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'Enough evidence to link cancer with tobacco'

By Staff Reporter

GUWAHATI, April 4 � Raising serious objections to the uncalled-for controversy created by a few public representatives of the country, who have confused the people by saying that there was no scientific evidence to relate tobacco consumption with cancer, Dr B Borooah Cancer Institute (BBCI), Guwahati, has asserted that there is enough evidence to associate cancer with tobacco consumption.

Citing the findings of the International Agency for Research on Cancer, 2004, the BBCI said that there was �sufficient evidence to show that the cancers of lips, tongue, mouth, pharynx, larynx, oesophagus, lungs, stomach, colo-rectal cancer, kidneys, urinary bladder, uterine cervix in females and myeloid leukaemia in adults are tobacco related.�

Dr AC Kataki, Director of BBCI, said that at present there were 29 population based cancer registries (PBCRs) in the country under the National Network of Cancer Registry Programme of the Indian Council of Medical Research, which conclusively establish the correlation between cancer and tobacco consumption.

�As per the three years� consolidated report of 25 PBCRs for the period, 2009-2011, the East Khasi Hills district of Meghalaya had the highest relative proportion of cancers associated with the use of tobacco for males and females at 69.3 per cent and 43.0 per cent respectively when compared to all sites of cancer,� he said.

The lowest proportion of tobacco-related cancer was among females in Thiruvananthapuram with 10.3 per cent of cancers being associated with the use of tobacco. This is largely due to the high literacy rate and low prevalence of tobacco consumption in Kerala.

The BBCI appealed to the policy makers of the country to take immediate steps to go ahead with the earlier decision of the Government of India to include 85 per cent of the pictorial warning on tobacco packages from April 1, 2015.

�It is hoped that this initiative will go a long way in reducing the burden of tobacco consumption from the public health perspective,� Dr Kataki said.

As per the report of the 25 PBCRs on males, mouth cancer was the leading site in ten registries, its contribution ranging from 22.6 per cent in the Barshi Registry to 39.6 per cent in the Wardha district of Maharashtra. Oesophageal cancer was the leading site in seven registries, its contribution ranging from 19.9 per cent in the Cachar district of Assam to 45.1 per cent in Meghalaya. Lung cancer was the leading site in eight registries, its contribution ranging from 24.7 per cent in Delhi to 48.9 per cent in Manipur.

�In females, mouth cancer, oesophageal cancer and lung cancer are the leading sites among tobacco-related cancers. Mouth cancer and lung cancer contributed to 48.2 per cent of tobacco-related cancer in Chennai. Similarly, mouth cancer and oesophageal cancer contributed to 66.6 per cent of tobacco-related cancer in Nagaland. Lung cancer contributed to 67.9 per cent and 72.8 per cent of tobacco-related cancer in Manipur and Mizoram respectively. In Meghalaya, 54.7 per cent of tobacco-related cancers belong to oesophageal cancer. As per the PBCR of Kamrup (Metro) district, cancer of the tongue in females is the highest in the country, whereas it is the second highest in case of males. Again, cancer of mouth and hypo-pharynx in female is the highest in the country.

Some 5,000 tobacco-related cancer patients are reported to the BBCI every year. About 50-55 per cent of all cancers in males and 25-30 per cent in females are tobacco-related cancers seen at the BBCI. It had conducted a research study on the pattern of tobacco-related cancers in a particular community, which was published in the International Research Journal of Social Sciences in May, 2014.

�In the study, it was found that 65 per cent of all cancers in males and 47 per cent in females were tobacco-related cancer because of the higher prevalence of tobacco consumption in that community,� Dr Kataki said.

In another community-based interventional study carried out by the BBCI and published in the Asian Pacific Journal of Cancer Prevention in January, 2015, it showed current tobacco use at 36 per cent of the population. Out of this, 81 per cent of the subjects were male and 19 per cent female. And 78 per cent of the population was in the age group of 20-39 years.

�There are numerous studies in the country to prove association of tobacco consumption and cancer. Tobacco consumption is also a risk factor for cardiovascular and other diseases. It has also an adverse effect on pregnancy and reproductive outcome. �A significant number of cancer of the gum occurs at the site where chewable tobacco is used,� Dr Ashok Kumar Das, head of the Department of Head and Neck Oncology, BBCI, said.

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