The Cancer Burden in the Indian

Subcontinent

Viji Venkatesh

The Max Foundation

Cancer

The enigma that is India

“It is very important to remember that a few million English –speaking Indians do

not make up India”N R Narayana Murthy

Founder Chairman of Infosys Technologies Ltd

The enigma that is India

�India is an amalgamation of many ‘countries’ every 100 miles, everything in India changes- the language (or dialect), landscape, food, dress, traditions, beliefs -almost like another European Union

The enigma that is India

� India is unarguably the largest producer of engineers and scientists in the world

� 350 million are illiterate and 250 million do not have access to basic medical care

The enigma that is India

� 318 million people do not have access to drinking water

� Satellite technology brings television to almost every village in India

� 51% of children in the country are undernourished

� Our urban youth however have no dearth of choices when it comes to the toppings for their pizzas

Common cancers in India

�Malignancies of the Head & Neck region

�Cervical Cancer

�Breast Cancer

Cancer in India

�Major % of new cancers detected every year is in developing countries like India

�Burden of maximum number of cancers BUT

�Minimum resources to cope with these

Cancer in India

The Challenges

� Not enough medical facilities

� Cost of treatment

� No private insurance

� No Government reimbursement

� The stigma of cancer

Some known facts about these cancers

� The most common cancers in India are those that can be prevented and detected early

� Causative and risk factors known and identified

� Despite that maximum new cancers are detected in countries like ours

Estimate of the Cancer Burden

2006 – 2016 (Male Cancers )

� Lip 1535 to 2032 � Tongue 22,775 to 30,269 � Mouth 22,603 to 29,962� Breast 2,367 to 3,127� Prostate 20,134 to 27,215� Lung 45,292 to 60,730� All sites 295,383 to 391,821

Estimate of the Cancer Burden 2006 – 2016 (Female Cancers)

� Breast Cancer 104,968 to 140,975

� Cervical Cancer No figures available

� Ovarian Cancer 27,159 to 36,085

� Stomach Cancer 13,029 to 17,699

� Mouth Cancer 16,072 to 21,951

� All Sites 232,317 to 312,388

Deterrents to cancer control

�IGNORANCE

�LACK OF AWARENESS

�MISCONCEPTIONS & MYTHS

Myths about cancer

�CANCER MEANS DEATH

�IT IS GOD’S WILL

�PUNISHMENT FOR PAST SINS

Oh God ! Why ?

Tobacco consumption in India – a socially accepted custom

� Beedi

� Cigarette

� Masheri – burnt tobacco powder

� Gutka and Pan Masala – chewing mix

� Sookha – dry powdered tobacco

� Dant manjhan – tooth paste

Tobacco related cancers

� Head &Neck

� Esophagus

� Lung

� Sub – Mucous fibrosis

Women in India

� One of the most enduring clichés about India is that it is a country of contradictions.

� At the heart of the contradiction stands the Indian women

� If it is true to say that they are among the most oppressed in the world,

� Then it is equally true to say that they are among the most liberated, the most articulate and perhaps even the most free.

The Modern Indian Woman and Breast Cancer

Risk Factors for Breast Cancer

� Late age at marriage

� Delayed Menarche

� Delayed pregnancy

� Absence of breast feeding

The girl child

Risk factors for Cervical Cancer

� Early age at marriage

� Multiple Pregnancies

� Unhygienic living conditions

� Lack of access to periodic screening

An access program as a tool that facilitates

� Access to treatment

� Out reach intervention

� Establishing Support Systems for patients and families

� Support and training for physicians

� Creating Awareness

� Setting up Education Programmes

� Promoting concept of good compliance

AIIMS NEW DELHI

GCRI AHMEDABAD

NOA/GIPAP CENTRES IN INDIA

CMCH VELLORE

CANCER INSTCHENNAIKIDWAI KIDWAI KIDWAI KIDWAI BANGALOREBANGALOREBANGALOREBANGALORE

MUMBAI

PUNE

LUDHIANA

COIMBATORE

SMS JAIPUR

PGI CHANDIGARH

RGI NEW DELHI

NIZAMS HYDERABAD

APOLLO CHENNAI

RCC TRIVANDRUM

KOLKATA

PATIENT LOAD IN INDIA 12200 +

TOWARDS A NEW DAWN