The changing landscape of cancer in rural setting

Abstract

Studying the trends of cancer in a population helps the health services to have directed and more effective approach. The article by Tiwari et al., on the presentation of the cancer among young women in rural centers, raises various important issues. The most important of them is to understand the changing trends of presentation of cancer and its incidence in the rural population compared to the urban population. This study helps in knowing that the urbanization of rural areas, has significant impact on the trends in the health of the people living there.[1] In India, the Indian Council of Medical Research (ICMR) started the National Cancer Registry Programme (NRCP) in 1981. Since then, there have been systematic and successful attempts to capture the trends of cancer in the general population. Srivastava et al. published their results on the time trends in breast and cervical cancer from year 1993 to 2003, i.e., over a period of 10 years. The census was included from four urban centers, Mumbai, Delhi, Bhopal, Chennai, Bangalore, and one rural center, Barshi. This paper showed that cancer trends are different in rural settings compared to urban settings. It showed that though there is an increasing trend of breast cancer in the rural settings, a decreasing trend was observed for cervical cancer. However, cervical cancer continues to be the leading site of cancer in rural settings.[2] Yeole et al. also showed the increasing trend of breast cancer in the overall population with decrease in the incidence of cervical cancer. It was postulated that the incidence of breast cancer could be on the rise due to progressive increase in the age of marriage causing delay in the first pregnancy, and there is also an increase in the unmarried population.[3] The present paper by Tiwari et al. is significant in a way that it shows the current trends and alarms us regarding the rapid impact of the changing life style of people in rural settings. Another important issue is of the decreasing age of presentation among women with breast cancer. Though this paper caters to a small population and data are collected over a period of 9 months, it also reflects the shift in the presentation of cancer among women and this needs to be addressed.[1] Overall, this paper raises various important issues which have direct impact on the health of the population of the country. Careful observation and systematic approach can help in capturing the changing trends, which can then help in formulating the guidelines for the prevention and improvement in the health scenario of the society. Our Journal always welcomes these kinds of initiatives from young and enthusiastic investigators who, with their dedicated and diligent work can provide understanding to the ever changing scenarios of the trends in oncology.