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...

Background: Poverty is a multi-faced wretched state of deprivation of basic need and facilities. There are different levels to its adverse influence on the individual, family and the community. Thus a Rashtriya Swasthaya Bima Yojana (RSBY) was launched to help these poverty stricken individuals. This study explores into the utilization of Rashtriya Swasthaya Bima Yojana card and their satisfaction. Aims & Objective: Our study explore the awareness level of RSBY beneficiaries with the aims and objective, (1) To analyze the socio-demographic profile and services utilized by beneficiaries; (2) To identify the problems experienced by the beneficiaries and measure the satisfaction level; and (3) Out of pocket expenditure of beneficiaries. Material and Methods: 198 patients were registered between the periods of 01/11/2012 to 28/02/2013 due to some reason 180 beneficiaries were telephonically interviewed about their experience by a pre-tested and pre-designed Performa. The data was collected and analyzed in epi info 7. Results: Male: Female ratio of beneficiaries is 1.4:1. Mean age of beneficiary was around 36 years. 80% beneficiaries were fully satisfied with the services. All the beneficiaries reported that they got the card easily without any hassle. They were not aware about all the benefits of RSBY so they had to spend out of pocket money for some services. Conclusion: RSBY beneficiaries were mostly satisfied with the services provided but there was a major lag in their knowledge regarding the benefits provided under RSBY. They were unaware regarding all benefits under RSBY which they can avail from the scheme. Thus IEC activities should be enhanced to increase the awareness among the RSBY card holders so that they can use better service for themselves and their families.

Studies suggest frailty occurs earlier in HIV-infected individuals, but data in postmenopausal HIV-infected women are lacking. We assessed the prevalence of frailty and association with anthropometric measures in HIV-infected and uninfected postmenopausal women. Fried’s frailty phenotype was measured in HIV-infected and uninfected Hispanic and African American postmenopausal women participating in a study of bone metabolism; fat and lean mass were measured by whole body dual energy x-ray absorptiometry (DXA). Multivariable logistic regression evaluated frailty risk factors. The study was conducted at Columbia University Medical Center between 2002 and 2007. The participants were 61 HIV-infected and 27 uninfected Hispanic and African American postmenopausal women. The study compared prevalence and predictors of frailty in HIV-infected and uninfected postmenopausal women. Prevalence of frailty tended to be higher among HIV-infected than uninfected controls (11.5% vs 0% p=0.07). Surprisingly, among HIV-infected women, total body fat, not lean mass, was associated with frailty in multivariate analysis. Higher prevalence of frailty in African American and Hispanic HIV-infected postmenopausal women (11.5%) was similar to the 11% prevalence reported in minority women who were 10 years older in the general population. Our data suggest that frailty occurs earlier in HIV-infected postmenopausal women, but larger longitudinal studies are necessary to confirm whether musculoskeletal aging is accelerated by HIV infection.

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Breast cancer accounts for 19-34% of all cancer cases among women in India ranking second to cervical cancer. The burden of breast cancer is increasing in both developed and developing countries; the peak occurrence of breast cancer in developed countries is above the age of 50 whereas in India it is above the age of 40. AIMS: Study and compare the perceptions regarding breast cancer among rural and urban women of Ahmedabad district. METHODS: The study is a Community based cross-sectional study conducted from May 2013 to September 2013 in Urban and Rural settings of Ahmedabad district. A pre-designed and pre-tested proforma was used to collect baseline data by house to house visits. Informed consent was also taken before the initiation of survey. Data was entered into MS Office-Excel 2007 and analysis was done in Epi info version 3.7.1. Chi square test were used to test statistical significance. RESULTS AND CONCLUSION: The findings of this study depicted a wide gap in knowledge about breast cancer and its risk factors among urban and rural women of Ahmedabad district. Though 87% of the urban women had heard about breast cancer, only 67% rural women were aware about it. Sadly, less than half of all women were aware of the cardinal symptoms of breast cancer.