In the battle of the female cancers, breast cancer has overtaken cervix as the top cancer among women in Chennai.
Statistics from the Madras Metropolitan Tumour Registry at the Adyar Cancer Institute’s hospital registry indicate that a subtle change has taken place that has had breast cancer incidence growing at a much higher rate than cervical cancer.
A comparative study between the incidence of the two conditions in 1982-87 and 2009-2010 makes this clear: In 1982-87, the incidence of Cervical Cancer in the Registry was 44.3 per 1,00,000 population. Comparatively, the breast cancer incidence was 19.1. In 2009 – 2010, the cervical cancer incidence had dropped to 19.3, while that of breast cancer rose to 35.8 per 1,00,000.
This trend is creeping up even in the State, says R. Swaminathan, head, Cancer Registry, Adyar Cancer Institute. Initial results from the Tamil Nadu Cancer Registry Project, to be shortly inaugurated formally by Chief Minister Jayalalithaa show similar trends, he adds. “That covers a population of over 7.3 crore and enumerates cancers from the entire State. While we are still at the preliminary stages of that investigation, it is clear that breast cancer is stealing ahead of cervical cancer, especially in urban areas,” Dr. Swaminathan explains.
In the rural areas, cervical cancer still remains high, and much ahead of breast cancer. For instance, in Dindugul, a rural centre, the incidence of cervical cancer is at 25.9, tailed by breast in a 2009-10 observation.
Whereas Coimbatore, an urban centre, reflects the Chennai picture: breast cancer is 20.3 and cervical cancer is 13.7.
What are the reasons for this difference, and the apparent reversal in the urban centres. At the outset, genital hygiene and a change in the reproductive profile of women in the metros, Dr. Swaminathan says. “Clearly, lifestyle factors have a play. The one measurable factor is education: that has made the difference,” says V. Shanta, chairman, Adyar Cancer Institute. Education is key, when girls study more, they are more likely to have better genital hygiene. It is the same with chewing tobacco, she adds.
“The incidence of oral cancers among women has come down (though not among men) and this is due to education,” she adds.
Dr. Swaminathan explains that in the metros, late age of marriage, child bearing and fewer children have probably to do with the reduction in the number of cervical cancer cases. With urbanisation, there have been consequent lifestyle changes – a sedentary life, and a diet of fast foods.
The number of people coming in with early stages of cervical cancer has also gone up substantially from 4.9 (1984- 1988) to 11.7 (2006 – 2009), whereas, with the breast it has only gone up from 1.2 to 2.2 (during the same period). However, oncologists are concerned about the late presentation of persons with both breast, and cervical cancers. 70 – 80 per cent of both cancers come in the locally advanced stage, and this needs to change, Dr. Swaminathan says.
