Factors associated with survival and lost to follow-up of cervical cancer patients in a tertiary cancer centre in rural Kerala.

Cancer cervix is the second common cause of cancer death in India. It is the most curable form of any human cancer if detected at the precancerous stage. Although several factors determine the survival of the disease, the clinical stage at presentation is the single most important predictor of long-term survival. The present study aimed to describe the performance and follow-up status and 5-year survival experience of the cervical cancer patients registered between 2010 and 2011 by the hospital registry of Malabar Cancer Centre, Kerala, and factors affecting lost to follow-up and survival among them. The case sheets of 227 patients retrospectively scrutinized during May-July 2014. The mean age of patients was 58.8 years (standard deviation = 11.67 years). The majority of the patients completed the initially planned treatment, but a low proportion of patients were likely to be on regular follow-up. This study revealed that most of the patients registered at the hospital only at an advanced stage. Using Kaplan-Meier method, the estimated 5 years survival rate was found to be 66.8%. It was noted that performance status before treatment and Federation of Gynecology and Obstetrics staging were significantly associated with lost to follow-up and survival rate majority of the cervical cancer patients are observed to be highly noncomplaint to complete treatment and on follow-up. Thus, these findings stress the importance of counseling family members regarding the importance of follow-up and formulating public health policies aimed at increasing the awareness and implementation of cervical cancer screening programs in North Malabar.

Lung cancer in Malabar Cancer Center in Kerala--a descriptive analysis.

The burden of lung cancer in terms of mortality is the highest among all types of cancers globally. The present study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lung cancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010. A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer cases in 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above 50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smoking habit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accounted for 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasis and the remainder had regional lymph node involvement. However, no statistically significant difference was observed for secondary site of tumor according to gender. As majority of the cases reported at MCC were in an advanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was taken for diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondary prevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lung cancer burden in Kerala.