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 Table of Contents  
LETTERS TO EDITOR
Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 61-62

A way forward to address the cancer burden in North-East India


1 Department of Cancer Epidemiology and Biostatistics, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
2 Department of Gynecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India

Date of Web Publication13-Jan-2016

Correspondence Address:
Manigreeva Krishnatreya
Dr. B. Borooah Cancer Institute, Gopinath Nagar, Guwahati - 781 016, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.173875

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How to cite this article:
Krishnatreya M, Kataki AC. A way forward to address the cancer burden in North-East India. Int J Health Allied Sci 2016;5:61-2

How to cite this URL:
Krishnatreya M, Kataki AC. A way forward to address the cancer burden in North-East India. Int J Health Allied Sci [serial online] 2016 [cited 2019 Oct 14];5:61-2. Available from: http://www.ijhas.in/text.asp?2016/5/1/61/173875

Sir,

In North-East India, there is a wide disparity in both the diagnosis and treatment of cancers, which are mostly due to lack of awareness, socioeconomic conditions, and difficulty to access the facilities for cancer diagnosis and treatment. Furthermore, as affordability of cancer care remains a major challenge in India for effective cancer control,[1] and hence in the North-East India, this will be more pronounced. The age-adjusted incidence rates of cancers of the gall bladder, stomach cancer, esophageal cancers, tongue cancer in females, and nasopharyngeal cancers is highest in the North-East part of India.[2] It has been seen that the incidence of cancer in India is highest in the North-Eastern region of the country. To add this problem, there is a lack of population-based cancer survival from this region.[3] As a metrics of cancer burden, the incidence and cancer mortality is commonly used in the Indian context. The burden of cancer is also measured by an epidemiologic metric called disability-adjusted life years. In simple words, it is the total duration of years of life lost prematurely due to cancer and years of life lived with the disability due to cancer. Global cancer transition study has shown that the burden of cancer in countries with low human development index is higher.[4] This is especially true for the region from remote North-East states. Hence it calls for the pressing need for improving resources for cancer care and treatment in North-East India. In addition, efforts toward cancer prevention will be immensely helpful to lower the burden of the disease in this part of the world. With the rising incidence rates of cancer in the North-Eastern India, the burgeoning of population and rise in the life expectancy of our population, it will compound the problem.

Cancer prevention studies in North-East India have remained as a domain for cancer epidemiologists. However, the combined role of physician oncologists, basic researchers, and cancer epidemiologists for cancer prevention and control cannot be underscored at any point of time. At this juncture, the high incidence of certain cancers in North-East India at times remains unexplained and often it cannot be solely explained by known or established risk factors as outlined in the Western literatures. Descriptive and analytic epidemiological researches have shown temporal trends of cancers from North-East India.[5],[6],[7] Secondary data analysis have shown an association of pesticides to nonmelanoma skin cancers in the population of North-East India, where there is a lack of use of protective gears while using pesticides.[8] Analytic molecular and epidemiologic studies on leading cancer of the region such as esophageal cancer have shown the role of dietary habits, molecular and genetic factors in esophageal cancer of North-East India.[9],[10],[11] In addition, analytic epidemiological researches are required using molecular biomarkers for prognostication of common cancers of the region, which somewhat differs from rest of India, for example, esophageal cancers, stomach cancer, lung cancer in females, and nasopharyngeal cancers. Emphasis on screening programs for common cancers in North-East India such as the uterine cervix, oral cavity, and breast should be laid. Currently, few organized screening programs for these cancers are ongoing in India, but none in this region. The prevalence of HPV subtypes in North-East Indian patients with cancer of the uterine cervix has been shown,[12] and it is the major step toward the initiation of preventive vaccination program in the North-East India. Any population-based intervention for the detection of cancers of breast, uterine cervix, and ovarian cancer should be started early in our population.[13] There is also a pressing need for the conduct of translational research on cancers in the North-East India. Because when it comes to cancer survival, it may not be possible to apply current international guidelines of cancer treatment to a population of North-East India to achieve high survival estimates like that of rest of India and high-income countries. This could be attributed to differences in the incidence and tumor biology, socioeconomic factors, and availability of resources in the region.

All these puts to the forefront the seemingly important and undeniable role of further cancer research in North-East India. Although much has been done on cancer research in India but, it will take a little longer for the real change to appear on the ground in this part of the country. The right path to tackle the situation in North-East India is by proactive participation in cancer research by all the stakeholders.

Acknowledgment

National Centre for Disease Informatics and Research under Indian Council of Medical Research.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014;15:489-538.  Back to cited text no. 1
    
2.
Consolidated Three Year Report of Population Based Cancer Registries. National Cancer Registry Programme. Bangalore: Indian Council of Medical Research; 2013.  Back to cited text no. 2
    
3.
Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang XS, et al. Global surveillance of cancer survival 1995-2009: Analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 2015;385:977-1010.  Back to cited text no. 3
    
4.
Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): A population-based study. Lancet Oncol 2012;13:790-801.  Back to cited text no. 4
    
5.
Hazarika M, Krishnatreya M, Bhuyan C, Saikia BJ, Kataki AC, Nandy P, et al. Overview of childhood cancers at a regional cancer centre in North-East India. Asian Pac J Cancer Prev 2014;15:7817-9.  Back to cited text no. 5
    
6.
Krishnatreya M, Kataki AC, Sharma JD, Bhattacharyya M, Nandy P, Hazarika M. Brief descriptive epidemiology of primary malignant brain tumors from North-East India. Asian Pac J Cancer Prev 2014;15:9871-3.  Back to cited text no. 6
    
7.
Krishnatreya M, Saikia A, Kataki A, Sharma J, Baruah M. Variations in the spatial distribution of gall bladder cancer: A call for collaborative action. Ann Med Health Sci Res 2014;4 Suppl 3:S329-31.  Back to cited text no. 7
    
8.
Krishnatreya M, Kataki AC, Sharma JD, Lahkar K. A retrospective analysis of occupational exposure to pesticides as a possible risk factor for non-melanoma skin cancers. South Asian J Cancer 2015;4:47-8.  Back to cited text no. 8
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9.
Phukan RK, Chetia CK, Ali MS, Mahanta J. Role of dietary habits in the development of esophageal cancer in Assam, the north-eastern region of India. Nutr Cancer 2001;39:204-9.  Back to cited text no. 9
    
10.
Singh A, Kapur S, Chattopadhyay I, Purkayastha J, Sharma J, Mishra A, et al. Cytokeratin immunoexpression in esophageal squamous cell carcinoma of high-risk population in Northeast India. Appl Immunohistochem Mol Morphol 2009;17:419-24.  Back to cited text no. 10
    
11.
Das M, Saikia BJ, Sharma SK, Sekhon GS, Mahanta J, Phukan RK. p16 hypermethylation: A biomarker for increased esophageal cancer susceptibility in high incidence region of North East India. Tumour Biol 2015;36:1627-42.  Back to cited text no. 11
    
12.
Das D, Rai AK, Kataki AC, Barmon D, Deka P, Sharma JD, et al. Nested multiplex PCR based detection of human papillomavirus in cervical carcinoma patients of North-East India. Asian Pac J Cancer Prev 2013;14:785-90.  Back to cited text no. 12
    
13.
Krishnatreya M, Kataki AC, Sharma JD, Nandy P, Talukdar A, Gogoi G, et al. Descriptive epidemiology of common female cancers in the north East India – A hospital based study. Asian Pac J Cancer Prev 2014;15:10735-8.  Back to cited text no. 13
    




 

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