Cancer Statistics, 2020: Report From National Cancer Registry Programme, India

Abstract

Purpose: The systematic collection of data on cancer is being performed by various population-based cancer registries (PBCRs) and hospital-based cancer registries (HBCRs) across India under the National Cancer Registry Programme-National Centre for Disease Informatics and Research of Indian Council of Medical Research since 1982.

Methods: This study examined the cancer incidence, patterns, trends, projections, and mortality from 28 PBCRs and also the stage at presentation and type of treatment of patients with cancer from 58 HBCRs (N = 667,666) from the pooled analysis for the composite period 2012-2016. Time trends in cancer incidence rate were generated as annual percent change from 16 PBCRs (those with a minimum of 10 years of continuous good data available) using Joinpoint regression.

Results: Aizawl district (269.4) and Papumpare district (219.8) had the highest age-adjusted incidence rates among males and females, respectively. The projected number of patients with cancer in India is 1,392,179 for the year 2020, and the common 5 leading sites are breast, lung, mouth, cervix uteri, and tongue. Trends in cancer incidence rate showed an increase in all sites of cancer in both sexes and were high in Kamrup urban (annual percent change, 3.8%; P < .05). The majority of the patients with cancer were diagnosed at the locally advanced stage for breast (57.0%), cervix uteri (60.0%), head and neck (66.6%), and stomach (50.8%) cancer, whereas in lung cancer, distant metastasis was predominant among males (44.0%) and females (47.6%).

Conclusion: This study provides a framework for assessing the status and trends of cancer in India. It shall guide appropriate support for action to strengthen efforts to improve cancer prevention and control to achieve the national noncommunicable disease targets and the sustainable development goals.

FIG 1

Comparison of all cancer sites’ age-adjusted incidence rates (AARs) of all population-based cancer registries, 2012-2016 (International Statistical Classification of Diseases and Related Health Problems, 10th revision: C00-C97). AARs are in blue and crude rates are given in parentheses in red. Thi'puram district, Thiruvananthapuram district.

FIG 2

Sites of cancer associated with the use of tobacco (%), 2012-2016. Crude rate in red and age-adjusted rates in blue are given in parentheses. Sites of cancer associated with the use of tobacco, anatomic sites (International Statistical Classification of Diseases and Related Health Problems, 10th revision codes), lip (C00); tongue (C01-C02); mouth (C03-C06); pharynx (C10 and C12-C14); esophagus (C15); larynx (C32); lung (C33-C34); urinary bladder (C67). Thi’puram district, Thiruvananthapuram district.

FIG 3

Relative proportion (%) of patients according to clinical extent of disease, 2012-2016 (proportion [%] may not total 100% because of rounding).

FIG 4

Annual percentage change (APC) in age-adjusted incidence rates (AAR) over the time period. Calendar years of incidence data for each population-based cancer registry (PBCR) used in trend analysis: Chennai (1982-2016); Mumbai (1982-2015); Bangalore (1982-2014); Barshi rural (1988-2016); Bhopal (1988-2015); Delhi (1988-2014); Kamrup urban (2003-2016); Mizoram state (2004-2016); Dibrugarh district, Sikkim state, Imphal West district; Aurangabad; Thiruvananthapuram (Thi'puram) taluk; Nagpur (2005-2016); Kollam district; Pune (2006-2016); PBCRs with small numbers (< 10 patients) per year not analyzed. Increase in APC in red, decrease in APC in green. (*) APC significantly different from zero; P < .05. Thi’puram PBCR expanded its coverage to district from the year 2012 onwards. Hence, Thi’puram taluk data was used for trend analysis. Thi’puram taluk, Thiruvananthapuram taluk.