EPIDEMIOLOGIC TREND IN THE DISTRIBUTION OF CANCER IN KASHMIR VALLEY

Study objective-To study the distribution of cancers, with particular emphasis on oesophageal cancer. Design-Patient records for 1986-88 in the Department of Oncology, SK Institute of Medical Sciences, were searched to identify cases and types of cancer. Setting-The Valley of Kashmir, India. Subjects-Patients with cancer resident in the valley. Main results-The seven most common types of cancer in men were those of the oesophagus, lungs, stomach, skin, upper respiratory tract, and urinary tract. In women the most common types of cancer were those affecting the oesophagus, breast, cervix, stomach, skin, colon/rectum, and lungs. Cancer of the oesophagus was the most frequent type in both sexes, accounting for 42.9% of all types of cancer in the valley. This distribution of cancer types is strikingly different from that in the rest of India where oropharyngeal cancer is the most common form. Again, contrary to the trend in India as a whole, cervical cancer is not a leading type of cancer in the valley and is less frequent even than cancer of the breast in the women. Conclusions-The preponderance of oesophageal cancer was attributable to the local practice of drinking boiling hot salt tea. Universal male circumcision in the majority community in the valley was considered to be partly responsible for low cervical cancer frequency.