preprintarticle.asp?id=359817




 > Introduction Top


Both in the developed as well as developing countries most common cause of morbidity and mortality is cancer.[1] According to World Health Organization before the age of 70 years in 112 countries 1st or the 2nd factor for death is cancer by collecting the data from 183 countries in 2019.[2] 14.1 million new cases and about 8.2 million deaths occur due to cancer according to the report given by GLOBOCAN 2012. This increased rate may be because of aging, lifestyle changes as well as physical inactivity.[3] Both cancer patterns as well as cancer rates differ by geographical location. In various investigations, it has been found that India has become a fast-growing economy throughout the world which results in the change in lifestyle and hence increased cancer burden.[4],[5] About 2.25 million cancer cases are registered with almost 1 lakh new cases added every year in India that too is predicted to be doubled by 2040 according to Cancerindia.org.[4],[5]

Epidemiological studies play an important role in both cancer understanding as well as the risk factors associated with and hence the cancer prevention. Previously, only the notable cancers were taken under epidemiological studies but now studies have been conducted to find out the relation of various risk factors with all the types of cancer. No doubt that epidemiological studies have a valuable role in the control as well as prevention of cancer but still fewer studies have been so for conducted. But now the trend is changing enough number of epidemiological studies are being conducted to find out the risk factors and their association with cancer occurrence.

The epidemiological studies of cancer have been conducted in different regions of India but very few studies have been conducted in western Uttar Pradesh. Hence this study was conducted in Aligarh with the objective to find out the age-wise cancer incidence in western Uttar Pradesh.


 > Subjects and Methods Top


Study Site. The study was conducted in Uttar Pradesh.

Study Design. This was a cross-sectional study.

Duration of Study. Data collection was done from 2018 to 2020.

Inclusion criteria. 1. Age [From less than 20 to more than 40 years] 2. Both genders 3. Histopathologically confirmed cases of malignancies.

Exclusion criteria. 1. Pre-malignant lesions. 2. Secondary malignancies.

Data Collection. Data were collected from hospital records as well as laboratory records. Data regarding age, gender and site were collected. A standardized core form was used for the collection of the data.

Statistical Analysis. Descriptive statistics were used for data calculation as well as summarization. Mean ± SD, percentage, and proportions were calculated.

Ethical consideration

An approval from the institutional Ethical Committee was taken and during this study patient information was not disclosed.


 > Results Top


In [Table 1] and [Table 2], age-wise cancer prevalence in the head and neck region among both the genders shows that the highest percentage of mouth cancer of 23.19% (409) was found among males above 40 years of age as compared to females with 4.76% (84) and in the oral cavity it was the tongue which was the most affected site with 22.80% (402) in males and 4.14% (73) in females next to oral cavity tonsils are the affected site of cancer with 6.06% (107) in males and 0.45% (8) in females. It was found that the least affected site in the head and neck region was the pharynx with 0.45% (8) in males and 0.11% (2) in females. The prevalence rate of head and neck cancer in the population of western Uttar Pradesh was found at 0.0024% (1763) in the sample size of 7616, as shown in the [Figure 1]
Table 1: Age-wise cancer prevalence in head and neck region in females

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Table 2: Age-wise cancer prevalence in head and neck region in males

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Figure 1: In this figure prevalence of mouth cancer among the males above 40 years of age is more as compared to females) and in the oral cavity it was the tongue which was the most affected site as compare to other parts of the mouth.

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[Table 3] highlights the age-wise breast cancer and lung cancer prevalence in western Uttar Pradesh, and it was found that below the age of 20 years the breast cancer was having only 0.92% (13) prevalence in females and as the age increases the prevalence was also increasing with reaching 42.79% (603) prevalence above the age of 40 years. As the lung cancer is taken into consideration below the age of 20 years almost 0% was found in males but as the age increases the relative percentage of lung cancer also increases with the highest percentage above the age of 40 years 32.57% (459) in case of males and only 6.31% (89) found in case of females, as shown in the [Figure 2].
Table 3: Age-wise breast cancer and lung cancer prevalence

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Figure 2: Shows that below the age of 20 years the breast cancer was having only 0.92% (13) prevalence in females and as the age increases the prevalence was also increasing with reaching 42.79% (603) above the age of 40 years. As the lung cancer is taken into consideration below the age of 20 years almost 0% was found in males but as the age increases the relative percentage of lung cancer also increases with the highest percentage above the age of 40 years 32.57% (459) in case of males and only 6.31% (89) found in case of females

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[Table 4] highlights the age-wise prevalence of stomach carcinoma, gallbladder carcinoma, and liver carcinoma with the highest percentage of gallbladder carcinoma in females of 37.882% (161) and 19.76% (84) in case of males. Liver malignancies were more found in the case of males with 9.41% (40) than females with 7.76% (33), no significant difference was found in the case of stomach malignancies between either gender. As per the relationship between the age and stomach, gallbladder and liver malignancy was taken into consideration it was found that all the three types of malignancies were increasing with increase in the age and showing the highest percentage above the age of 40 years, as shown in the [Figure 3].
Table 4: Age-wise stomach carcinoma, gallbladder carcinoma, and liver carcinoma

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Figure 3: Shows the relationship between the age and stomach, gallbladder, and liver malignancy it was found that all the three types of malignancies were increasing with increase in the age and showing the highest percentage above the age of 40 years

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[Table 5] highlights malignancies of the female reproductive system with the highest percentage of cervical malignancies having 56.85% (485) next to the cervix was the ovarian malignancy with a significant percentage of 19.22% (164) than uterus 2.57% (22) and vagina 1.758% (15). By taking into consideration different age groups and the female reproductive system malignancies it was found that with an increase in the age relative proportion of cancer increases. The total prevalence of malignancies of the female reproductive system in the population of western Uttar Pradesh was found at 0.0011% (853) in the sample size of 7616, as shown in the [Figure 4].
Table 5: Age-wise cancer prevalence of female reproductive system

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Figure 4: Shows relationship between different age groups and the female reproductive system malignancies and it was found that with an increase in the age relative proportion of cancer increases.

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 > Discussion Top


In this cross-sectional study, histopathologically confirmed cases of malignancies were included. The population for this study was western Uttar Pradesh with a sample size of 7616 this sample size Prevalence rate of head and neck carcinoma was 0.0024% (1763) and the highest percentage of oral cancer of 23.19% (409) in the case of males above 40 years of age as compared to females with 4.76% (84). In the other studies conducted in the different regions of India, different results as compared to our study were found for example in the study conducted in the South India and Bihar the highest percentage of carcinoma of the larynx was found with (38.37%).[6],[7] A study conducted in Uttar Pradesh and Ahmednagar found oral cancer to be the leading malignancy in the head and neck region of (41.28%)[8] similar findings to the current study. In contrast to our study, the study conducted in the Northeast and Meghalaya found the oropharynx to be the leading cancer in the head and neck region with (24%).[9] Throughout the world, head and neck malignancies are more found in the case of males in all the age groups as compared to females.[10],[11] In the current study, similar results were found with males having more prevalence of head and neck carcinomas as compared to females in all the age groups. As the tobacco consumption and hand and neck malignancies are in direct proportionality and with an increase in age tobacco consumption as well as head and neck malignancies also increases in a study conducted it was found that up to the 50 years of age tobacco consumption increases than after that there is a decline.[12],[13] Similar results were found in our study with an increase in the age group head and neck malignancies increase in percentage above the age of 40 years and below the age of 20 years, no significant percentage of malignancies were found. A report given by GLOBOCAN worldwide the most common cancer among females is breast cancer with 25.8% and cervical cancer contributes the fourth most common with (6.9%).[14] The results in our study were different from this report with cervical cancer leading to cancer in females with 56.85% as compared to breast cancer with 42.79%. According to the report given by the National Cancer Registry Program, the Indian Council of Medical Research 2021 breast cancer is leading cancer in females with (25.4%) next to that is cervical cancer (15.2%). A report given by GLOBOCAN worldwide, the most common cancer among males is lung cancer 14.3% and in the case of females, it is the 3rd highest cancer 8.4% but according to the report given by the National Cancer Registry Program Indian Council of Medical Research 2021 in case of males lung cancer has a relative proportion of 10.8% and in case of females it was 7.4%. In our study in the case of males, relative proportion of lung cancer was 32.5% and in the case of females, it was 6.3%. In some studies conducted in Denmark, Iceland, and Sweden it was found that lung cancer incidence rates were on the higher side as compared to the males.[15] Even in the study conducted in the United States, it was found that higher female prevalence of lung cancer as compared to males because of sex-specific differences in smoking behavior.[16],[17] These results were opposite to our study. It was given in the report by GLOBOCAN 2020 that the incidence of stomach cancer in case of males 7.1% and case of females it was 4.0% and similar results were found in our study as well with 5.4% in case of males and 4.9% in case of females that too the significant percentage was found above the age of 40 years. According to the report given by the National Cancer Registry Program Indian council of medical research 2021 relative proportion of stomach cancer in the case of males and females was 4.4% and 2.3%, respectively, in accordance with our study and similarly, the proportion increases with an increase in the age. But in recent studies, it was found that increase in the incidence of stomach cancer in young age groups in the countries like United States, Canada, the United Kingdom, Chile, and Belarus.[18],[19] It was found in the studies that this increased incidence of stomach cancer may be attributed to the increased use of antibiotics and acid suppressants.[20],[21] Liver cancer in the case of males is found in a higher percentage as compared to females with 2.0% and 0.7%, respectively, according to the report given by the National Cancer Registry Program Indian Council of Medical Research 2021. In our study, similar findings were found with 9.4% liver cancer in males as compared to females with 7.7%. In another report given by GLOBOCAN 2020, similar results were found with 6.3% incidence of liver cancer in case of males and 3% in case of females. It has been found that in the countries like china liver cancer has reached a plateau[22] but in the countries like Europe, Northern America, Australia/New Zealand, and South America there is an increase in the incidence.[23] In the current study relative proportion of gallbladder, malignancies were on the higher side in the case of females as compared to the males with 37.8% and 19.9%, respectively. In a study conducted, it was found that Gallbladder cancer was 2-6 times more prevalent in the case of females as compared to males that too maybe because of the hormone estrogen that causes increased saturation of cholesterol in bile.[24],[25] In a five-year report given by the National Cancer Registry Program Indian Council of Medical Research 2021 relative proportion of carcinoma gallbladder in the case of females was 3.7% and in the case of males 2.2%. In the report given by Memorial Sloan–Kettering.[26] It was highlighted that the median age for gallbladder cancer was 67 years and similar results were found in our study also that with an increase in the age the percentage of gallbladder cancer was increasing.


 > Conclusion Top


Such epidemiological studies provide data for the development of new national strategies for cancer control. The present study not only provides information regarding cancer prevalence in western Uttar Pradesh but also a relative proportion of different malignancies in either genders as well as age-wise distribution. In this study, it was found that the highest percentage of oral cancer in case of males above 40 years of age as compared to females. Hence, primary prevention of the malignancies common in either of the genders as well as malignancies found at the young age or the old age should remain in priority. The combined strategies like convergent health policies cost-effective vaccination and screening, nutritional improvement, and a healthy lifestyle would be highly effective in cancer control and prevention.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
 > References Top

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

 
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