Abstract
Variations in cancer incidence, mortality and pattern exist in rural and urban areas. Understanding these differences helps in developing targeted cancer prevention and control strategies. However, no previous studies have explored the differences in cancer demographics between the rural and urban areas of Nepal. The data of Kathmandu Valley (urban area) Population-Based Cancer Registry (PBCR) and Rukum (rural area) PBCR were analysed to identify the differences in cancer pattern in rural and urban areas.The age-adjusted incidence rate (AAR) in Kathmandu was higher than that in Rukum (1.6 times among males and 1.9 times among females). The top two leading sites in males were lungs and stomach in both the regions; however, the rates were higher in Kathmandu. The incidence rate for cancer of the urinary bladder among males in Kathmandu was particularly higher – 4.4 times that of Rukum. In females, the leading site of cancer in Kathmandu was breast, which was eight times higher compared to Rukum, whereas the incidence rate of cervix cancer in Kathmandu is 30% less than in Rukum. The incidence of tobacco-related cancer was found to be higher in Kathmandu compared to Rukum.These findings reveal the need for different policy priorities for cancer control in the urban versus rural regions of Nepal, based on the different demographics of cancer in the two areas. Similar studies from other regions of Nepal are needed to develop a targeted cancer control strategy.
Highlights
The burden of cancer is on the rise worldwide
The cancer incidence and mortality rate both were found to be higher in the Kathmandu district compared to the Rukum district
The age-adjusted incidence rate (AAR) of all cancer sites among males in Kathmandu (95.3 per 100,000) was 1.6 times higher than the incidence rates in Rukum (59.1 per 100,000)
Summary
The burden of cancer is on the rise worldwide. According to GLOBOCAN, an estimated 19.3 million new cancer cases were diagnosed, accounting for 9.9 million death cases in 2020, which has increased from previous years [1]. Around half of the cancer cases and more than half of the cancer deaths were estimated to occur in Asia. Disparities in cancer incidence, patterns and mortality occur across countries and across different regions within the same country. Many studies have reported that the cancer incidence and mortality rates are higher among urban residents than rural residents. Studies suggest that rural residents are diagnosed in advanced stages, which might influence cancer mortality [3, 4]
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