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Background Studies of immigrants have provided unique opportunities for examining disparities in cancer screening and the impact of lifestyles and environmental exposures on cancer risk. Findings have been useful for planning cancer control strategies and generating etiological hypotheses. Although India is a leading source of immigration to British Columbia (BC), Canada, little is known about the cancer profiles of Indo-Canadians, information needed for planning health services and health promotion initiatives for this population.Methods Using data from three population-based cancer registries, cancer incidence was compared for four population groups (in each of Delhi and Mumbai, India; Indo-Canadians in BC, Canada; and the BC general population) over three time periods (1976-1985, 1986-1995 and 1996-2003). BC Indo-Canadians were identified by using Indian surnames.Results Age-standardized incidence rates (ASRs) for all cancers combined were lowest for men and women in Delhi and Mumbai, intermediate for BC Indo-Canadians, and highest for the BC general population. Ranking of common cancer sites and ASRs for Indo-Canadian men and women more closely resembled those for the BC general population, rather than those for either Delhi or Mumbai. ASRs and rankings of common cancer sites are presented by gender for the four population groups.Conclusions Cancer incidence patterns in BC Indo-Canadian men and women differed from those in India, being more similar to the BC general population. [ABSTRACT FROM AUTHOR]

Background: The role of vasectomy in the development of prostate cancer remains controversial. In particular, there has been concern about detection bias and confounding in the previously published epidemiological studies examining this hypothesis. With the goal of minimizing detection bias, we have evaluated the relation between vasectomy and prostate cancer in a population without routine prostate cancer screening.Methods: A case-control study consisting of 175 prostate cancer cases and 978 controls with cancer diagnoses other than prostate cancer was conducted at hospitals covered by the Bombay Cancer Registry in Bombay, India. History of vasectomy, demographic, and lifestyle factors were obtained by structured interview. Multiple logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI).Results: Standardizing by age, 8.7% of cases and 8.3% of controls had had a vasectomy. The OR for prostate cancer comparing men who had had a vasectomy to those who did not was 1.48 (95% CI: 0.80-2.72) controlling for age at diagnosis, smoking status, alcohol drinking, and other demographic and lifestyle factors. Risk of prostate cancer associated with vasectomy appeared to be higher among men who underwent vasectomy at least two decades prior to cancer diagnosis or who were at least 40 years old at vasectomy.Conclusions: Although not statistically significant, the results of this hospital-based case-control study are consistent with the hypothesis of a positive association between vasectomy and prostate cancer. Because routine prostate cancer screening is not common in this population, detection bias was unlikely to account for this association. [ABSTRACT FROM AUTHOR]

Background: Increasing trends in the incidence of breast cancer have been observed in India, including Mumbai. These have likely stemmed from an increasing adoption of lifestyle factors more akin to those commonly observed in westernized countries. Analyses of breast cancer trends and corresponding estimation of the future burden are necessary to better plan rationale cancer control programmes within the country.Methods: We used data from the population-based Mumbai Cancer Registry to study time trends in breast cancer incidence rates 1976-2005 and stratified them according to younger (25-49) and older age group (50-74). Age-period-cohort models were fitted and the net drift used as a measure of the estimated annual percentage change (EAPC). Age-period-cohort models and population projections were used to predict the age-adjusted rates and number of breast cancer cases circa 2025.Results: Breast cancer incidence increased significantly among older women over three decades (EAPC = 1.6%; 95% CI 1.1-2.0), while lesser but significant 1% increase in incidence among younger women was observed (EAPC = 1.0; 95% CI 0.2-1.8). Non-linear period and cohort effects were observed; a trends-based model predicted a close-to-doubling of incident cases by 2025 from 1300 mean cases per annum in 2001-2005 to over 2500 cases in 2021-2025.Conclusions: The incidence of breast cancer has increased in Mumbai during last two to three decades, with increases greater among older women. The number of breast cancer cases is predicted to double to over 2500 cases, the vast majority affecting older women. [ABSTRACT FROM AUTHOR]

Background: Demographic, socioeconomic and cultural changes in India have increased longevity, delayed childbearing, decreased parity and resulted in a more westernised lifestyle, contributing to the increasing burden of cancer, especially among women., Methods: We evaluated secular changes in the incidence of breast, cervical and ovarian cancer in Mumbai women aged 30-64 between 1976 and 2005. Age-standardised incidence rates were calculated and presented by site and calendar period. An age-period-cohort (APC) analysis quantified recent time trends and the significance of birth cohort and calendar period effects. The estimated annual percent change (EAPC) was obtained from the drift parameter, expressing the linear time trend common to both calendar period and birth cohort., Results: Over the 30-year study period, the age-standardised rates significantly increased for breast cancer (EAPC: 1.1% (95% confidence interval (CI): 1.0, 1.3)), significantly decreased for cervical cancer (EAPC: -1.8% (95% CI: -2.0, -1.6)) and there was no statistically significant change for ovarian cancer (EAPC: 0.3% (95% CI: -0.1, 0.6)). For breast and cervical cancer, the best-fitting model was the APC model., Conclusions: The rates of breast, cervical and ovarian cancer remain low in comparison with western countries, and the divergent trends of breast (increasing) and cervical cancer (decreasing) in Mumbai were similar to those observed in several other Asian countries. The changing risk profile in successive generations - improved education, higher socioeconomic status, later age at marriage and at first child, and lower parity - may in combination partially explain the diverging generational changes in breast and cervical cancer in Mumbai in the last decades.

Objective: Bidis are hand-rolled cigarettes commonly smoked in South Asia and are marketed to Western populations as a safer alternative to conventional cigarettes. This study examined the association between bidis and other forms of tobacco use and cancer incidence in an urban developing country population., Methods: Using data from the large, well-characterized Mumbai cohort study, adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed from Cox proportional hazards regression models in order to compare the relative effect of various forms of tobacco use on cancer incidence., Results: During 649,228 person-years of follow-up 1,267 incident cancers occurred in 87,222 male cohort members. Incident oral cancer in bidi smokers (HR = 3.55; 95% CI = 2.40,5.24) was 42% higher than in cigarette smokers (HR = 2.50;95% CI = 1.65,3.78). For all respiratory and intrathoracic organs combined, the increase was 69% (HR = 5.54; 95% CI = 3.46,8.87 vs. HR = 3.28; 95% CI = 1.99,5.39); for lung and larynx, the increases were 35 and 112%, respectively. Smokeless tobacco use was associated with cancers of the lip, oral cavity, pharynx, digestive, respiratory, and intrathoracic organs., Conclusions: Despite marketing claims to the contrary, we found that smokeless tobacco use and bidi smoking are at least as harmful as cigarette smoking for all incident cancers and are associated with increased risk of oral and respiratory/intrathoracic cancers.

The Bombay cancer registry is the second oldest population-based cancer registry in Asia, and the first of its kind in India. It was established in 1963, and registration of cases is done by active methods. Data on survival from 28 cancer sites or types registered during 1992-1999 are reported. Follow-up has been carried out predominantly by active methods, with median follow-up ranging between 1-51 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 41-100%; death certificates only (DCOs) comprised 0-15%; 84-99% of total registered cases were included for survival analysis. Complete follow-up at five years ranged from 85-92% for different cancers. The 5-year age-standardized relative survival rates for common cancers were breast (48%), cervix (44%), lung (11%), oesophagus (14%), oral cavity (35%) and non-Hodgkin lymphoma (34%). The 5-year relative survival by age group portrayed either an inverse relationship or was fluctuating. Cases with a regional spread of disease were the highest for cancers of the tongue, oral cavity, larynx and cervix; survival decreased with the increasing extent of disease for all cancers studied.

Stomach cancer is the one of the leading cause of cancer in southern region of India. Its incidence is decreasing worldwide yet on global scale stomach cancer remains one of the most common causes of cancer death. Etiology of gastric cancer includes Helicobacter pylori infection, diet and lifestyle, tobacco, alcohol and genetic susceptibility. In this review, we tried to find the contribution of Indian scientist in understanding the descriptive and observational epidemiology of stomach cancer. PubMed was used as a search platform using key words such as "stomach cancer, treatment, clinical characteristics, stomach cancer outcome, epidemiology, etiological factor and their corresponding Mesh terms were used in combination with Boolean operators OR, AND". Most of the reported studies on gastric cancer from India are case report or case series and few are case-control studies. Indian studies on this topic are limited and have observed H. pylori infection, salted tea, pickled food, rice intake, spicy food, soda (additive of food), tobacco and alcohol as risk factors for gastric cancer. More research is required to understand the etiology, develop suitable screening test, to demarcate high-risk population and to develop and evaluate the effect of primary prevention programs.

Background: Population-based cancer survival data, a key indicator for monitoring progress against cancer, are not widely available from countries in Africa, Asia, and Central America. The aim of this study is to describe and discuss cancer survival in these regions., Methods: Survival analysis was done for 341 658 patients diagnosed with various cancers from 1990 to 2001 and followed up to 2003, from 25 population-based cancer registries in 12 countries in sub-Saharan Africa (The Gambia, Uganda), Central America (Costa Rica), and Asia (China, India, Pakistan, Philippines, Saudi Arabia, Singapore, South Korea, Thailand, Turkey). 5-year age-standardised relative survival (ASRS) and observed survival by clinical extent of disease were determined., Findings: For cancers in which prognosis depends on stage at diagnosis, survival was highest in China, South Korea, Singapore, and Turkey and lowest in Uganda and The Gambia. 5-year ASRS ranged from 76-82% for breast cancer, 63-79% for cervical cancer, 71-78% for bladder cancer, and 44-60% for large-bowel cancers in China, Singapore, South Korea, and Turkey. Survival did not exceed 22% for any cancer site in The Gambia; in Uganda, survival did not exceed 13% for any cancer site except breast (46%). Variations in survival correlated with early detection initiatives and level of development of health services., Interpretation: The wide variation in cancer survival between regions emphasises the need for urgent investments in improving awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources., Funding: Association for International Cancer Research (AICR; St Andrews, UK), Association pour la Recherche sur le Cancer (ARC, Villejuif, France), and the Bill & Melinda Gates Foundation (Seattle, USA)., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Pakistan, India, Sri Lanka, Bangladesh, Nepal and Bhutan, with their total population of more than 1,500 million, make up the subcontinent of South Asia. Despite massive diversity across the region, there are sufficient similarities to warrant a collective approach to chronic disease control, including development of cancer control programs. Cancer is already a major problem and there are general similarities in the prevalence patterns. In males, oral and lung cancer are either number one or two, depending on the registry, with the exceptions of Quetta in the far north, Larkana and Chennai. Moderately high numbers of pharyngeal and/or laryngeal cancer are also consistently observed, with prostate cancer now becoming visible in the more developed cities. Breast and cervical cancer share first and second place except in Muslim Pakistan, where oral cancer generally follows breast. The ovary is often included in the five most prevalent types. Markedly increasing rates for breast cancer and distribution shifts in other cancers suggest that, despite improvement in cervical and oral rates, the overall burden will only become heavier over time, especially with increasing obesity and aging of what are still youthful populations. Coordination of activities within South Asia is a high priority for cancer control in the region.

Objective: To estimate the probability of developing lung cancer in the entire life span of the people of Greater Mumbai and variation according to age and sex. Information on cancer incidence trends in a community forms the scientific basis for planning and organising prevention, diagnosis and treatment. During the last 24 year period, a total of 11,458 lung cancer cases were registered (9,052 male and 2,406 female) by the Bombay Cancer Registry. Lung cancer accounts for 9.4% of all male cancers and 2.7% of those in females (6.2% of all cancers) in Greater Mumbai. The probability of developing cancer in the entire life span of the people of Greater Mumbai was estimated., Methods: A method based on the cumulative risk of cancer was used to estimate the probabilities using lung cancer data collected by the population-based Bombay Cancer Registry from the years 1982 to 2005. For evaluation of trends, a linear regression model based on the logarithm of the observed incidence rates was applied. The annual percentage change was also computed for the evaluation. The cumulative incidence rate percentage was calculated by adding up the age-specific incidence rates at single ages and then expressed as a percentage., Results: The results show that age-adjusted incidence rates of lung cancer during the period 1982 to 2005 showed a statistically significant decreasing trend in males and a statistically significant increasing trend among females. When these trends were examined across different age-groups (0-39, 40-64 and 65 or older), the rates showed a statistically significant decreasing trend from 0-64 years in males and a statistically significant increasing trend in females aged 65 years and older. The rates proved stable across the other age-groups. The probability estimates indicate that one out of every 74 men and one out of every 242 women will contract lung cancer at some time in their whole life in the absence of other causes of death, assuming that the current trends prevail over the time period. Most of them will acquire the disease after the age of 40 years, after which risk increases with time., Conclusions: The variation in age-adjusted incidence rate across different age-groups in both sexes clearly indicate that there has been a change in the etiology of lung cancer in Greater Mumbai over time. The most important reason for this would be decrease in smoking prevalence among males. The other reasons for this have to be explored through risk assessment studies, but these findings may be of general interest because changes in diagnostic practices are confounders in time trends of lung cancer in many developed countries, preventing inferences on changes in risk factors.

Non-Hodgkin's lymphoma is the 11th most common cancer in terms of incidence. It is most frequent in high income countries, with rates more than twice those of middle--to low-income countries. It is usually fatal, with a 5 year survival rate of less than 35 percent. It is not a single cancer, but rather a wide group of cancers (including entities such as Burkitt's lymphoma and diffuse large B-cell lymphoma), each with a district geographical distribution, development path, age profile and prognosis. Non-Hodgkin's lymphoma is increasing in incidence world wide. On this background, in this paper an attempt has been made to study the trends in Non-Hodgkin's lymphoma in various Indian populations in both sexes.

This article provides an overview of aspects of the burden of cancer in the elderly, in India highlighting certain demographic and epidemiological data. In India the normal retirement age is 60 years, so the definition of the elderly, in India is considered above the age of 60 years. Information on the aging of the Indian population is based on various census figures, cancer incidence figures are taken from Mumbai registry data. Men and women aged > or = 60 years are at high risk for major cancers. Men have a risk 15 times greater risk and in women 8 times greater risk than the persons having age < 60 years. Lung and prostate cancers are most prominent cancer in men having age > or = 60 years while in women breast is the leading site followed by cervix and ovary in the same age group. Demographic and epidemiologic data characterize the aging / cancer interface. The changing demographic structures underscore the current incidence imperative for elderly; suggesting a starting demand will be made in the future requiring physician's abilities and skills to meet these needs.

Trends in cancers of the central nervous system in both sexes in five Indian population based cancer registries (Mumbai, Chennai, Bangalore, Delhi & Bhopal) were evaluated over a period of the last two decades. For this purpose we applied a model that fits the data is the logarithm of Y=ABx which represents a Linear Regression model. This approach revealed an increasing trend in cancers of nervous system in both sexes throughout the entire period of observation in almost all registries. As CNS cancers are increasing, analytic epidemiological studies should be planned in a near future on a priority basis to understand the etiology of these cancers in depth.

Trends in breast, cervix uteri, corpus uteri and ovarian cancers in six population based cancer registries (Mumbai, Bangalore, Chennai, Delhi, Bhopal, and Barshi) were evaluated over a period of the last two decades. For studying trends we used a model that fits this data is the logarithm of Y=ABx which represents a Linear Regression model. This approach showed a decreasing trend for cancer of the cervix and increasing trends for cancers of breast, ovary and corpus uteri throughout the entire period of observation in most of the registries. The four cancers, breast, cervix, corpus uteri and ovary, constitute more than 50% of total cancers in women. As all these cancers are increasing, to understand their etiology in depth, analytic epidemiology studies should be planned in a near future on a priority basis.

Time trends in cancers of the esophagus, stomach, colon, rectum and liver cancers among the male population in five Indian urban population based cancer registries (Mumbai, Bangalore, Chennai, Delhi, and Bhopal) were examined over the period of the last two decades. The model applied fits data to the logarithm of Y=ABx. This Linear Regression method showed decreasing trends in age-adjusted incidence rates for cancers of the stomach and esophagus, especially in Bjopal, and increasing trends for colon and rectum and liver, throughout the entire period of observation in most of the registries. The five cancers together constitute more than 80% of the total gastro intestinal cancers and are serious diseases in both sexes. To understand the etiology of these cancers in depth, analytic epidemiological studies should be planned in the near future on a priority basis.

Trends in prostate cancer in five population-based cancer Registries (Mumbai, Chennai, Bangalore, Delhi & Bhopal) in India were studied over a period of two decades using a model that fitting the data as the logarithm of Y=ABx which represents a Linear Regression model. This approach showed increasing trends in the age adjusted incidence rates throughout the entire period of observation for most of the registries, especially in Chennai and Bhopal and to the least extent in Mumbai. Particularly in Asia we face a future major increase in the rates of prostate cancer. Collaborative action now is a high priority to allow the preparations necessary for effective control of prostate cancer.

Information relating to cancer incidence trends forms the scientific basis for the planning and organization of prevention, diagnosis and treatment of cancer in a community. An attempt was here made to study the trends in the age adjusted incidence rates for the sites of head and neck cancers in Mumbai, Bangalore, Chennai, Delhi, Bhopal, and Barshi registry's populations. For carrying out trend analysis the gum, the floor of mouth, the mucosa of cheek, the hard and soft palate and the uvula were grouped together and assigned as cancers of mouth. The trend analysis was carried out for all sites together, tongue, mouth, hypopharynx and larynx in males and all sites together and mouth in females. Sites such as lip, hypopharynx and nasopharynx were not considered. In males, for all sites together linear regression showed no increase or decrease in age adjusted rates overall for Bangalore and Delhi registries, a significant decrease for Mumbai and Delhi registries, but a rising trend for Chennai and Bhopal registries over a period of time. In females, for all sites together no change was observed in age adjusted incidence rates for Mumbai, Chennai, Bhopal, Bangalore and Barshi registries while a decreasing trend was noted for Delhi registries over a period of time. For the specific sites, variation among registries was also apparent. The results point to local differences in sub-site specific risk factors which might be elucidated by analytical epidemiological assessment.

In this paper an attempt has been made to study the geographic variations in cancer incidence and its pattern in Urban Maharashtra. Data collected by Mumbai, Poona, Nagpur, and Aurangabad, Population based Cancer Registries, for the year 2001 have been utilized. The incidence patterns by sex, age, and religion has been compared between these four agglomerations. Besides this childhood cancers and tobacco related cancers for each registry are also described. Age specific cancer incidence rates show increasing trend with increasing age in all the four populations. The curves for Mumbai, Poona, Nagpur are closed together with fluctuations, indicating similarities in the rise. In all the four registries, amongst males, cancers of the lung, larynx, oesophagus, tongue and prostate while in females breast, cervix, ovary, oesophagus, mouth and leukemias occupy places in ten leading sites. The proportion of childhood cancers varies from 1.9% in females in Poona to 4.5% in males in the Nagpur populations. The proportion of tobacco related cancers varies in males from 38.9% in Poona to 54.4% in Aurangabad, where as in females from 14.1% in Nagpur to 21.7% in Aurangabad. Considerable variations was observed in the incidence of cancer of various sites in both the sexes, professing different religious faiths within this populations. The findings of this paper can be used to estimate the incidence and prevalence of cancer for future for whole Maharashtra state and studies in cancer etiology and control can be planned.

Data on incidence, prevalence, and disease specific mortality are frequently incomplete, not very reliable or are lacking in many countries particularly in Asia and Africa. In the absence of dependable data from the Civil Registration System (CRS), many countries have developed their own Sample Registration System (SRS). Due to several socio-economic constraints cause is not adequately noted in the death certificates. Sample registration system practice in India helps in this but for correlating with cancer registry data this is not the optimal. When cancer morbidity figures from SRS system and cancer registry are compared the SRS figures are low. Reasons for fewer cancer deaths in Municipal Corporation reports may be due to that they only look at primary cause of death and overlook the secondary or underlying causes. There are also a number of reasons for under-registration of cancer deaths in cancer registries but they nevertheless give a more accurate picture. Many registries collect follow-up information for survival studies, which is also helpful to improve cancer mortality data. Tumour registries also represent important resources for rapid identification of cancer survivors for research studies.

There are major differences in cancer burden across socioeconomic classes, as is evident from the data for cancer incidence and mortality from Greater Mumbai, India. Changes over time are also evident and recently there has been a clear shift to increasing breast cancer particularly in well-educated women, who conversely are at much lower risk of cervical cancer. With infection-related and tobacco-related cancers, programs of prevention and early detection will yield desirable results only if it is associated with a program directed towards elimination of poverty, illiteracy and restoring social inequality. Similarly education must play a role in combatting diet-related neoplasia but here the target population may differ, requiring a specific awareness of psychological profiles.

Survival experience of patients with cancer of the larynx (ICD-32) or lung (ICD-34) registered by the Mumbai (Bombay) population based cancer registry, India, during the years 1992-94 was determined. The vital statistics of the patients were established by matching with death certificates from the Mumbai Municipal death register and by active methods such as telephone enquiry, reply-paid postal enquiry, house visits and scrutiny of case records. Of the 1905 (675 larynx and 1230 lung) eligible cases for analysis, 1480 were dead (450 larynx and 1030 lung) and 425 were alive (225 larynx and 200 lung). The overall 5-year observed and relative survival rates for laryngeal cancers were 29.1% and 36.4%, and for lung cancers were 12.5% and 15.9% respectively. On multivariate analysis, age, treatment and clinical extent of disease emerged as independent predictors of survival with both cancers. People aged 55 years and above had a relative risk of four or more for laryngeal cancer and 2.3 times and more for lung cancer death as compared to those aged less than 35 years. Early detection and prompt treatment should improve overall survival from lung as well as laryngeal cancer.

India lacks nationwide cancer registration and systematic death registration. Gaining insight into the magnitude of the cancer problem in India depends mainly on 14 population based cancer registries, which provide relatively accurate statistics although the area and population cover by these registries is minimal at about 7% (20% Urban and 1 % Rural). With estimation of cancer burden from other sources, paucity of adequate data on the one hand and the complex pathogenesis of disease on other makes for complexity in dealing with rural populations. However, surveys of cause of death do reveal some interesting patterns that may very well be of use for international comparisons. In this paper an attempt has been made to estimate the cancer burden in rural India using the information available from surveys of cause of death for rural populations conducted by the Government of India.

Background: Information relating to cancer incidence trends in a community forms the scientific basis for the planning and organization of prevention, diagnosis and treatment of cancer. We here estimated the cumulative risk and trends in incidence of prostate cancer in Mumbai, India, using data collected by the Bombay Population-based Cancer Registry from the year 1986 to 2000., Methods: During the 15 year period, a total of 2864 prostate cancer cases (4.7% of all male cancers and 2.4% of all cancers) were registered by the Bombay Population-based Cancer Registry. For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the evaluation. Cumulative incidence rates percentages were calculated by adding up the age specific incidence rates at single ages and then expressed as a percentage., Results: Analysis of the trends in age-adjusted incidence rates of prostate cancer during the period 1986 to 2000 showed no statistically significant increase or decrease and the rates proved stable across the various age groups (00-49, 50-69 and 70+) also. The probability estimates indicated that one out of every 59 men will contract a prostate cancer at some time in his whole life and 99% of the chance is after he reaches the age of 50., Conclusion: The stability in age adjusted-incidence rates indicates that there are no changes in the etiological factors for prostate cancer in Mumbai, India. These findings may be of general interest because changes in diagnostic practices are confounded in the time trends of prostate cancer change in many western countries preventing inferences on the changes in risk.

Background: Breast, cervix and ovarian cancers contribute more than 45% of the total in women in Mumbai and survival proportions for these neoplasms are very high in most developed populations in the World. The authors here report and discuss the population-based survival for these cancers in Mumbai, India., Methods: Follow-up information on 4865 cancers of breast, cervix and ovary, registered in the Mumbai Population Based Cancer Registry for the period 1992-1994 was obtained by a variety of methods, including matching with death certificates from the Mumbai vital statistics registration system, postal/telephone enquiries, home visits and scrutiny of medical records. The survival for each case was determined as the duration between the date of diagnosis and date of death, date of loss to follow-up or the closing date of the study (December 31(st), 1999). Cumulative observed and relative survival was calculated by the Hakulinen Method. For comparison of results with other populations, age-standardized relative survival (ASRS) was calculated by directly standardizing age specific relative survival to the specific age distributions of the estimated global incidence of major cancers in 1985. The log rank test was used in univariate analysis to identify the potentially important prognostic variables. The variables showing statistical significance in univariate analysis were introduced stepwise into a Cox Regression model to identify the independent predictors of survival., Results: The 5-year relative survival rates were 46.2% for breast, 47.7% for the cervix and 25.4% for the ovary. Higher survival was observed for those younger than 35 years for all these three sites. For each, survival declined with advancing age. Single patients who remained unmarried had better survival. For all sites Muslims had a better and Christians a lower survival as compared to Hindus. Education did not appear to be of significance. Survival decreased rapidly with advancing clinical extent of disease for all sites. With localized cancer, 5-year rates ranged from 54.7% to 69.3%, for regional spread 20.4% to 41.6% and distant metastasis not a single site recorded more than 5%. On multivariate analysis, age and extent of disease emerged as independent predictors of survival for all the sites., Conclusion: All the sites included in the study demonstrated moderate survival rates with significant variation. Comparison with other populations revealed lower survival rates as compared to developed countries, particularly for breast and ovary. In Indian populations survival proportions did not show much variation for these cancers. Early detection and treatment are clearly important factors to reduce the mortality from these cancers.

Objective: We estimated the time trends in the incidence and the risk of developing an oral cancer in Mumbai, Indian population using the data collected by the Bombay Population Based Cancer Registry during the 15 year period from 1986 to 2000., Methods: A total of 9,670 oral cancers (8.2% of all neoplasms) were registered, of which 6577 were in males and 3093 in females (10.7% and 5.4% of the respective totals for the two genders). For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the incidence rates to evaluate the time trend., Results: In males, a statistically significant decreasing trend in the overall age-adjusted incidence rates were observed during the period 1986 to 2000, with an yearly decrease of 1.70%. This decrease was significant for men above the age of 40, but for young adult men below the age of 40, there was no significant decrease, the level being stable. In females, the overall decreasing trend in the age-adjusted incidence rates of oral cancers was not significant, but in the age group 40-59, a significant decline was observed. The probability estimates indicated that one out of every 57 men and one out of every 95 women will contract any oral cancer at some time in their whole life and 97% of the chance is after he or she completes the age of 40., Conclusion: The observed decreasing trend in oral cancers in Indian men may be attributed to a decrease in the usage of pan and tobacco. The high prevalence of the usage of smokeless tobacco among young adult men and women may explain the stable trend in oral cancer incidence in this group. These findings help to strengthen the association between tobacco use and oral cancer risk.

The time trend in incidence of stomach cancer in males and females in Mumbai, India during 1988 to 1999 was estimated using data collected by the Bombay Population-based Cancer Registry. During the 12-year period, a total of 3657 stomach cancer cases (3.9% of all cancers) were registered by the Bombay Population-based Cancer Registry of which 2467 (5.1% of all male cancers) were in males and 1184 (2.6% of all female cancers) in females. For evaluation of the trend, we applied a linear regression model based on the logarithm of the observed incidence rates. The annual percentage changes were also computed for the incidence rates for evaluating the time trend. A statistically significant decreasing trend in the overall age-adjusted incidence rates of stomach cancer was observed during the period 1988 to 1999, with an yearly decrease of 4.44% in males and 2.56% in females. This decrease was most striking in males in the age groups 40-59 and 60+, and in females only in the age group 40-59. The probability estimates indicated that one out of every 92 men and one out of every 187 women will contract a stomach cancer at some time in their whole life and 95% of the chance is after his or her 40th birthday. The decreasing trend in the age-adjusted incidence rates of stomach cancer in both the sexes indicates that there is a critical change in the etiology of this cancer. The findings may provide clues relating to various life-style and environmental changes impacting on stomach cancer incidence.

Background: Oesophagus, stomach, pancreas and lung cancers contribute more than 35% of the total cancer incidence in Mumbai and survival rates for these cancers are very poor in most populations in the world. The authors here report and discuss the population-based survival from these cancers in Mumbai, India., Methods: Follow-up information on 5717 cancers patients having a low prognosis, registered in the Mumbai Population-Based Cancer Registry for the period 1987-1991, was obtained by a variety of methods, including matching with death certificates from the Mumbai vital statistics registration system, postal/telephone enquiries, home visits and scrutiny of medical records. The survival for each case was determined as the duration between the date of diagnosis and date of death, loss to follow-up or the closing date of the study at the end of 1996. Cumulative observed and relative survival rates were calculated by the Hakulinen Method. For comparison of results with other populations, age-standardized relative survival (ASRS) was calculated by directly standardizing age specific relative survival to the specific age distributions of the estimated global incidence of major cancers in 1985. The log rank test was used with univariate analysis to identify the potentially important prognostic variables. The variables showing statistical significance in univariate analysis were introduced stepwise into a Cox Regression model to identify the independent predictors of survival., Results: The 5-year relative survival rates were 11.8% for oesophagus, 10.1% for the stomach, 4.1% for the pancreas, and 7.0% for lung. Females had higher survival rates than males, except with lung cancer. Lower survival was observed for those younger than 35 years for all 4 sites. For each site, survival declined with advancing age. Single patients who remained unmarried had better survival, except with pancreatic cancer. For all sites Muslims had a better survival and Christians had a lower survival as compared to Hindus. Education did not show any pattern for any site. Survival decreased rapidly with advancing clinical extent of disease for all sites. Survival for localized cancer ranged from 12.5% to 31.3%, for regional spread 1.3% to 3.4% and with distant metastasis not a single site recorded more than 1%. On multivariate analysis, extent of disease emerged as an independent predictor of survival with all the sites. Also, age for oesophagus, stomach and lung, religion for oesophagus and stomach, and education for stomach and lung, emerged as independent predictors of survival., Conclusion: All the sites included in the study demonstrated very low survival rates with significant variation. Comparison with other populations revealed lower survival rates than for Shanghai-China. In remaining populations, survival proportions did not show much variation for pancreas and lung cancers. For stomach cancer, European countries showed better survival rates. Early detection with treatment is clearly important to reduce the mortality from these cancers.

Objective: Cancer survival information is available for only few populations in developing countries. Data on survival of oral cancer patients registered by the Bombay population-based cancer registry, India, during 1992-1994 is presented in this paper., Methods: Vital status of the patients was established by matching against death certificates, reply paid postal enquiries, telephone enquiries, scrutiny of hospital records and house visits. Of the 1808 eligible cases for analysis, 1204 (66.6%) were dead; and 604 (33.4%) were alive at last follow-up, of whom 136 were lost to follow-up during the first 5-years after diagnosis. Observed and relative survival rates are presented and hazard ratios and corresponding 95% confidence intervals were estimated using Cox proportional hazard model., Results: The overall 5-year observed and relative survival rates were 30.5% and 39.7%, respectively. Survival steadily declined with advancing age and advanced clinical stages. Five-year observed survival was 59.1% for localised cancer, 15.7% for cancers with regional extension and 1.6% for those with distant metastasis. Those with tongue, buccal mucosa and retromolar trigone cancers had poor survival rates., Conclusions: Our study shows that detecting oral cancer in early stages, when these are amenable to single modality therapies, offers the best chance of long-term survival. However, primary prevention by tobacco/alcohol control measures is important in the long-term perspective.

The survival experience of patients with cancer of the larynx (ICD 10) registered by the Bombay population-based cancer registry India, during the years 1992-1994, is described. The vital status of these subjects were established by matching with death certificates from the Bombay Municipal death register and by active methods such as reply-paid postal enquiries, telephone enquiries, scrutiny of case records and house visits. Of the 675 eligible cases for analysis, 458 (67.9%) were dead and 217 (32.1%) were alive at last follow-up. The 5-year observed and relative survival rates were 29.1 and 38.2%, respectively; these were 52.1 and 58.5% for glottic laryngeal cancer and 24.2 and 31.4% for supraglottic laryngeal cancer, respectively. The 5-year observed survival was 53.1% for those with localised cancer and 17.8% for those with regional extension. Advancing age, regional and metastatic disease and supraglottic cancers were associated with significantly reduced survival. Early detection and prompt treatment should improve overall survival from laryngeal cancer.

A great deal is known on the epidemiology of breast cancer. In this paper an attempt has been made to discuss the epidemiology and trends in incidence of breast cancer in various populations of India with special reference to the data available at Mumbai Cancer Registry. For discussing descriptive epidemiology of breast cancer the data collected for most recent year, 1999, by Mumbai Cancer Registry has been utilized. For studying time trends in breast cancer the data collected for the Mumbai Cancer Registry for the years 1982-99 and for Bangalore and Chennai 1982-96 and for Barshi, Bhopal and Delhi for the years 1988-96 has been employed. A linear regression model based on the logarithms of the various incidence rates, a method frequently used for studying time trends, was applied to the entire dataset. Age specific incidence rates for breast cancer for most of the urban population in India were found to show steep increase till menopause years, after which the curves plateau. Most of the registries data indicate that Christians in India have the greatest risk of breast risk and Muslims have the lowest rate. In all the populations breast cancer was found to be less prevalent at the lower education level and the incidence increased with the education level. The trends for increase in breast cancer incidence over time for most of the populations in India were found to be statistically significant.

The challenge of population based cancer registration in developing countries is enormous. In India, the first Population Based Cancer Registry named "Bombay Cancer Registry" was established by the Indian Cancer Society in Mumbai (formerly Bombay) in 1963, covering the population of the Mumbai Agglomeration. Up to now this registry has collected epidemiological information on more than 200,000 cancer incidence cases and 100,000 cancer deaths. At present this registry covers an area of 603.00 sq.kms having a population of 12 million. Here, an attempt has been made to analyse and interpret cancer incidence and mortality data for women, registered in Mumbai during 1993-97.

Reliable data on incidence and mortalityfor childhood cancers are available from only a few areas in the developing countries. Neoplasia in children is rare as compared with adult cancer. In Europe, North America and Australia, retinoblastomas account for 2-4 percent of the total and the relative frequency is similar in Asia. In contrast, in African countries retinoblastomas account for 10 to 15% of cancers in children. The data collected at Bombay Cancer Registry for the latest 13 years, 1986-1998, were used for the present study. Analyses were carried out on retinoblastomas by sex, age, religion and laterality, based on differences in rates and proportions. In Mumbai, during the 13-year period in question, there were only 211 cases of malignant tumors of the eyes. Of these, 147 were retinoblastomas, 84 in males and 63 in females, with crude incidence rates per million population of 4.0 and 3.1, respectively. The corresponding age adjusted incidence rates per million population were 4.2 and 3.3. The crude values were found to be higher in Muslims as compared to Hindus and other religious groups, in both sexes. Out of the total retinoblastomas, 105 were localized, 24 demonstrated regional spread and 16 had metastasized or were very advanced. Some 23 patients had bilateral disease. In a total of 60 patients, retinoblastomas developed on the right side and in 58 in the left eye. The highest annual age standardized incidence rates for retinoblastomas, in excess of 7 per million population have been observed in the Fortaleza area of Brazil, Nigeria (Ibadan) and Uganda-Kampala. Retinoblastomas have the lowest median age of all childhood malignancies, approximately 15 months. The male to female ratio generally fluctuates around unity but our data indicated a higher proportion in males. Ethnic differences in the frequencies of unilateral and bilateral retinoblastomas are apparent. There is little evidence that any significant change in the incidence of retinoblastoma over time has occurred in any part of the world. Knudson proposed a 2-mutation hypothesis to explain the occurrence of retinoblastoma in both hereditary and sporadic forms with differing frequencies of bilaterality, and this model has become a paradigm for considering the role of genetic factors in the etiology of cancer in general.

Survival estimates of patients registered by population-based cancer registries reflect the average prognosis from a given cancer as they are based on unselected patients with a wide range of natural histories and treatment patterns. In this paper, we report the survival experience of colorectal cancer patients in Mumbai (Bombay), India. Follow-up information on 1642 colorectal cancer patients registered by the Bombay Population-based Cancer Registry for the period 1987-1991 was obtained by matching with death certificates from the Bombay vital statistics registration system, postal/telephone enquiries, home visits and scrutiny of medical records. Cumulative observed and relative survival proportions were calculated by Hakulinen's method. For comparison of results with other populations, age-standardised relative survival (ASRS) was calculated by directly standardising age-specific relative survival to the specific age distributions of the world standard cancer patient population in 1985. The log-rank test was used to identify the potential prognostic variables which were introduced step-wise into a Cox regression model to identify the independent predictors of survival. The 5-year relative survival was 36.6% for colon and 42.2% for rectal cancer. Age, site of cancer and clinical stage of disease emerged as independent predictors of survival. Age-specific 5-year relative survival declined with advancing age. Survival at 5 years was 61.2% for localised colon cancer; 31.9% for regional and 9.0% for distant metastatic disease. These were 65.7, 25.6 and 4.3%, respectively for rectal cancers. Comparison of the results with other populations revealed significant variations, which seem to be related to differences in detection and treatment. The prognosis from colorectal cancer in Mumbai and developing countries, may be further improved through early detection linked with treatment.

Survival from cancer reflects the aggressiveness of the disease, the effectiveness of treatment and host factors such as age. Population based survival reflects the effectiveness of the overall cancer control strategy in the region. Here we report the survival experience of 740 prostate cancer patients registered by the Mumbai (Bombay) Cancer Registry during 1987-1991. There have been very few reports on survival from cancer in India, mainly because of poor patient follow up and inadequate system of registration of death. This has been largely overcome in this study by means of matching with death certificate of Municipal Corporation, telephone and postal enquiries and active follow up through visits of homes of patients. Scrutiny of medical record was also carried out whenever it was possible. Thus information on survival status as on January 1, 1997 was available for 602 patients (82%). The observed survival was 35.1% and the corresponding relative survival was 41.6%. The clinical extent of disease, treatment given and age of the patient were independent predictors of survival. The observed survival was 49.2% for localised disease, 23.5% for direct extention and regional node involvement and 12.7% for distant metastatis patients.

The Mumbai Cancer Registry has been in operation since 1964 and reliable morbidity and mortality data on cancer have been obtained for the first time in India, from a precisely outlined population. An attempt has been made to examine the differences noticed in the site-specific cancer risk, between two groups of people living in this area-the Parsi and non Parsi population of Mumbai. For this study, data has been utilized, collected by Mumbai Cancer Registry for the latest five years. For comparison between Parsi and non Parsi populations, crude and age-adjusted rates have been used. The overall age-adjusted rates for the Parsi's were found to be lower than those for the non Parsi populations and more noticeably their site-specific risks seem to differ radically from the non Parsi pattern. Cancers of the buccal cavity, pharynx, larynx, oesophagus and cervix uteri which are frequently seen in the non Parsi population, are less commonly observed in the Parsi community. On the other hand the Parsi rates are higher at site such as the female breast, endometrium, lymphomas and leukaemias. The observed site-specific contrast are believed to be due to differences present in the habits, customs and economic status of the two groups.

The Mumbai Cancer Registry was established in 1964 with the aim of obtaining reliable morbidity and mortality data from precisely defined urban population. It was first and only such registry for merely two decades functioning in the country. Up to now more than 200,000 cancer cases are registered and with over 100,000 cancer deaths are recorded in data files. For studying improvements in the Mumbai Cancer Registry data, the data published in consecutive seven volumes (Vol.-II to Vol.-VIII) of "Cancer Incidence of Five Continents published by International Agency on Research on Cancer", Lyon, France have been used. For studying completeness of the data, the indicators 'Proportion of Deaths in Period'; 'Proportion of Death Certificates only' and stability of age incidence rates have been utilized. The indicators 'Proportion of cases registered on histological verification', 'The proportion of cases where age is not known', 'The flattening of age incidence curve' and 'Proportion of other and unspecified neoplasms can throw some light on the quality of data collected by the registry. There has been notable improvement in percentages of histological verification cases and substantial decrease in the proportion of death certificate alone cases in both the sexes over a period of time. Mortality Incidence ratio remained stable over a period of time in both the sexes. The proportion of cases where age is not known never exceeded 0.020% in either sex, for any site, for any period. The proportion of cases registered as other and unspecified sites, initially was around 8 to 9% then it has been dropped down to 5%. The crude incidence rates for all sites together are stable throughout the period of observation in both the sexes while age adjusted incidence rates show declining trend in both the sexes. There is no change in the pattern of age-specific incidence curves over a period of time in both the sexes. On examining various indices of reliability and completeness of Mumbai cancer registry data it can be concluded that, the data collected by this registry is quiet complete and reliable. While applying various checks for validity for a period from 1964-66 to 1993-97, it indicates that there is quiet improvement in almost all indices over a period of time in Mumbai cancer registry data.

Background: Head and neck cancers, among the 10 most frequent cancers in the world, are common in regions with a high prevalence of tobacco and alcohol habits. They account for one-fourth of male and one-tenth of female cancers in India. The authors report and discuss the survival from these cancers in Mumbai (Bombay), India., Methods: Follow-up information on 6311 head and neck cancer patients registered in the Bombay Population-Based Cancer Registry for the period 1987-1991 was obtained by a variety of methods, including matching with death certificates from the Bombay vital statistics registration system, postal/telephone enquiries, home visits, and scrutiny of medical records. The survival for each case was determined as the duration between the date of incidence and the date of death or date of loss to follow-up or the closing date of the study (December 31, 1996). Cumulative observed and relative survival were calculated by the Hakulinen method. For comparison of results with other populations, age-standardized relative survival (ASRS) was calculated by directly standardizing age specific relative survival to the specific age distributions of the estimated global incidence of major cancers in 1985. The log rank test was used in univariate analysis to identify the potentially important prognostic variables. The variables showing statistical significance in univariate analysis were introduced stepwise into a Cox regression model to identify the independent predictors of survival., Results: The 5-year relative survival rates were 74.5% for the lip, 42.7% for the anterior tongue, 25.5% for the posterior tongue, 45.1% for the mouth, 29.7% for the oropharynx, 38.7% for the nasopharynx, 29.1% for the hypopharynx, and 41.2% for the larynx. Age, marital status, religion, and site and clinical extent of disease emerged as independent predictors of survival. Age specific 5-year relative survival declined with advancing age. Single patients had a 20% excess risk of death compared with married patients. Those with cancers of the lip, mouth, nasopharynx, and larynx had a better prognosis than those with cancer at other sites. Those with regional spread of disease experienced a threefold increased risk of death, and those with distant metastasis experienced a sixfold excess risk. Less than one-fourth of cancers were localized in the organ of origin at diagnosis; 5-year survival for localized cancers ranged from 52.9% to 80.2% depending on the subsite., Conclusions: There were significant variations in survival from cancer at individual sites within the head and neck region. Comparison with other populations revealed variations that seemed to be related to differences in detection and treatment. Tobacco and alcohol control measures and early detection linked with treatment are important measures to reduce mortality from head and neck cancer., (Copyright 2000 American Cancer Society.)

In order to estimate the resources needed for the diagnosis, treatment, follow-up and rehabilitation services needed for cancer patients, it is important to know the magnitude of common cancers at present and in future. Keeping this view in mind an attempt has been made to predict cancer incidence cases for most common cancers for Greater Bombay upto the year 2002. The trend analysis is carried out for major 30 cancer sites for both the sexes using age incidence data of Greater Bombay for the period 1968 to 1987. The age-period-cohort model which was fitted to the data for studying trends for each site and sex has also been utilized for prediction also. Prediction was based on the assumption that the characteristic features of the model estimated from the observed rates would continue to hold during the prediction periods. Present trend analysis showed that cancers of the tongue, mouth, oropharynx, oesophagus, stomach and larynx in both sexes and cervix for females have registered a decline in incidence over a period of observation. While, during the same period, cancers of the liver, pancreas, bladder, brain and thyroid in both the sexes, breast, endometrium and ovary in females, and testis in males showed increasing trends in incidence, while cancers of the hypopharynx, lung, bone, connective tissue and lymphomas in both the sexes did not show any significant change in the incidence. In males in 1968-1972 cancer of the oesophagus was the leading cancer, followed by lung, larynx, tongue and stomach, while in 1988-2002 cancer of the lung will be the most predominant cancer, followed by hypopharynx, oesophagus, prostate and tongue. It is believed that the results of the present study will provide a sound basis for planning the cancer control, prevention, diagnostics, treatment and rehabilitation in Mumbai for the years to come.

Bone tumours are comparatively uncommon, constituting only 0.5% of the total world cancer incidence. As Bone tumors consist of several distinct clinico-pathological entities, descriptive epidemiology of tumors at this site can be based only on studies where they can be distinguished. Ewing's sarcoma Chondrosarcoma and Osteosarcoma are the principal tumors involving bones. The basic data utilized for this study was collected from the Bombay Cancer Registry which was established in 1963, and is the first population based registry to be established in India. For studying the descriptive epidemiological variables the most recent 5 year incidence rates have been used. As a group, bone cancers represent 0.9% of the total number of incident cancer are seen in Greater Bombay. Males in general are seen to have a higher incidence of bone cancers than females. Ewing's sarcoma was found to be the commonest bone cancer in Bombay. The age specific incidence curves present striking differences according to cell types of bone cancer. Time trends in the incidence of these cancers, over the past 30 years have been presented. Our data indicate that there is a decreasing trend in incidence of bone cancers in females, whilst the rates are stable in males. Ionising radiation is the only environmental agent to cause this cancer. The discovery of other risk factors is the key prevention and will depend upon the experimental work undertaken to develop sub-clinical measures of risk that can be applied in interdisciplinary studies to identify more completely the causes of bone cancers.

In this paper an attempt has been made to present a descriptive epidemiology of thyroid cancer in Bombay, and it is discussed in relation to age, demographic and socio economic composition of the population, using the most recent five year date. Time trend analysis of this cancer by sex has also been discussed using the last 30 years data. When international incidence of thyroid cancer was ranked in descending order for various countries, the incidence recorded for Bombay was found to be at the lowest level in both the sexes. Thyroid cancer is about three times more frequent among women than men, but this relative excess varies with the histologic type and age. As in the case of the majority of cancers, the incidence curve for thyroid cancer rises with age. However in men, the increase continues consistently with advancing age, while in women it begins to level off after the age 30, leading to an almost equal sex ratio in old age. In Bombay the incidence of thyroid cancer in men was found to be the highest in Muslims and in Christian women. No association was observed between thyroid cancer and education level attained by these patients. The four main histologic types of thyroid cancers i.e. papillary, follicular, anaplastic and medullary are also observed in Bombay. It has been noted that there is an increasing trend in the age-adjusted incidence rate for thyroid cancer in both the sexes in Bombay in the period under review 1964 to 1993. But the increase in incidence was found to be statistically significant only in males.

Background: There is little data available on the occurrence of leukaemias in India. This is despite a large number of patients being diagnosed and treated at various cancer centres all over the country. We, therefore, analysed the available data of the Bombay Cancer Registry to ascertain the epidemiological characteristics of leukaemias in India., Methods: The incidence and mortality rates of leukaemias by cell type and sex were obtained for the most recent 5 years (1989-93). The data of the past 30 years were used to study the time trends using a linear regression model based on the logarithms of the incidence rates., Results: Leukaemias constituted 3.9% of all registered cancer cases and 5.4% of all registered deaths in Greater Mumbai. Males were affected more frequently than females. Myeloid leukaemias were the commonest. A bimodal age incidence was observed with the first peak in childhood, a trough between 15 to 19 years of age and a slow rise thereafter. Among the various religious groups Hindus had the highest rate. An increasing trend in the incidence of all types of leukaemias was also observed., Conclusion: The incidence of leukaemias in Greater Mumbai is comparable to world rates. There is a male preponderance in all cell types and an increase in incidence was observed over the last 30 years. The higher incidence of myeloid leukaemias observed by us might be related to under-reporting of chronic lymphatic leukaemia.

Lymphoid malignancies as a group constitute one of the important cancers met in India as elsewhere in the world, but while information on incidence, mortality, survival and trends, are available from most of the developed countries, there are very few reports available from the rest of the world. The basic data utilized for this study was obtained from the Bombay Cancer Registry, the first population based registry to be established in India. Descriptive epidemiology of these malignancies was obtained by utilizing 5-year data of incidence and mortality of different cell types in males and females. For studying time trends in the incidence of these cancers, data of the past 30 years has been used. As a group, the lymphatic malignancies represent only 5% of the incidence and 3.9% of the mortality of the total number of cancers in Greater Bombay. Males in general, seem to be more affected by lymphomas than females. Non-Hodgkin's lymphomas are the commonest lymphatic malignancies to be detected in Bombay. The incidence curves show striking difference in lymphatic malignancies by cell type. In Bombay the incidence of these cancers was found to be the highest in the Parsis. Our data indicates that there is an increasing trend in incidence in all cell types of lymphomas, in both sexes. To obtain the details of the risk factors of these malignancies, more analytic epidemiological studies have to be undertaken of the Indian data and more importance given to lymphomas in the early detection and control of cancer.

For studying the descriptive epidemiology of cancers of the urinary bladder and kidney, the data reported by Bombay Cancer Registry for the most recent five years have been utilised. For studying time trends in these cancers, data of the past 30 yr have been used. In Bombay, bladder cancer is very uncommon in the first three decades of life; but after the age of 30, the incidence rates increase with age, in log-linear fashion, in both sexes. The incidence of kidney cancer is almost absent between the ages 5 to 35; but later up to the age of 70, it show a steady increase. The incidence of urinary bladder and kidney cancers are found to be associated with the marital status in both sexes. No association was observed between the incidence and educational level attained by the patients having urinary bladder and kidney cancers. An increasing trend was found in the age adjusted incidence rates of cancers of the urinary bladder and kidney in both sexes during the period 1964-1993.