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DEPARTMENT OF EPIDEMIOLOGY AND BIOSTATISTICS

(HOSPITAL BASED CANCER REGISTRY)

KIDWAI MEMORIAL INSTITUTE OF ONCOLOGY

Dr.C. Ramesh: PROF. & HEAD

 

WORLD: It is estimated that about 9 million new cancer cases are diagnosed every year and over 4.5 million people die from cancer each year in the world.

INDIA: The estimated number of new cancers in India per year is about 7 lakhs and over 3.5 lakhs people die of cancer each year. Out of these 7 lakhs new cancers about 2.3 lakhs (33%) cancers are tobacco related.

KARNATAKA: There would be about 1.5 lakhs cancer cases at any given time in Karnataka and about 35,000 new cancer cases are added to this pool each year.

The Department of Epidemiology and Biostatistics comprises of both the Hospital Based Cancer Registry and Population Based Cancer Registry.  The Hospital Based Cancer Registry collects information on each and every patient registered at Kidwai Memorial Institute of Oncology in a predivised questionnaire devised by the National Cancer Registry Programme Project of the Indian Council of Medical Research.  The Registry Provides Information on the Magnitude of cancer patients attending KIMIO, various types of cancers, the treatment particulars and its outcome, which enables the Insitution to plan for the management / control of the cancer disease.  The information so collected by the registry enables initiation of epidemiological studies to find out various causative factors for different cancers and also play an important role in Cancer Control Activities.  Over 16,000 new cases are registered every year with more than 20 % from neighbouring states of Andhra Pradesh and Tamil Nadu and Kerala.

The Faculty staff of the Department is also involved in teaching students of Undergraduate, Postgraduate students and also for Superspeciality courses in addition to involvement in many of the Research Projects / Clinical Trials conducted by various departments of the Institute.

Research Activities - Projects:

1. Cancer Atlas Project: The HBCR is involved in the Cancer Atlas Project of the WHO,    ICMR under taken by the NCRP since 2001 and provide information on all non resident cases registered at KMIO.

2. Pattern of Care and Survival Studies: The HBCR has taken up the project titled "Pattern of Care and Survival Studies in Head and Neck Cancers, Cancers of Cervix and Breast".

All though thousands of cancer patients are receiving treatment from various cancer hospitals in India, no scientific evaluation of therapeutic efficacy in terms of pattern of care and survival has been done.  The data from HBCRs of India has shown that Cancer of Cervix (28%) and Breast (16%) in women are most common and cancer of Head and Neck region constitute about 30 % of all cancer in males and females.  Realising the problem of follow-up of cancer patients wherein huge number of patients drop out from regular follow-up visits. ICMR decided to initiate pattern of care and survival studies on three of the most common cancers i.e Cancer of Cervix, cancer of Breast and Head and Neck Cancers.  The project being carried out in all the HBCRs of India where Cancer Registry are established.

OBJECTS OF THE PROJECT:

  1. To obtain core indentifying and diagnostic information in all patients in the particular    center / Institution with cancer cervix / breast / head and Neck.

  2. To record details of clinical stage and types of treatment of patients included.

  3. To have periodic follow-up and record the patient and disease status in all patients suffering from these cancers so as to have clinical stage and treatment based on survival on these sites of cancer.

The project has already been in progress with grants funded by the ICMR.  The duration of the project is of 3 years.

Two epidemiological studies - One on Oral Cancers and another one on Pharyngeal cancers are in progress which are aimed at investigating various risk factors in the causation of these two major sites of cancer.

Leading Sites of Cancer - Male:

Pharyngeal cancers (excluding cancer of nasopharynx) continue to be the most common form of cancers among males and accounts for 14.1% of the total cancers in males. Among Pharyngeal cancers, cancer of the Hypopharynx is the most predominant site of cancer accounting for over 68 % of the Pharyngeal cancers.  The other common cancers among males in order are oral cavity (11.2%), Leukaemias (8.4%), Oesophagus (8.3%) and Lung (6.8%)

Leading Sites of Cancer - Female:

Cancer of the cervix uteri continues to be the most predominant site of cancer and accounted for 26.7% of all cancers in females.  Cancer of the breast is the second most common site (16.6%) followed by cancers of oral cavity (11%), Oesophagus (5.7%) and ovary (5%).  Over the years, a gradual decrease in the proportion of cervical cancers and marginal but steady increase in the numbers and relative proportion of breast cancers is observed.

Common Cancers:

The Commonest cancers among Males and Females seen at KMIO-2004-05 are as below:

MALE

 FEMALE
Pharynx Cervix
Oral Cavity Breast
Leukaemia Oral Cavity
Oesophagus Oesophagus
Lung Ovary
Lymphoma Leukaemia
Stomach Thyroid
Brain & Ner.Sys Stomach
Larynx Lymphoma
Liver Pharynx

  

 

DEPARTMENT OF EPIDEMIOLOGY AND BIOSTATISTICS

(POPULATION BASED CANCER REGISTRY)

Kidwai Memorial Institute of Oncology

Dr.K.Ramachandra Reddy:Prof. & Head

 

The Population Based Cancer Registry at Kidwai Memorial Institute of Oncology was established during the year 1981 with the main objective of assessing the incidence/magnitude and type of various cancers in Bangalore and to provide a framework for controlling the impact of cancer on the community. The registry was included under the network project of the National Cancer Registry Programme (NCRP) of Indian Council of Medical Research (ICMR) and the actual registration of cancer cases was commenced in the year 1982. The registry covers the resident population of Bangalore Urban Agglomeration which has an area of  741 sq.kms and has an estimated population of 7.0 million as of 2007. The inclusion criteria for registration of cases is that patients who have lived in the defined areas of Bangalore Urban Agglomeration for a minimum period of one year at the time of fist diagnosis of cancer. The registration of cancer cases is done by active registration method. The staff of the registry visits all hospitals,  nursing homes, diagnostic labs besides the base institution and death registration units in the defined areas to elicit the required information from cancer patients in a standard format. On an average about 5000 new cancer cases are registered in the registry area per year. During the period from 1982 through 2004 a total number of 73524 (34045 males & 39479 females) cases of cancers were reported to the National Cancer Registry Programme by the Population Based Cancer Registry of Bangalore. The average annual age adjusted rates of cancer among males & females were 96 and 120 per 100,000 persons respectively. Tobacco related cancers accounted for 34% of all cancers in males and 16% of all cancers in females and paediatric cancers accounted for 3% of all cancers in males and 2% of all cancers in females.

LEADING SITES OF CANCER

The first ten leading sites of cancer among males and females are shown in table. Ranking of these sites are based on the frequency of their occurrence.  Among males, cancer of the stomach is the  most predominant site of cancer constituting 9% of the total cancers among males followed by cancers of the lung (7.0%), oesophagus (6.6%), prostate (5.3%) and NHL (4.6%).  Among females, cancer of the breast is the predominant site of cancer and has accounted for 24.6% of the total cancers in females followed by cancer of the cervix (15.9%), ovary (4.9%), oesophagus (4.7%)  and mouth cancers (4.6%). The incidence of breast cancer among females in Bangaloreans is showing a steady and statistically significant increase as is the case in other Urban cities. Altogether, the first ten leading sites of cancers among males and females accounted for 53.1% of the total cancers in males and about 70.9% of the total cancers in females.

CUMULATIVE RISK : In the absence of other causes of death, the risk of developing cancer by an individual among Bangaloreans would be 15.1% in males and 16.8% in females (cumulative risk). In other words, one in six persons in either sex has the risk of developing cancer during their life time.

 
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