A clinicoepidemiological profile of lung cancers in India - Results from the National Cancer Registry Programme

Abstract

Background & objectives: Lung cancer is a significant public health concern in low- and middle-income countries such as India. The present article describes the epidemiology, and clinical profile of lung cancer in India, based on recent data from the National Cancer Registry Programme (NCRP).

Methods: The latest data on lung cancer from the NCRP were collated from 28 population-based cancer registries and 58 hospital-based cancer registries across a five-year (2012-2016) reporting period.

Results: The highest age-adjusted incidence rate and mortality (AAMR) was found amongst males and females in the Aizawl district of Mizoram. A significant increase in the annual per cent change of lung cancer incidence was observed in metropolitan cities from 1982 to 2016. About one-third of the cases (36.5%) in males and females (31.7%) were recorded in the age group of 55-64 yr. Adenocarcinoma accounted for about a third (34.3%) of the morphological type in males and half (52.7% ) amongst females. Out of 22,645 recorded lung cancer cases, close to half (44.8%) of the patients presented with distant spread, while over one-third (35.3%) had loco-regional spread of disease at the time of diagnosis.

Interpretation & conclusions: Our estimates suggest that the number of cases is expected to rise sharply to 81,219 cases amongst males and 30,109 in females in 2025. The rising incidence and delayed diagnosis of lung cancer in India are grave concerns. The findings of the present study call for scaling up and intensification of lung cancer-specific preventive, early diagnosis and control measures.

Keywords: Incidence; India; lung cancer; morphology; registry.

Fig. 1

Lung Cancer: Trends over time in age-adjusted rate 1982-2016.The annual per cent change among females, for Bengaluru (4.43) and Chennai (4.41) is nearly the same and hence is overlapping in the Figure.

Fig. 2

Clinical extent of disease at presentation.

Fig. 3

Time between first diagnosis and commencement of cancer-directed treatment at reporting institution.

Fig. 4

Projected age-wise number and age specific incidence rate for Lung cancer cases (2025).