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Indian Journal of Cancer
Medknow Publications on behalf of Indian Cancer Society
ISSN: 0019-509X EISSN: 1998-4774
Vol. 46, Num. 1, 2009, pp. 73-74

Indian Journal of Cancer, Vol. 46, No. 1, January-March, 2009, pp. 73-74

Letter To Editor

Changing trends in incidence of breast cancer: Indian scenario

National Cancer Registry Programme (ICMR), 557, Srinivasa Nilaya, New BEL Road, Dollars Colony, Bangalore - 560 094
Correspondence Address:National Cancer Registry Programme (ICMR), 557, Srinivasa Nilaya, New BEL Road, Dollars Colony, Bangalore - 560 094
nsmurthy44@yahoo.com

Code Number: cn09016

Sir,

In India, cancer of the breast is the most common cancer among women in many regions and has overtaken cervix cancer, which was the most frequent cancer a decade ago. The present communication attempts to report time trends in incidence of breast cancer for the Indian population by 5-year calendar periods and age of women.

Incidence rates (age-standardized to the world-standard population as well as age specific) for breast cancer between 1968 and 2002 were obtained from volumes III-IX of Cancer Incidence in Five Continents (CI5), [1],[2],[3],[4],[5],[6] individual registries and publications of the National Cancer Registry Programme. [7],[8],[9] The CI5 included incidence data for 5-year time periods reported by the Indian Population-Based Cancer Registries covering areas Ahmedabad, Bangalore, Chennai, Delhi, Mumbai, Nagpur and Pune.

The data for Ahmedabad, Bangalore and Chennai, Mumbai, Nagpur, Pune and Delhi relate to the periods 1983-87 to 1993-97, 1983-87 to 1998-02, 1968-72 to 1998-2002, 1978-82 to 1998-02, 1973-77 to 1998-02 and 1988-92 to 1998-02 respectively. The measure of trend over the period has been estimated as the overall or mean annual percentage change (MAPC%) in age standardized (AAR) and age-specific incidence rates (ASIR) using the relative difference in the incidence rates between the latest and furthest time periods.

The AAR of breast cancer during 1998-2002 in the six registries ranged from 24.4 (Pune) to 29.2 per 100,000 women (New Delhi). Trend analysis by period revealed that incidence rates (AARs) rose among women in all the registries, with the exception of Ahmedabad, which showed a decreasing trend [Figure - 1]. The AAR increased from 18.2 to 25.2, 19.9 to 26.6, 20.2 to 26.9, 19.2 to 27.4, 23.3 to 24.4, and 26.6 to 29.4 with the corresponding MAPC% of 1.05, 1.33, 0.96, 1.86, 0.16 and 0.7 in Bangalore, Chennai, Mumbai, Nagpur, Pune and Delhi respectively.

The ASIR for age intervals (viz.15-34, 35-44, 45-54, 55-64 and 65+ years) by period revealed an increase in the incidence of the disease in various age groups in all the registries except in Ahmedabad [Figure - 2]. Increase in MAPC% was noted in all the age-intervals in most of the registries. The MAPC% in the youngest age group of 15-34 years were 2.28, 1.42, and 5.89 while for the oldest age interval of 65+ years, it ranged from 0.97% to 2.35% in Chennai, Mumbai and Nagpur respectively. In Bangalore and Delhi, except in the first and the first two age intervals, increases were noted in other age groups.

India is rapidly stepping towards industrialization vis-à-vis urbanization resulting in change of lifestyle factors. These factors possibly contributed to a gradual increase in the incidence of breast cancer in the country. The burden of breast cancer will continue to grow not only in terms of the absolute number of cases but also in terms of incidence. As mammography will be difficult to implement in India for various reasons, efforts should be made to detect breast cancer at an early stage by educating the population about risk factors and through screening by physical examination or by self-breast examination.

Acknowledgements

The Authors wish to acknowledge with thanks the Indian Cancer Society, Parel, Mumbai, India under whose supervision the PBCRs of Mumbai, Nagpur and Pune are operating.

References

1.Waterhouse JAH, Muir CS, Correa P. Cancer incidence in Five Continents III. International Agency for research on cancer. Lyon, France: IARC Scientific Publication No. 15; 1976.  Back to cited text no. 1    
2.Waterhouse JA, Muir CS, Shanmugarathanam K. Cancer incidence in five continents IV. International Agency for research on Cancer. Lyon, France: IARC Scientific Publication No. 42; 1982.  Back to cited text no. 2    
3.Muir CS, Waterhouse JAH, Mack T. Cancer incidence in Five Continents V. International Agency for research on Cancer. Lyon, France: IARC Scientific Publication No. 88; 1987.  Back to cited text no. 3    
4.Parkin DM, Muir CS, Whelan Sl. Cancer incidence in five continents VI. International agency for research on cancer. Lyon, France. IARC Scientific Publication No 143; 1992.  Back to cited text no. 4    
5.Parkin DM, Whelan SL, Ferlay J. Cancer Incidence in Five Continents. VII and VIII. International Agency for research on Cancer. Lyon, France. IARC Scientific Publication No 143 and 155; 1997 and 2002.  Back to cited text no. 5    
6.Curado MP, Edwards B, Sinha HR, Storm H, Ferlay J, Heanue M, and Boyle P. Cancer Incidence in Five Continents IX. Lyon, France: IARC Scientific Publication No. 160; 2007.  Back to cited text no. 6    
7.National Cancer Registry Programme. Indian Council of Medical Research, Two- year report of the population based Cancer Registries 1997-98. Incidence and Distribution of cancer: Bangalore, India: 2002.  Back to cited text no. 7    
8.National Cancer Registry Programme. Indian Council of Medical Research, Two- year report of the population based Cancer Registries, 1999-2000. Incidence and Distribution of cancer, Bangalore, India, 2005.  Back to cited text no. 8    
9.Population based cancer registry, Biennial report, 2000 and 2001, 2002, Department of Epidemiology and Bio-Statistics, Kidwai Memorial Institute of Oncology, Bangalore, India, 2004 and 2005.  Back to cited text no. 9    

Copyright 2009 - Indian Journal of Cancer


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