Lung cancer is more common among men in SAS Nagar (Mohali) while oesophageal (food-pipe) cancer is found among men in Mansa and Sangrur districts of Punjab, according to a study on cancer incidence and mortality for 2013 in these areas.
Among women, breast cancer has the highest proportion in SAS Nagar and Sangrur, while cervix uteri is the leading cancer in Mansa. The study, Population-based Cancer Registeries at Chandigarh, SAS Nagar, Sangrur and Mansa districts of Punjab, is a joint collaboration of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, and Tata Memorial Centre, Mumbai, with cooperation from the Punjab government and the health department, Chandigarh administration.
Change in trend from urban to rural areas
In urban Punjab (SAS Nagar), lung cancer is leading among men; on the other hand, in rural Punjab (Mansa and Sangrur), oesophageal cancer is most common among men.
“Urban cancer is more related to lifestyle. You have more alcohol and tobacco prevalence. Central obesity is another reason. In rural areas, it could be more infection-related or environmental,” said Dr Rajesh Dixit, Tata Memorial Centre, Mumbai.
Dr D Behra, head, pulmonary medicine, PGIMER, explained, “In rural areas, environmental factors like excessive use of pesticides and fertilisers may be the main reasons for high rise in oesophageal cancer. It should be looked into.”
Male and female oesophageal cancer
“The interesting part is that in other parts of the country, if we look at the oesophageal cancer, the male to female ratio is quite different. There are more male cancer cases than the female cases. But in Sangrur and Mansa, the male and female cancer are almost same,” Dr Dixit pointed out.
He said, “I think it is more related to environmental etiology, so we have to look for the environmental etiology rather than alcohol and smoking; that would be there but in addition, there could be more reasons.”
Cancer, mortality in SAS Nagar
A total of 769 cancer cases were registered (334 male, 435 female). The age-adjusted incidence rate is 74.3 per lakh population for males and 104.2 per lakh population for females.
A total of 322 cancer deaths were recorded.
Among men, lung cancer topped the list with 9.7% cases, followed by prostate cancer 8.8% and oesophagus cancer 7.6 %.
Among women, breast cancer (31.8%), followed by cervix uteri (13.5%) and ovarian cancer (7.4%) were the main cancer sites.
Cancer incidence, mortality in Sangrur
In 2013, a total of 798 cancer cases were registered in Sangrur, out of which 378 cases were of males and 420 were of females. The ageadjusted incidence rate among men was 43.7 per 100,000 and among women, it was 52.6 per 100,000.
A total of 448 cancer deaths were reported (male 243, female 205) In males, oesophagus cancer topped the list with 11.6%, followed by prostrate cancer 6.3% and brain cancer 4.5%.
In female, breast cancer was the highest with 22.9% cases, followed by cervix uteri (18.3%) and oesophagus cancer(7.4%)
Incidence and mortality in Mansa
A total of 403 cancer cases were registered (male 187 and female 216). The age-adjusted incidence rate for men was 45.3 per lakh and for women, it was 55.8 per lakh.
A total of 233 deaths were registered, out of which 112 were men and 121 women.
Among men, 15% cases were of oesophagus cancer, followed by 5.3% of mouth cancer and 4.3% of lymphoid leukemia. Among women, maximum cases (22.2%) were of cervix uteri, followed by 18.5 cases of breast cancer and 11.1% of oesophagus cancer.