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Time trends analysis of cancers related to lifestyle "westernization" in Mumbai, India 1976-2000

Preet K. Dhillon, MPH, PhD, Bombay Cancer Registry, Indian Cancer Society & IARC Research Training Fellowship, 3450 Cody Road, Sherman Oaks, CA 91403-5010, 818.905.9526, preet@u.washington.edu, Freddie Bray, BSc, MSc, PhD, The Cancer Registry of Norway, Montebello, N-0310 Oslo, Norway, and B.B. Yeole, MSc, PhD, Bombay Cancer Registry, Indian Cancer Society, 74 Jerbai Wadia Road, Parel, Mumbai, 400 012, India.

We conducted an age-period-cohort (APC) analysis to study the trends of cancers associated with increasing “westernization” of lifestyle in persons aged 30-64 years living in Mumbai, India between 1976 and 2000. The analysis focuses on period and cohort-specific interpretations of the observed trends, with an emphasis on younger generations diagnosed in the recent past. The Bombay Cancer Registry was used to identify incident cases of prostate, colon, breast, cervical and ovarian cancer in this urban Indian population.

In men, colon cancer age-adjusted rates (based on the WHO world standard) increased from 14.3 to 19.1 per 100,000 (1.4% annual change- PAC) and prostate cancer rates increased from 32.2 to 48.1 per 100,000 (2.0 PAC). While there is no consistent trend in colon cancer, there is a pattern for prostate cancer in men 55 years and older, in whom we see higher rates for men born in more recent birth cohorts and diagnosed later in time.

In females, age-adjusted colon cancer rates increased from 14.1 to 16.1 per 100,000 (0.6 PAC), while breast cancer increased from 111.1 to 166.2 per 100,000 (2.0 PAC) and ovary from 35.2 to 44.4 per 100,000 (1.1 PAC). Incidence rates of cervical cancer decreased from 104.3 to 92.0 per 100,000 (-0.5 PAC) for the same 25-year period. The increasing trend in breast cancer is due to cohort and period effects whereby women of recent birth cohorts and of later diagnoses in time experience consistently higher rates. Cohort and period effects with the inverse association help explain declining trends of cervical cancer incidence. No consistent trend is observed for colon or ovarian cancer.

This is part of a time trends analysis series of cancer incidence rates in an urban Indian population. The Bombay Cancer Registry regularly reports high quality data for international case registration and comparative studies. These data have been collected over three decades in India's largest metropolitan city, where Mumbai residents are becoming increasingly “westernized” in terms of lifestyle habits including sedentary work, increased stress levels, decreased leisure time, postponement of family planning, less nutritious diets and exercise. This analysis will focus on changing rates that might be attributable to such factors.

Learning Objectives:

Keywords: Cancer, India

Presenting author's disclosure statement:

Not Answered

Perspectives on Chronic Disease and Aging

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA