The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990-2016

被引：307

作者：

Dhillon, Preet K. ^{[1
]}

Mathur, Prashant ^{[2
]}

Nandakumar, A. ^{[2
]}

Fitzmaurice, Christina ^{[3
]}

Kumar, G. Anil ^{[1
]}

Mehrotra, Ravi ^{[4
]}

Shukla, D. K. ^{[5
]}

Rath, G. K. ^{[6
]}

Gupta, Prakash C. ^{[7
]}

Swaminathan, Rajaraman ^{[8
]}

Thakur, J. S. ^{[10
]}

Dey, Subhojit ^{[12
]}

Allen, Christine ^{[3
]}

Badwe, R. A. ^{[13
]}

Dikshit, Rajesh ^{[14
]}

Dhaliwal, R. S. ^{[5
]}

Kaur, Tanvir ^{[5
]}

Kataki, Amal C. ^{[15
]}

Visvveswara, Rudrapatna N. ^{[2
]}

Gangadharan, P. ^{[16
]}

Dutta, Eliza ^{[1
]}

Furtado, Melissa ^{[1
]}

Varghese, Chris M. ^{[1
]}

Bhardwaj, Deeksha ^{[1
]}

Muraleedharan, Pallavi ^{[1
]}

Odell, Christopher M. ^{[3
]}

Glenn, Scott ^{[3
]}

Bal, Manjit S. ^{[17
]}

Bapsy, P. P. ^{[18
]}

Bennett, James ^{[3
]}

Bodal, Vijay K. ^{[17
]}

Chakma, J. K. ^{[5
]}

Chakravarty, Sekhar ^{[19
]}

Chaturvedi, Meesha ^{[2
]}

Das, Priyanka ^{[2
]}

Deshmane, Vinay ^{[20
]}

Gangane, Nitin ^{[21
]}

Harvey, James ^{[3
]}

Jayalekshmi, P. ^{[22
]}

Jerang, Kaling ^{[23
]}

Johnson, Sarah C. ^{[3
]}

Julka, P. K. ^{[24
]}

Kaushik, Debnath ^{[25
]}

Khamo, Vinotsole ^{[26
]}

Koyande, Shravani ^{[20
]}

Kutz, Michael ^{[3
]}

Langstieh, W. B. ^{[27
]}

Lingegowda, K. B. ^{[28
]}

Mahajan, R. C. ^{[11
]}

Mahanta, Jagadish ^{[30
]}

机构：

[1] Publ Hlth Fdn India, Gurugram 122002, National Capita, India

[2] Indian Council Med Res, Natl Ctr Dis Informat & Res, Bengaluru, India

[3] Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA

[4] Indian Council Med Res, Natl Inst Canc Prevent & Res, Noida, India

[5] Indian Council Med Res, New Delhi, India

[6] All India Inst Med Sci, Dr BRA Inst Rotary Canc Hosp, New Delhi, India

[7] Healis Sekhsaria Inst Publ Hlth, Bombay, Maharashtra, India

[8] Canc Inst WIA, Dept Biostat & Canc Registry, Madras, Tamil Nadu, India

[9] Canc Inst WIA, Madras, Tamil Nadu, India

[10] Postgrad Inst Med Educ & Res, Sch Publ Hlth, Chandigarh, India

[11] Postgrad Inst Med Educ & Res, Chandigarh, India

[12] Publ Hlth Fdn India, Indian Inst Publ Hlth Delhi, Gurugram, India

[13] Tata Mem Hosp, Bombay, Maharashtra, India

[14] Tata Mem Hosp, Canc Epidemiol, Bombay, Maharashtra, India

[15] Dr B Borooah Canc Inst, Gauhati, India

[16] Amrita Inst Med Sci & Res Ctr, Kochi, Kerala, India

[17] Govt Med Coll, Patiala, Punjab, India

[18] Apollo Hosp, Bengaluru, India

[19] Silchar Med Coll & Hosp, Silchar, India

[20] Indian Canc Soc, Bombay, Maharashtra, India

[21] Mahatma Gandhi Inst Med Sci, Dept Pathol, Wardha, India

[22] Reg Canc Ctr, Thiruvananthapuram, Kerala, India

[23] Bakin Perlin Gen Hosp, Dept Pathol, Pasighat, India

[24] Max Oncol Daycare Ctr, New Delhi, India

[25] Reg Inst Med Sci, Imphal, India

[26] Naga Hosp Author Kohirna, Healthcare Lab & Res Ctr, Kohirna, India

[27] Civil Hosp, Shillong, Meghalayn, India

[28] Kidwai Mem Inst Oncol, Bengaluru, India

[29] Kidwai Mem Inst Oncol, Dept Epidemiol & Biostat, Bengaluru, India

[30] Indian Council Med Res, Reg Med Res Ctr, Dibrugarh, Assam, India

[31] Reg Canc Glum, Agartala, India

[32] Nargis Dutt Mem Canc Hosp, Barshi, India

[33] Indian Council Med Res, Reg Med Res Ctr, Bhubaneswar, India

[34] Sir Thodup Namgyal Mem Hosp, Dept Pathol, Gangtok, India

[35] Fortis Mem Res Inst, Dept Med Oncol & Haematol, Gurugram, India

[36] Gujarat Canc Res Inst, Ahmadabad, Gujarat, India

[37] Gandhi Med Coll, Dept Pathol, Bhopal, India

[38] Tomo Riba Inst Hlth & Med Sci, Dept Pathol, Naharlagun, India

[39] St Johns Med Coll, Dept Gynaecol Oncol, Bengaluru, India

[40] Sikkim Manipal Inst Med Sci, Dept Pathol, Gangtok, India

[41] Govt Mizoram, Hlth & Family Welf Dept, Aizawl, India

来源：

LANCET ONCOLOGY | 2018年 / 19卷 / 10期

基金：

比尔及梅琳达.盖茨基金会;

关键词：

STOMACH-CANCER; BREAST-CANCER; TOBACCO USE; EPIDEMIOLOGY; POPULATION; MIZORAM; RISK; INFECTION; ADULTS; MIDDLE;

D O I：

10.1016/S1470-2045(18)30447-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Previous efforts to report estimates of cancer incidence and mortality in India and its different parts include the National Cancer Registry Programme Reports, Sample Registration System cause of death findings, Cancer Incidence in Five Continents Series, and GLOBOCAN. We present a comprehensive picture of the patterns and time trends of the burden of total cancer and specific cancer types in each state of India estimated as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 because such a systematic compilation is not readily available. Methods We used all accessible data from multiple sources, including 42 population-based cancer registries and the nationwide Sample Registration System of India, to estimate the incidence of 28 types of cancer in every state of India from 1990 to 2016 and the deaths and disability-adjusted life-years (DALYs) caused by them, as part of GBD 2016. We present incidence, DALYs, and death rates for all cancers together, and the trends of all types of cancers, highlighting the heterogeneity in the burden of specific types of cancers across the states of India. We also present the contribution of major risk factors to cancer DALYs in India. Findings 8.3% (95% uncertainty interval [UI] 7.9-8-6) of the total deaths and 5.0% (4.6-5-5) of the total DALYs in India in 2016 were due to cancer, which was double the contribution of cancer in 1990. However, the age-standardised incidence rate of cancer did not change substantially during this period. The age-standardised cancer DALY rate had a 2.6 times variation across the states of India in 2016. The ten cancers responsible for the highest proportion of cancer DALYs in India in 2016 were stomach (9.0% of the total cancer DALYs), breast (8.2%), lung (7.5%), lip and oral cavity (7.2%), pharynx other than nasopharynx (6.8%), colon and rectum (5.8%), leukaemia (5.2%), cervical (5.2%), oesophageal (4.3%), and brain and nervous system (3.5%) cancer. Among these cancers, the age-standardised incidence rate of breast cancer increased significantly by 40.7% (95% UI 7.0-85.6) from 1990 to 2016, whereas it decreased for stomach (39.7%; 34.3-44.0), lip and oral cavity (6.4%; 0.4-18-6), cervical (39.7%; 26.5-57-3), and oesophageal cancer (31.2%; 27.9-34.9), and leukaemia (16.1%; 4.3-24.2). We found substantial inter-state heterogeneity in the age-standardised incidence rate of the different types of cancers in 2016, with a 3.3 times to 11.6 times variation for the four most frequent cancers (lip and oral, breast, lung, and stomach). Tobacco use was the leading risk factor for cancers in India to which the highest proportion (10.9%) of cancer DALYs could be attributed in 2016. Interpretation The substantial heterogeneity in the state-level incidence rate and health loss trends of the different types of cancer in India over this 26-year period should be taken into account to strengthen infrastructure and human resources for cancer prevention and control at both the national and state levels. These efforts should focus on the ten cancers contributing the highest DALYs in India, including cancers of the stomach, lung, pharynx other than nasopharynx, colon and rectum, leukaemia, oesophageal, and brain and nervous system, in addition to breast, lip and oral cavity, and cervical cancer, which are currently the focus of screening and early detection programmes. Copyright (C) The Author(s). Published by Elsevier Ltd.

引用

页码：1289 / 1306

页数：18

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