Tamil Nadu's Cancer Burden Surges: 30% Increase In Projections Compared To Five Years Ago

2 hours ago 4

ARTICLE AD BOX

Among women, more than 50% of the cancers were in reproductive organs. AI image

From 78,000 projected cases just five years ago to more than one lakh now, Tamil Nadu’s cancer burden has climbed steadily, highlighting the urban-rural divide in access to diagnosis and care.The report from the Tamil Nadu Cancer Registry Project, a joint effort by the Cancer Institute (WIA) and the department of health and family welfare, show that in 2021 (the latest available data), more women (43,163) were diagnosed with the disease compared to men (33,805).

The projection for 2025 is 100,097.The registry collects data from hospitals, nursing homes, and diagnostic centres, and clears out duplications before analysis. “We make the projection based on the trend we have been seeing,” says Cancer Institute senior epidemiologist Swaminathan R, who heads the registry. “A combination of reasons, including better diagnosis and awareness, besides genetic and environmental triggers lead to the increase.”One in 11 women in the 0-74 age group had a cumulative risk of getting cancer compared to one in 12 men, says the report. Among men, mouth cancer tops the list, followed by colorectum and stomach.

Among women, more than 50% of cancers were in reproductive organs.Environmental changes and lifestyle behaviour in cities showed in the incidence, says Swaminathan. For instance, in certain rural districts such as Ariyalur, Perambalur, Tiruvannamalai, Villupuram and Dharmapuri, cervical cancers topped the list of cancers among women.Oncologists say cervical cancer cases are higher in most rural areas, where there is limited access to pap smear screenings.

Poverty, lower education, and lack of healthcare infrastructure contribute to delayed diagnoses. On the other hand, in cities, delayed pregnancies, fewer children, and higher rates of obesity, in addition to advanced screening facilities, lead to higher detection rates of breast cancer.Prostate cancer is more common among men in urban areas. In Chennai, it ranks among the top five cancers, and in several other urban and semi-urban districts it figures in the top 10.

But in districts such as Dindigul, Madurai, Theni, Tuticorin, Tiruvarur, Perambalur, Pudukottai, Ramanathapuram, Villupuram, and Thanjavur, it does not feature in the top 10.The projections have been nearly accurate until 2019, when the projected cases were 78,148 and the observed number of cancer cases was 78,678. In 2020, however, the observed cases were 68,750 compared to the projected 81,683, and in 2021, it was 76,968 compared to 85,216.

“Screening and diagnosis came down following lockdowns during the Covid-19 pandemic. It resulted in underdiagnosis and delayed treatment. It is likely to take a couple of years for us to see normalisation,” says Swaminathan.Unlike cancer registries in developed countries, Tamil Nadu’s does not accurately capture deaths from the disease because of limited information. Only about 40% of deaths in the state — mostly in cities or hospitals — have a medically certified cause. Rural registration units account for more than half of the registered deaths, but only 5% are medically certified in institutions, and the rest are home deaths.

Better facilities at govt hospitals, but survival under 30% when diagnosed late

Early detection of cancer is improving in TN, owing to master health checks and diagnostic technology, but doctors say survival remains low for many patients who continue to be diagnosed at advanced stages, especially in public hospitals. While the state registry does not have adequate data on survival trends, doctors in public hospitals say most rural patients arrive with advanced-stage cancers, unlike in private hospitals.

“It is still rare to pick pre-cancerous or early cancerous conditions even at private hospitals,” says radiation oncologist Dr Rakesh Jalali, head of Apollo Proton Cancer Centre. But more patients are being diagnosed in late stage 2 or early stage 3. Also, the number of people detected with cancer for the first time, in advanced stages where it has spread into multiple organs, has decreased because of better awareness and annual health screening.”

Advancements in diagnostic equipment, precision surgeries with robotic arms, medicines in chemotherapy and radiation therapy that target cancer cells expedite the cure and minimise side effects, he says. “The treatment helps in early recovery.”

But the survival rates of some cancers, particularly of head and neck remain low. At Arignar Anna Memorial Cancer Hospital and Research Institute’s regional cancer centre, less than 5% of the patients are in precancerous or stage 1. More than 50% are diagnosed in stage three or four (when disease has advanced locally or spread to other organs).
“Facilities in govt hospitals have improved but outcomes are poor with survival rates for some cancers dropping to less than 30% because of delayed medical intervention,” says Dr S Saravanan, who heads the Arignar Anna Cancer Hospital in Kancheepuram.

The hospital is working with IIT-M to expand mass screening using AI. “Mobile screening camps with mammograms can help improve diagnosis of breast cancers in women. We are also working on treatment protocols to improve survival rates of head and neck cancers,” he says.

Email your feedback with name and address to [email protected]

Read Entire Article