Patterns of Cancer : A Study of 500 Punjabi Patients

Cancer prevalence vary not only throughout the world but also between different population groups within the same country. Of the 10 million new cases of cancer diagnosed every year worldwide, over half are from the developing countries1.Study of the magnitude and pattern of cancer is the first step in determining clues to the causes of cancer and in having a baseline to plan and assess control measures. Until 1964, information on cancer occurrence in India was available from surveys. Initiation of Population Based Cancer Registry at Bombay in 1964, at Pune in 1973, at Aurangabad in 1978, and at Ahemdabad and Nagpur in 1980, started the availability of data on cancer incidence on a continuous basis. However, the boost for cancer registration in India was in 1982, through initiation of National Cancer Registry Program (NCRP) by Indian Council of Medical Research (ICMR). The NCRP began with three Population Based existing Bombay registry, new registries at (Bangalore and Chennai) and three Hospital based registries at Chandigarh, Dibrugarh and Thiruvananthapuram. The data from cancer registries helps in highlighting the magnitude and common sites of cancer in India, and is useful in planning the National Cancer Control Program. Currently there are 28 PBCRs


Introduction
Cancer prevalence vary not only throughout the world but also between different population groups within the same country. Of the 10 million new cases of cancer diagnosed every year worldwide, over half are from the developing countries1.Study of the magnitude and pattern of cancer is the first step in determining clues to the causes of cancer and in having a baseline to plan and assess control measures. Until 1964, information on cancer occurrence in India was available from surveys. Initiation of Population Based Cancer Registry at Bombay in 1964, at Pune in 1973, at Aurangabad in 1978, and at Ahemdabad and Nagpur in 1980, started the availability of data on cancer incidence on a continuous basis. However, the boost for cancer registration in India was in 1982, through initiation of National Cancer Registry Program (NCRP) by Indian Council of Medical Research (ICMR). The NCRP began with three Population Based existing Bombay registry, new registries at (Bangalore and Chennai) and three Hospital based registries at Chandigarh, Dibrugarh and Thiruvananthapuram. The data from cancer registries helps in highlighting the magnitude and common sites of cancer in India, and is useful in planning the National Cancer Control Program. Currently there are 28 PBCRs

Patterns of Cancer: A Study of 500 Punjabi Patients
Manjit Singh Bal 1 , Vijay Kumar Bodal 1 *, Jaspreet Kaur 2 , Mohanvir Kaur 1 , Swati Sharma 2 and 9 HBCRs working under NCRP, Bangalore. Over the last few years there have been unauthorized reports of increased occurrence of cancer cases in Punjab, especially Malwa region (Southern Punjab). Hence, "Population Based Cancer Registry" (PBCR) & "Punjab Cancer Atlas" (PCA)Patiala, projects of ICMR were started in June, 2011 & January, 2013 respectively under the auspices of "National Cancer Registry Program" (NCRP) at Pathology Department of Govt. Medical College, Patiala. The main objective of these projects is to assess the magnitude of cancers in the state of Punjab, to provide a framework for assessing the impact of cancer on the community and to prepare strategies for diagnosis and management2. The objective of assessing the cancer problem is to aid control of cancer. The community burden, the site pattern and the incidence of disease over time is essential information required for implementing and evaluating cancer control programs.
Government of Punjab is very particular about cancer patients as far as early detection, management and prevention of this disease is concerned. There are various schemes for benefit and welfare of cancer patients like "Mukh Mantri Punjab Cancer Rahat Kosh Scheme" -a scheme from which cancer patients get financial help for their treatment and investigations. Even otherwise hematological malignancies like leukemias, multiple myeloma & lymphomas are diagnosed & affective treatment is provided.

Materials and Methods
The study comprises of 500 microscopically diagnosed cancer patients who came to pathology department for verification of their histopathology/cytology/haematology reports. Record of each patient was noted like name, age, sex, religion, residence, date of diagnosis and type of cancer etc. Record was tabulated and analyzed statistically. The measure used in this study is relative frequency. The study period was from August, 2013 to August, 2014.

Results
Out of the total 500 Cancer cases, males were (175, 35%) and females were (325,65%). Majority of cancer cases, (360,72%) were from rural area & (140,28%) cases were from urban area. Maximum cases (342,68.40%) belonged to Sikh community followed by Hindus (144,28.8%) and Muslims (14, 2.80%). This is because 70% of population of the Punjab is living in villages and Sikhism is the commonest religion followed by people of Punjab.
Colon cancer was the most common cancer amongest males followed by Oesophagus, Tongue, Urinary Bladder and Lung. Amongest females Breast was the commonest cancer site followed by Cervix, Ovary, Oesophagus and Endometrium.

Discussion
Of the 500 cancer patients included for analysis, 325(65%) were females & 175 (35%) were males. The rate of cancer was higher in females than in males in our study.
According to the study by Thakur etal, there were 107 histologically confirmed cancer cases at Talwandi Sabo, out of which 27 (25.2%) were males and 80 (74.7%) were females. There were 71confirmed cancer cases at Chamkaur Sahib, out of which 25(35.2%) were males and 46(64.7%) were females3. In this study also rate of cancer was higher in females than in males. This is in contrast to the study done by Sambasivaiah etal,in the Rayalaseema region of Andhra Pradesh where cancer rates were higher in males(588, 53.99%) than in females(501, 46.01%) out of total 1089 cancer patients4.
In our study cancer rates are comparatively higher in