Journal of Health Care Communications Open Access

Incidence Estimate of Cancer Cases in State/UT of India from 2018 to 2021-v-1

Department of Health and Government of Bihar, India
Bar council, India
^*Correspondence: Piyush Kumar, Department of Health and Government of Bihar, India, Email:

Received: 01-Jun-2022, Manuscript No. IPJHCC-22-13789; Editor assigned: 03-Jun-2022, Pre QC No. IPJHCC-22-13789 (PQ); Reviewed: 17-Jun-2022, QC No. IPJHCC-22-13789; Revised: 22-Jun-2022, Manuscript No. IPJHCC-22-13789 (R); Published: 29-Jun-2022, DOI: 10.36846/2472-1654-7.6.70023

Abbreviations

(PBCRs) Population Based Cancer Registries; (HBCRs) Hospital Based Cancer Registries; (NCRP) National Cancer Registry Programme; (NCDs) Non-communicable Diseases; (NCDIR) National Centre for Disease Informatics and Research; (ICMR) Indian Council of Medical Research; (NPCDCS) National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke; (NHM) National Health Mission; (PIPs) Programme Implementation Plans; (SCIs) State Cancer Institute’s; (TCCCs) Tertiary Care Cancer Centres; (PMJAY) Pradhan Mantri Jan Arogya Yojana; (PMBJP) Pradhan Mantri Bhartiya Janaushadhi Pariyojana; (AMRIT) Affordable Medicines and Reliable Implants for Treatment; (RAN) Rashtrya Arogya Nidhi

Introduction

Cancer is caused by a variety of risk factors such as ageing, lifestyle, tobacco, lack of balanced diet and air pollution etc. [1]. Alcohol consumption is causally associated with the cancers of the oesophagus, colorectal, oral cavity, pharynx, larynx, liver and female breast [2]. Noncommunicable diseases (NCDs) accounts for 71% of all deaths globally [3]. NCDs account for 63% of all deaths in India of which cancer is one of the leading causes (9%) [4]. Cancer registries in India, has been started since 1982 by two routes, the population based cancer registries (PBCRs) and hospital based cancer registries (HBCRs) under project of the National Cancer Registry Programme (NCRP)-National Centre for Disease Informatics and Research (NCDIR) of the Indian Council of Medical Research (ICMR; ICMR-NCDIR-NCRP), Bangalore [5]. HBCRs provide information on patients with cancer in a particular hospital which are used for reviewing clinical performance and the hospital cancer program. Patterns, trends, projections, and mortality and also the stage at presentation type of treatment of patients with cancer from will be analyzed in version 2 of this research. Health is a state subject in India. The Department of Health and Family Welfare provides support to the States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) which was launched in 2010 as part of National Health Mission (NHM), with focus on strengthening human resource development, infrastructure, management and referral, health promotion, early diagnosis. Cancer control is an integral part of NPCDCS. NPCDCS is population based initiative for prevention, control and screening for Non-Communicable Diseases (NCDs) such as diabetes, hypertension, cancers etc. in the country under NHM (also as a part of Comprehensive Primary Health Care). Under this initiative, persons aged more than 30 years are target for screening for 03 common cancers i.e. oral, breast and cervical. Screening is an integral part of Ayushman Bharat through Ayushman Bharat Health Wellness Centre scheme. NPCDCS gives financial support for awareness generation (IEC) activities to be undertaken by the States/UTs as per their Programme Implementation Plans (PIPs). The Central Government is Strengthening Tertiary Care of Cancer, 19 State Cancer Institute’s (SCIs) and 20 Tertiary Care Cancer Centers (TCCCs) have been approved so far in order to enhance the facilities for tertiary care of cancer. Treatment of Cancers is available under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY). Under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) quality generic medicines are made available at affordable prices to all, in collaboration with the State Governments. AMRIT Pharmacy (Affordable Medicines and Reliable Implants for Treatment) stores have been set up with an objective to make available Cancer drugs at a discount vis-à-vis the Maximum Retail Price. Rashtrya Arogya Nidhi (RAN), provides financial assistance to families living below poverty line for their treatment, including treatment of Cancer in hospitals.

Objectives

The NCRP was launched with the objective of generating reliable data on the burden and patterns of cancer. The key objective is to estimate the incidence of cancer in State/UT-wise during the last four years and to calculate growth rate. Incidence per lakh populations of all reported cancers and other epidemiological discussions will be presented in next version-2.

Methods

Study Design

Data from 36 PBCRs and 236 HBCRs registered under the ICMR- NCDIR-NCRP were collected. All neoplasm with code of 3 as defined in the International Classification of Diseases for Oncology, 3^rd Edition, and the International Statistical Classification of Diseases and Related Health Problems (10th revision; ICD10) were registered in NCRP.

Setting

Cancer registration data were collected from accredited sources such as hospitals, diagnostic laboratories, vital statistics departments were collected on a standardized core form followed by specific quality control checks, measurability, and accuracy with timeliness, and reliability. Incidence data were retrieved from PBCRs (urban or rural, or both).

Participants

Patients with cancer who were residents in the registration area for a minimum period of 1 year before the date of diagnosis were included in the registry.

Variables

Cancer registration data from different sources such as hospitals, diagnostic laboratories, vital statistics departments were collected.

Data Sources/Measurement

Multiple cancer data sources were followed for data collection. Quality of the data was maintained per International Association of Cancer Registries/International Agency for Research on Cancer (IACR/IARC) norms.

Bias

Limited secondary data sources were the main bias observed.

Study Size

28 PBCRs of 2012-2016

Quantitative Variables

28 PBCRs of 2012-2016 were only reliable data available.

Statistical Analysis

NCRP has developed its own in house software (PBCR and HBCR Data Management) for data capture, quality checks, duplicates checks etc, and incidence calculations. The errors found during calculation were sent back to source registries for clarifications and corrections. Projected cancer incidence cases for India were computed using Age specific incidence Rate of 28 PBCRs of 2012-2016 and the projected population (person-years).

Results

As per cancer registry data on National Cancer Registry Programme Report, the estimated number of incidence of cancer cases in the country from 2018 to 2021 by State/UT wise is shown in Table 1. Ref: National Cancer Registry Programme report, 2020^* projected cancer cases for India were computed using age specific incidence rate of 28 PBCRs of 2012-2016 and the projected population (person years). Uttar Pradesh is having maximum cases as per estimate (14%) followed by west Bengal and Maharashtra with 8% of cases and Bihar 7%, please view Figure 1 for details.

Table 1: Estimated Incidence and growth rate of cancer cases in India by different State/UT - All sites (ICD10: C00-C97) - (2018-2021)^* - Both sexes.

Figure 1: Projected cancer cases in states and union territories of India.

Discussion

Cancer is not declared a notifiable disease by Government of India hence registration faces several challenges. The causal mortality registration system gaps include incomplete and inaccurate certification of cause of death. Registering cases through passive notification by health care providers/facilities to report cancer occurrence in India would improve the coverage with limited resources. Linking of cancer registry data with Ayushman Bharat, mortality databases, and the Health management Information System would improve cancer registration, follow up, and outcome data. This study provides a snapshot of the status and trends of cancer in India. Cancer registration needs more support for action to strengthen efforts for cancer prevention and control to achieve the sustainable development goals.

Conclusion

The key limitation is the methodology which assumes constant incidence rate for future as a conservative approach. PBCR covers only 10% of the population in India hence many parts of the country are not covered. Other influencing factors likely to influence the projection of cancer cases are risk factors/ behaviour, case finding procedure, screening programme, improved technique for detecting cancer patients etc.

Funding

The author declares that no funds are taken from any individual or agency institution for this study.

Declarations

This version of paper has not been previously published in any peer reviewed journal and is not currently under consideration by any journal. The document is Microsoft word with English (India) language and 1500 words excluding reference and declaration etc. (2337 words Total including all).

Ethics Approval and Consent to Participate

Not applicable. This study has not involved any human or animals in real or for experiments. The submitted work does not contain any identifiable patient/participant information.

Consent for Publication

The author provides consent for publication.

Availability of Data and Materials

Electronic records from National Cancer Registry Programme, HMIS (health management information system) of MoHFW (ministry of health and family welfare), Government of India, etc.

Conflicts of Interest

There are no conflicts/competing of interest.

Authors Contributions

The whole work is done by the Author Dr. Piyush Kumar, M.B.B.S., E.M.O.C., P.G.D.P.H.M., Senior General Medical Officer, Bihar Health Services, Health Department, Government of Bihar, India and Advocate Anupama-Senior Lawyer, Bar Council, Patna.

Acknowledgement

I am thankful to Advocate Anupama my wife and daughters Aathmika and Atheeva for cooperation.

Author Information

The author is currently working as Senior General Medical Officer for the government of Bihar and Advocate Anupama-Senior Lawyer, Bar Council, Patna.

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