Cancer trends in India: A review of population-based cancer registries (2005–2014)

There is a constant rise in cancer cases, but the trends and pattern vary according to the geographical region. The aim of this brief research was to present an update of all cancer incidences through age-adjusted rates and their changes in different regions of the country. The data for this study were obtained from published reports of 28 population-based cancer registries (2005–2014) in India. Among males, currently, East/Northeast region ranked first, on the basis of incidence of cancer cases. Out of 28 registries, 11 registries encountered lung cancer as the leading site. Currently, East/Northeast regions were ranked first on the basis of incidence of cancer cases among females. Our study showed that 20 registries among the 28 had breast cancer as the leading one. Thus, the present overview revealed that all cancers in both males and females are consistent and had a high incidence in East/Northeast region of the country.

A comparative study of cervical cancer screening methods in a rural community setting of North India.

CONTEXT: Pap smear testing as a conventional cervical screening approach has limitations for implementation and aided visual cervical testing has varying results in different regions. AIMS: The aim of this study is to demonstrate the performance of aided visual cervical screening tests as against conventional Pap smear testing in a rural community setting of North India. SETTINGS AND DESIGN: This was a rural community based cross‑sectional study. MATERIALS AND METHODS: All 7603 ever married women of age 30‑59 years surveyed in a pocket of Dadri Tehsil, Uttar Pradesh, India were targeted for screening by Pap, visual inspection of cervix using acetic acid (VIA) and visual inspection of cervix using Lugol’s iodine (VILI) methods. Screen positives were referred to colposcopy and confirmation by histology. STATISTICAL ANALYSIS USED: Detection of histological cervical intraepithelial neoplasia (CIN) II + and CIN III + assessed separately by sensitivity, specificity and likelihood ratio’s and predictive values. Analysis of data was performed by using IBM SPSS statstics software version 16.0. RESULTS: A total of 65.6%(4988/7604) eligible women of 30‑59 years age group in the target population were screened. Out of 4988, further analysis was performed on 4148 after excluding those who did not complete all screenings, who lost to follow‑up and had missing histology results. Screen positivity rates by Pap (ASCUS and above), VIA and VILI were 2.6%, 9.7% and 13.5% respectively. Sensitivity and specificity of detecting the CIN III+ lesions were 87.5 and 98.8% for Pap, 50.0% and 96.7% for VIA and 50.0% and 95.7% for VILI respectively. CONCLUSIONS: VIA screening demonstrated as a feasible primary screening test for detecting high grade CIN and as to perform better when the Pap test is not feasible.

Waste explosives and other hazardous materials--hazard potential and remedial measures: an overview.

A large amount of energetic materials including propellants, high explosives, pyrotechnics are subjected to disposal either due to expiry of their useful life or rejection in the manufacturing process. The environmental regulations do not allow the hazardous materials for open burning / detonation in view of the health hazard involved in these operations. The present paper describes the hazard potential of energetic materials and associated hazardous chemicals. It also deals with global technological status for remedial measures of hazardous chemicals along with their merits and demerits.

Prevalence and risk factors for development of lymphedema following breast cancer treatment.

BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area > 1. 5 m2, presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema.

Neoadjuvant chemotherapy in advanced gastric cancer--results of a pilot study.

INTRODUCTION: Adenocarcinoma of the stomach is usually advanced at presentation, and local or distant spread may preclude the option of primary curative resection. Neoadjuvant chemotherapy (NAC) has shown promise in downstaging initially unresectable disease. This pilot study was planned to assess the utility of NAC using Cisplatin and 5-Fluoro uracil in the management of initially unresectable gastric cancer. PATIENTS AND METHODS: Ten patients with unresectable gastric adnocarcinoma were included. They received two cycles of cisplatin, 30 mg/m2 intravenously in combination with 5-Fluoro Uracil, 1000 mg/m2. They were restaged using Endoscopy and CT scan and taken up for exploratory laparotomy. RESULTS: Eight of 10 patients (80%) had an objective response to chemotherapy. Six patients (60%) with initially unresectable disease could be offered curative surgery. The median survival was 10 months (range 1-60 months). There were two long term survivors (48 and 60 months respectively). CONCLUSION: Neoadjuvant chemotherapy (NAC) is an effective option in downstaging initially unresectable gastric carcinoma. Complete response to chemotherapy also predicts long term survival.

Screening for obesity in affluent females: body mass index and its comparison with skin fold thickness.

In the present study 625 females above 15 years of age residing in affluent localities of Varanasi city were selected by multi-stage stratified random sampling technique. Body Mass Index (BMI) and Skin-Fold Thickness (SFT) were compared as indices of obesity. Prevalence of obesity by BMI and SFT was 30.24 and 49.12 respectively. SFT gave significantly higher prevalence rate of obesity as compared to BMI. It is possible that western population based SFT cut-off points may not be truly applicable to Indian study. The sensitivity, specificity and predictive value of 'sum of SFT at four sites' were calculated at different cut-off points, and it was observed, that values > or = 90 mm is the best cut-off point instead of 80 mm, for detecting obesity in the Indian context.