Smith Robert D, Mallath Mohandas K
King's College London, London, United Kingdom.
Tata Medical Center, Kolkata, India.
J Glob Oncol. 2019 Jul;5:1-15. doi: 10.1200/JGO.19.00048.
This review traces the growing burden of cancer in India from antiquity. We searched PubMed, Internet Archive, the British Library, and several other sources for information on cancer in Indian history. Paleopathology studies from Indus Valley Civilization sites do not reveal any malignancy. Cancer-like diseases and remedies are mentioned in the ancient Ayurveda and Siddha manuscripts from India. Cancer was rarely mentioned in the medieval literature from India. Cancer case reports from India began in the 17th century. Between 1860 and 1910, several audits and cancer case series were published by Indian Medical Service doctors across India. The landmark study by Nath and Grewal used autopsy, pathology, and clinical data between 1917 and 1932 from various medical college hospitals across India to confirm that cancer was a common cause of death in middle-aged and elderly Indians. India's cancer burden was apparently low as a result of the short life expectancy of the natives in those times. In 1946, a national committee on health reforms recommended the creation of sufficient facilities to diagnose and manage the increasing cancer burden in all Indian states. Trends from the Mumbai population-based cancer registry revealed a four-fold increase in patients with cancer from 1964 to 2012. Depending on the epidemiologic transition level, wide interstate variation in cancer burden is found in India. We conclude that cancer has been recognized in India since antiquity. India's current burden of a million incident cancers is the result of an epidemiologic transition, improved cancer diagnostics, and improved cancer data capture. The increase in cancer in India with wide interstate variations offers useful insights and important lessons for developing countries in managing their increasing cancer burdens.
本综述追溯了印度自古以来不断增长的癌症负担。我们在PubMed、互联网档案馆、大英图书馆以及其他几个来源中搜索了有关印度历史上癌症的信息。来自印度河流域文明遗址的古病理学研究未发现任何恶性肿瘤。印度古代的阿育吠陀和悉达手稿中提到了类似癌症的疾病及治疗方法。印度中世纪文献中很少提及癌症。印度的癌症病例报告始于17世纪。1860年至1910年间，印度医疗服务机构的医生在印度各地发表了多项审计报告和癌症病例系列。纳特和格雷瓦尔的里程碑式研究利用了1917年至1932年间印度各地医学院附属医院的尸检、病理和临床数据，以证实癌症是印度中老年人死亡的常见原因。由于当时印度当地人的预期寿命较短，印度的癌症负担显然较低。1946年，一个全国卫生改革委员会建议建立足够的设施，以诊断和管理印度所有邦日益增加的癌症负担。孟买基于人群的癌症登记处的数据显示，1964年至2012年间癌症患者数量增加了四倍。根据流行病学转变水平来看，印度各邦之间的癌症负担存在很大差异。我们得出结论，印度自古以来就已认识到癌症问题。印度目前每年有100万例新发癌症病例，这是流行病学转变、癌症诊断改善以及癌症数据收集改进的结果。印度癌症病例增加且各邦差异很大，这为发展中国家应对日益增加的癌症负担提供了有益的见解和重要的经验教训。
