Leads to cancer control based on cancer patterns in a rural population in South India

Objective: Cancer patterns and incidence rates for a rural population (359, 674) resident in 384 villages spread over 2058 km(2) in Palani and Oddancha thram taluks of Dindigul District, Tamil Nadu, in South India, are describe d in this paper. Methods: A population-based cancer registry was established in 1995 to regi ster incident invasive and in-situ cancers. Cases were found and details ab stracted by cancer registry staff visiting 26 data sources, comprising canc er hospitals, tertiary and secondary care hospitals, pathology laboratories and death registration offices. A customized version of CANREG-3 software was used for data entry and analysis. Results: During the period 1996-1998, 783 invasive cancers (310 male and 47 3 females) were registered, yielding an all-cancer crude incidence rate of 56.8/100,000 males and 88.5/100,000 females; the corresponding age standard ized incidence rates (ASR) were 83.3 and 122.3 respectively. In males, mout h cancer (ASR 11.5) was the most frequently recorded malignancy followed by tongue (ASR 8.6), hypopharynx (ASR 7.8), esophagus (ASR 7.8) and larynx (A SR 7.8). Thus head and neck cancers accounted for half of the male cases. I n females, cervical cancer (ASR 65.4) accounted for more than half of the c ancers followed by breast (ASR 14.2) and mouth (ASR 10.2). Ambillikai Cance r Registry (ACR) reports the second highest incidence of cervical cancer in the world. More than four-fifths of cervical cancer cases were diagnosed i n stages II B and III B; a third of these cancer patients either did not ha ve, or did not complete, treatment. Conclusions: The observed cancer patterns in this population establish that measures directed at prevention and early detection (linked with treatment ) of cervix and head and neck cancers are of paramount importance for cance r control in this and other rural populations of India where three-fourths of the total population live.