Time Trends in Breast Cancer Among Indian Women Population: An Analysis of Population Based Cancer Registry Data

Chaturvedi, Meesha; Vaitheeswaran, K; Satishkumar, Kochunarayanan; Das, Priyanka; Stephen, Shine; Nandakumar, A.

doi:10.1007/s13193-015-0467-z

Cited by 19 publications

(16 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…India has a population of 1·3 billion spread across 29 states and seven union territories, and many of the states are as large as other countries, with varying degrees of development, population genetics, environments and lifestyles, leading to a heterogeneous distribution of disease burden and health loss 4 . There have been previous attempts to describe national-level patterns of cancer burden and epidemiology in different parts of India as well as areas of importance for cancer control,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 but a systematic and comprehensive understanding of the magnitude and time trends of all types of cancers in each state of India is not readily available. This is needed to inform action for cancer control that is commensurate with the need in each state, since delivery of health care is a state subject in India.…”

Section: Introductionmentioning

confidence: 99%

The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016

Dhillon¹,

Mathur²,

Nandakumar³

et al. 2018

The Lancet Oncology

Self Cite

349

223

View full text Add to dashboard Cite

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...

show abstract

Section: Introductionmentioning

confidence: 99%

The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016

Dhillon¹,

Mathur²,

Nandakumar³

et al. 2018

The Lancet Oncology

Self Cite

349

223

View full text Add to dashboard Cite

show abstract

“…A steady increase in breast cancer in most of the PBCRs including newer PBCRs, poses a great health challenge to women in India. 24 Presently, breast cancer and cervix uteri are the leading sites of cancer among women in India, posing an important public health problem that needs important input from various health and other agencies to tackle. 25 A multidisciplinary approach to breast cancer, including awareness programs, preventive measures, screening programs for early detection, and availability of treatment facilities, are vital for reducing both incidence and mortality of cancer in Indian women.…”

Section: Discussionmentioning

confidence: 99%

Cancer Statistics, 2020: Report From National Cancer Registry Programme, India

Mathur

Sathishkumar

Chaturvedi

et al. 2020

JCO Global Oncology

Self Cite

848

394

View full text Add to dashboard Cite

PURPOSE The systematic collection of data on cancer is being performed by various population-based cancer registries (PBCRs) and hospital-based cancer registries (HBCRs) across India under the National Cancer Registry Programme–National Centre for Disease Informatics and Research of Indian Council of Medical Research since 1982. METHODS This study examined the cancer incidence, patterns, trends, projections, and mortality from 28 PBCRs and also the stage at presentation and type of treatment of patients with cancer from 58 HBCRs (N = 667,666) from the pooled analysis for the composite period 2012-2016. Time trends in cancer incidence rate were generated as annual percent change from 16 PBCRs (those with a minimum of 10 years of continuous good data available) using Joinpoint regression. RESULTS Aizawl district (269.4) and Papumpare district (219.8) had the highest age-adjusted incidence rates among males and females, respectively. The projected number of patients with cancer in India is 1,392,179 for the year 2020, and the common 5 leading sites are breast, lung, mouth, cervix uteri, and tongue. Trends in cancer incidence rate showed an increase in all sites of cancer in both sexes and were high in Kamrup urban (annual percent change, 3.8%; P < .05). The majority of the patients with cancer were diagnosed at the locally advanced stage for breast (57.0%), cervix uteri (60.0%), head and neck (66.6%), and stomach (50.8%) cancer, whereas in lung cancer, distant metastasis was predominant among males (44.0%) and females (47.6%). CONCLUSION This study provides a framework for assessing the status and trends of cancer in India. It shall guide appropriate support for action to strengthen efforts to improve cancer prevention and control to achieve the national noncommunicable disease targets and the sustainable development goals.

show abstract

“…Most of them have however, focused on ER positive, HER2 negative subgroup of breast tumors in elderly women (median age >60 years) in predominant Caucasian women. Breast cancer in the south Asian population is seen to arise at least a decade earlier with half of the women less than 50 years of age at first diagnosis ( 19 , 20 ). In this study, we have investigated the role of AR by evaluating the AR/ER ratio specifically in patients younger than 50 years of age and who are likely to have a dominant estrogenic environment and the role of this particular hormonal environment on tumor progression.…”

Section: Introductionmentioning

confidence: 99%

Pre-Menopausal Women With Breast Cancers Having High AR/ER Ratios in the Context of Higher Circulating Testosterone Tend to Have Poorer Outcomes

et al. 2021

View full text Add to dashboard Cite

PurposeWomen with breast tumors with higher expression of AR are in general known to have better survival outcomes while a high AR/ER ratio is associated with poor outcomes in hormone receptor positive breast cancers mostly in post menopausal women. We have evaluated the AR/ER ratio in the context of circulating androgens specifically in patients younger than 50 years most of whom are pre-menopausal and hence have a high estrogenic hormonal milieu.MethodsTumor samples from patients 50 years or younger at first diagnosis were chosen from a larger cohort of 270 patients with median follow-up of 72 months. Expression levels of ER and AR proteins were detected by immunohistochemistry (IHC) and the transcript levels by quantitative PCR. Ciculating levels of total testosterone were estimated from serum samples. A ratio of AR/ER was derived using the transcript levels, and tumors were dichotomized into high and low ratio groups based on the third quartile value. Survival and the prognostic significance of the ratio was compared between the low and high ratio groups in all tumors and also within ER positive tumors. Results were further validated in external datasets (TCGA and METABRIC).ResultsEighty-eight (32%) patients were ≤50 years, with 22 having high AR/ER ratio calculated using the transcript levels. Circulating levels of total testosterone were higher in women whose tumors had a high AR/ER ratio (p = 0.02). Tumors with high AR/ER ratio had significantly poorer disease-free survival than those with low AR/ER ratio [HR-2.6 (95% CI-1.02–6.59) p = 0.04]. Evaluation of tumors with high AR/ER ratio within ER positive tumors alone reconfirmed the prognostic relevance of the high AR/ER ratio with a significant hazard ratio of 4.6 (95% CI-1.35–15.37, p = 0.01). Similar trends were observed in the TCGA and METABRIC dataset.ConclusionOur data in pre-menopausal women with breast cancer suggest that it is not merely the presence or absence of AR expression but the relative activity of ER, as well as the hormonal milieu of the patient that determine clinical outcomes, indicating that both context and interactions ultimately influence tumor behavior.

show abstract

Time Trends in Breast Cancer Among Indian Women Population: An Analysis of Population Based Cancer Registry Data

Cited by 19 publications

References 3 publications

The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016

The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016

Cancer Statistics, 2020: Report From National Cancer Registry Programme, India

Pre-Menopausal Women With Breast Cancers Having High AR/ER Ratios in the Context of Higher Circulating Testosterone Tend to Have Poorer Outcomes

Contact Info

Product

Resources

About