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Cancer should be made notifiable disease, says health expert
Our Correspondent
Kohima, Sep. 9 (EMN): Alluding that the Northeast is the hotspot of cancer in the country and Nagaland has a high prevalence in cancer incidence, which is a huge burden to the state and a matter of concern, Dr. V. Khamo, Consultant at Naga Hospital Authority, Kohima (NHAK), on Friday impressed upon the government on the need to make cancer a notifiable disease.
Khamo, who is also the principal investigator of Population Based Cancer Registry Nagaland (NHAK) and officer in-charge of BSL labs, Research and Ethics, was giving a presentation on ‘Common Cancer Burden: Global and India Perspective with Special reference to Nagaland’ at Hotel Vivor in Kohima, during the Continuing Medical Education (CME) on early detection and prevention of common cancers.
The programme was organised by Tata Memorial Hospital and the state health department of Nagaland.
The doctor informed that globally, an estimated 19.3 million new cancer cases are detected annually with 10 million cancer deaths; female breast cancer is the most commonly diagnosed cancer with an estimated 2.3 million new cases, followed by lung, colorectal, prostate and stomach cancers.
The global cancer burden is expected to be 28.4 million cases by 2040 (47% rise from 2020) and the disease is one of the leading causes of death before the age of 70, she said.
Cancer prevalence
Khamo said that the number of cancer incidence in India is projected to increase from 26.7 million in 2021 to 29.8 million by 2025 while highlighting the common cancer in the country: lung (10.6%), breast (10.5%), oesophagus (5.8%), mouth (5.7%), stomach (5.2%), liver (4.6%) and cervix uteri (4.3%), which accounted for more than 40% of the total disease burden.
Dwelling on the high prevalence of cancer in the Northeast and Nagaland state in particular, which is ranked 11 in cancer incidence in India and 2nd highest in the world for nasopharynx with incidence rate in male at 124.5 (AAR) per lakh population and in female 88.2 (AAR), while adding that tobacco- related cancer in male is 39.3 % and female 11.5%.
Maintaining the cumulative risk of developing cancer in one’s lifetime is 1 in 7 for male and 1 in 10 for female, she said new cases registered every year is around 700 and the average number of cancer deaths is 126 per year, while highlighting the 10 leading sites of cancer in the state. (Ref. graph 1 & 2)
The doctor pointed out that nasopharynx comparison age adjusted incidence rates of all PBCRs in male is 14.4 (rate per lakh) and female is 6.5 (rate per lakh), which is highest in the country and second in the world just behind China, Zhongshan City, which has 25.0 (rate per lakh).
Whereas in stomach cancer, comparison age adjusted incidence rates of all PBCRs in Nagaland in male is 17.9 (rate per lakh), which is sixth in the country with Aizawl on the top with 44.2 (rate per lakh); while among female, Nagaland has 11.8 (rate per lakh), which is also sixth, with Papum Pare district of Arunachal Pradesh topping at 27.1 (rate per lakh).
In oesophagus cases, East Khasi hill district tops the table in the country with 75.4 (rate per lakh) and male in Nagaland in the ninth place with 13.9 (rate per lakh); in cervical cancer, Papum Pare district is on top with 27.7 (rate per lakh) in the country, while Nagaland have 13.3 (rate per lakh) which is thirteenth in the country.
In hyphopharynx, East Khasi hills tops in the country with 21.8 (rate per lakh), and Nagaland is in eighth spot with 9.0 (rate per lakh).
The doctor also highlighted the probability of developing any of leading cancers in 0-74 age group.
Cancer burden in Nagaland
Dr. Khamo stated that cancer has emerged as a major public health problem in the state with 57% of the cancer patients having sought healthcare outside the state; 75% availing treatment at private health facilities; 60.7% self-financing; and 10.7% covered by health insurance.
She stressed on the need to make cancer treatment affordable, saying that many discontinued the treatment after the first chemotherapy owing to financial limitation.
Survey of risk factor
It was pointed out that tobacco (smoked and smokeless) is highly prevalent with the prevalence of current tobacco use at 39.3%, and smokeless (khaini, talab, etc.) tobacco use – 35%.
The official stated smoked tobacco use stands at 13.2%, while the mean age of tobacco initiation was 20.3 years and self-attempts to quit smoking was 13.8%.
While 28.4% of the respondents were current users of non-tobacco betel products in the form of pan masala, supari, and tamul, of which the use of tamul was highest among current users with 16.0%, she said, accrediting the source to report on monitoring survey of cancer risk factors and health system response in NER.
Concerns and intervention
The doctor stressed on the need to create cancer awareness, provide early detection facilities/cancer screening, provide counselling/rehabilitation facility, create awareness on the availability of healthcare insurance schemes, and provide common cancer drugs at subsidized rates.
Mission Director of National Health Mission (NHM), Dr. Thorusie Katiry launched a training manual during the occasion, while commending the Tata Memorial Centre for their care and support for cancer treatment.
Dr. Subita Patil, Dr. Suvarna Gore, and Dr. Kedouvinuo Keditsu also spoke at the event.
Caption: Dr. Thorusie Katiry, Dr. V Khamo, Dr. Ravikant Singh, Dr. Kedouvinuo Keditsu and others at Hotel Vivor in Kohima on Friday. (EM Images)