Clinicopathological Profile of Cancers in India: ICMR

In News 

• The study ‘Clinicopathological Profile of Cancers in India was released by the Indian Council of Medical Research (ICMR).

Major Findings 

• Gender wise:
  • Out of the 6,10,084 cancers, 3,19,098 (52.4%) cancers were reported in males, and 2,90,986 (47.6%) in females.
    • The proportion of all cancer cases was higher in males than females with gynaecological cancers, including breast cancer, comprising over half of all cancers in females.
  • Cancers of the head and neck region accounted for nearly one third (31.2%) of the cancers among males. 

• Age-wise : 
  • The highest proportion of cancer from all sites was reported in the 45 to 64 years age group, except for prostate cancer in males, which was higher in those over 65 years.

• Tobacco use:
  •  Cancers in sites associated with tobacco use comprised 48.7% of cancers among males and 16.5% among females.
    • In the category of cancers associated with the use of tobacco in males, lung cancer was the highest at 30% followed by oesophagus (16%); mouth and tongue cancers (13% each); larynx (9%) and urinary bladder (7%).
    • Among females, the incidence of mouth cancers were the highest at 28% followed by lung (27%), oesophagus (24%), tongue (7%), urinary bladder (4%), and larynx (3%).
• Childhood cancers constitute 7.9% of all cancers. 

What is Cancer?

• It is a large group of diseases that can start in almost any organ or tissue of the body when abnormal cells grow uncontrollably and go beyond their usual boundaries to invade adjoining parts of the body and/or spread to other organs. 
• The branch of medicine dedicated to diagnosing, treating and researching cancer is known as oncology, while a physician who works in the field is called an oncologist

Types

• Cancers are named for the area in which they begin and the type of cell they are made of, even if they spread to other parts of the body.
•  There are also several clinical terms used for certain general types of cancer:
  • Carcinoma-It is cancer that starts in the skin or the tissues that line other organs.
  • Sarcoma -It is a cancer of connective tissues such as bones, muscles, cartilage, and blood vessels.
  • Leukemia-It is a cancer of bone marrow, which creates blood cells.
  • Lymphoma and myeloma-They are cancers of the immune system.
  • The other common cancers included gastrointestinal tract cancers and breast cancer.

Treatment

• Surgery:
  • Surgically removes as much cancer as possible.

• Chemotherapy:
  • It uses medications that are toxic to cells to kill rapidly dividing cancer cells.
  • It is the most typical treatment modality for many cancers regardless of the clinical extent of disease at presentation, including cancers of the liver, gallbladder, stomach, lung and childhood cancers and regardless of the organ site and clinical extent, most cancer patients, were initiated on cancer-directed treatment within 8 to 30 days of diagnosis.

• Radiation Therapy:
  • It uses powerful, focused beams of radiation inside (brachytherapy) or outside (external beam radiation) your body to kill cancer cells.

• Stem Cell (Bone Marrow) Transplant:
  • It Repairs diseased bone marrow with healthy stem cells. 
  • Stem cells are undifferentiated cells that can have a variety of functions. These transplants allow doctors to use higher doses of chemotherapy to treat cancer.

• Immunotherapy (Biological Therapy):
  • It uses antibodies to help the body’s immune system recognize cancer so it can fight it off.

• Hormone Therapy:
  • It removes or blocks hormones that fuel certain cancers to stop cancer cells from growing.

• Targeted Drug Therapy:
  • It uses drugs to interfere with certain molecules that help cancer cells grow and survive.

• Multimodality treatment: 
  • It is a varied combination of surgery, chemotherapy and radiation therapy.
  •  It is  administered for cancers of the breast and head & neck, 

Cancer Burden in India

• According to the National Cancer Registry Programme Report 2020:
  • In 2020, tobacco-related cancers are estimated to contribute 3.7 lakhs (27.1%) of the total cancer burden. 
  • Cancer cases in India are likely to increase to 15.6 lakhs by 2025 — a 12% increase from currently estimated cases.
  • 1 in 10 Indians will develop cancer during their lifetime and 1 in 15 will die of the disease.
  • Oral cancer is the most prevalent form of cancer among men in India, largely fuelled by tobacco-chewing.

Government Initiatives

• India is committed to achieving a one-third reduction in cancer-related deaths by 2030 as part of the Sustainable Development Goals, and it has made considerable progress. 
• India has improved in some areas, such as personal hygiene, which are distant drivers of cancer. 
• Government programmes such as Ayushman Bharat, Swasthya Bharat, Swachh Bharat Abhiyan, Poshan Abhiyaan and Pradhan Mantri Bhartiya Janaushadhi Pariyojana and initiatives such as FSSAI’s new labelling and display regulations and drug price control can encourage inter-sectoral and multi-sectoral action. 
• Other initiatives such as the National Health Policy, the National Tobacco Control Programme, and the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke are also paving the way for progress.

• The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) is being implemented under the National Health Mission (NHM) for up-to-the district-level activities.
• India creates the world’s 1st Database of Genomic Variants of Oral Cancer ‘dbGENVOC’.
  • dbGENVOC is a browsable online database of GENomic Variants of Oral Cancer and is a free resource. 

Conclusion 

• We need to focus on three key aspects: risk reduction, early detection and programmatic and policy solutions.
• Cancer drugs need to be affordable so that whenever required the treatment can be provided at the earliest in the early stages when the cancer is curable. 
  • Availability and affordability of cancer drugs will give impetus to treatment outcomes bringing down the cost of treatment.  

Source:TH