Cancer Incidence and Mortality: District Cancer Registry,Trivandrum, South India

Background: Cancer is emerging as a major cause of morbidity and mortality in low and middle-income countries. Cancer registry figures help for planning and delivery of health services. This paper provided the first results of cancer incidence and mortality [Crude (CR) and age-standardized (ASR)] rates (world-standard population) of Trivandrum district, South India and compared with other registries under the network of National Cancer Registry Programme (NCRP), Government of India. Materials and Methods: Trivandrum district cancer registry encompasses a population of 3.3 million, compiles data from nearly 75 sources (hospitals and diagnostic laboratories) and included under the NCRP in 2012. During 2012-2014, registry recorded 15,649 incident cases and 5667 deaths. Proportion of microscopic diagnosis was 85% and ‘Death certificate only’ was 8%. Results: Total cancer incidence (CRs) rates were 161 and 154 (ASR: 142.2 and 126) and mortality rates were 66 and 49 (ASR: 54 and 37) per 105 males and females respectively. Common cancers in males were lung (ASR:19), oral cavity (ASR:15), colo-rectum (ASR:11.2), prostate (ASR:10.2) and lymphoma (ASR:7) and in females, breast (ASR:36), thyroid (ASR:13.4), cervix-uteri (ASR:7.3), ovary (ASR:7) and colo-rectum (ASR:7). Nationally, the highest CRs for breast, prostate, colo-rectum, corpus-uteri and urinary bladder cancers and low incidence of cervix-uteri cancer were observed in Trivandrum. Conclusion: Cancer incidence (CR) in Trivandrum was the highest in both genders in India (except Aizwal). This is mainly due to the highest life-expectancy in Kerala. Also, an epidemiologic transition in cancer pattern is taking place and is changing to more similar to "western" jurisdictions.     

Cancer Incidence and Mortality in Central Myanmar: Report of Nay Pyi Taw Population-Based Cancer Registry

Background: Cancer is a major public health problem in Myanmar, and cancer registration activities are currently underway through both hospital-based and population-based approaches. So far, there are no population-based cancer incidence and mortality estimates in the country. Methods: According to the 2014 census, the total population of Nay Pyi Taw Union Territory was 1,160,242 within the area of 70,571 km2. Nay Pyi Taw Cancer Registry team collected data of new cancer cases both actively and passively from all data sources in the region. The data were registered, updated, cross-checked, quality-assured, and analyzed in CanReg5. The results were presented as the number of cases by site, sex, and age, cumulative risk (CR), crude rate, age-specific, and age-standardized incidence rates (ASRs) per 100,000. Results: Total 5,952 new cancer cases and 1874 cancer deaths were recorded among the population of the Nay Pyi Taw Union Territory between 2013 and 2017. The age-standardized incidence rate for all cancer sites excluding non-melanoma skin cancers in males was 125.9 and 107.3 for females. For both sexes combined, the most common cancers were lung (14%), breast (11.4%), liver (10.2%), mouth and pharynx (8.5%), and stomach cancers (7.8%). In males, the most common were lung (18.1%), liver (14.8%), mouth and pharynx (13%), stomach (8.9%) and colon, rectum, and anus (7.4%) cancers. In females, these were breast (21.2%), cervix (13.0%), lung (10.3%), stomach (6.9%) and colon, rectum, and anus (6.3%) cancers. The most common cancer deaths were caused by liver (20.8%), lung (15.7%), mouth and pharynx (9.3%), stomach (7.5%), and Colon, rectum, and anus (6.8%) cancers. Conclusion: The findings in this study are salient and have potential to serve as important information for the National Cancer Control Program to formulate prevention and control strategies.     

Cancer Incidence in Southwest of Iran: First Report from Khuzestan Population-Based Cancer Registry, 2002-2009

Background: Cancer incidence rates are increasing particularly in developing countries. It is crucial for policymakers to know basic cancer epidemiology in each region to design comprehensive prevention plans. There havehitherto been no population-based data available for cancer in Khuzestan province. The present report is a firstfrom the regional population-based cancer registry for the period of 2002-2009. Materials and Methods: Datawere collected retrospectively reviewing all new cancer patients whom were registered in Khuzestan provincecancer registry during an 8-year period (2002-2009). All cases were coded based on the ICD-O-3 coding systemand collected data were computerized using SPSS (Chicago, IL) software, version 11.5. The age standardizedincidence rates (ASRs) per 100,000 person-year for all cancers were computed using the indirect method ofstandardization to the world population. Results: During the 8-year study period, 16,801 new cancer cases wereregistered. Based on the computed ASRs, the five most frequent malignancies in females were breast (26.4 per100,000), skin (13.6), colorectal (5.72), stomach (4.31) and bladder(4.07) and in males, the five most frequentwere skin (16.0 per 100,000), bladder (10.7),prostate (7.64), stomach (7.17), and colorectal (6.32).The ASR forall malignancies in women was 92.5 per 100,000, and that for men was 87.4. Conclusions: The observed patternsfrom the analysis of Khuzestan cancer registry data will lead to better understanding of the epidemiology ofvarious malignancies in this part ofthe country and consequently provide a useful guide for authorities to makeefficacious decisions and policies about a cancer control program for south-west Iran.     

2013年湖北省肿瘤登记地区恶性肿瘤发病与死亡分析

目的 分析2013年湖北省肿瘤登记地区恶性肿瘤的发病与死亡情况。方法 收集2013年湖北省9个肿瘤登记处上报的恶性肿瘤发病与死亡数据以及人口资料,并用相关工具对数据进行审核与质量评估。各项质量评价指标均按国家标准纳入。结果 2013年,湖北省9个肿瘤登记地区新发病例数29 738例,发病率为284.85/10万,中标率为188.08/10万,世标率为203.59/10万。肺癌、消化系统肿瘤乳腺癌的发病率和死亡率均居前列。2013年,湖北省肿瘤登记地区恶性肿瘤死亡病例数17 986例,死亡率172.28/10万,中标率和世标率分别为107.97/10万和122.54/10万。男性发病率与死亡率均高于女性,城市地区发病率与死亡率均高于农村地区。结论 2013年湖北省肿瘤登记地区恶性肿瘤发病中标率较2012年略下降,死亡率略低于全国水平。肺癌、消化系统恶性肿瘤（肝癌、胃癌、食管癌、结直肠癌）以及乳腺癌是湖北省肿瘤防治工作的重点癌种,需重点针对这些癌种加强居民防癌核心知识的健康教育。     

中国11市县肿瘤发病和死亡登记资料统计分析（1988年—1992年）

目的：研究我国肿瘤登记资料,掌握人群肿瘤发病,死亡规律和特征。方法：根据国际癌症研究中心和国际癌症登记协会推荐的肿瘤登记方法,结合我国肿瘤浒病学研究的具体情况和需要,汇集,整理,审核和分析了我国１１市县肿瘤登记处１９８８年－１９９２年的肿瘤发病和死亡资料。结果：研究期间的内,１１市县肿瘤登记处覆盖人群合计１０６１８３１７３人年,肿瘤新病例２１２５０２例,死亡病例１５３９３４例。通过审核合格进行入分     

Increasing Trend in Colorectal Cancer Incidence in the Southeast of Iran 2003-2013: A Population Based Cancer Registry Study

Rates based on age-adjusted incidence of colorectal cancers over a 10-year period in Kerman, the biggestprovince of Iran, were estimated from 2003 to 2013. Data were obtained from the population-based cancerregistry unit of Kerman University of Medical Sciences (CR-KMU). Information included age, sex, city, ICD-Oand year of registry. Our trend analyses cover 3.91% of the Iranian population. The data set comprised casesdiagnosed from 2003 to 2013.The population of over 20 years was interpolated using 2003 and 2010 censuses.Then, truncated age-adjusted incidence rates were calculated. Increase was noted from 2003-2009 to 2010-2013for 731 cancer cases considered in the analysis. The increases was most prominent in 2009. Totally, the frequencyof the cancer was greater in males. Moreover, calculating truncated age-adjusted incidence rate indicated thatthe most prevalent age of colorectal incidence was in the 50-59 year age group except in 2007-2008 and 2012-2013, when greatest incidences occurred in people aged 60-69 years. Our data revealed that the incidence ratesof colorectal cancer have increased over the past decade in our region of Iran.     

Estimation of Esophageal Cancer Incidence in Tehran by Loglinear Method using Population-based Cancer Registry Data

Background: Having knowledge or estimation of cancer incidence is necessary for planning and implementationof any cancer prevention and control programs. Population-based registries provide valuable information toachieve these objectives but require extra techniques to estimate the incidence rate. The present study aimed toestimate the esophageal cancer incidence using a log-linear method based on Tehran population-based cancerregistry data. Materials and Methods: New cases of esophageal cancer reported by three sources of pathologyreports, medical records, and death certificates to Tehran Metropolitan Area Cancer Registry Center during2002-2006 were entered into the study and the incidence rate was estimated based on log-linear models. We usedAkaike statistics to select the best-fit model. Results: During 2002-2006, 1,458 new cases of esophageal cancerwere reported by the mentioned sources to the population-based cancer registry. Based on the reported cases,cancer incidence was 4.5 per 100,000 population and this was estimated to be 10.5 per 100,000 by the log-linearmethod. Conclusions: Based on the obtained results, it can be concluded that an estimated incidence for 2004 of8.3 per 100,000 population could be a good benchmark for the incidence of esophageal cancer in the populationof Tehran metropolis.     

Stage at Diagnosis and Relative Differences in Breast and Prostate Cancer Incidence in India : Comparison with the United States

Purpose: To examine and reconcile differences in incidence rates and stage-at-initial-presentation of prostate andbreast cancers in India, a country in epidemiologic transition. Methods: Age-adjusted prostate and female breastcancer incidence rates and proportion of cases by stage-at-diagnosis were compared. Data were derived from theNational Cancer Registry Program of India, other Indian registries, the International Agency for Research on Cancer,and the US/ NCI Surveillance, Epidemiology, and End Results (SEER) Program. Results: Average annual cancerincidence rates in India ranged from 5.0 to 9.1 per 100,000/year for prostate and 7.2 to 31.3 per 100,000/year forfemale breast. Comparative rates in the US for prostate cancer are 110.4 for Whites and 180.9 for Blacks; for femalebreast, the rates are 86.6 for Blacks and 96.4 for Whites. Notable differences were observed between rural and urbanareas in India, while such differences by rurality appear to be much smaller in the US. Overall, about 50-55% ofbreast cancer cases and about 85% of prostate cancers were detected at late (III and IV) stage; in contrast to the USwhere 15% of either cancer is diagnosed at late stage. Conclusions: Differences in stage-at-diagnosis help explainvariations in incidence rates among cancer registries in India and rate differences between India and the US. Thesefindings indicate that erroneous inferences will result from incidence-rate comparisons that do not take into accountstage-at-diagnosis. Results also point to epidemiologic studies that could be conducted to deepen understanding ofthe etiology of these cancers. By enhancing data on staging, the Indian cancer registries could widen the scope ofcollaborative, cross-national research.     

Cancer patterns in eastern India: the first report of the Kolkata cancer registry

There are no population-based data available for the cancer patterns in Eastern India. This is the first report of cancer incidence in the region from the population-based cancer registry in Kolkata (Calcutta), the capital city of the state of West Bengal, India, for the period 1998-1999. The cancer registry collects data on all new cases of cancer diagnosed in the resident population of Kolkata. Since cancer is not a notifiable disease in India, registration is carried out by active data collection by the registry staff. The cancer registry staff visits 50 data sources comprising cancer hospitals, secondary and tertiary care hospitals, nursing homes, diagnostic laboratories and death registration offices; scrutinizes medical records and collects details on incident cancer cases. A customized version of CanReg-3 software was used for data entry and analysis. A total of 11,700 cases were registered during the 2-year period from 1 January 1998 to 31 December 1999. The overall age-adjusted (world population) incidence rates were 102.1 per 100,000 males and 114.6 per 100,000 females. The most frequently reported malignancies in males were lung cancer (16.3%), followed by cancers of the oral cavity (7.1%), pharynx (5.7%) and larynx (5.7%). In females, the most frequently reported malignancies were breast (22.7%) followed by uterine cervix (17.5%), gallbladder (6.4%) and ovary (5.8%). The data reported by the Kolkata cancer registry provide information on the cancer profile in Eastern India for the first time. The highest incidence rate of lung cancer in males in India is reported from Calcutta. A high risk of gallbladder cancer is observed in women. The observed cancer patterns indicate that tobacco-control measures and early detection of head and neck, breast and cervical cancers are of importance for cancer control in this population.     

湖北省肿瘤登记地区2012年宫颈癌发病及死亡分析

目的 分析湖北省肿瘤登记地区2012年女性宫颈癌发病及死亡情况。方法 运用描述流行病学研究,对2012年湖北省肿瘤登记地区的宫颈癌发病及死亡资料进行分析,计算城乡之间肿瘤发病率和标化率,并进行比较。结果 2012年湖北省肿瘤登记地区的女性宫颈癌发病率为20.88/105,中标率为14.85/105,世标率为14.54/105,累积率（0~74岁）为1.36%。20岁以上女性宫颈癌各年龄段发病率农村地区高于城市。宫颈癌的死亡率为5.50/105,中标率为3.60/105,世标率为3.75/105,累积率（0~74岁）为0.37%。农村地区死亡粗率、中标率,世标率等均高于城市地区。年龄别死亡率总体呈上升趋势,在80岁组达到死亡率最高峰值（22.48/105）。7个肿瘤登记地区中,死亡率最高的是五峰县,最低是钟祥市,五峰县中标死亡率是钟祥市的11.62倍。结论 湖北省肿瘤登记地区宫颈癌发病农村高于城市,不同地域发病差别较大,应积极开展宫颈癌防治知识的健康教育,同时继续推进宫颈癌高危人群的筛查工作。     

Burden of preventable cancers in India: Time to strike the cancer epidemic

India has a rapidly growing population inflicted with cancer diagnosis. From an estimated incidence of 1.45 million cases in 2016, the cancer incidence is expected to reach 1.75 million cases in 2020. With the limitation of facilities for cancer treatment, the only effective way to tackle the rising and humongous cancer burden is focusing on preventable cancer cases. Approximately, 70% of the Indian cancers (40% tobacco related, 20% infection related and 10% others) are caused by potentially modifiable and preventable risk factors. We review these factors with special emphasis on the Indian scenario. The results may help in designing preventive strategies for a wider application.     

Role of Tobacco in the Development of Head and Neck Squamous Cell Carcinoma in an Eastern Indian Population

Head and neck squamous cell carcinoma (HNSCC) accounts for about 30-40% of all cancer types in Indiaand the subcontinent in general. HNSCCs are primarily not hereditary, but rather a disease of older and middleaged adults. Many etiological factors like tobacco, alcohol and HPV infection are known to play importantroles. Eastern India, particularly Kolkata, has a population heavily exposed to various types of smoked andsmokeless tobacco, with only limited exposure to alcoholic beverages. Since there have been no previousepidemiological studies on tobacco as the main risk factor for head and neck carcinogenesis in Kolkata, we herecarried out a hospital based case control study in the city and its adjoin regions. Data from 110 patients diagnosedwith HNSCC and a similar number of matched control samples were analyzed using chi-square (χ2) test. Survivalstatus of the patients was also analyzed using the Kaplan-Meier method. A tobacco habit was significantlycorrelated with the incidence of HNSCC and persons with current addiction had a 2.17 fold increased risk ofcancer development. Dose-response relationships were seen for the frequency (p=0.01) and duration (p=0.02) oftobacco exposure with the risk. No significant difference in impact was found with smoked as opposed to smokelesstobacco in the development of the disease. Among HNSCC patients, significant poor survival in cases withtobacco habit than in those with no addiction and in cases with >10 years of addiction than in those with ≤ 10years of addiction. Our data suggest that tobacco in both smoked and smokeless forms is the most importantrisk factor for both development and prognosis of HNSCCs and may be a major source of field cancerization onthe head and neck epithelium in the eastern Indian population.     

Improving Cancer Care in India: Prospects and Challenges

The World Cancer Report, a 351 - page global report issued by International Agency for Research on Cancer ‍(IARC) tells us that cancer rates are set to increase at an alarming rate globally (Stewart and Kleiues 2003). Cancer ‍rates could increase by 50 % to 15 million new cases in the year 2020. This will be mainly due to steadily aging ‍populations in both developed and developing countries and also to current trends in smoking prevalence and the ‍growing adoption of unhealthy lifestyles. The report also reveals that cancer has emerged as a major public health ‍problem in developing countries, matching its effect in industrialized nations. Healthy lifestyles and public health ‍action by governments and health practitioners could stem this trend, and prevent as many as one third of cancers ‍worldwide. ‍In a developing country such as India there has been a steady increase in the Crude Incidence Rate (CIR) of all ‍cancers affecting both men and women over the last 15 years. The increase reported by the cancer registries is nearly ‍12 per cent from 1985 to 2001, representing a 57 per cent rise in India's cancer burden. The total number of new ‍cases, which stood at 5.3 lakhs Care lakh is 100,000 in 1985 has risen to over 8.3 lakhs today. The pattern of cancers ‍has changed over the years, with a disturbing increase in cases that are linked to the use of tobacco. In 2003, there ‍were 3.85 lakhs of cases coming under this category in comparison with 1.94 lakhs cases two decades ago. Lung ‍cancer is now the second most common cancer among men. Earlier, it was in fifth place. Among women in urban ‍areas, cancer of the uterine cervix had the highest incidence 15 years ago, but it has now been overtaken by breast ‍cancer. In rural areas, cervical cancer remains the most common form of the disease (The Hindu 2004).     

Patterns and Trends with Cancer Incidence and Mortality Rates Reported by the China National Cancer Registry

National cancer registration reports provide a huge potential for identifying patterns and trends of important policy, research, prevention and treatment significance. As summary reports written on an annual basis, the China Cancer Registry Annual Reports (CCRARs) fall short from fully addressing their potential. This paper attempts to explore part of the patterns and trends hidden behind published CCRARs. It extracted data for cancer incidence rates (IRs) and mortality rates (MRs) for 2004, 2006 and 2009 from relevant CCRARs and portrayed 4 kinds of indicators in line graphs. The study showed that: a) all of the line graphs of age-specific IRs and MRs characterized typical “growth curves or histogram”; b) graphs of IRs and MRs for males and urban areas had higher peaks than that for females and rural regions; c) most of the line graphs of IR/MR ratios comprised a starting peak, a secondary peak and a decreasing tail and the secondary peaks for females and urban areas were higher than those for males and rural areas; d) most of the urban versus rural IR ratios valued above one, but most the urban versus rural MR ratios, below one; e) the accumulative IRs and MRs showed a stable increasing trend from 2004 to 2009 for urban areas, but mixed for rural regions.     

A Population-Based Study of Incidence and Survival of 1588 Thymic Malignancies: Results From the California Cancer Registry

BackgroundThymic malignancies are rare and there are limited contemporary population-based epidemiological studies for this uncommon cancer.Patients and MethodsAdults aged 20 years and older diagnosed with thymic malignancies between 1988 and 2015 were identified from the California Cancer Registry (n = 1588). Trends in age-adjusted incidence rates were examined overall and according to race/ethnicity, and the proportion diagnosed according to stage was evaluated over time. Cox proportional hazards regression was used to estimate hazard ratios (HRs) for overall survival (OS), and Fine and Gray competing risks regression for cause-specific survival (CSS).ResultsAge-adjusted incidence increased on average 2.08% per year over the study period (95% confidence interval [CI], 1.30%-2.86%; P < .0001), with an incidence of 0.277 cases per 100,000 in 2015. Incidence was highest among Asian/Pacific Islander and non-Hispanic black individuals. The proportion of unknown stage at diagnosis declined as localized diagnoses increased over time. Compared with patients with thymoma, those with thymic carcinoma had significantly worse OS (HR, 1.63; 95% CI, 1.33-2.01; P < .0001) and CSS (subdistribution HR, 2.99; 95% CI, 2.29-3.91; P < .0001). Advanced stage at diagnosis was also associated with worse survival. Surgical intervention was associated with better prognosis for patients with localized (HR, 0.08; 95% CI, 0.02-0.30; P = .0002) or regional disease (HR, 0.14; 95% CI, 0.06-0.34; P < .0001).ConclusionThymic malignancy incidence is increasing in California. There was incidence variation across race/ethnicity, which warrants future study. These findings provide contemporary insight into the incidence and prognostic factors of thymic malignancies.     

An Independent Survey to Assess Completeness of Registration: Population Based Cancer Registry,Chennai, India

Cancer registration in the population based cancer registry (PBCR), Chennai, India, is carried out by activemethods. It undertakes re-screening of cases in government hospitals and Cancer Institute (WIA), trace back deathcertificate notifications and collect information on all the deaths, irrespective of the stated cause on the deathcertificate, occurring in the registry area routinely to reduce the under-registration of incident cancer cases andassociated mortality. The completeness of registration during 1982-95 was assessed by conducting an independentsurvey in randomly selected areas in Chennai. The total number of households covered in the survey was 7737 andwere collected which constituted 1% of the Chennai city population. The response rate to the survey was 96%. Atotal of 42,502 incident cancer cases were registered in Chennai PBCR during 1982-95. The total number of cancercases that were already registered in PBCR from the survey area during 1982-95 was 208. Out of 208 cases, 91 (44%)were identified in the survey; the families of the remaining 117 had migrated out of the surveyed area. Two newcancer cases hitherto unregistered in the PBCR during 1982-95 were identified from the survey. Based on the survey,it is estimated that the completeness of cancer registration in Chennai PBCR is 96%, which is comparable to those ofother registries in the world.     

Cancer Prevalence in Aichi,Japan for 2012: Estimates Based on Incidence and Survival Data from Population-Based Cancer Registry

Background: Cancer is the leading cause of death among both men and women in Japan. Monitoring cancer prevalence is important because prevalence data play a critical role in the development and implementation of health policy. We estimated cancer prevalence in 2012 based on cancer incidence and 5-year survival rate in Aichi Prefecture using data from a population-based cancer registry, the Aichi Cancer Registry, which covers 7.4 million people. Methods: The annual number of incident cases between 2008 and 2012 was used. Survival data of patients diagnosed in 2006–2008 and followed up until the end of 2012 were selected for survival analysis. Cancer prevalence was estimated from incidence and year-specific survival probabilities. Cancer prevalence was stratified by sex, cancer site (25 major cancers), and age group at diagnosis. Results: The estimated prevalence for all cancers in 2012 was 68,013 cases among men, 52,490 cases among women, with 120,503 cases for both sexes. Colorectal cancer was the most incident cancer with 6,654 cases, accounting for 16.0% of overall incident cases, followed by stomach cancer with 5,749 cases (13.8%) and lung cancer with 5,593 cases (13.4%). Prostate cancer was the most prevalent among men, accounting for 21.5%, followed by colorectal and stomach cancers. Breast cancer was the most prevalent among women, accounting for 28.6%, followed by colorectal, stomach, and uterine cancers. Conclusion: This study provides cancer prevalence data that could serve as useful essential information for local governments in cancer management, to carry out more practical and reasonable countermeasures for cancer.     

Epidemiology and Histopathological Spectrum of Head and Neck Cancers in Bihar,a State of Eastern India

Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of thecancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, whichare all preventable. This retrospective study presents data from the histopathology register for a five year periodfrom 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entireBihar state, the 3rd most populous state of India with the majority of the population residing in rural areas.Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females,with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for allmalignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commonerin males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by thechi-square (χ2) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 populationrespectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the mostcommon. Larynx was the most common site for malignancy, the supraglottic region being its most commonlyaffected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness,low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocatefor reliable cost-effective programs to create awareness, for early detection and plan appropriate managementstrategies. There is a compelling demand for a cancer registry in this region as well as proper implementationof preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.     

Breast Cancer Awareness at the Community Level among Women in Delhi,India

Background: To assess women’s awareness from diverse sections of society in Delhi regarding various aspectsof breast cancer (BC) – perceptions, signs and symptoms, risk factors, prevention, screening and treatment.Materials and Methods: Community-level survey was undertaken in association with the Indian Cancer Society(ICS), Delhi during May 2013-March 2014. Women attending BC awareness workshops by ICS were givenself-administered questionnaires before the workshop in the local language to assess BC literacy. Informationprovided by 2017 women was converted into awareness scores (aware=1) for analysis using SPSS. Awarenessscores were dichotomized with median score=19 as cut off, create more aware and less aware categories. Bivariateand multivariate analysis provided P-values, odds ratios (ORs) and 95% confidence intervals (CIs). Results:Broadly, 53.4% women were aware about various aspects of BC. Notably, 49.1% women believed that BC wasincurable and 73.9% women believed pain to be an initial BC symptom. Only 34.9% women performed breast selfexamination(BSE) and 6.9% women had undergone clinical breast-examination/mammography. 40.5% womenhad higher awareness (awareness score > median score of 19), which was associated with education [graduates(OR=2.31; 95%CI=1.78, 3.16), post-graduates (OR=7.06; 95%CI=4.14, 12.05) compared to ≤ high school] andsocio-economic status (SES) [low-middle (OR=4.20; 95%CI=2.72, 6.49), middle (OR=6.00; 95%CI=3.82, 9.42)and upper (OR=6.97; 95%CI=4.10, 11.84) compared to low SES]. Conclusions: BC awareness of women in Delhiwas suboptimal and was associated with low SES and education. Awareness must be drastically increased viacommunity outreach and use of media as a first step in the fight against BC.     

2015年陕西省肿瘤登记地区恶性肿瘤流行状况分析

[目的]分析了解陕西省2015年肿瘤登记地区恶性肿瘤的发病、死亡情况。[方法]收集陕西省14个肿瘤登记地区的恶性肿瘤发病、死亡信息,并用SPSS25.0分析计算城乡、性别、年龄别发病(死亡)率、标化发病(死亡)率、累积发病(死亡)率(0~74岁)。标准人口采用2000年全国普查人口年龄构成和Segi’s世界人口年龄构成。[结果]2015年陕西省肿瘤登记地区恶性肿瘤发病率为214.39/10万,中标率为152.44/10万,世标率为151.53/10万,城市地区肿瘤发病率高于农村地区,男性肿瘤发病率高于女性,40岁前恶性肿瘤发病率处于较低水平,40岁后快速升高,80岁达到发病率最高水平,到85岁组发病率略微下降,2015年陕西省肿瘤登记地区恶性肿瘤发病第1位的是肺癌,其次为乳腺癌、胃癌、肝癌、食管癌。全省肿瘤登记地区2015年恶性肿瘤死亡率为136.13/10万,中标率为94.00/10万,世标率为94.15/10万。全省肿瘤登记地区恶性肿瘤死亡率在45岁以前处于较低水平,45岁之后逐渐上升,到85岁年龄组达到死亡率峰值,全省恶性肿瘤登记地区恶性肿瘤死亡第1位的是肺癌,其次为肝癌、胃癌、食管癌。[结论]陕西省恶性肿瘤以肺癌、乳腺癌、胃癌、肝癌、食管癌为主要癌种。与全国平均水平比,乳腺癌和上消化道肿瘤负担较重,应作为陕西省肿瘤预防重点。