Popula on-Based Cancer Registries at Chandigarh and SAS Nagar, Sangrur, Mansa Districts Punjab State, India
A collabora ve project of Tata Memorial Centre (TMC), Mumbai, Maharashtra State, India Homi Bhabha Na onal Ins tute (HBNI), Mumbai, India Post Graduate Ins tute of Medical Educa on and Research (PGIMER), Chandigarh, India Department of Health and Family Welfare, Government of Punjab State, India Director of Health Services, Chandigarh, India
Cancer Burden in Chandigarh and Punjab State Report: 2013 – 2016 Popula on-Based Cancer Registry Report Release 2014
Dr. G Dewan, Director of Health Services Chandigarh; Mrs. Anjali Bhawara, Principal Secretary Health and Family Welfare Punjab; Prof Jagat Ram, PGI Director; Dr. Prashant Mathur, Director NCDIR-NCRP, ICMR; Dr. Freddie Bray, Head sec on of cancer surveillance, IARC; Dr. Rajesh Dikshit, Director CCE-TMC; Prof JS Thakur, PGIMER and Dr. Atul Budukh, Professor, CCE - TMC along with other dignitaries released the reports of Chandigarh and Punjab PBCR concurrently during World NCD Congress held at PGIMER from 4th November 2017 to 6th November 2017. The message from the second year report is that all site cancer incidence rates are in comparison with other parts of India.
Cancer Registry Principal Inves gator, Co-Principal Inves gator, a nd Co-inves gators
Tata Memorial Centre (TMC), Mumbai
Nam e Role Designa on Dr. R A Badwe Principal Inves gator Director Dr. Rajesh Dikshit Co – Inves gator Director, CCE Dr. Pankaj Chaturvedi Co – Inves gator Dy Director, CCE Officer-In-Charge, HBCH & Dr. Prathamesh Pai Co – Inves gator RC, Mullanpur Dr. Atul Budukh Co – Principal Inves gator Professor Epidemiology Mr. T. Anbumani Project Consultant Administrator
Post Graduate Ins tute of Medical Educa on and Research (PGIMER), Chandigarh
Nam e Role Designa on
Dr. Jagat Ram Steering Commi ee Chairman Director (From 1st November 2016 to ll date) Dr. J S Thakur Principal Inves gator Professor Dr. Rakesh Kapoor Co- Inves gator Professor Dr. Pankaj Malhotra Co- Inves gator Professor Dr. Pankaj Arora Co-Inves gator Assistant Professor
Department of Health and Family Welfare, Punjab
Nam e Role Designa on
Dr. Raj Kuma r Co-Inves gator Civil Surgeon, Sangrur Dr. Lalchand Thakra l Co-Inves gator Civil Surgeon, Mansa Dr. Jai Singh Co-Inves gator Civil Surgeon, S AS Nagar
i Homi Bhabha Cancer Hospital, Sangrur
Name Designa on
Dr. Tapas Dora Asst Professor – Radiotherapy Dr. Sankalp Sanche Asst Professor – Pathology
Dr. Debashish Chaudhary Asst Professor – Surgical Oncology
Dr. Anshul Singla Asst Professor – Head and Neck Surgery
Dr. Alok Kumar Goel Asst Professor – Medical Oncology
Dr. Pramod Kharade Asst Professor – Preven ve Oncology
Mr. Prithviraj Kadam Project Manager
Suppor ve staff from TMC
Name Designa on
Mrs. Sonali Bagal Research Coordinator
Ms. Shraddha Shinde Scien fic Assistant Mrs. Suchita Yadav Scien fic Assistant Dr. Priyal C hakravar Sr. Project Coordinator
Cancer Registry Staff
Mrs. Balkiran Kaur, Mrs. Pra bha Saxena, Ms. Pooja and Chandigarh Mr. Manoj Kumar
Mr. Randeep Singh, Mr. Narinderjit Singh, Mr. Ashok Kumar and SAS Nagar Mr. Rajinder Singh
Ms. Divya Singh, Mr. Lakhwinder Singh, Mr. Amarjeet Singh, Sangrur Mr. Charanjit Singh, Mr. Sandeep Singh, Mr. Gurwinder Singh, Mr. Manoj Kumar and Mr. Deepak Saini
Mr. Sanjeev Kumar, Mrs. Gurpreet Kaur, Mrs. Kirna Kaur and Mansa Mr. Mandeep Kumar
ii Steering Commi ee Member
Name Designa on st Dr. Jagat Ram (1 November, 2016 onwards) Chairman Director, PGIMER, Chandigarh
Dr. R A Badwe Member Director, TMC, Mumbai Dr. Subhash C. Varma Member Professor and Head of Internal Medicine, PGIMER, Chandigarh Dr. Arvind Rajwansh i Professor and Head of Cytology and Gynaecological Pathology, Member PGIMER, Chandigarh Dr. Sushmita Ghosha l Member Professor and Head of Radiotherapy, PGIMER, Chandigarh
Dr. Rajesh Dikshit Member Director, CCE-TMC, Mumbai Dr. J S Thakur Professor, Department of Community Medicine and School of Member Public Health, PGIMER, Chandigarh
Dr. Atul Budukh Member Professor of Epidemiology, CCE-TMC, Mumbai
iii
Contents
Page Sr. No. Topic Number 1 Background 1 2 Popula on Covered 1 3 Release of the Second Year Report of the Cancer Registries 1 4 Area Covered 2 5 Cancer Incidence and Mortality 3 6 Leading Cancer Sites 5 7 Comparison of Cancer Incidence Rates with other Indian Registries 9 8 Highlights 16 9 Cancer Control in Punjab 17 10 References 18 11 Acknowledgment 19
1. Background
Popula on-based cancer registries (PBCRs) are essen al to know the true cancer burden in the popula on. In the year 2013, Tata Memorial Centre (TMC) in collabora on with Post Graduate Ins tute of Medical Educa on and Research (PGIMER), Chandigarh and Government of Punjab started the popula on-based cancer registries in urban, semi-urban and rural popula ons to know the cancer burden and trends over the period in these areas. These PBCRs cover 4.6 million popula on. The data have been collected from Chandigarh Union Territory (UT) and three districts in Punjab viz; SAS Nagar, Mansa and Sangrur. The informa on presented in this report pertains to all cancer cases registered with four registries men oned above in the year 2013 – 2016.
2. Popula on Covered The Mansa and Sangrur registries are rural, SAS Nagar registry is a semi-urban registry whereas Chandigarh is predominantly urban. Table1: Es mated average popula on distribu on among selected districts across rural and urban areas: 2013-2016 Popula on covered PBCR Rural Area (%) Urban Area (%) (in million)* Chandigarh 1.1 2% 98% SAS Nagar 1.0 45% 55% Sangrur 1.75 69% 31% Mansa 0.8 79% 21%
* Es mated popula on-based on growth rate of 2001 and 2011 census popula on
3. Release of the Second Year Report of the Cancer Registries
Dr. G Dewan, Director of Health Services Chandigarh; Mrs. Anjali Bhawara, Principal Secretary Health and Family Welfare Punjab; Prof Jagat Ram, PGI Director; Dr. Prashant Mathur, NCDIR- NCRP, ICMR Director; Dr. Freddie Bray, Head sec on of cancer surveillance, IARC; Dr. Rajesh Dikshit, Director CCE-TMC; Prof JS Thakur, PGIMER and Dr. Atul Budukh, Professor, CCE - TMC along with other dignitaries released the reports of Chandigarh and Punjab PBCR concurrently during World NCD Congress held at PGIMER on 4th November 2017 to 6th November 2017. The message from the second year report is that all site cancer incidence rates are in comparison with other parts of India.
1 4. Area Covered
Chandigarh SAS Nagar District
Sangrur District Mansa District
2 5. Cancer Incidence and Mortality
Table 2: Popula on covered, incidence cases registered and incidence rate by sex: (2013-2016)
Chandigarh SAS Nagar Sangrur Mansa
Male Average popula on covered 625,093 601,204 916,056 426,231 Number of cases registered 1754 1594 1905 886 AAR per 100,000 * 96.0 83.1 54.7 52.0 Cumula ve risk of ge ng the 11.6% 9.8% 6.4% 5.8% disease (0-74 age group) (1 in 9) (1 in 10) (1 in 16) (1 in 17) Female Average popula on covered 518,525 538,031 812,852 377,091 Number of cases registered 1749 1785 2070 1012 AAR per 100,000 * 102.4 98.6 63.6 62.4 Cumula ve risk of ge ng the 12.3% 11.3% 7.2% 6.9% disease (0-74 age group) (1 in 8) (1 in 9) (1 in 14) (1 in 14) *AAR: Age-adjusted rate per 100,000 popula on
Table 3: Popula on covered, death due to cancer and death rate by sex: (2013-2016)
Chandigarh SAS Nagar Sangrur Mansa
Male Average popula on covered 625,093 601,204 916,056 426,231 Number of deaths registered 835 841 1323 625 AAR per 100,000 * 46.7 44.3 38.1 36.4 Cumula ve risk of death due to 5.6% 5.4% 4.6% 4.1% disease (0-74 age group) (1 in 18) (1 in 19) (1 in 22) (1 in 24) Female Average popula on covered 518,525 538,031 812,852 377,091 Number of deaths registered 597 691 1185 591 AAR per 100,000 * 36.3 37.9 36.5 36.2 Cumula ve risk of death due to 4.5% 4.5% 4.7% 4.2% disease (0-74 age group) (1 in 22) (1 in 22) (1 in 21) (1 in 22) *AAR: Age-adjusted rate per 100,000 popula on
3 Figure 1: Cancer incidence by sex (2013-2016)
120 Male
Female 102.4 98.6 100 96.0
83.1 n
o 80 la u p 63.6 po
62.4 0 0
0 60
, 54.7
0 52.0 0 1
r e p
R 40 A A
20
0 Chandigarh SAS Nagar Sangrur Mansa
Figure 2: Cancer mortality by sex (2013-2016)
50 Male 46.7 44.3 45 Female
40 37.9 38.1 36.3 36.5 36.4 36.2
n 35 o la
u 30 op p
0 25 00 , 0 10
r 20 e p R A
A 15
10
5
0 Chandigarh SAS Nagar Sangrur Mansa
4 6. Leading Cancer Sites
Figure 3: Leading cancer sites in Chandigarh – Males (2013-2016)
Lung 12.9 (12.8%)
Prostate 10.2 (9.0%)
Oesophagus 5.8 (5.9%)
Bladder 5.6 (5.5%)
Mouth 4.9 (5.2%)
NHL 4.9 (5.2%)
Larynx 4.8 (4.9%)
Tongue 4.4 (5.0%)
Gallbladder etc. 3.0 (3.0%)
Colon 2.9 (3.0%)
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0
AAR per 100,000 popula on
Figure 4: Leading cancer sites in Chandigarh – Females (2013-2016)
Breast 33.0 (32.6%)
Cervix uteri 8.1 (8.1%)
Corpus uteri 7.2 (6.6%)
Ovary 6.2 (6.2%)
Gallbladder etc. 5.7 (5.7%)
NHL 4.3 (3.9%)
Lung 4.2 (3.6%)
Oesophagus 2.4 (2.2%)
Colon 2.1 (2.1%)
Mul ple myeloma 2.0 (1.8%)
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 AAR per 100,000 popula on
5 Figure 5: Leading cancer sites in SAS Nagar – Males (2013-2016)
Lung 7.8 (9.0%)
Prostate 7.7 (9.6%)
Oesophagus 5.9 (6.5%)
Bladder 4.9 (5.8%)
Tongue 4.2 (5.0%)
Liver 4.1 (4.8%)
Mouth 4.0 (4.5%)
Larynx 4.0 (4.4%)
Brain, nervous system 3.3 (4.5%)
NHL 2.9 (3.5%)
0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0
Figure 6: Leading cancer sites in SAS Nagar – Females (2013-2016)
Breast 30.2 (30.3%)
Cervix uteri 10.4 (10.4%)
Ovary 7.4 (7.5%)
Gallbladder etc. 4.8 (4.8%)
Corpus uteri 4.7 (4.5%)
Oesophagus 4.7 (4.8%)
NHL 3.5 (3.5%)
Lung 2.2 (2.2%)
Myeloid leukaemia 2.1 (2.4%)
Brain, nervous system 2.0 (2.1%)
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 AAR per 100,000 popula on
6
Figure 7: Leading cancer sites in Sangrur – Males (2013-2016)
Oesophagus 5.8 (10.7%)
Prostate 3.3 (6.5%)
Liver 3.3 (5.7%)
Tongue 2.8 (5.0%)
Lung 2.6 (4.6%)
Larynx 2.4 (4.1%)
Mouth 2.4 (4.3%)
Bladder 1.7 (3.0%)
NHL 1.6 (3.0%)
Brain, NS 1.5 (2.8%)
0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0
Figure 8: Leading cancer sites in Sangrur – Females (2013-2016)
Breast 16.7 (26.2%)
Cervix uteri 8.7 (13.7%)
Oesophagus 5.2 (8.1%)
Ovary 4.1 (6.3%)
Gall bladder 3.2 (5.1%)
Brain, NS 1.5 (2.3%)
Corpus uteri 1.5 (2.3%)
Myeloid leukaemia 1.4 (2.3%)
Thyroid 1.2 (2.1%)
Liver 1.1 (1.7%)
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0 AAR per 100,000 popula on
7 Figure 9: Leading cancer sites in Mansa – Males (2013-2016)
Oesophagus 6.3 (12.1%)
Liver 2.8 (5.2%)
Prostate 2.3 (4.7%)
Lung 2.3 (4.4%)
Mouth 2.3 (4.4%)
Brain, nervous system 2.2 (4.4%)
Tongue 2.2 (4.4%)
Myeloid leukaemia 2.1 (4.3%)
Larynx 2.1(4.1%)
Lymphoid leukaemia 1.8 (3.3%)
0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0
Figure 10: Leading cancer sites in Mansa – Females (2013-2016)
Breast 13.3 (21.1%)
Cervix uteri 10.1 (16.1%)
Oesophagus 7.1 (11.4%)
Ovary 5.0 (7.7%)
Gallbladder etc. 3.2 (5.0%)
Myeloid leukaemia 2.3 (3.7%)
Kidney 1.3 (1.9%)
Liver 1.3 (2.2%)
Lung 1.2 (1.8%)
Pancreas 0.9 (1.5%)
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 AAR per 100,000 popula on
8 7. Comparison of Cancer Incidence Rate with other Indian Registries
Figure 11: Age-adjusted incidence rate of all cancer sites from Indian PBCR – Males
Meghalaya (2012-2014) 169.6 Delhi (2012) 149.4 Thiruvananthapuram District (2012-2014) 132.0 Nagaland (2012-2014) 125.8 Cachar District (2012-2014) 125.4 Kollam District (2012-2014) 120.5 Chennai (2012-2013) 116.1 Mumbai (2013-2014) 111.0 Pasighat (2012-2014) 107.4 Bangalore (2012) 105.4 Naharlagun (2012-2014) 103.5 Bhopal (2012-2013) 101.5 Kolkata (2012) 100.9 Ahmedabad Urban (2012-2013) 98.5 Pa ala District (2012-2014) 97.9 Chandigarh (2013-2016) 96.0 Dibrugarh District (2012-2014) 92.8 Sikkim State (2012-2014) 90.7 India (2018) 89.8 Nagpur (2012-2013) 89.4 S.A.S. Nagar District (2013-2016) 83.1 Pune (2012-2013) 77.6 Tripura State (2012-2014) 76.4 Aurangabad (2012-2014) 72.0 Manipur State (2012-2014) 60.5 Wardha District (2012-2014) 60.2 Sangrur District (2013-2016) 54.7 Barshi Rural (2012-2014) 53.9 Mansa District (2013-2016) 52.0 Barshi Expanded (2012) 40.9
0.0 50.0 100.0 150.0 200.0 AAR per 100,000 popula on
(Reference: 1 to 7)
9 Figure 12: Age-adjusted incidence rate for all cancer sites from Indian PBCR - Females
Delhi (2012) 144.8
Chennai (2012-2013) 126.2 Bangalore (2012) 125.9
Thiruvananthapuram District (2012-2014) 120.4
Mumbai (2013-2014) 119.7
Pa ala District (2012-2014) 111.2 Bhopal (2012-2013) 108.3
Kolkata (2012) 103.4
Chandigarh (2013-2016) 102.4
Kollam District (2012-2014) 101.7 Pasighat (2012-2014) 101.4
Naharlagun (2012-2014) 100.5
Sikkim State (2012-2014) 100.3 S.A.S. Nagar District (2013-2016) 98.6
Cachar District (2012-2014) 95.2
Nagpur (2012-2013) 94.5
Meghalaya (2012-2014) 94.4 India (2018) 90.0
Nagaland (2012-2014) 84.9
Pune (2012-2013) 84.9
Dibrugarh District (2012-2014) 78.6 Ahmedabad Urban (2012-2013) 76.5
Aurangabad (2012-2014) 73.0
Manipur State (2012-2014) 68.6 Wardha District (2012-2014) 66.7
Sangrur District (2013-2016) 63.6
Mansa District (2013-2016) 62.4
Barshi Rural (2012-2014) 60.4 Tripura State (2012-2014) 54.9
Barshi Expanded (2012) 52.0
0.0 50.0 100.0 150.0 200.0 AAR per 100,000 popula on (Reference: 1 to 7)
10 Figure 13: Age-adjusted incidence rates of breast cancer from Indian PBCR
Delhi (2012) 41.0 Chennai (2012-2013) 37.9 Mumbai (2013-2014) 36.0 Bangalore (2012) 34.4 Thiruvananthapuram District (2012-2014) 33.7 Pa ala District (2012-2014) 33.1 Bhopal (2012-2013) 33.1 Chandigarh (2013-2016) 33.0 S.A.S. Nagar District (2013-2016) 30.2 Nagpur (2012-2013) 29.3 Kollam District (2012-2014) 27.7 Kamrup Urban District (2012-2014) 27.1 Pune (2012-2013) 26.4 Kolkata (2012) 25.5 India (2018) 24.7 Ahmedabad Urban (2012-2013) 23.8 Aurangabad (2012-2014) 22.6 Mizoram(2012-2014) 19.9 Wardha District (2012-2014) 18.8 Pasighat (2012-2014) 17.4 Sangrur District (2013-2016) 16.7 Dibrugarh District (2012-2014) 13.9 Mansa District (2013-2016) 13.3 Cachar District (2012-2014) 12.8 Barshi Rural (2012-2014) 12.4 Barshi Expanded (2012) 11.7 Sikim State (2012-2014) 11.1 Manipur State (2012-2014) 9.7 Naharlagun (2012-2014) 9.4 Nagaland (2012-2014) 9.1 Tripura State (2012-2014) 6.9 Meghalaya (2012-2014) 6.7
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 AAR per 100,000 popula on
(Reference: 1 to 7)
11 Figure 14: Age-adjusted incidence rates of cervix uteri cancer from Indian PBCR
Mizoram State (2012-2014) 23.1 Pasighat (2012-2014) 22.5 Barshi Rural (2012-2014) 16.1 Chennai (2012-2013) 15.9 Delhi (2012) 15.5 Bangalore (2012) 15.3 India (2018) 14.7 Barshi Expanded (2012) 14.7 Kamrup Urban District (2012-2014) 14.5 Aurangabad (2012-2014) 14.3 Bhopal (2012-2013) 13.8 Nagaland (2012-2014) 13.1 Nagpur (2012-2013) 12.9 Cachar District (2012-2014) 12.7 Pa ala District (2012-2014) 11.5 Naharlagun (2012-2014) 11.3 Kolkata (2012) 10.4 S.A.S. Nagar District (2013-2016) 10.4 Mansa District (2013-2016) 10.1 Sikkim State (2012-2014) 10.1 Meghalaya (2012-2014) 9.6 Tripura State (2012-2014) 9.2 Pune (2012-2013) 9.0 Sangrur District (2013-2016) 8.7 Wardha District (2012-2014) 8.6 Mumbai (2013-2014) 8.4 Chandigarh (2013-2016) 8.1 Thiruvananthapuram District (2012-2014) 7.0 Ahmedabad Urban (2012-2013) 6.9 Kollam District (2012-2014) 6.7 Manipur State (2012-2014) 6.1 Dibrugarh District (2012-2014) 4.9
0.0 5.0 10.0 15.0 20.0 25.0 AAR per 100,000 popula on
(Reference: 1 to 7)
12 Figure 15: Age-adjusted incidence rates of prostate cancer from Indian PBCR
Delhi (2012) 12.4 Kamrup Urban District (2012-2014) 12.2 Chandigarh (2013-2016) 10.2 Mumbai (2013-2014) 9.7 Thiruvananthapuram District (2012-2014) 9.4 Bangalore (2012) 8.2 Kolkata (2012) 8.2 S.A.S. Nagar District (2013-2016) 7.7 Chennai (2012-2013) 6.7 Pa ala District (2012-2014) 6.3 Pune (2012-2013) 6.3 Kollam District (2012-2014) 6.1 Bhopal (2012-2013) 5.6 Ahmedabad Urban (2012-2013) 4.4 India (2018) 4.4 Sangrur District (2013-2016) 3.3 Mizoram(2012-2014) 3.0 Nagpur (2012-2013) 2.5 Mansa District (2013-2016) 2.3 Aurangabad (2012-2014) 2.2 Dibrugarh District (2012-2014) 2.2 Barshi Rural (2012-2014) 2.1 Cachar District (2012-2014) 1.9 Sikim State (2012-2014) 1.9 Wardha District (2012-2014) 1.8 Meghalaya (2012-2014) 1.6 Barshi Expended (2012) 1.5 Manipur State (2012-2014) 1.5 Naharlagun (2012-2014) 1.1 Nagaland (2012-2014) 1.0 Tripura State (2012-2014) 1.0 Pasighat (2012-2014) 0.8
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 AAR per 100,000 popula on
(Reference: 1 to 7)
13 Figure 16: Age-adjusted incidence rates of oesophagus cancer from Indian PBCR
51.2 Meghalaya (2012-2014) 22.7 32.6 Mizoram State (2012-2014) 7.6 29.1 Kamrup Urban District (2012-2014) 20.7 14.6 Dibrugarh District (2012-2014) 8.1 13.8 Nagaland (2012-2014) 3.5 12.9 Cachar District (2012-2014) 7.1 11.5 Pa ala District (2012-2014) 6.7 8.7 Naharlagun (2012-2014) 4.7 6.7 Bangalore (2012) 4.6 6.7 Nagpur (2012-2013) 4.1 6.4 Sikkim State (2012-2014) 6.2 6.3 Delhi (2012) 3.6 6.3 Mansa (2013-2016) 7.1 6.2 Tripura State (2012-2014) 3.5 5.9 S.A.S. Nagar (2013-2016) 4.7 5.9 Ahmedabad Urban (2012-2013) 3.5 5.8 Chandigarh (2013-2016) 2.4 5.8 Sangrur (2013-2016) 5.2 5.7 Pasighat (2012-2014) 4.1 5.5 India (2018) 2.9 5.4 Aurangabad (2012-2014) 2.6 4.9 Bhopal (2012-2013) 3.6 4.5 Chennai (2012-2013) 3.3 4.1 Wardha District (2012-2014) 3.0 4.1 Mumbai (2013-2014) 3.4 4.0 Barshi Rural (2012-2014) 2.2 3.9 Kollam District (2012-2014) 1.4 3.8 Thiruvananthapuram District (2012-2014) 0.9 3.8 Pune (2012-2013) 2.7 Manipur State (2012-2014) 3.3 1.2 Male 2.7 Kolkata (2012) 1.8 2.7 Female Barshi Expanded (2012) 1.1 0.0 20.0 40.0 60.0 AAR per 100,000 popula on
(Reference: 1 to 7)
14 Figure 17: Age-adjusted incidence rates of lung cancer from Indian PBCR
32.6 Mizoram State (2012-2014) 29.3 21.6 Kollam District (2012-2014) 3.8 19.1 Kolkata (2012) 7.4 18.7 Kamrup Urban District (2012-2014) 8.2 17.2 Delhi (2012) 4.9 16.8 Thiruvananthapuram District (2012-2014) 4.5 14.2 Tripura State (2012-2014) 2.7 12.9 Chandigarh (2013-2016) 4.2 12.8 Meghalaya (2012-2014) 4.3 12.4 Bhopal (2012-2013) 3.8 11.7 Bangalore (2012) 4.9 11.6 Chennai (2012-2013) 4.2 11.5 Cachar District (2012-2014) 3.6 11.4 Mumbai (2013-2014) 6.4 11.4 Manipur State (2012-2014) 11.0 9.7 Aurangabad (2012-2014) 3.4 9.1 Ahmedabad Urban (2012-2013) 2.7 7.9 Nagaland (2012-2014) 3.6 7.8 India (2018) 3.0 7.8 S.A.S. Nagar District (2013-2016) 2.2 7.4 Naharlagun (2012-2014) 5.6 7.4 Pa ala District (2012-2014) 2.7 6.9 Pune (2012-2013) 3.9 6.7 Sikkim State (2012-2014) 7.8 6.5 Nagpur (2012-2013) 2.7 5.5 Pasighat (2012-2014) 1.7 5.0 Dibrugarh District (2012-2014) 2.3 3.8 Wardha District (2012-2014) 2.2 2.6 Sangrur District (2013-2016) 0.9 2.3 Mansa District (2013-2016) 1.2 2.2 Barshi Rural (2012-2014) 2.1 Male 2.1 Barshi Expanded (2012) 0.7 Female 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 AAR per 100,000 popula on (Reference: 1 to 7)
15 8. Highlights
· The popula on-based cancer registry covers a 100% popula on of the Chandigarh Union Territory.
· SAS Nagar, Sangrur and Mansa registries cover around 3.6 million popula on, which cons tutes 13% of the total popula on of Punjab state.
· Cancer registry covers the Chandigarh area as well as 419 villages of SAS Nagar, 589 of Sangrur and 242 of Mansa districts (total 1250 villages).
· The Chandigarh PBCR incidence rates for both males and females are higher than the na onal rate (Chandigarh male 96.0, India male 89.8 per 100,000 popula on; Chandigarh female 102.4, India female 90.0 per 100,000 popula on). However, it is lower than Mumbai, Delhi, Chennai and Bangalore cancer registries.
· SAS Nagar female cancer incidence rate is slightly higher than the na onal rate (98.6 Vs 90.0 per 100,000 popula on); however, the male cancer incidence rate is lower than the na onal rate (83.1 Vs 89.8 per 100,000).
· Sangrur and Mansa cancer registry incidence rates are lower than the urban cancer registries; however, it is in comparison with other rural registries of the country.
· 1 in 9 males is at risk of developing cancer in Chandigarh; whereas, it is 1 in 10 in SAS Nagar, 1 in 16 in Sangrur and 1 in 17 in Mansa district.
· 1 in 8 females is at risk of developing cancer in Chandigarh; whereas, it is 1 in 9 in SAS Nagar, 1 in 14 in both Sangrur and Mansa districts.
· 1 in 18 males is at risk of dying due to cancer in Chandigarh; while it is 1 in 19 in SAS Nagar, 1 in 22 in Sangrur district and 1 in 24 in the Mansa district.
· 1 in 22 females is at risk of dying due to cancer in Chandigarh, SAS Nagar and Mansa district whereas it is 1 in 21 in Sangrur district.
· Female breast cancer incidence rate of Chandigarh is 33.0 per 100,000 popula on which is compara vely higher but it is lower than Delhi, Chennai, Mumbai and Bangalore cancer registries.
· Female breast cancer is the most predominant cancer reported by Chandigarh, SAS Nagar, Sangrur, and Mansa popula on-based cancer registries.
· 1 in 25 females is at risk of ge ng breast cancer in Chandigarh, 1 in 29 in SAS Nagar, 1 in 53 in Sangrur and 1 in 71 in the Mansa district. This report recommends an early detec on program for breast cancer to be organized in this region.
· Cervix uteri cancer is the second leading cancer site followed by breast cancer in all the cancer registries.
· Lung, Prostate, Oesophagus and Bladder cancers are the leading cancer sites in males as per Chandigarh and SAS Nagar registries data. 16 · Oesophagus, Prostate and Liver cancers are the leading cancer sites in males as per Sangrur and Mansa registries data.
· Gall bladder cancer is one of the top five leading cancer sites in females in all the cancer registries (Chandigarh 5.7, SAS Nagar 4.8, Sangrur and Mansa 3.2 per 100,000 popula on).
· Most of the cancer cases from rural and urban areas are diagnosed at the advanced stage of the disease.
· Approximately 50% of male cancer cases are surviving in the urban popula on whereas only 31% of male cases are surviving in the rural popula on.
· 62% to 65% of female cancer cases are surviving in the urban popula on whereas only 42% to 43 % of cases are surviving in the rural popula on.
· Based on the recommenda on of the cancer registry report, we have started an early detec on program for breast, cervix uteri and oral cancer in the Sangrur area.
· The cancer incidence rates for all cancer sites are stable in all the registries for the year 2013 to 2016. There is an improvement in the cancer registra on process. The rates of all cancer sites are in comparison with the other parts of India.
· This report recommends a cancer control program to be organized in these regions with the focus on breast, cervix uteri, oesophagus, prostate, lung and oral cancer.
9. Cancer Control in Punjab
Cancer registries are the first step in cancer control. The registry data have es mated the risk of developing cancer in the range of 6 to 12% for males and for females, it is 7 to 12%. The risk is double in the urban areas as compared to rural areas.
The major cancers in Punjab are Breast, Cervix Uteri, Lung, Prostate and Oesophagus. Most of the cancers are preventable. Based on the observa on from the registry, Tata Memorial Centre has started a satellite center in Sangrur and will establish a comprehensive cancer center in SAS Nagar (Mohali). The cancer center in Mohali will be in opera on soon. PGIMER Chandigarh has also established a satellite center beside a regional cancer center. Govt. of Punjab has taken various other steps to strengthen the cancer care services in the state.
In addition to the above, Homi Bhabha Cancer Hospital has started an early detec on program for Breast, Cervix Uteri and oral cancer in the Sangrur area. The registries will be useful in the future to monitor cancer trends and to evaluate the effects of preven on and treatment.
17 10. Reference
1. Na onal Cancer Registry Programme – Indian Council of Medical Research: Three-year report of PBCR 2012-2014, Bangalore 2016
2. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018). Global Cancer Observatory: Cancer Today. Lyon, France: Interna onal Agency for Research on Cancer. Available from: h ps://gco.iarc.fr/today , accessed 07.01.2020
3. Chandigarh Popula on-Based Cancer Registry Report: (2013, 2014 and 2015-2016) – Tata Memorial Center, Mumbai and Post Graduate Ins tute of Medical Educa on and Research (PGI), Chandigarh
4. SAS Nagar Population-Based Cancer Registry Report: (2013, 2014 and 2015-2016) – Tata Memorial Center, Mumbai and Post Graduate Ins tute of Medical Educa on and Research (PGI), Chandigarh
5. Mansa Popula on-Based Cancer Registry Report: (2013, 2014 and 2015-2016) – Tata Memorial Center, Mumbai and Post Graduate Ins tute of Medical Educa on and Research (PGI), Chandigarh.
6. Sangrur Popula on-Based Cancer Registry Report: (2013, 2014 and 2015-2016) – Tata Memorial Center, Mumbai and Post Graduate Ins tute of Medical Educa on and Research (PGI), Chandigarh.
7. Cancer Incidence and Mortality Greater Mumbai 2013-2014, Mumbai Cancer Registry, Mumbai.
18 11. Acknowledgement
We gratefully acknowledge Mr. Vijay Inder Singla – Hon Minister of PWD and Educa on for his support to Homi Bhabha Cancer Hospital, Sangrur and Mansa Popula on-Based Cancer Registry. Our special thanks to Mrs. Vini Mahajan, Ex-Principal Secretary – Ministry of Health & Family Welfare , Government of Punjab for her valuable support.
The cancer registries gratefully acknowledge the help provided by Chandigarh administra on as well as the Punjab Government. The registries appreciate the support provided by all the departments of PGIMER, Chandigarh. The registries acknowledge the support provided by all the departments of Acharya Tulsi Das Regional Cancer Treatment & Research Ins tute, Bikaner The registries acknowledge the help provided by all the diagnos c and treatment centers from Chandigarh, SAS Nagar, Sangrur, Mansa district and across the Punjab, Haryana, and Rajasthan state. The names of the centers are men oned below.
We acknowledge the support provided by the administra on and account unit Tata Memorial Centre in the smooth func oning of the cancer registry project.
Tata Memorial Hospital, Mumbai Mr. Tukaram H Medar – AAO , CCE Dr. C S Pramesh, Director Mr. Suryakant Shedge – As st Accts Officer, CCE Dr. Banavli S, Director – Academics Mr. Sanjeev Sood – Director Administra on Homi Bhabha Cancer Hospital, Sangrur (Project) Dr. Midhila Baby, Medical Oncologist Mr. Anil Sathe, CAO Dr. Rakesh Sharma, Surgical oncologist Mr. Suryakant Mohapatra, JCFA Dr. Sachin Khandelwal, Surgical oncologist Mr. Vijendra Tiwari, DCA Dr. Dimple Kalra, Administrator Mrs. Ruchita Dhanvade, AAO Dr. Navnath Dhone – Sr. Resident of Radiology Mr. Benny George, HRD Officer Mr. Mihir Panda, AAO Mr. Chandrakant She y, Jr AO Mr. Manbir Punia, Scien fic Officer, ‘C’-IT Mrs. Anagha Kadam, AAO Mr. Rahul Dev Dwivedi, Scien fic Officer, ‘C’ -IT Mrs. Varsha Pa l, Stenographer Mr. Keshav Sharma, Accountant Mr. Ni n Chautale, PO Advanced Centre for Treatment, Research, and Mr. Darshan Singh, Store Incharge Educa on in Cancer, Kharghar, Navi Mumbai Mr. Harinder Singh – I T Dr. Sudeep Gupta, Director, Dr. HKV Narayan, Dy. Director, Post Graduate Ins tute of Medical Educa on Dr. Navin Kha ry, Dy. Director – CRC and Research, Chandigarh Dr. Prasanna Venkatraman, Dy Director – CRI Dr. Pra bha D. Singhi, Professor & Head, Mr. Umesh Kumar V. Mote – Sr. AO Advanced Pediatric Center (APC) Mr. M Y Shaikh - Administra ve officer Dr. Ranjana W. Minz, Professor & Head, Mrs. Anuradha Narayanan – DCA Department of Immunopathology Mrs. Kusum Pednekar – Jr. PO, CCE 19 Dr. R. K. Vasishta, Professor & Head, Mrs. RimiKour, Microbiologist Department of Histopathology Mr. Lakhwinder Kumar Sr LT Dr. A. K. Gupta, Department of Hospital Administra on Civil Hospital, District Mansa Medical Superintendent-cum-Professor & Head, Dr. Surindar Singh, ACS/DMC, Mansa Department of Hospital Administra on Dr. Ashok Kumar, SMO, DH -Mansa Dr. N. Khandelwal, Professor & Head, Sh. Santosh Kumar Bhar , Dist. Epidemiologist Department of Radio Diagnosis & Imaging Dr. Kanwalpreet Brar, MD Pathologist Mr. Kar keyan, Sr. MRO, Central Registra on Dr. Rakesh Sarpal, Nodal officer NPCDCS Department (CRD) DR. Sushank Sood, Eye Specialist Ms. C. Uma Rani, Sr. MRO, Central Registra on Dr. Mohan Lal, Radiographer Department (CRD) Dr. Pooja, Ayurvedic Dr. Kathirvel S, Sr. Resident, Department of Dr. Nishant Gupta, Skin Specialist Community Medicine and School of Public Dr. Parvish Child Specialist Health(CRD) Dr. Nishi Sood, TB Officer Dr. Ravneet Kaur, Ex Assistant Professor, Dr Vishal Garg, Surgeon Department of Community Medicine and Dr. Kamaldeep Kumar, Ortho School of Public Health Dr. M. A. Bashar, Dr. Shavi Bajaj, Neurologist Department of Community Medicine and Dr. Rashmi Garg, Gynecologist School of Public Health Dr. Baljeet Kaur, Gynecologist Dr. S.P.S. Bha a, Ex -Lecturer, Department of Dr. Navneet Kaur, Gynecologist Biosta s cs Dr. Sunil Oberoi, SMO-Khiala Kalan Dr. Ranjit Singh Rai, MO-CH Civil Hospital, Sangrur Dr. Pushpinder Singla, SMO- Bhikhi Dr.Parminder Kaur, DMC Dr. Hardeep Sharma, SMO- Budhlada Dr. Baljeet Singh, DH SMO Dr. Sohan Lal, SMO-Sardulgarh Dr.Upasna, District Epidemiology Unit Dr. Harpal Sran, MO-CH Mansa Dr.Kirpal Singh, SMO Dr. Vivek Kumar, MO-Jhunir Mrs. Parneet Kaur, Consultant, Fluorosis Dr. Jagtar Singh, Pharmacist Dr. Pallavi Garg, Pathologist Sh. Tejinder Pal, FLO, CH-Mansa Dr. Jagmohan, MD Medicine Sh. Kewal Singh, BEE-Khiala kalan Dr. Rahul, MD Medicine Sh. Krishan Kumar, BEE-Budhlada Dr.Vinod Kumar (M.S) Sh. Tirlok Singh, BEE-Sardulgarh Dr. Sunita Singla (M.S) Ms. Tanu Bala, Data Entry Operator Dr.Chamandeep Singh Raikhy Sh. Avinash Chugh, Data Entry Operator Dr.Harbans Singh, Sh. Narinder Singh, Data Entry Operator Dr. Varinder Singh, Dr. Dinesh Kumar (M.S ENT) Acharya Tulsi Regional Cancer Treatment & Dr. Juhi Goyal (Gynecologist) Research Ins tute, Bikaner Dr. Navdeep Arora (MD) Dr. MR Bardia, Director Dr. Parveen Markan Dr. H.S Kumar, H.O.D Radiotherapy Dr.Ramanbir Kaur, Gynecologist Mr. Pravin Soni, D.O.P Dr. Vikas Dhir, MD(Medicine) PCMS- 1 Mr. Pradeep Bhardwaj (L.D.C) Dr. Sanjeev Aggarwal, MS Eye Dr.Paramvir Singh Kalair, Pediatrician Dr.Ravinderpal, Radiologist Dr. Nidhi, Ophthalmologist Dr. KC Goyal, Ex- SMO
20 Guru Gobind Singh Medical College & Hospital, Government Medical College and Hospital, Faridkot Sector 32, Chandigarh Dr. Deepak John Ba , Principal Dr. Atul Sachdeva, Former Director Principal Dr. Rajiv Joshi , Medical Superintendent Dr. Awadesh Kumar Pandey, Professor & Head, Dr. J. P. Sing, Deputy Medical Superintendent Department of radiotherapy Sh. Rajeev Grover, Medical College Dr. Sonia Puri, Ass. Prof. Dep. of Superintenden t CommunityMedicine Sh. Padampal Maini, Medical Record Officer Dr. Uma Handa, Prof & Head, Dep. of Pathology Sh. Kewal Singh, Data Entry Operator Dr. A.K. Janmeja, Former Medical Sh. Jagtar Singh, Data Entry Operator Superintendent Sh. Sikander Kumar, Data Entry Operator Dr. Ravi Gupta, Professor & Head, Department of Orthopedics cum Medical Superintendent Rajindra Hospital/ Govt. Medical College/ GDC, Mr. Suraj, Social Worker, HBCR Pa ala Mr. Sunil, Office A endant Dr. Harjinder Singh, Principal Mrs. Deepa, Clerk Dr. Renu Bala, Principal GDC Dr. Ashwani Kumar, MS Government Mul -Specialty Hospital, Dr. Raja Parmjeet Singh, Head of RT Chandigarh Department Dr. AbhaSarwal Saini, Head of the Department Dr.Ramesh K.Kundal, MD and Senior Medical Officer (Pathology) Dr. D.J.S Walia Dr. Ranjana Mehta, Medical Officer (Pathology) Dr.Anubha Dr. Sandeep Tandon, Medical Officer(Pathology) Dr. Sanjeev Bhagta Dr. Vandana Gupta, Medical Superintendent Mrs.Sudarshan, SLT Mr. Rocky Daniel, Senior Medical Lab Technician Ms. Dharamjit Kaur (please add) Mr. Anil Kumar, SeniorMedical Lab Technician Ms. Sandeep Mr. Stephen Ma u, Medical Lab Technician Sh. Mukesh Kumar, Pharmacist
Ms.Alisha, Pharmacis t For s Hospital, SAS Nagar Sh. Pawan Kumar, Data Entry Operator Dr. Abhijit, Singh, Director Dr. Rajiv Bedi, Consultant Onc ology Dept. Mohandai Oswal Cancer Hospital, Ludhiana Dr.Minishi Bansal, Medical Oncologist Dr. V. K.Kaushal, Director Dr.Ritu Pankaj, Pathologist Dr.Gurenderjit Singh, Medical Superintendent Dr.Irneep, Pathologist Dr. Naveen Kanda, Dep . of radia on Oncology Ms. Ruchi, Lab Assistant Dr.Raman Arora, Department of Medical Mr. Deepak Saini, Medical Record Dept. In - Oncology charge Dr. Gurshaminder Singh Hara, Dep . of general Mr. Ja nder Katoch, HOD, MRD Surgery and Surgical oncology Mr. Naresh Kumar, Supervisor Dr. Yogesh Guaba, Dep . of general Surgery Mr. Deepak Nagpal, Senior Assistant and Surgical oncology Mr. Gurpreet Singh, Senior Assistant Dr. Pradeep Kapur, Sr.Consultant Head & chest Mr. Jagjeet Singh, Senior Assistant Sh. Sohan Singh Negi, Clerk Mr. Mal Ba sh, Assistant Ms. Raman Bajwa, Accessioning Officer Dayanand Medical College & Hospital, Mr. Ravinder Kumar, Assistant Ludhiana Dr.SandeepPuri, Principal Dr. Sandeep Sharma, Medical Superintendent Sh. Pawan Kumar, Sr. Medical Record Officer
21 IVY Hospital, SAS Nagar Indus Super Speciality Hospital, SAS Nagar Mr. Gurtej Singh, Chairman Dr. Sant Parkash, Chairperson Dr.Kanwaldeep Kaur, Medical Director Dr. Ramandeep Singh, Chief Financing Officer Dr. Shivani Punjj, Medical Administrator Dr. Vinod Nimbran, Oncology Head Radia on Dr.Ja n Sarin, Medical Oncologist Department Dr. Vijay Bansal, Surgical Oncologist Dr. Romita Trehan, Radia on Oncology Dr.Ritu Bisht, Pathologist Dr. Ashwini Anand, Onco-Surgeon Mr. Ja nder Singh, Sr. MRD Execu ve Mr. Pritam Singh, Medical Record In -charge Mr. Romy Yadav, Medical Record Dept. Execu ve Malhotra Laboratory, Sector-22, Chandigarh Mr. Jagdev Singh, Medical Record Dept. Dr. Vijay Malhotra, MD Pathology Assistant Ms. Anju, Recep onist Mr. Jaswinder, Medical Record Dept. Assistant Poonam Path Lab, Sangrur Max Superspeciality Hospital, SAS Nagar Dr. Poonam, MD Pathologist Dr. Sandeep Dogra, General Manager Dr. Sachin Gupta, Medical Oncologist Sodhi Scan Centre Hospital, Sangrur Dr. Gautam Goyal, Medical Oncologist Dr. Jasbir Kaur Sodhi, Radiologist Dr.Amita, Senior Resident Dr. Harman, Senior Resident Chandigarh Cancer and Diagnos c Centre, Dr. Ri ka, Senior Resident Sector-33 B, Chandigarh Dr.Aradhna, Senior Resident Dr. Ja n Sarin, Head Medical Oncologist Mr. Bikram, Data Entry Operator Dr. Arvinder, Medical Officer Miss. Shama, Data Entry Operator
Contact details: Chandigarh and SAS Nagar PBCR Office Address : Popula on Based Cancer Registry, Chandigarh and SAS Nagar Room No - 0005, Department of Community Medicine and School of Public Health, PGIMER, Chandigarh – 160 012 Contact : Landline Number- 0172-2755219 Email - [email protected], [email protected] Sangrur and Mansa PBCR Office Address : Popula on Based Cancer Registry, Sangrur District Homi Bhabha Cancer Hospital, Civil Hospital Campus, Sangrur – 148 001 Punjab State, India Contact : Mobile Number: 09920863069 Email - [email protected], [email protected]
22 Tata Memorial Centre, Mumbai
Centre for Cancer Epidemiology, ACTREC, Kharghar, Navi Mumbai
Homi Bhabha Cancer Hospital, Sangrur, Punjab
Post Graduate Ins tute of Medical Educa on and Research (PGIMER), Chandigarh
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