Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the... more Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the Pathology Laboratory of Cancer Hospital with the support from hospital-based cancer registry (HBCR), Sangrur, Punjab, India for the years 2018 and 2019. Methods HBCR abstracts data from electronic medical records. Trained cancer registry staff abstracts cases in standard pro forma. Dual primary was coded as per the International Agency for Research on Cancer rule and was rechecked by the pathologist. Statistical Analysis Data about multiple primary was entered and documented in an Excel sheet. Time interval was calculated by subtracting the date of diagnosis for second primary and first primary. Results A total of 6,933 cases were registered, 45 cases are dual primary (26 females, 19 males) of which 64.4% are synchronous and 35.6% metachronous cases. Seventy-nine percent received cancer-directed treatment for synchronous and 87% for metachronous. The most common sites of the primary tum...
Dear editor, A nationwide multiround National Family Health Survey (NFHS) is conducted by the Gov... more Dear editor, A nationwide multiround National Family Health Survey (NFHS) is conducted by the Government of India (GOI), representing sample of households across India. The fifth round of NFHS results has been released for the years 2019 to 2021. The NFHS-5 comprises data of 636 699 households (Women: 724 115; Men: 101 839). This latest survey of NFHS-5 has also provided the data on cervix, breast and oral cancer screening uptake by adults (age group: 30-49) and results are alarming, showing less than 2% of screening participation. The screening coverage is extremely low compared to European region where screening coverage for cervical cancer (age group: 30-59) and breast cancer (age group: 45-49) is 40.2% and 68.9%, respectively. The GOI has initiated cervix, breast and oral cancer screening, respectively, by visual inspection of cervix with acetic acid, clinical breast examination and thorough examination of oral cavity by oral visual examination using a mouth mirror and a white light for the age group of 30 to 65 once in every 5 years with no cost. These population-based cancer screening programs were started in the year 2016 and are being conducted in nearly 400 districts. The trained health workers are playing an important role in executing these government-run screening programs. The screen positive cases are referred to nearby government health facilities for further evaluation by a health professional. The district hospitals are responsible for the further management of screen positive cases. Several center and state government-funded health schemes are available that assist patients in avoiding financial hardship. The data on screening uptake for cervix, breast and oral cancers are given for the first time in NFHS-5 series. Based on NFHS-5 data, we estimated the number of people who underwent screening using population for the year 2021 provided by the Indian census. The findings are concerning as the number of population covered under screening programs is significantly low. The data suggest that of the total population of 186 015 000 women aged 30 to 49 years, only 3 534 285 (1.9%) women reported to uptake cervix cancer screening test whereas 1 674 135 (0.9%) women reported taking screening test for breast and oral cancers. Similarly, for males, 2 295 540 (1.2%) male population out of the total population of 191 295 000 of the age group 30 to 49 reported to undertake oral cancer screening. Since the screening uptake data in NFHS-5 survey is specific for the age group of 30 to 49 years, the information is not available for the 50 years and above age group. However, compared to the age range of 30 to 49 years, screening uptake is reported to be lower for those aged 50 and above. The state-wise screening uptake for cervix, breast and oral cancers is presented in Table 1. In India, the reported incidence of cervix, breast and oral cancers is high. As per GLOBOCAN 2020, there are 135 929 new lip and oral cavity cancer cases with the age-standardized incidence rate 9.8 per 100 000 population. Moreover, a total of 178 361 and 123 907 breast and cervix cancer cases were reported in India with the agestandardized incidence rate of 25.8 and 18.0, respectively. Furthermore, as per the National Cancer Registry Programme (NCRP) India 2020, data from 28 Population-based Cancer Registries (PBCRs) indicate that oral cancer is the leading cancer among males; whereas breast and cervix cancers are predominant cancers in females. For males, oral cancer is reported the highest among tobacco-related cancers in central (45.0%) and western (34.6%) regions of India; whereas for females, central (44.8%) region is leading, followed by eastern (37.0%), southern (33.9%) and western (29.5%) regions. The oral cancer incidence in Uttar Pradesh state is high and a report published by the Varanasi PBCR reported oral cancer incidence in males for urban area 22.4 per 100 000 and rural 16.2 per 100 000. Even though oral cancer incidence is high in Uttar Pradesh state, the screening uptake for oral cancer is 1%. The current incidence of cervix, breast and oral cancers in India and evidence from NFHS-5 regarding screening uptake point towards the dire need of strengthening the ongoing screening and early detection activities. It is recommended that the policymakers should utilize these data and implement strategic interventions to cover more populations under screening programs and focus on early detection of these preventable cancer cases. The government is taking the necessary steps; however, interventions that improve screening participation are required to reduce the burden of preventable cancers in India. Evidence from the randomized control trials (RCTs) conducted in India show the positive outcome of screening and demonstrates reduced mortality of cervix, breast Received: 11 December 2021 Revised: 18 January 2022 Accepted: 28 January 2022
Percent of deaths by cause from the standard (physician assignment) arm compared to deaths (2010â... more Percent of deaths by cause from the standard (physician assignment) arm compared to deaths (2010â 2013) in the Indian Million Deaths Study in the trial state by age groups. (DOCX 286 kb)
Cause of death counts, proportions, and rankings for adults with dual physician coding of the aut... more Cause of death counts, proportions, and rankings for adults with dual physician coding of the automated arm. (DOCX 27 kb)
Percent proportion of causes of death by age groups and training dataset: comparing physician ass... more Percent proportion of causes of death by age groups and training dataset: comparing physician assignment deaths versus the closest automated assignment proportion of deaths for the same cause. (DOCX 25 kb)
Context: Cervical cancer is most common type of cancer in women of rural India. More than 60-70% ... more Context: Cervical cancer is most common type of cancer in women of rural India. More than 60-70% of cancers are diagnosed in later stages with poor survival rate. Screening helps in early detection of cervical cancer and better survival. Awareness and attitude of women towards cervical cancer screening may determine health-seeking behavior. As per operational framework of cancer screening in India, community health workers will be key mobilizers for encouraging women to undergo cervical cancer screening. Aim: This study aims to assess the knowledge, attitude and practice (KAP) of cervical cancer and its screening amongst community health workers of Varanasi district, Uttar Pradesh. Settings and Design: Descriptive, cross-sectional study was done to assess the socio demographic profile and KAP for cervical cancer and its screening of community health workers. Scoring for awareness and attitude for cervical cancer screening was done. Statistical Analysis Used: Descriptive statistics such as mean±SD, frequency and proportion were used for socio-demographic data and KAP of study population. Determinants of knowledge and practice for screening was determined using Chi-square test. P value < 0.05 was considered statistically significant. Results: We observed that despite of good knowledge and perception less than 10 percent of workers have undergone screening. Significant association was seen between level of knowledge and practice of screening. Conclusion: It is of utmost importance that narrowing of existing gap between the perception and practice of cervical cancer screening should be initiated through introducing more educational programs for workers and encouraging them to participate in screening campaigns.
Indian journal of urology : IJU : journal of the Urological Society of India
Globally, prostate cancer is the second most frequently diagnosed cancer and the fifth most commo... more Globally, prostate cancer is the second most frequently diagnosed cancer and the fifth most common cause of cancer death among men with an estimated 1.1 million new cases (15% of all cancer in men) and 0.3 million cancer deaths (7% of all cancer deaths) in men in 2012.[1] In India , there were 19,095 incidences and 12,231 death cases in 2012.[2] The population -based cancer incidence data from cancer registries in the five continents is regularly published by the International Agency for Research on Cancer, Lyon, France (CI5).[3] We evaluated data from the Mumbai, Chennai, Barshi, and Bengaluru registries, published in the CI5, to determine the ranking of prostate cancer in the period of 1988–1992 and in the recent data of the year 2008–2012.[3,4]
Background India accounts for a quarter of the world cervical cancer burden. Cervical cancer is h... more Background India accounts for a quarter of the world cervical cancer burden. Cervical cancer is highly preventable. However, low level of participating women in screening is one of the major issues. The aim of this work was to study the factors that influence women to participate in cervical cancer screening by providing menstrual pads for human papillomavirus (HPV) testing. Methods Menstrual clothes were collected from two different populations from the rural areas of Maharashtra state for HPV testing to screen for cervical cancer. For this study, out of 945 participated women, 557 (58.9%) provided their menstrual pads. Multivariate logistic regression was applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Results The probability of providing the menstrual pads was high among the women who were highly educated compared to those with less education (OR: 1.4; 95% CI: 1.0-1.9), having mobile phone facilities as compared to those with no mobile phones (OR: 1.4; 95% CI: 1.0-2.0), who were using new cloths as menstrual pads compared to those who did not use the same (OR: 8.5; 95% CI: 5.0-14.3), who did not have tobacco habit as compared to those who had tobacco habit (OR: 1.4; 95% CI: 1.1-1.9) and in the village where health worker was stationed as compared to the village where health worker was not stationed (OR: 1.8; 95% CI: 1.4-2.5). Conclusion Factors including health worker availability, using mobile phones for communication and high education level facilitate women's participation. To improve the participation, there is need to apply special strategies for older age group, less educated women and women having tobacco habit.
Percent of deaths by cause for adults (12–69 years) and children (0–4 years) in the Indian Millio... more Percent of deaths by cause for adults (12–69 years) and children (0–4 years) in the Indian Million Death Study (2001–2013) compared to deaths in the 3% Million Death Study resample. (DOCX 254 kb)
Comparison of population-level concordance in cause of death assignment for adults predicted betw... more Comparison of population-level concordance in cause of death assignment for adults predicted between different algorithms for the automated assignment arm. (DOCX 19 kb)
Background: Population based Cancer Registries(PBCRs) are hallmark of cancer surveillance and can... more Background: Population based Cancer Registries(PBCRs) are hallmark of cancer surveillance and cancer control activity .The value of cancer registries rely heavily on underlying quality of their data. Current study assessed data quality of four new PBCRs of Chandigarh, SAS Nagar, Mansa and Sangrur covering a total population of 4.5 millions on three quality parameters i.e. comparability, validity and completeness as recommended by International Agency of Research on Cancer(IARC), Lyon, France. Methods: For assessing comparability, data of the registries were reviewed in terms of system of classification and coding, definition of incidence date and rule for multiple primaries. For assessing validity (Accuracy) four different methods i.e. re-abstraction and re-coding, percentage morphologically verified cases (MV%), percentage of death certificate only (DCO%) cases and percentage of cases with other and unspecified sites (O and U%) were used. For assessing completeness of coverage, different semi-quantitative methods were used. Results: Re-abstraction done for 10% of the total incident cases yielded overall percentage agreement of 97.4%, 97.2%, 95.4% and 94.9% for PBCR Chandigarh, SAS Nagar, Mansa and Sangrur respectively. MV% was found to be 96.3% for PBCR Chandigarh, 92.8% for PBCR SAS Nagar , 89.3% for PBCR Mansa and 82.9% for PBCR Sangrur. Percentage of DCO cases and O and U cases were 1.4% and 2.8% for PBCR Chandigarh, 3.9% and 5.3% for SAS Nagar, 6.4% and 16.4% for Mansa and 6.3% and 8.3% for Sangrur. Completeness assessed through the various methods showed good level of completeness at PBCR Chandigarh and SAS Nagar and somewhat lower but acceptable level of completeness at PBCR Mansa and Sangrur. Conclusions: All the four PBCRs are comparable internationally. PBCR Chandigarh and SAS Nagar, predominantly urban registries, have higher accuracy of their data and good completeness levels as compared to predominantly rural registries of Mansa and Sangrur. Cancer estimates given by all the four registries are reliable and data from these registries can be utilized for planning cancer prevention and control activities in the region.
Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the... more Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the Pathology Laboratory of Cancer Hospital with the support from hospital-based cancer registry (HBCR), Sangrur, Punjab, India for the years 2018 and 2019. Methods HBCR abstracts data from electronic medical records. Trained cancer registry staff abstracts cases in standard pro forma. Dual primary was coded as per the International Agency for Research on Cancer rule and was rechecked by the pathologist. Statistical Analysis Data about multiple primary was entered and documented in an Excel sheet. Time interval was calculated by subtracting the date of diagnosis for second primary and first primary. Results A total of 6,933 cases were registered, 45 cases are dual primary (26 females, 19 males) of which 64.4% are synchronous and 35.6% metachronous cases. Seventy-nine percent received cancer-directed treatment for synchronous and 87% for metachronous. The most common sites of the primary tum...
Dear editor, A nationwide multiround National Family Health Survey (NFHS) is conducted by the Gov... more Dear editor, A nationwide multiround National Family Health Survey (NFHS) is conducted by the Government of India (GOI), representing sample of households across India. The fifth round of NFHS results has been released for the years 2019 to 2021. The NFHS-5 comprises data of 636 699 households (Women: 724 115; Men: 101 839). This latest survey of NFHS-5 has also provided the data on cervix, breast and oral cancer screening uptake by adults (age group: 30-49) and results are alarming, showing less than 2% of screening participation. The screening coverage is extremely low compared to European region where screening coverage for cervical cancer (age group: 30-59) and breast cancer (age group: 45-49) is 40.2% and 68.9%, respectively. The GOI has initiated cervix, breast and oral cancer screening, respectively, by visual inspection of cervix with acetic acid, clinical breast examination and thorough examination of oral cavity by oral visual examination using a mouth mirror and a white light for the age group of 30 to 65 once in every 5 years with no cost. These population-based cancer screening programs were started in the year 2016 and are being conducted in nearly 400 districts. The trained health workers are playing an important role in executing these government-run screening programs. The screen positive cases are referred to nearby government health facilities for further evaluation by a health professional. The district hospitals are responsible for the further management of screen positive cases. Several center and state government-funded health schemes are available that assist patients in avoiding financial hardship. The data on screening uptake for cervix, breast and oral cancers are given for the first time in NFHS-5 series. Based on NFHS-5 data, we estimated the number of people who underwent screening using population for the year 2021 provided by the Indian census. The findings are concerning as the number of population covered under screening programs is significantly low. The data suggest that of the total population of 186 015 000 women aged 30 to 49 years, only 3 534 285 (1.9%) women reported to uptake cervix cancer screening test whereas 1 674 135 (0.9%) women reported taking screening test for breast and oral cancers. Similarly, for males, 2 295 540 (1.2%) male population out of the total population of 191 295 000 of the age group 30 to 49 reported to undertake oral cancer screening. Since the screening uptake data in NFHS-5 survey is specific for the age group of 30 to 49 years, the information is not available for the 50 years and above age group. However, compared to the age range of 30 to 49 years, screening uptake is reported to be lower for those aged 50 and above. The state-wise screening uptake for cervix, breast and oral cancers is presented in Table 1. In India, the reported incidence of cervix, breast and oral cancers is high. As per GLOBOCAN 2020, there are 135 929 new lip and oral cavity cancer cases with the age-standardized incidence rate 9.8 per 100 000 population. Moreover, a total of 178 361 and 123 907 breast and cervix cancer cases were reported in India with the agestandardized incidence rate of 25.8 and 18.0, respectively. Furthermore, as per the National Cancer Registry Programme (NCRP) India 2020, data from 28 Population-based Cancer Registries (PBCRs) indicate that oral cancer is the leading cancer among males; whereas breast and cervix cancers are predominant cancers in females. For males, oral cancer is reported the highest among tobacco-related cancers in central (45.0%) and western (34.6%) regions of India; whereas for females, central (44.8%) region is leading, followed by eastern (37.0%), southern (33.9%) and western (29.5%) regions. The oral cancer incidence in Uttar Pradesh state is high and a report published by the Varanasi PBCR reported oral cancer incidence in males for urban area 22.4 per 100 000 and rural 16.2 per 100 000. Even though oral cancer incidence is high in Uttar Pradesh state, the screening uptake for oral cancer is 1%. The current incidence of cervix, breast and oral cancers in India and evidence from NFHS-5 regarding screening uptake point towards the dire need of strengthening the ongoing screening and early detection activities. It is recommended that the policymakers should utilize these data and implement strategic interventions to cover more populations under screening programs and focus on early detection of these preventable cancer cases. The government is taking the necessary steps; however, interventions that improve screening participation are required to reduce the burden of preventable cancers in India. Evidence from the randomized control trials (RCTs) conducted in India show the positive outcome of screening and demonstrates reduced mortality of cervix, breast Received: 11 December 2021 Revised: 18 January 2022 Accepted: 28 January 2022
Percent of deaths by cause from the standard (physician assignment) arm compared to deaths (2010â... more Percent of deaths by cause from the standard (physician assignment) arm compared to deaths (2010â 2013) in the Indian Million Deaths Study in the trial state by age groups. (DOCX 286 kb)
Cause of death counts, proportions, and rankings for adults with dual physician coding of the aut... more Cause of death counts, proportions, and rankings for adults with dual physician coding of the automated arm. (DOCX 27 kb)
Percent proportion of causes of death by age groups and training dataset: comparing physician ass... more Percent proportion of causes of death by age groups and training dataset: comparing physician assignment deaths versus the closest automated assignment proportion of deaths for the same cause. (DOCX 25 kb)
Context: Cervical cancer is most common type of cancer in women of rural India. More than 60-70% ... more Context: Cervical cancer is most common type of cancer in women of rural India. More than 60-70% of cancers are diagnosed in later stages with poor survival rate. Screening helps in early detection of cervical cancer and better survival. Awareness and attitude of women towards cervical cancer screening may determine health-seeking behavior. As per operational framework of cancer screening in India, community health workers will be key mobilizers for encouraging women to undergo cervical cancer screening. Aim: This study aims to assess the knowledge, attitude and practice (KAP) of cervical cancer and its screening amongst community health workers of Varanasi district, Uttar Pradesh. Settings and Design: Descriptive, cross-sectional study was done to assess the socio demographic profile and KAP for cervical cancer and its screening of community health workers. Scoring for awareness and attitude for cervical cancer screening was done. Statistical Analysis Used: Descriptive statistics such as mean±SD, frequency and proportion were used for socio-demographic data and KAP of study population. Determinants of knowledge and practice for screening was determined using Chi-square test. P value < 0.05 was considered statistically significant. Results: We observed that despite of good knowledge and perception less than 10 percent of workers have undergone screening. Significant association was seen between level of knowledge and practice of screening. Conclusion: It is of utmost importance that narrowing of existing gap between the perception and practice of cervical cancer screening should be initiated through introducing more educational programs for workers and encouraging them to participate in screening campaigns.
Indian journal of urology : IJU : journal of the Urological Society of India
Globally, prostate cancer is the second most frequently diagnosed cancer and the fifth most commo... more Globally, prostate cancer is the second most frequently diagnosed cancer and the fifth most common cause of cancer death among men with an estimated 1.1 million new cases (15% of all cancer in men) and 0.3 million cancer deaths (7% of all cancer deaths) in men in 2012.[1] In India , there were 19,095 incidences and 12,231 death cases in 2012.[2] The population -based cancer incidence data from cancer registries in the five continents is regularly published by the International Agency for Research on Cancer, Lyon, France (CI5).[3] We evaluated data from the Mumbai, Chennai, Barshi, and Bengaluru registries, published in the CI5, to determine the ranking of prostate cancer in the period of 1988–1992 and in the recent data of the year 2008–2012.[3,4]
Background India accounts for a quarter of the world cervical cancer burden. Cervical cancer is h... more Background India accounts for a quarter of the world cervical cancer burden. Cervical cancer is highly preventable. However, low level of participating women in screening is one of the major issues. The aim of this work was to study the factors that influence women to participate in cervical cancer screening by providing menstrual pads for human papillomavirus (HPV) testing. Methods Menstrual clothes were collected from two different populations from the rural areas of Maharashtra state for HPV testing to screen for cervical cancer. For this study, out of 945 participated women, 557 (58.9%) provided their menstrual pads. Multivariate logistic regression was applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Results The probability of providing the menstrual pads was high among the women who were highly educated compared to those with less education (OR: 1.4; 95% CI: 1.0-1.9), having mobile phone facilities as compared to those with no mobile phones (OR: 1.4; 95% CI: 1.0-2.0), who were using new cloths as menstrual pads compared to those who did not use the same (OR: 8.5; 95% CI: 5.0-14.3), who did not have tobacco habit as compared to those who had tobacco habit (OR: 1.4; 95% CI: 1.1-1.9) and in the village where health worker was stationed as compared to the village where health worker was not stationed (OR: 1.8; 95% CI: 1.4-2.5). Conclusion Factors including health worker availability, using mobile phones for communication and high education level facilitate women's participation. To improve the participation, there is need to apply special strategies for older age group, less educated women and women having tobacco habit.
Percent of deaths by cause for adults (12–69 years) and children (0–4 years) in the Indian Millio... more Percent of deaths by cause for adults (12–69 years) and children (0–4 years) in the Indian Million Death Study (2001–2013) compared to deaths in the 3% Million Death Study resample. (DOCX 254 kb)
Comparison of population-level concordance in cause of death assignment for adults predicted betw... more Comparison of population-level concordance in cause of death assignment for adults predicted between different algorithms for the automated assignment arm. (DOCX 19 kb)
Background: Population based Cancer Registries(PBCRs) are hallmark of cancer surveillance and can... more Background: Population based Cancer Registries(PBCRs) are hallmark of cancer surveillance and cancer control activity .The value of cancer registries rely heavily on underlying quality of their data. Current study assessed data quality of four new PBCRs of Chandigarh, SAS Nagar, Mansa and Sangrur covering a total population of 4.5 millions on three quality parameters i.e. comparability, validity and completeness as recommended by International Agency of Research on Cancer(IARC), Lyon, France. Methods: For assessing comparability, data of the registries were reviewed in terms of system of classification and coding, definition of incidence date and rule for multiple primaries. For assessing validity (Accuracy) four different methods i.e. re-abstraction and re-coding, percentage morphologically verified cases (MV%), percentage of death certificate only (DCO%) cases and percentage of cases with other and unspecified sites (O and U%) were used. For assessing completeness of coverage, different semi-quantitative methods were used. Results: Re-abstraction done for 10% of the total incident cases yielded overall percentage agreement of 97.4%, 97.2%, 95.4% and 94.9% for PBCR Chandigarh, SAS Nagar, Mansa and Sangrur respectively. MV% was found to be 96.3% for PBCR Chandigarh, 92.8% for PBCR SAS Nagar , 89.3% for PBCR Mansa and 82.9% for PBCR Sangrur. Percentage of DCO cases and O and U cases were 1.4% and 2.8% for PBCR Chandigarh, 3.9% and 5.3% for SAS Nagar, 6.4% and 16.4% for Mansa and 6.3% and 8.3% for Sangrur. Completeness assessed through the various methods showed good level of completeness at PBCR Chandigarh and SAS Nagar and somewhat lower but acceptable level of completeness at PBCR Mansa and Sangrur. Conclusions: All the four PBCRs are comparable internationally. PBCR Chandigarh and SAS Nagar, predominantly urban registries, have higher accuracy of their data and good completeness levels as compared to predominantly rural registries of Mansa and Sangrur. Cancer estimates given by all the four registries are reliable and data from these registries can be utilized for planning cancer prevention and control activities in the region.
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