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Background: The cancer registry provides reliable data from the population. In this article, we provide cancer burden and its patterns from the Varanasi district. Methods: The method adopted by the Varanasi cancer registry is community interaction along with regular visits to more than 60 sources to collect data on cancer patients. The cancer registry was established by the Tata Memorial Centre, Mumbai, in 2017 covering 4 million population (57% rural and 43% urban population). Results: The registry has recorded 1,907 incidence cases (1,058 male and 849 female). The age-adjusted incidence rate per 100,000 population in male and female of Varanasi district is 59.2 and 52.1, respectively. One in 15 male and one in 17 female are at risk of developing the disease. Mouth and tongue cancers are the predominant cancers in male, whereas breast, cervix uteri, and gallbladder are the leading cancer sites among the female. In female, cervix uteri cancer is significantly higher (double) in rural areas when compared with urban areas (rate ratio [RR] 0.5, 95% confidence interval [CI; 0.36, 0.72]), whereas in male, mouth cancer is higher in urban areas when compared with rural areas (RR 1.4, 95% CI [1.11, 1.72]). More than 50% of cancer cases in male are due to tobacco consumption. There may be underreporting of the cases. Conclusion: The results of the registry warrant policies and activities related to early detection services for the mouth, cervix uteri, and breast cancers. The Varanasi cancer registry is the foundation for cancer control and will play an important role in the evaluation of the interventions. Keywords: Cancer control, cancer prevention, India, population-based cancer registry, rural and urban, Author(s): Atul M Budukh (corresponding author) [1]; Satyajit Pradhan [2]; Virendra B Singh [3]; Divya Khanna [4]; Sonali S Bagal [5]; Priyal S Chakravarti [5]; Anand N Sharma [5]; Rajesh [...]

In low‐ and middle‐income countries most of the cancer patients attend the hospital at a late stage and treatment completion of these cases is challenging. The early detection program (EDP), in rural areas of Punjab state, India was initiated to identify breast, cervical, and oral cancer at an early stage by raising awareness and providing easy access to diagnosis and treatment. A total of 361 health education programs and 99 early detection clinics were organized. The symptomatic and self‐interested (non‐symptomatic individuals who opted for screening) cases visited the detection clinic. They were screened for breast, cervical, and/or oral cancer. Further diagnosis and treatment of screen‐positive cases were carried out at Homi Bhabha Cancer Hospital (HBCH), Sangrur. Community leaders and healthcare workers were involved in all the activities. The EDP, Sangrur removed barriers between cancer diagnosis and treatment with the help of project staff. From 2019 to 2023, a total of 221,317 populations were covered. Symptomatic and self‐interested individuals attended the breast (1627), cervical (1601), and oral (1111) examinations. 46 breast (in situ‐4.3%; localized‐52.2%), 9 cervical (localized‐77.8%), and 12 oral (localized‐66.7%) cancer cases were detected, and treatment completion was 82.6%, 77.8%, and 50.0%, respectively. We compared cancer staging and treatment completion of cases detected through EDP with the cases attended HBCH from Sangrur district in 2018; the difference between two groups is statistically significant. Due to the early detection approach, there is disease down‐staging and improvement in treatment completion. This approach is feasible and can be implemented to control these cancers in low‐ and middle‐income countries. [ABSTRACT FROM AUTHOR]

Byline: Atul. Budukh, Jarnail. Thakur, Tapas. Dora, Prithviraj. Kadam, Sonali. Bagal, Kamalesh. Patel, Alok. Goel, Sankalp. Sancheti, Ashish. Gulia, Pankaj. Chaturvedi, Rajesh. Dikshit, Rajendra. Badwe Introduction: There is a scarcity [...]

Breast cancer (BC) remains a global health challenge, devastatingly impacting women's lives. Low‐and‐middle‐income countries (LMIC), such as India, experience a concerning upward trend in BC incidence, necessitating the implementation of cost‐effective screening methods. While mammography, ultrasonography, and magnetic resonance imaging are preferred screening modalities in resource‐rich settings, limited resources in LMICs make clinical breast examination (CBE) the method of choice. This review explores the merits of CBE, its coverage, barriers, and facilitators in the Indian context for developing strategies in resource‐constrained settings. CBE has shown significant down‐staging and cost‐effectiveness. Performed by trained health workers in minutes, CBE offers an opportunity for education about BC. Various individual and health system barriers, such as stigma, financial constraints, and the absence of opportunistic screening hinder CBE coverage. Promising facilitators include awareness programs, capacity building, and integrating CBE through universal health care. No healthcare provider must miss any screening opportunity through CBE. [ABSTRACT FROM AUTHOR]

COVID-19 started in 2019 and spread rapidly throughout the world. The pandemic has presented a lot of public health challenges globally. The virus mostly affected the respiratory system, so tobacco consumers (smoke/smokeless) were at a higher risk of developing severe illnesses due to COVID-19. National Tobacco Quit Line Services (NTQLS) plays an important role in tobacco cessation. However, due to the COVID-19 pandemic, it was challenging to run these services. There were several challenges faced by the NTQLS during the lockdown. The data from the NTQLS team was retrieved to analyze if the work from home and the pandemic had affected the number of attended calls and quitters during the pandemic (2020) and compared it with before the pandemic (2019). The results showed that before the pandemic, the attended calls were 36.4% whereas, during the pandemic, they were 27%. Quit-date set decreased during the pandemic (29.2%) compared to before the pandemic (41.8%). Furthermore, the number of quitters decreased during the pandemic (27.5%) compared to before the pandemic (35.9%). Telephone counseling is effective in various countries to increase the quit attempts among the individuals during the pandemic, however, these services were jeopardized due to COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Byline: Sourav. Sarkar, Kedar. Deodhar, Atul. Budukh, Munita. Bal, Mukta. Ramadwar Background: A comprehensive histopathology report of colorectal carcinoma surgery is important in cancer staging and planning adjuvant treatment. Our [...]

Byline: Atul. Budukh, Amita. Maheshwari, Sonali. Bagal, Arpit. Singh, Kedar. Deodhar, Nandkumar. Panse, Vrushali. Palyekar, Rajesh. Dikshit, Rajendra. Badwe Background: India accounts for a quarter of the world cervical cancer [...]

Byline: Atul. Budukh, Snehal. Shah, Suyash. Kulkarni, Sharmila. Pimple, Suvarna. Patil, Devendra. Chaukar, C. Pramesh Background: Promoting awareness of tobacco and cancer in the community needs multipronged efforts. We performed [...]

The electronic cigarette (EC) was developed as an alternative to cigarette smoking. In less than a decade, the prevalence of past-month EC usage increased from 1.5 to 27.5 % among US high-school students. In the coming years, Asia–Pacific countries will have the highest sales of electronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) after Western Europe. Based on the World Health Organization and Indian Council of Medical Research recommendations, India approved a complete ban on EC in 2019. Even though it has been three years since the ban, EC is still being sold in India's grey markets, where marketing is not regulated. In this narrative review, we discuss that vaping is not just a harm reduction strategy for tobacco smoking cessation but poses a serious threat to India's existing tobacco control efforts as well as the health of the country's young people. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) is a major public health problem in India. This article presents the HNC burden in different regions of India. The published population-based cancer registries (PBCRs) data from the National Cancer Registry Programme, Bengaluru, and the Tata Memorial Centre, Mumbai, India, were utilised. The 37 PBCRs were divided into six regions including central, east, north, northeast, west and south. The age-standardised incidence rate of HNC was 25.9 (95% CI 25.7-26.1) and 8.0 (95% CI 7.9-8.1) per 100,000 population, respectively, in males and females. HNC accounted for about 26% of all cancer cases in males and 8% in females. The risk of developing HNC was 1 in 33 for males and 1 in 107 for females. The northeastern registries reported the highest incidence rate 31.7 per 100,000 population in males followed by northern (28.5), central (28.3), western (24.4), southern (23.9) and eastern (18.3). In females, the incidence was in the range of 6.2-10.1 per 100,000 population. For all PBCRs together, the HNC burden was two to three times higher in the age group 60+ as compared to 20-39 years. The HNC burden in India is higher than in the USA, UK, Australia, Africa and Brazil. The PBCRs from the south-east Asia region such as the Colombo district, Sri Lanka, as well as Siraha, Saptari, Dhanusha and Mohattari - Nepal have also reported a high burden of HNC. All regions reported mouth as a leading cancer site followed by tongue, larynx, hypopharynx and tonsil except the northeastern region registries where hypopharynx was the top leading cancer. The burden of other sites of HNC is low. Raising awareness of the disease and associated risk factors, providing early detection services, as well as easy access to diagnosis and treatment are required. The government should focus on building the infrastructure and capacity building to control this disease. [ABSTRACT FROM AUTHOR]

Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the Pathology Laboratory of Cancer Hospital with the support from hospital-based cancer registry (HBCR), Sangrur, Punjab, India for the years 2018 and 2019. Methods HBCR abstracts data from electronic medical records. Trained cancer registry staff abstracts cases in standard pro forma. Dual primary was coded as per the International Agency for Research on Cancer rule and was rechecked by the pathologist. Statistical Analysis Data about multiple primary was entered and documented in an Excel sheet. Time interval was calculated by subtracting the date of diagnosis for second primary and first primary. Results A total of 6,933 cases were registered, 45 cases are dual primary (26 females, 19 males) of which 64.4% are synchronous and 35.6% metachronous cases. Seventy-nine percent received cancer-directed treatment for synchronous and 87% for metachronous. The most common sites of the primary tumor were breast (33%), head and neck (22.2%), gynecological sites (11%), prostate (9%), esophagus (4%), and remaining other tumors (20.8%). Most common sites for second malignancies were gastrointestinal (GI) tract (31%), gynecological sites (18%), head and neck (16%), hematological malignancies (7%), soft tissue sarcoma (4%), breast (2%), and other sites (22%). Conclusion More than 70% of cases of primary tumors were in breast, head and neck, gynecological, and prostate. Of these, more than 60% of the second malignancy was found in the GI tract, gynecological, and head and neck sites. Around two-thirds of dual tumors are synchronous. Breast cancer cases have higher incidence of second malignancy. Regular follow-up is necessary to assess the survival of the second primary. [ABSTRACT FROM AUTHOR]

Objectives: To describe utilisation of verbal autopsy as one of the data collection approaches in cancer registration in an Indian setting. We aimed to estimate the proportion and epidemiological characteristics of malignancies identified by the Varanasi population‐based cancer registry (PBCR) using verbal autopsy between 2017 and 2019 and to develop a thematic network for implementing verbal autopsy. Methods: This was a cross‐sectional mixed‐methods study. Quantitative methods were applied to analyse information from PBCR proforma of the verbal autopsy‐confirmed cancers; qualitative methods were applied to evaluate verbal autopsy conducted by field staff from key informants. In‐depth interviews of field staff for the challenges and potential solutions during verbal autopsy were assessed. Results: Of 6466 registered cancers, 1103 (17.1%) were verbal autopsy‐confirmed cancers, which had no other source of information. The majority of verbal autopsy cases were from vulnerable populations who were aged >50 years (721, 65.4%), female (607, 55.1%), from rural backgrounds (853, 77.3%), illiterate or just able to read and write (636, 57.7%), and from lower and middle‐income groups (823, 74.6%). Verbal autopsy helped provide information about symptoms and site of disease, diagnostic and treatment details, and disease status. Major challenges during verbal autopsy described by field staff were incomplete cancer treatment, destruction of medical records and non‐cooperation by the community and lack of support from the local workforce as cancer is not notifiable. Conclusion: Verbal autopsy helped identify cancers that would have been missed during active case finding from available resources. The majority of verbal autopsy‐confirmed patients belonged to vulnerable populations. Non‐cooperation from community and local health systems was major challenge during verbal autopsy. Developing robust cancer awareness, patient navigation, and social support programmes will strengthen verbal autopsy. Integration of standardised and reproducible methods of verbal autopsy in cancer registry and digitalization of health information, especially in limited‐resource settings with weak vital registration, will facilitate completeness in cancer registration. [ABSTRACT FROM AUTHOR]

Byline: Atul. Budukh, Amita. Maheshwari, Vrushali. Palayekar, Sonali. Bagal, Pallavi. Purwar, Kedar. Deodhar, Rajesh. Dikshit, Rajendra. Badwe OBJECTIVE: To find out the prevalence of human papilloma virus (HPV) in adolescent [...]

Byline: Atul. Budukh, Ganesh. Bakshi, Gagan. Prakash Dear Editor, Globally, prostate cancer is the second most frequently diagnosed cancer and the fifth most common cause of cancer death among men [...]

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes -- either organized or opportunistic -- have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives.

A study was conducted to evaluate the efficacy of a single round of human papillomavirus (HPV) screening in significantly reducing the number of advanced cervical cancers and mortality. Results indicated that such screening did help reduce mortality due to cervical cancer in rural India, in low-income settings.

Objective To determine the factors associated with participation in cervical cancer screening and follow-up treatment in the context of a randomized controlled trial. The trial was initiated to evaluate the efficacy and cost effectiveness of visual inspection with acetic acid, cytological screening and testing for human papillomavirus in reducing the incidence of and mortality from cervical cancer in Maharashtra, India. Methods Between October 1999 and November 2003 women aged 30-59 years were randomized to receive one of the three tests or to a control group. Participation was analysed for all three intervention arms. The differences between those who were screened versus those who were not was analysed according to the sociodemographic characteristics of the 100 800 eligible women invited for screening. Those who were treated versus those who were not were analysed according to the sociodemographic characteristics of the 932 women diagnosed with high-grade lesions. Participation in screening and compliance with treatment were also analysed according to the type of test used. Findings Compared with women who were not tested, screened women were younger (aged 30-39), better educated and had ever used contraception. A higher proportion of screened women were married and a lower proportion had never been pregnant Of the 932 women diagnosed with high-grade lesions or invasive cancer, 85.3% (795) received treatment. Women with higher levels of education, who had had fewer pregnancies and those who were married were more likely to comply with treatment. There were no differences in rates of screening or compliance with treatment when results were analysed by the test received. Conclusion Irrespective of the test being used, good participation levels for cervical cancer screening can be achieved in rural areas of developing countries by using appropriate strategies to deliver services. Communication methods and delivery strategies aimed at encouraging older, less-educated women, who have less contact with reproductive services, are needed to further increase screening uptake. Bulletin of the World Health Organization 2007;85:264-272. Resume Objectif Identifier les facteurs amenant les femmes a se soumettre a un depistage et a un traitement du cancer du col uterin dans le cadre d'un essai controle randomise. L'objectif de cet essai etait d'evaluer l'efficacite et le rapport cout/efficacite d'une inspection visuelle a l'acide acetique, d'un examen cytologique et d'un test de depistage du papillomavirus humain dans la reduction de l'incidence du cancer du col et de la mortalite due a cette maladie a Maharashtra en Inde. Methodes Entre octobre 1999 et novembre 2003, on a selectionne au hasard des femmes de 30 a 69 ans pour les soumettre a l'un des trois tests ou les integrer a un groupe temoin. La participation a ete etudiee pour chacun des trois bras d'intervention. Les differences entre les personnes testees et non testees ont ete analysees en fonction des caracteristiques sociodemographiques des 100 800 femmes remplissant les criteres d'inclusion dans l'essai et invitees a subir ce depistage. De meme, les differences entre les femmes traitees et non traitees ont ete analysees en fonction des caracteristiques sociodemographiques des 932 femmes chez lesquelles on avait diagnostique des lesions de haut grade. La participation au depistage et l'observance du traitement ont fait l'objet d'une analyse selon le type de test utilise. Resultats Par comparaison avec les femmes non testees, celles s'etant soumises a un depistage etaient plus jeunes (30 a 39 ans), presentaient un niveau d'education plus eleve et avaient fait usage d'une contraception. Parmi les personnes testees, on relevait aussi une proportion plus forte de femmes mariees et plus faible de femmes n'ayant jamais eu de grossesse. Chez les 932 femmes diagnostiquees comme porteuses de lesions de haut grade ou atteintes d'un cancer invasif, 85,3% (795) avaient recu un traitement. La plus forte probabilite d'observance du traitement s'observait chez les femmes possedant un bon niveau d'education, chez celles ayant eu jusque la un petit nombre de grossesses ou chez les femmes mariees. L'analyse en fonction du type de test subi n'a fait apparaitre aucune difference concernant les taux de depistage et d'observance du traitement. Conclusion Quel que soit le test employe, il est possible d'obtenir des taux de participation au depistage du cancer du col uterin satisfaisants dans les zones rurales des pays en developpement en appliquant des strategies de prestation des services appropriees. Pour accroitre encore le recours au test, des methodes de communication et des strategies de prestation de services, visant a encourager a se faire depister, les femmes plus agees et moins eduquees, ayant moins de contacts avec les services de sante genesique, sont necessaires. Resumen Objetivo Determinar los factores asociados a la participacion en el cribado y el tratamiento de seguimiento dei cancer cervicouterino en el contexto de un ensayo controlado aleatorizado. Se emprendio este ensayo a fin de evaluar la eficacia y la relacion costo/eficacia de la inspeccion visual con acido acetico, el cribado citologico y el analisis de la presencia de papilomavirus humano como medios para reducir la incidencia de cancer cervicouterino y la mortalidad por esa causa en Maharashtra, India. Metodos Entre octubre de 1999 y noviembre de 2003 se distribuyo aleatoriamente a una muestra de mujeres de 30 a 59 anos para que se sometiera a una de las tres pruebas o formara parte dei grupo testigo. Se analizo la participacion para los tres tipos de intervencion. Las diferencias entre las mujeres sometidas a cribado y las demas se analizaron en funcion de las caracteristicas sociodemograficas de las 100 800 mujeres elegibles invitadas a someterse al tamizaje. El analisis comparativo de las tratadas y las no tratadas se realizo en funcion de las caracteristicas sociodemograficas de las 932 mujeres a las que se les diagnosticaron lesiones de gran malignidad. La participacion en el cribado y el cumplimiento del tratamiento se analizaron tambien segun el tipo de prueba utilizada. Resultados En comparacion con las mujeres no sometidas a analisis, las mujeres cribadas eran mas jovenes (30-39 anos), tenian un mayor nivel de estudios y habian usado anticonceptivos con mas frecuencia. Una mayor proporcion de las mujeres sometidas a cribado estaban casadas, y una proporcion inferior no habia estado nunca embarazada. De las 932 mujeres a las que se les diagnosticaron lesiones de gran malignidad o cancer invasivo, el 85,3% (795) recibieron tratamiento. Las mujeres con mayor nivel de instruccion, que habian tenido menos embarazos y que estaban casadas tenian mas probabilidades de seguir el tratamiento. Cuando se procedio a analizar los resultados en funcion de la prueba realizada, no se observo ninguna diferencia en cuanto a las rasas de cribado o la observancia dei tratamiento. Conclusion Independientemente de la prueba utilizada, si se usan las estrategias apropiadas para dispensar los servicios, es posible lograr un buen nivel de participacion en el cribado del cancer cervicouterino. Si se desea aumentar la participacion en las iniciativas de cribado, se necesitan metodos de comunicacion y estrategias de prestacion de servicios que motiven a las mujeres de mas edad, con menor nivel de instruccion y con menor contacto con los servicios de atencion reproductiva., Introduction In developed countries, cervical cancer prevention programmes have been shown to be effective in reducing the incidence of and mortality from cervical cancer, while in developing countries, where these [...]