Context:Breast cancer (BC) is one of the major causes of cancer mortality in India. Late-stage diagnosis of BC is associated with poor survival. Identification of factors affecting late presentation of the disease could be an effective step to reduce BC mortality.Aims:To study the association of sociodemographic factors with BC stage at diagnosis.Settings and Design:The study is a retrospective analysis from the case records from a single institution.Subjects and Methods:Data for the year 2008 was collected from the hospital records. A total of 1210 cases were included for the analysis. Sociodemographic factors included were age, place of residence, religion, marital status, level of education, and occupation. Other study variables were family history, presence of comorbidity, and stage at diagnosis.Statistical Analysis:Association between sociodemographic factors by stage at diagnosis was tested using Chi-square statistics, with odds ratios (ORs) estimated through logistic regression modeling.Results:In the study cohort, 46% patients had reported at early stages and 54% at advanced stages. All factors were evaluated for being predictors of disease stage at presentation using univariate and multivariate logistic regression model. Women from urban background were less likely to present with advanced stage disease (OR = 0.64; 95% confidence interval [CI]: 0.49–0.84) as compared to rural women. Similarly, illiterate women were also more likely to present with advanced-stage disease (OR = 1.55; 95% CI: 1.16–2.09).Conclusions:This data clearly indicate that the patients of rural background and of low education status are more likely than their respective counterparts to have an advanced stage of BC diagnosis. Our results may be considered the keys to determining how stage variation may be related to patients and community characteristics and where limited resources need to be invested to ensure early diagnosis of BC.
Background: In the year 2010, it is estimated that nearly 0.36 million new cases and 0.19 million deaths with Non-Hodgkin lymphoma occurred. In India, among males, NHL incidence rates vary across the country which has encouraged us to conduct a case-control study to study risk factors. Materials and Methods: The present unmatched hospital-based case-control study conducted at Tata Memorial Hospital included subjects registered between the years 1997-99. There were 390 'lymphoma cases' and 1,383 'normal controls. Results: Data on age, tobacco habits, occupational history, dietary factors, tea, coffee were collected by the social investigators. Univariate and multivariate methods were applied for obtaining the odds ratios for risk factors. Conclusions: In the study, cigarette smoking (OR=2.0) and bidi smoking (OR=2.8), were associated with excess risk of lymphoma. Among the dietary items, only consumption of mutton showed 7.3-fold significant excess risk for lymphoma. Consumption of milk showed a 6-fold excess risk (OR=1.5); while coffee showed a 50% reduction in risk for lymphoma. Among occupational exposure, exposure to use of pesticides showed 3-fold excess risk for lymphoma.
Background:In India, prostate cancer is one of the five leading sites of cancers among males in all the registries. Very little is known about risk factors for prostate cancer among the Indian population.Objectives:The present study aims to study the association of lifestyle factors like chewing (betel leaf with or without tobacco, pan masala, gutka), smoking (bidi, cigarette), comorbid conditions, diet, body mass index (BMI), family history, vasectomy with prostate cancer.Materials and Methods:This an unmatched hospital-based case-control study, comprised of 123 histologically proven prostate ‘cancer cases’ and 167 ‘normal controls. Univariate and regression analysis were applied for obtaining the odds ratio for risk factors.Results:The study revealed that there was no significant excess risk for chewers, alcohol drinkers, tea and coffee drinkers, family history of cancer, diabetes, vasectomy and dietary factors. However, patients with BMI >25 (OR = 2.1), those with hypertension history (OR = 2.5) and age >55 years (OR = 19.3) had enhanced risk for prostate cancer.Conclusions:In the present study age, BMI and hypertension emerged as risk factors for prostate cancer. The findings of this study could be useful to conduct larger studies in a more detailed manner which in turn can be useful for public interest domain.
Objectives: The incidence and mortality rates of cervical cancer in the world are 13.1/105 and 6.9/105, respectively. In India, it is estimated that there are 96,922 new cervical cancer cases and 60,078 deaths and ranked second among women cancers. The incidence and mortality rates are 14.7/105 and 9.2/105, respectively, although the incidence varies within Indian population. The majority of these cervical patients report at a late-stage of disease in health-care facility due to lack of awareness. A premier tertiary cancer hospital in Mumbai conducted the present survival-study. The aim of the study was to assess the various factors that determine the survival outcomes by age at diagnosis, role of comorbidities, stage of disease, and treatment. Material and Methods: The main source of information was patients’ medical records from which the data were abstracted, and active follow-up was undertaken. 1678 cases diagnosed between the years 2006 and 2008 at Tata Memorial Hospital are analyzed using actuarial method for obtaining survival rates and log-rank tests for comparison of survival groups. Results: The 5-year survival rate was 76.0% for those aged ≤50 years, 73.3% for non-residents, 74.4% for literates, and 81.8% for Christians and 72.5% for those with squamous cell carcinoma histology; those with no comorbidities had marginally better survival than their counter-parts. The survival rates were 83.5%, 80.6%, 66.0%, and 37.1% for Stage I, Stage II, Stage III, and Stage IV, respectively. The best survival outcomes were for those treated with only surgery (95.6%), or in combination with either radiotherapy (90.6%) or with radiotherapy and chemotherapy (85.5%). Involvement of either nodes/sites had poorer survival than those with no-involvement. In the multivariate analysis, only stage of the disease emerged as a significant prognosis factor. Conclusion: The study concluded that younger patients, early stage of disease, non-involvement of any sites/ nodes, and radiotherapy either alone or in combination with other treatment type provided better outcomes. Early detection and prevention strategies are keys to obtain better outcomes.
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