Abstract
Purpose:This study aims to determine the incidence, histology, clinical extent of disease, and trends of gastrointestinal (GI) cancers in India. Methods:GI cancer cases diagnosed between 2012-2016 from 28 Population-Based Cancer Registries and 58 Hospital Based Cancer Registries under the National Cancer Registry Programme were included. Crude incidence rate and age-standardized incidence rates (AARs) were calculated. Joinpoint regression program, 4.0.1 was used for trend analysis for data from 1982 to 2016, and a P-value of <<0.05 was considered statistically significant. Results:GI cancers’ occurrence was more common among men (60.5%) than in women (39.5%). The incidence of GI cancer was highest in India’s northeast region, Aizawl district (AAR 126.9) among males, and in Papumpare district (AAR 75.9) among females. The commonest cancer among men was cancer of the esophagus (28.2%), followed by stomach cancer (21%) and rectum cancer (14.3%). Among women, cancer of the esophagus (25.7%), gallbladder (23.8%), stomach (14.8%), and rectum (14.6%) were common. Adenocarcinoma (57.83%) was the commonest type of GI tumors, followed by Squamous Cell neoplasms (25.99%). Majority of the GI cancers presented at the locoregional stage, but cancer of the gall bladder and pancreas presented at advanced stages. A rising trend for cancers of the colon, rectum, liver, gall bladder, pancreas was seen, while a declining trend was observed for stomach and oesophageal cancer. Conclusion:Our study highlights an increasing magnitude of GI cancers across different regions of India. Cancer registries form an essential tool for surveillance of GI cancers thus guiding prevention, early detection, and control programs.
Highlights
Cancer is a significant public health problem worldwide as well as in India
As per the Global Burden of Disease India study report (1990-2016), stomach cancer accounted for 9%, colon and rectum (5.8%) and esophageal (4.3%), liver cancer (3.5%) and gall bladder and biliary tract cancer (3.1%) of the total cancer DALYs in India (India State-Level Disease Burden Initiative Cancer Collaborators, 2018)
The age-standardized incidence rates (AARs) of GI cancer was highest among the NorthEastern registries
Summary
The gastrointestinal (GI) cancers include cancer of the esophagus, stomach, small intestine, colon, rectum, anus & anal canal, liver & intrahepatic bile ducts, gall bladder, and pancreas. Colorectal and pancreatic cancers were highest in Europe and North America, while gastric, esophageal, and liver cancers were more common in Asia (Arnold et al, 2020). In India, cancer of the esophagus and stomach were common among males (Mathur et al, 2020). There is a high incidence of gallbladder cancer in the North and Northern-East parts of India in both sexes(ICMR-NCDIR, 2020). As per the Global Burden of Disease India study report (1990-2016), stomach cancer accounted for 9%, colon and rectum (5.8%) and esophageal (4.3%), liver cancer (3.5%) and gall bladder and biliary tract cancer (3.1%) of the total cancer DALYs in India (India State-Level Disease Burden Initiative Cancer Collaborators, 2018)
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