Trends in Lung Cancer Incidence in Delhi,India 1988-2012: Age-Period-Cohort and Joinpoint Analyses |
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| Authors: | Rajeev Kumar Malhotra1Nalliah Manoharan1Omana Nair2Suryanarayana Deo3Goura Kishor Rath2 |
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| Affiliation: | 1Delhi Cancer Registry, New Delhi, India.2Department of Radiation Oncology, Dr. B.R.Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.3Department of Surgical Oncology, Institute Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences, New Delhi, India. |
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| Abstract: | Introduction: Lung cancer (LC) has been one of the most commonly diagnosed cancers worldwide, both in termsof new cases and mortality. Exponential growth of economic and industrial activities in recent decades in the Delhiurban area may have increased the incidence of LC. The primary objective of this study was to evaluate the time trendaccording to gender. Method: LC incidence data over 25 years were obtained from the population based urban Delhicancer registry. Joinpoint regression analysis was applied for evaluating the time trend of age-standardized incidencerates. The age-period-cohort (APC) model was employed using Poisson distribution with a log link function and theintrinsic estimator method. Results: During the 25 years, 13,489 male and 3,259 female LC cases were registered,accounting for 9.78% of male and 2.53% of female total cancer cases. Joinpoint regression analysis revealed that LCincidence in males continued to increase during the entire period, a sharp acceleration being observed starting from2009. In females the LC incidence rate remained a plateau during 1988-2002 and thereafter increased. The cumulativerisks for 1988-2012 were 1.79% and 0.45%. The full APC (IE) model showed best fit for an age-period-cohort effecton LC incidence, with significant increase with age peaking at 70-74 years in males and 65-69 years in females. Arising period effect was observed after adjusting for age and cohort effects in both genders and a declining cohort effectwas identified after controlling for age and period effects. Conclusion: The incidence of LC in urban Delhi showedincreasing trend from 1988-2012. Known factors such as environmental conservation, tobacco control, physical activityawareness and medical security should be implemented more vigorously over the long term in our population. |
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| Keywords: | Lung cancer Incidence Population based cancer registry Annual percentage change |
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