The word cancer usually sends a shiver down the spine, but it is curable disease if diagnosed early, says Rajendra A Badwe, Director of the Tata Memorial Centre here.
In an interview, he speaks on a range of issues related to cancer and how to tackle with its various forms.
Excerpts of the interview:
Q) How is India faring in tackling the menace of cancer?
A) Cancer in India is remarkably constant, as far as "per lakh incidence" is concerned, over the last 20 years. Unlike the other BRIC countries - Brazil, Russia and China, where the cancer incidence is rising, in India it is a straight line. But there are some geographic variations - if you look at numbers in urban India, it is annually about 90 to 100 per 100,000. The same in a semi-urban area is about 60-70 per 100,000 per annum. And the same in rural India is 40-50 per 100,000.
Q) So do you think cities are causing cancer?
A) It is the urbanisation that is causing cancer. Some cancers are on the rise and some on the wane. In women, breast and ovarian cancers are on the rise; they have risen from 15 per 100,000 to about 30 or 35 per 100,000 in cities.
As against that, uterine cervical cancer has reduced from 13 to 8.5 in Mumbai, which is a remarkable reduction. The incidence of cervical cancer in rural Barshi, a town in Solapur district of Maharashtra is about 32 per 100,000, while 50 km away in urban Barshi it is 15 per 100,000.
So, there is personal cleanliness that comes in - with running water, sanitation and personal hygiene, privacy of bathroom, (when these basic necessities are available) you will have a reduction in cervical cancer incidence.
You look at the Muslim population in Barshi rural, urban, and in Mumbai - in all three, the cervical cancer incidence is same (5 per 100,000). It is only because of circumcision in males that personal hygiene happens naturally. Whereas in rural areas, men have their baths in common wells - where is the personal hygiene? And the possibility of transmission of virus is extremely high.
We then ask, in the whole of the Middle East, cervical cancer does not exist! It is 4 or 5 per 100,000. Why cannot we have a choice offered? We can do circumcision - the possibility of transmission of human papilloma virus (HPV), human immunodeficiency virus (HIV), all are reduced. Second, we can run screening program for cervical cancer - our own studies have shown that 30 per cent reduction is possible. Third, one can give vaccines.