Murthy N S, Chaudhry Kishore, Rath G K
National Cancer Registry Programme (ICMR), 557, Srinivasa Nilaya, New BEL Road, Dollars Colony, Bangalore, India.
Asian Pac J Cancer Prev. 2008 Oct-Dec;9(4):671-7.
Plausible projections of future burden of cancer in terms of incident cases and requirement of radiotherapy treatment facilities at the national and state level are useful aids in planning of cancer control activities. The present communication attempts to provide a scenario for cancer in India during the year 2001 and its likely change by 2016 for all sites of cancer as well for selected leading sites. Further, a study was made of: (i) the state-wise distribution of radiotherapy treatment facilities and short falls; and (ii) pattern of investment of finances through central assistance by Government of India for cancer control activities during the various plan periods. The age, sex and site-wise cancer incidence data along with populations covered by 12 Indian population based cancer registries were obtained from the eighth volume of Cancer Incidence in Five Continents (CIV-VIII) and other published reports. Pooled age sex, site specific cancer incidence rates for twelve registries were estimated by taking weighted average of these registries with respective registry population as weight. Population of the country and states according to age and sex for different calendar years viz. 2001, 2006, 2011 and 2016 were obtained from the report of Registrar General of India. Population forecasts were combined with the pooled incidence rates of cancer to estimate the number of cancer cases by age, sex and site of cancer for the above 5-yearly periods. The existing radiotherapy facilities available in the country for cancer treatment during the year 2006 was based on the published reports and updated through personal communication from the Ministry of Health of India. During the year 2001, nearly 0.80 million new cancer cases were estimated in the country and this can be expected to increase to 1.22 million by 2016 as a result of change in size and composition of population. The estimated numbers were greater for females (0.406 millions, 2001) than males (0.392 millions, 2001). Lung, esophagus, stomach, oral and pharyngeal cancers are much higher in men while in women, cancers of cervix and breast are predominant forms followed by those of oral cavity, stomach and esophagus. Considering all the sources, it was noted that during the year 2006, there were 347 teletherapy units in the country as against a requirement of 1059. The state-wise analysis of the distribution of RCCs, and radio-therapy units shows wide gaps in the availability of facilities. The existing treatment facilities for cancer control in-terms of radiotherapy and financial allocation are woefully inadequate to take care of even the present load. The only way to fight this scourge under such circumstances is to have pragmatic programmes and policies based on currently available scientific information and sound public health principles.
从国家和邦层面，依据癌症发病病例以及放射治疗设施需求对未来癌症负担进行合理预测，有助于规划癌症控制活动。本交流旨在呈现2001年印度癌症的情况以及到2016年所有癌症部位及部分主要部位可能发生的变化。此外，还进行了两项研究：（i）放射治疗设施的邦级分布及短缺情况；（ii）印度政府在不同计划时期通过中央援助为癌症控制活动提供资金的投入模式。年龄、性别及部位特异性癌症发病率数据以及12个基于印度人群的癌症登记处覆盖的人口数据，取自《五大洲癌症发病率》第八卷（CIV - VIII）及其他已发表报告。通过以各登记处人口为权重对这12个登记处进行加权平均，估算出合并的年龄、性别、部位特异性癌症发病率。不同历年（即2001年、2006年、2011年和2016年）按年龄和性别的全国及各邦人口数据取自印度注册总署的报告。将人口预测与合并的癌症发病率相结合，以估算上述5年期间按年龄、性别和癌症部位划分的癌症病例数。2006年该国现有用于癌症治疗的放射治疗设施情况基于已发表报告，并通过与印度卫生部的个人交流进行了更新。2001年，该国估计有近80万例新发癌症病例，由于人口规模和构成的变化，预计到2016年这一数字将增至122万。估计女性病例数（2001年为40.6万）多于男性（2001年为39.2万）。男性中肺癌、食管癌、胃癌、口腔癌和咽癌的发病率要高得多，而女性中宫颈癌和乳腺癌是主要类型，其次是口腔癌、胃癌和食管癌。综合所有来源的数据可知，2006年该国共有347个远距离治疗设备，而需求为1059个。对放射治疗中心（RCCs）和放射治疗设备分布的邦级分析显示，设施可及性存在巨大差距。就放射治疗和资金分配而言，现有的癌症控制治疗设施严重不足，甚至无法应对当前的负担。在这种情况下抗击这一祸害的唯一办法，是基于当前可得的科学信息和合理的公共卫生原则制定务实计划和政策。
