Kerala's cancer incidence has gone much above the national average, oncologists and public health experts say
As cancer incidence spirals in Kerala, oncologists and public health experts have called for targetted interventions to improve the awareness of risk factors for cancer and to encourage early diagnosis of the disease.
Kerala's cancer incidence has gone much above the national average, with the State reporting an incidence of 243/lakh population in men and 219/lakh population in women, against the national average of 105/lakh for men and men and 103/lakh for women
Kerala's cancer landscape was discussed in detail at the Kerala Cancer Conclave, which began here on Saturday.
Cancers of the lung (14%) oral cavity (10%), colorectal (10%), prostate (9%) and liver (8%) are the leading cancers in men in Kerala. In women, breast cancer incidence has gone up 300 fold in Kerala in the last 25 years and today it accounts for 34 % of all cancers in women. Thyroid (11%), colorectal (9%) and uterine cancer (6%) have also been going up in women, while cervical cancer no longer figures among the first five cancers in women .
Metastatic cancers
Reeling off statistics, Prashant Mathur, the Director of ICMR-National Centre for Disease Informatics and Research, Bengaluru, pointed out that a huge number of locally advanced metastatic cancers were being reported in Kerala than anywhere else in the country and that early diagnosis of cancer was extremely important for bringing down the stage at diagnosis and thus, the cancer burden.
He pointed out that Kerala did very well when it came to five-year survival rates, which spoke a lot about the quality of cancer care.
The high proportion of the elderly in Kerala – 16.5% of the population in 2021 and which is projected to hit 22.8% in 2036, according to UNFPA's India's Ageing Report 2023 – could be the primary factor driving the cancer incidence in Kerala. In Pathanamthitta, one of the districts with the highest proportion of elderly, the cancer incidence was 300/lakh population.
Specialised geriatric oncology services and a primary cancer prevention programme, integrated to the primary healthcare delivery, would be an intervention that Kerala would have to invest in, to check the rising burden of cancer, Aleyamma Mathew, cancer epidemiologist, said.
Dr. Mathew said that when 90% of the breast cancers in the State were curable in early stages, two-thirds of cases were being reported to hospitals at stages 3 and 4. Even the educated in Kerala seemed to report very late to hospitals, making for a poor prognosis.
Dr. Mathew pointed out that over the years, the drop-out rate in cancer treatment was going up in Kerala, with many patients refusing to turn up for follow-up treatment after the initial surgery.
Renowned public health expert and epidemiologist, V. Ramankutty, sought to put Kerala's high cancer incidence in perspective, when he pointed out that Kerala's cancer incidence was still much lower than that of the West. Detection bias and Kerala's data gathering expertise could be the reasons for the State emerging with one of the highest cancer incidences in the country, he pointed out.
Actual risk factors
Dr. Ramankutty pointed out that the actual risk factors for cancer – lack of dietary fibre, poor consumption of vegetables, alcohol and lack of exercise – were not being adequately projected by authorities as risk factors for cancer and people continued to remain ignorant.
If quests after cancer cure in alternative medicine and unscientific treatment methods were resulting in late diagnosis of cancer, catastrophic treatment expenses, inadequate insurance cover and loss of livelihood were the reasons why people were dropping out of cancer treatment, Dr. Ramankutty said.
Unless the government addressed these issues and took steps to integrate comprehensive cancer care with primary care, Kerala's current cancer landscape was unlikely to change.
Speaker A.N. Shamseer inaugurated the conclave, which is organised by the Association of Medical and Paediatric Oncologists of Kerala. The event has brought together over 200 oncology and public health experts.
Those who participated in the discussions on Saturday included S.H. Advani, renowned oncologist to have pioneered bone marrow transplant in the country; C.S. Pramesh, director, Tata Memorial Hospital, Mumbai; B. Satheesan, director, Malabar Cancer Centre; M.R. Rajagopal, founder-director, Pallium India, among many others.
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As cancer incidence spirals in Kerala, oncologists and public health experts have called for targetted interventions to improve the awareness of risk factors for cancer and to encourage early diagnosis of the disease. Kerala's cancer incidence has gone much above the national average, with the State reporting an incidence of 243/lakh population in men and 219/lakh population in women, against the national average of 105/lakh for men and men and 103/lakh for women Kerala's cancer landscape was discussed in detail at the Kerala Cancer Conclave, which began here on Saturday. Cancers of the lung (14%) oral cavity (10%), colorectal (10%), prostate (9%) and liver (8%) are the leading cancers in men in Kerala. In women, breast cancer incidence has gone up 300 fold in Kerala in the last 25 years and today it accounts for 34 % of all cancers in women. Thyroid (11%), colorectal (9%) and uterine cancer (6%) have also been going up in women, while cervical cancer no longer figures among the first five cancers in women . Metastatic cancers Reeling off statistics, Prashant Mathur, the Director of ICMR-National Centre for Disease Informatics and Research, Bengaluru, pointed out that a huge number of locally advanced metastatic cancers were being reported in Kerala than anywhere else in the country and that early diagnosis of cancer was extremely important for bringing down the stage at diagnosis and thus, the cancer burden. He pointed out that Kerala did very well when it came to five-year survival rates, which spoke a lot about the quality of cancer care. The high proportion of the elderly in Kerala – 16.5% of the population in 2021 and which is projected to hit 22.8% in 2036, according to UNFPA's India's Ageing Report 2023 – could be the primary factor driving the cancer incidence in Kerala. In Pathanamthitta, one of the districts with the highest proportion of elderly, the cancer incidence was 300/lakh population. Specialised geriatric oncology services and a primary cancer prevention programme, integrated to the primary healthcare delivery, would be an intervention that Kerala would have to invest in, to check the rising burden of cancer, Aleyamma Mathew, cancer epidemiologist, said. Dr. Mathew said that when 90% of the breast cancers in the State were curable in early stages, two-thirds of cases were being reported to hospitals at stages 3 and 4. Even the educated in Kerala seemed to report very late to hospitals, making for a poor prognosis. Dr. Mathew pointed out that over the years, the drop-out rate in cancer treatment was going up in Kerala, with many patients refusing to turn up for follow-up treatment after the initial surgery. Renowned public health expert and epidemiologist, V. Ramankutty, sought to put Kerala's high cancer incidence in perspective, when he pointed out that Kerala's cancer incidence was still much lower than that of the West. Detection bias and Kerala's data gathering expertise could be the reasons for the State emerging with one of the highest cancer incidences in the country, he pointed out. Actual risk factors Dr. Ramankutty pointed out that the actual risk factors for cancer – lack of dietary fibre, poor consumption of vegetables, alcohol and lack of exercise – were not being adequately projected by authorities as risk factors for cancer and people continued to remain ignorant. If quests after cancer cure in alternative medicine and unscientific treatment methods were resulting in late diagnosis of cancer, catastrophic treatment expenses, inadequate insurance cover and loss of livelihood were the reasons why people were dropping out of cancer treatment, Dr. Ramankutty said. Unless the government addressed these issues and took steps to integrate comprehensive cancer care with primary care, Kerala's current cancer landscape was unlikely to change. Speaker A.N. Shamseer inaugurated the conclave, which is organised by the Association of Medical and Paediatric Oncologists of Kerala. The event has brought together over 200 oncology and public health experts. Those who participated in the discussions on Saturday included S.H. Advani, renowned oncologist to have pioneered bone marrow transplant in the country; C.S. Pramesh, director, Tata Memorial Hospital, Mumbai; B. Satheesan, director, Malabar Cancer Centre; M.R. Rajagopal, founder-director, Pallium India, among many others.
