SummaryBackgroundPrevious efforts to report estimates of cancer incidence and mortality in India and its different parts include the National Cancer Registry Programme Reports, Sample Registration System cause of death findings, Cancer Incidence in Five Continents Series, and GLOBOCAN. We present a comprehensive picture of the patterns and time trends of the burden of total cancer and specific cancer types in each state of India estimated as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 because such a systematic compilation is not readily available.MethodsWe used all accessible data from multiple sources, including 42 population-based cancer registries and the nationwide Sample Registration System of India, to estimate the incidence of 28 types of cancer in every state of India from 1990 to 2016 and the deaths and disability-adjusted life-years (DALYs) caused by them, as part of GBD 2016. We present incidence, DALYs, and death rates for all cancers together, and the trends of all types of cancers, highlighting the heterogeneity in the burden of specific types of cancers across the states of India. We also present the contribution of major risk factors to cancer DALYs in India.Findings8·3% (95% uncertainty interval [UI] 7·9–8·6) of the total deaths and 5·0% (4·6–5·5) of the total DALYs in India in 2016 were due to cancer, which was double the contribution of cancer in 1990. However, the age-standardised incidence rate of cancer did not change substantially during this period. The age-standardised cancer DALY rate had a 2·6 times variation across the states of India in 2016. The ten cancers responsible for the highest proportion of cancer DALYs in India in 2016 were stomach (9·0% of the total cancer DALYs), breast (8·2%), lung (7·5%), lip and oral cavity (7·2%), pharynx other than nasopharynx (6·8%), colon and rectum (5·8%), leukaemia (5·2%), cervical (5·2%), oesophageal (4·3%), and brain and nervous system (3·5%) cancer. Among these cancers, the age-standardised incidence rate of breast cancer increased significantly by 40·7% (95% UI 7·0–85·6) from 1990 to 2016, whereas it decreased for stomach (39·7%; 34·3–44·0), lip and oral cavity (6·4%; 0·4–18·6), cervical (39·7%; 26·5–57·3), and oesophageal cancer (31·2%; 27·9–34·9), and leukaemia (16·1%; 4·3–24·2). We found substantial inter-state heterogeneity in the age-standardised incidence rate of the different types of cancers in 2016, with a 3·3 times to 11·6 times variation for the four most frequent cancers (lip and oral, breast, lung, and stomach). Tobacco use was the leading risk factor for cancers in India to which the highest proportion (10·9%) of cancer DALYs could be attributed in 2016.InterpretationThe substantial heterogeneity in the state-level incidence rate and health loss trends of the different types of cancer in India over this 26-year period should be taken into account to strengthen infrastructure and human resources for cancer prevention and control at both the national and state levels. These efforts should focu...
Life expectancy at birth, mortality and morbidity rates are important indicators of health status of a population. India is a large country with huge variations in health indicators across states and districts of the country. 1 The life expectancy has increased from 23 years in 1901 to 62.6 in 2002-06, and infant mortality has declined from 215 per thousand in 1901 to 50 in 2009. The death rates have declined from 44 per 1000 in 1901 to 10 in 1992 and 7.3 in 2009. 2 However; there are no realistic and comparable estimates of morbidity over a period of time. The estimates of morbidity in general and the disease specific incidence rates in particular would serve as valuable information to the health planners and administrators for appropriate and timely measures to monitor, control and eradicate the diseases. It will also
Background:The pattern of morbidity reflects the burden of disease in a particular community. This pattern shows geographic variations between communities and countries. The knowledge of the pattern of diseases in a given country is very important in evaluating its health care delivery system. Such knowledge is important for health planning and for improving the healthcare services in that particular nation. We set out to study the morbidity pattern in our medical wards. Materials and methods: This is a retrospective study that reviewed the causes of morbidity amongst admitted cases from January 2014 to December 2014. The data were obtained from the medical record section. Data were analyzed using software Statistical Package for Social Sciences (SPSS) version 16. Results: A total of 19,609 patients were admitted during the study period. Of these males were 10,556 (53.8%) and females were 9,053 (46.2%). Out of the total cases, 19203 patients (97.9%) were discharged or relieved as cured, 210 patients (1.1%) had expired. The sex ratio was 858 females to 1,000 males. Of the most common causes of morbidities/system involved (ICD.10) in males, chronic ischemic heart disease (4.7%) was the leading cause followed by live born infants (3.8%), hypertension (3.7%), lymphoid leukemia (2.7%) and malignant neoplasm of brain (2.1%). In females, malignant neoplasm of breast (6.2%) was the leading cause followed by delivery by caesarean section (4.9%), live born infants (3.8%), secondary malignant neoplasm of other and unspecified sites (3.1%) and hypertension (2.4%). Overall bed occupancy rate (BOR) for all patients was 66.8 percent. Conclusion: Morbidity in the medical wards reflects the emerging trend of mixed disease spectrum burden comprising communicable and non-communicable diseases. Public health education, raising the socio-economic status of our people and as well as improving the standards of our health care facilities and personnel can contribute towards bringing down morbidity and mortality rates from medical wards.
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