Table 3.1 : Average Annual Crude (CR) and Age Adjusted Incidence Rates (AAR) per 100,000 population in Indian PBCRs during the time period indicated in parentheses.

              The highest AAR in males was seen among the black population of Detroit, Michigan State, USA, whereas the highest AAR in females was seen in Geneva, Switzerland. In both males and females the highest rates seen in other registries were considerably higher than that observed in the Indian PBCRs. Some of the lowest rates seen in the other registries were also higher. However, the AAR from India was comparable with the AAR of the Indian population of Singapore. Moreover, the picture becomes much different and more meaningful (see Chapter 6) when such comparison of AAR is done for specific anatomical sites.

Leading Sites of Cancer

              Figure 3.2 gives the bar charts of leading sites of cancer in twelve PBCRs (six under the NCRP and six others) in India.

              Among males cancer of the stomach was the leading site of cancer in Bangalore and Chennai. Cancer of the lung was the leading site of cancer in six of the twelve PBCRs. These six PBCRs are Bhopal, Delhi, Mumbai, Ahmedabad, Karunagappally and Kolkata. It was the second leading site of cancer in Chennai and Thiruvananthapuram and the third leading site at Bangalore, Nagpur and Pune. Cancer of the oesophagus was an important leading site of cancer and was the leading site at Nagpur. It was the second or third leading site of cancer at Bangalore, Barshi, Chennai, Mumbai, Ahmedabad, Karunagappally and Pune. Other sites of cancer associated with use of tobacco, viz., tongue, mouth, hypopharynx and larynx are among important leading sites. Besides, cancer of the prostate was the third leading site in Delhi and among the leading sites in Bangalore, Chennai, Mumbai, Ahmedabad, Kolkata and Pune. Non-Hodgkin's lymphoma as a leading site was seen in almost all PBCRs.

              In females, cancer of the breast and cervix were the two leading sites. Cancer of the breast was followed by cancer of the cervix in all the twelve PBCRs except, Barshi and Chennai where cancer of the cervix was followed by cancer of the breast. Among the sites of cancer associated with the use of tobacco, cancer of the mouth, oesophagus and lung were important. The incidence rates of cancer of the oesophagus, in Bangalore females have over the years paralleled that in males. Cancer of the thyroid was the third leading site in Karunagappally and Thiruvananthapuram. It was also among the ten leading sites in Bangalore, Barshi and Nagpur. Cancer of the gall bladder was the third leading site in Kolkata, fourth in Delhi and sixth in Bhopal. This site of cancer, is not among the ten leading sites of cancer in other PBCRs. Cancer of the ovary was one of five leading sites in all the PBCRs except, Karunagappally where it was the sixth leading site of cancer.