Incidence of colorectal cancer in Kashmir valley, India.

Background There is wide variation in the incidence of colorectal cancer globally and also within the same country among different racial or ethnic groups. The present population-based study was undertaken to determine the incidence of colorectal cancer in Kashmiri population which is non-migratory and ethnically homogeneous having stable food habits. Methods Over a period of one year, all newly diagnosed and histological proved cases of colorectal cancer in all possible areas, where such patients are diagnosed and treated were prospectively registered. Results A total of 212 cases of colorectal cancers were registered; of them 113 (53.3%) originated in the colon and other 99 (46.7%) in rectum. Male to female ratio was 1.2:1. The crude incidence rate of colorectal cancer was 3.65/ 100,000; it was 3.78 in males, and 3.50/100,000 in females. The incidence rates for colorectal cancer in Muslims and Hindus were different. The crude incidence rate for colorectal carcinoma was highest for district Srinagar 6.19/100,000 (urban area) and lowest for district Kupwara (rural area) 1.59/100,000. The highest numbers of cases were detected in the age group 55–59 years (n=34). The agespecific rate for colorectal carcinoma was highest in the age group 55–59 years (17.21/100,000), followed by 65–69 years (14.86/100,000). The age standardized incidence rate was 4.52/100,000 per year. The truncated age adjusted incidence rates in age group 35–64 years was 8.31/100,000; while that for colorectal carcinoma was 8.77/100,000 in males and 7.66/100,000 in females. Conclusion We conclude that the incidence of colorectal cancer in Kashmir valley is similar to that reported in the rest of India.

Teaching community diagnosis: experience of a new institution.

Community diagnosis is one method of making medical education more community oriented and making the students learn and appreciate intellectual discovery and critical thinking. Being a relatively young institution with constraints of manpower, finances and logistic support we proceeded to developed a short programme which would allow students to achieve the skills of community diagnosis. Instead of a structured programme, we empowered the students to plan their own from meeting the villagers’ right up to developing and successfully implementing a health promotion campaign specially focused to the need of the villagers. The lecturers were present only to guide and supervise the students. Self assessment by the students at the end of the programme showed improvement in all the five domains assessed i.e. change in knowledge, change in skills, leadership and team work, attitudes and perceptions and humanistic attributes. The paper outlines how a brief programme can achieve substantial gain in skills and attitudes.