Bidi smoking and lung cancer incidence among males in Karunagappally cohort in Kerala, India

Abstract

The association of lung cancer incidence with bidi smoking was examined using a cohort study data in Karunagappally, Kerala, India. We sought interview of all the residents in Karunagappally with the population of 385,103 in 1991 census, and established a cohort of 359,619 (93% of the population in 1991) in the 1990s. There were 65,829 men aged 30–84 at interview after excluding those diagnosed as cancer or died of any cause before 1997. Among them, 212 newly diagnosed lung cancer cases were ascertained during the 8‐year period between 1997 and 2004 through Karunagappally Cancer Registry. The relative risk (RR) of lung cancer was obtained from Poisson regression analysis of grouped data. Lung cancer incidence was relatively high among Moslem people and those with lower educational history. When taking into account attained age, religion and education, the RR between current bidi smokers and those who had never smoked bidis was 3.9 (95%CI = 2.6–6.0, p < 0.001). The lung cancer risk did not return to the level of non‐smokers within 10 years after cessation. In further analyses using only those never smoked cigarettes to examine the effect of bidi smoking alone on lung cancer risk, current smokers of bidis had the RR of 4.6 (95%CI = 2.5–8.5, p < 0.001). Lung cancer incidence increased with larger amounts of bidi smoked a day (p < 0.001), with longer durations of smoking bidis (p < 0.001), and with younger ages starting smoking bidis (p < 0.001). Immediate measures should be taken to stop bidi smoking, which is common in south Asia. © 2008 Wiley‐Liss, Inc.

Tobacco chewing and female oral cavity cancer risk in Karunagappally cohort, India

“…House visits of the deceased, to supplement information on cause of death, were started in 1997. The proportion of DCO cases in Karunagappaly cancer registry was 14% during 1990 -1994 (Nair et al, 1997), 10% during 1993) and 4% during 1998(Jayalekshmi and Rajan, 2007. The ratio of incidence to mortality (M/I percent) for all cancer among women was 39% during the period between (Jayalekshmi et al, 2005, similar to those in other major cancer registries in India (Nandakumar et al, 2005).…”

“…This taluk consisted of 12 panchayats at taluk being an administrative unit, corresponding to a county, with panchayats as subunits. According to the 1991 Census, this taluk had a population of 385 103 (191 149 males and 193 954 females) residing in an area of 192 km 2 All the households (N ¼ 71 674) in Karunagappally taluk were visited by 12 -14 trained interviewers, starting from 1 January 1990 and ending on 31 December 1997 (Jayalekshmi et al, 2008). Using a 6-page standardised questionnaire, they collected information on sociodemographic factors, religion, family income in rupees, education, occupation, lifestyles and other factors.…”

“…Cancer cases among the cohort were ascertained by the cancer registry in Karunagappally, which was officially initiated as of 1 January 1990 and has been reported in 'Cancer Incidence in Five Continents', vols. VII -IX (Nair et al, 1997Jayalekshmi and Rajan, 2007). As there was no dedicated cancer centre in this rural area, we had to pursue an active registration method by visiting all health-care facilities of the taluk and outside where cancer patients are seen (Jayalekshmy et al, 2008).…”

The hazards and benefits associated with smoking and smoking cessation in Asia: a meta-analysis of prospective studies

“…In all, this gave 77 individual studies for inclusion in the meta-analysis: 73 cohort studies and four nested case-control studies. The characteristics of these studies are summarised in table 1, according to country and initial year of baseline survey 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74. Of the 77 studies, 42 studies were from Japan; 16 from China, five from Singapore, five from Taiwan, four from Korea, three from Hong Kong, one from India and one from Thailand.…”

Projection of Cancer Incident Cases for India - Till 2026

“…This would lead to large increases in the incidence of lung cancer. Lung cancer incidence was strongly related to the amount of bidis smoked a day, duration of smoking and age at starting smoking (Jayalekshmy et al, 2008). One third of male cancers are attributable to Tobacco smoking (WHO 2010).…”