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Lokhande M, Kannusamy S, Oak A, Cheulkar S, Chavan S, Mishra V, Gode P, Thakadiyil AS, Mendhe S, Kadam S, Balasubramaniam G, Chaturvedi P, Dikshit R. A hospital-based study of survival in oral cancer patients of Tata Memorial Hospital, Mumbai. Ecancermedicalscience 2024; 18:1669. [PMID: 38439812 PMCID: PMC10911663 DOI: 10.3332/ecancer.2024.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction Oral cancer represents a significant global public health concern, with the death rate for lip and oral cavity malignancies experiencing a 1.40-fold increase worldwide in the past three decades. This retrospective study aimed to comprehensively understand overall survival (OS) and the influence of sociodemographic and clinical factors on patients diagnosed with oral cavity cancer. Materials and methods The study focused on oral cancer patients enrolled in 2016 and treated at Tata Memorial Hospital, Mumbai, with a follow-up period extending to 5 years until 2021. Utilising the Kaplan-Meier technique and log-rank test, we examined OS and variations based on sociodemographic factors, while the Cox proportional hazard model allowed us to investigate the simultaneous impact of multiple factors on OS. Results A total of 1,895 eligible participants were included. The overall 5-year survival rate was 65%. After adjusting for age, gender, education, primary site, tumour grade, TNM staging, treatment intention, status and modality, we found in our study oral cancer patients aged more than 60 years (HR = 1.37, 95% CI: 1.01-1.85, p-value 0.03), patients who had poorly differentiated carcinoma (HR = 2.44, 95% CI: 1.56-3.81, p-value < 0.001), belonged to stage IV as per TNM staging (HR = 2.44, 95% CI: 1.65-3.61, p-value < 0.001), patient who have received partial treatment (HR = 2.44, 95% CI: 1.65-3.61, p-value < 0.001) and only chemotherapy (HR = 3.56, 95% CI: 2.43-5.23, p-value < 0.001) found to have a higher hazard of dying while literate (HR = 0.73, 95% CI: 0.56-0.95, p-value 0.02) are protective. Limitations The retrospective nature of the study posed constraints in exploring additional variable associations. Implication Overall early detection, appropriate treatment, and regular follow-up are critical for improving the survival rate of patients with oral cavity cancer. Conclusion This research proposes that improving the socioeconomic status and promoting proactive treatment-seeking behaviour is crucial for enhancing the survival of oral cancer patients. Cancer hospitals, in collaboration with the wider public healthcare system in India, which includes clinicians and policymakers, should consider these suggestions to enhance cancer treatment and control in low-middle-income countries.
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Affiliation(s)
- Monika Lokhande
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
- https://orcid.org/0009-0005-2587-7188
| | - Sivaranjini Kannusamy
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Amey Oak
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
- https://orcid.org/0009-0004-1893-4191
| | - Sandhya Cheulkar
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Shalmali Chavan
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Varsha Mishra
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Pragati Gode
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Aijimol S Thakadiyil
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Saket Mendhe
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Supriya Kadam
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
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Bagal S, Budukh A, Thakur JS, Dora T, Qayyumi B, Khanna D, Fernandes D, Chakravarti P, Singh R, Patil S, Dikshit R, Chaturvedi P. Head and neck cancer burden in India: an analysis from published data of 37 population-based cancer registries. Ecancermedicalscience 2023; 17:1603. [PMID: 37799939 PMCID: PMC10550331 DOI: 10.3332/ecancer.2023.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Indexed: 10/07/2023] Open
Abstract
Head and neck cancer (HNC) is a major public health problem in India. This article presents the HNC burden in different regions of India. The published population-based cancer registries (PBCRs) data from the National Cancer Registry Programme, Bengaluru, and the Tata Memorial Centre, Mumbai, India, were utilised. The 37 PBCRs were divided into six regions including central, east, north, northeast, west and south. The age-standardised incidence rate of HNC was 25.9 (95% CI 25.7-26.1) and 8.0 (95% CI 7.9-8.1) per 100,000 population, respectively, in males and females. HNC accounted for about 26% of all cancer cases in males and 8% in females. The risk of developing HNC was 1 in 33 for males and 1 in 107 for females. The northeastern registries reported the highest incidence rate 31.7 per 100,000 population in males followed by northern (28.5), central (28.3), western (24.4), southern (23.9) and eastern (18.3). In females, the incidence was in the range of 6.2-10.1 per 100,000 population. For all PBCRs together, the HNC burden was two to three times higher in the age group 60+ as compared to 20-39 years. The HNC burden in India is higher than in the USA, UK, Australia, Africa and Brazil. The PBCRs from the south-east Asia region such as the Colombo district, Sri Lanka, as well as Siraha, Saptari, Dhanusha and Mohattari - Nepal have also reported a high burden of HNC. All regions reported mouth as a leading cancer site followed by tongue, larynx, hypopharynx and tonsil except the northeastern region registries where hypopharynx was the top leading cancer. The burden of other sites of HNC is low. Raising awareness of the disease and associated risk factors, providing early detection services, as well as easy access to diagnosis and treatment are required. The government should focus on building the infrastructure and capacity building to control this disease.
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Affiliation(s)
- Sonali Bagal
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- https://orcid.org/0000-0002-2510-1751
| | - Atul Budukh
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- Homi Bhabha National Institute (HBNI), Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0001-6723-802X
| | - Jarnail Singh Thakur
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
- https://orcid.org/0000-0002-8270-4268
| | - Tapas Dora
- Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centre (TMC), Sangrur 148001, India
| | - Burhanuddin Qayyumi
- Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Tata Memorial Centre (TMC), Muzaffarpur 842004, India
| | - Divya Khanna
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC), Tata Memorial Centre (TMC), Varanasi 221005, India
- https://orcid.org/0000-0001-7856-8059
| | - Dolorosa Fernandes
- Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Tata Memorial Centre (TMC), Visakhapatnam 530053, India
| | - Priyal Chakravarti
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- https://orcid.org/0000-0003-2163-796X
| | - Ravikant Singh
- Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Tata Memorial Centre (TMC), Muzaffarpur 842004, India
| | - Suvarna Patil
- Bhaktshreshtha Kamalakarpant Laxman Walawalkar (BKLW) Hospital, Diagnostic and Research Centre, Ratnagiri 415606, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- Homi Bhabha National Institute (HBNI), Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0003-4830-0486
| | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology (CCE), Advance Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Navi Mumbai 410210, India
- Homi Bhabha National Institute (HBNI), Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0002-3520-1342
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Noronha V, Sekar A, Rajendra A, Mokal S, Patil V, Menon N, Chopade S, Singh AK, Kaushal RK, Mahajan A, Janu A, Purandare N, Dikshit R, Banavali S, Prabhash K, Badwe R. Epidemiological Trend of Esophageal Cancer at a Tertiary Cancer Center in Mumbai, India, Over the Past 15 Years. J Gastrointest Cancer 2023; 54:903-912. [PMID: 36418768 DOI: 10.1007/s12029-022-00887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND In developed countries, there has been a definite change in the histopathological spectrum of esophageal cancer towards adenocarcinoma. There are limited data from India regarding the histopathological profile of patients with esophageal cancer. MATERIALS AND METHODS We retrospectively evaluated patients with histologically proven esophageal cancer who were registered at the Tata Memorial Hospital (Mumbai, India) between 2003 and 2018. The primary aim of the study was to analyze the time-trend of the histological pattern of esophageal cancer. Our secondary objectives included evaluating whether there was any correlation between the histology of the esophageal cancer and the age, sex, socioeconomic status (the paying ability of the patient, which was reflected in the treatment category of the patient, i.e., private [full payment], general [subsidized payment], or no charge), comorbidities, and a history of substance abuse. RESULTS Among 7874 patients with esophageal cancer, 5092 (64.7%) were men, with a male-to-female ratio of 1.8:1. The median age was 57 years (IQR, 50-65). Of the 4912 patients in whom a history of tobacco or alcohol use had been elicited, 1360 (27.7%) had no history of substance abuse. A majority of the tumors (2942, 37.4%) originated in the middle-third of the esophagus. Squamous cell carcinoma was the predominant histological type, noted in 6413 (81.4%) patients and remained the most common histologic type consistently through the study with no evidence of a time-trend in the histological pattern. On the multivariate analysis, female sex and a history of substance abuse were associated with higher odds of squamous cell carcinoma, while the presence of comorbidities and lower esophageal/gastroesophageal junction primaries were associated with higher odds of adenocarcinoma. CONCLUSIONS There is no evidence of an epidemiological shift in the histopathologic spectrum of esophageal cancer in India over the last two decades. Four out of five Indian patients with esophageal cancer have squamous cell histology, with the commonest site of origin being the middle third. This is important to recognize, given the varying molecular spectrum and efficacy of therapeutic modalities based on histopathology.
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Affiliation(s)
- Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Anbarasan Sekar
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Akhil Rajendra
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Smruti Mokal
- Department of Biostatistics, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Vijay Patil
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Sunil Chopade
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Ajay Kumar Singh
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Rajiv Kumar Kaushal
- Department of Pathology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Abhishek Mahajan
- Department of Radiodiagnosis, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Amit Janu
- Department of Radiodiagnosis, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Nilendu Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Rajesh Dikshit
- Department of Epidemiology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Shripad Banavali
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India.
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
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Nag S, Dikshit R, Desai S, Mane A, Mhatre S, Neve R, Gurav M, Bhosale N, Perumal P, Kembhavi Y, Jethwa D, Badwe R, Gupta S. Risk factors for the development of triple-negative breast cancer versus non-triple-negative breast cancer: a case-control study. Sci Rep 2023; 13:13551. [PMID: 37599285 PMCID: PMC10440340 DOI: 10.1038/s41598-023-40443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023] Open
Abstract
The risk factors for breast cancer have been defined in several studies but there is deficient data for specific subtypes. We report here the pathological characteristics of a breast cancer cohort and risk factors for patients with triple-negative disease. In this case-control study, a prospective breast cancer cohort was evaluated for demographic, reproductive, obesity-related and other risk factors using a validated questionnaire. Tumors were characterized for routine pathological characteristics and immunohistochemical markers of basal-like breast cancer. Patients with triple-negative breast cancer (TNBC) constituted cases and those with non-TNBC were controls. Odds ratios (OR) were calculated for each risk factor and independent associations were tested in an unconditional logistic regression analysis. Between 2011 and 2014, 1146 patients were recruited, of whom 912 [TNBC 266 (29.1%), non-TNBC 646 (70.9%)] with sufficient pathology material were analysed. Reproductive factors of parity, breastfeeding, age-at-menarche, age at first full-term pregnancy and oral contraceptive use were not significantly associated with TNBC. Higher body mass index (BMI > 24.9 vs ≤ 24.9, OR 0.89, 95%CI 0.63-1.24, p = 0.49) was not significantly associated while lesser waist circumference (> 80 cm vs ≤ 80 cm, OR 0.64, 95%CI 0.45-0.9, p = 0.012) and lower waist-to-hip ratio were significantly associated (> 0.85 vs ≤ 0.85, OR 0.72, 95%CI 0.51-1.0, p = 0.056), with TNBC. History of tobacco use was not significantly associated while lower socio-economic status was borderline associated with TNBC (socio-economic category > 5 versus ≤ 5, OR 0.73, 95%CI 0.50-1.06, p = 0.106). No factor was significant after adjustment for covariates. Central obesity seems to be preferentially associated with non-TNBC, and lower socio-economic status with TNBC in India, while most other conventional risk factors of breast cancer show no significant association with TNBC versus non-TNBC.
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Affiliation(s)
- Shona Nag
- Medical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Rajesh Dikshit
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sangeeta Desai
- Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anupama Mane
- Surgical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Sharayu Mhatre
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rakesh Neve
- Surgical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Mamta Gurav
- Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Prema Perumal
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Yogesh Kembhavi
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Dinesh Jethwa
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajendra Badwe
- Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
- Tata Memorial Hospital/Centre, Room 1109, Homi Bhabha Block, Parel, Mumbai, 400012, India.
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Sawant P, Perera S, Jayanthi KGN, Ziyad AIA, Saoba S, Ervik M, Mery L, Bray F, Dikshit R, Budukh A. Application of Rupantaran software to Sri Lankan hospitals: an innovative tool developed to merge population-based cancer registry data into CanReg5. Ecancermedicalscience 2023; 17:1553. [PMID: 37377679 PMCID: PMC10292847 DOI: 10.3332/ecancer.2023.1553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Indexed: 06/29/2023] Open
Abstract
The purpose of a population-based cancer registry is to provide information on the disease burden for cancer control planning and is essential in studies on assessing the effectiveness of prevention, early detection, screening and cancer care interventions, where implemented. Sri Lanka is one of the Member States of the World Health Organisation's South-East Asia Region and receives technical support for cancer registration from the International Agency for Research on Cancer (IARC), and the IARC Regional Hub based at the Tata Memorial Centre in Mumbai, India. For data management of cancer registry records, Sri Lanka National Cancer Registry (SLNCR) uses the open-source registry software tool, CanReg5, as developed by IARC. The SLNCR has received data from 25 centres located across the country. Inputted data from the respective centres was then exported from various CanReg5 systems to the main centre in Colombo. As the import to the central CanReg5 system held in the capital is manual, the records were manually modified to avoid any duplicate entries, and the quality of data was compromised. To overcome this issue, a new software tool, Rupantaran, has been created and developed by IARC Regional Hub, Mumbai to help merge the records from different centres. Rupantaran was tested and implemented successfully at the SLNCR with 47,402 merged records. The Rupantaran software has proven beneficial in maintaining the quality of cancer registry data by avoiding manual errors, thus enabling rapid analysis and dissemination, a limiting factor previously.
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Affiliation(s)
- Pratik Sawant
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, Maharashtra, India
- https://orcid.org/0000-0002-8781-4618
| | - Suraj Perera
- Strategic Information Management Unit, National Cancer Control Programme, Colombo 00500, Sri Lanka
- https://orcid.org/0000-0002-6842-0330
| | | | | | - Sushama Saoba
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, Maharashtra, India
| | - Morten Ervik
- Cancer Surveillance Branch, International Agency for Research on Cancer, 69366 Lyon Cedex 07, France
- https://orcid.org/0000-0003-4485-3577
| | - Leslie Mery
- Cancer Surveillance Branch, International Agency for Research on Cancer, 69366 Lyon Cedex 07, France
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, 69366 Lyon Cedex 07, France
- https://orcid.org/0000-0002-3248-7787
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0003-4830-0486
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
- https://orcid.org/0000-0001-6723-802X
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Mailankody S, Bajpai J, Budukh A, Swaminathan R, Dikshit R, Dhimal M, Perera S, Tshomo U, Bagal S, Bhise M, Chaturvedi P, Banavali SD, Gupta S, Badwe RA, Trama A. Epidemiology of rare cancers in India and South Asian countries - remembering the forgotten. Lancet Reg Health Southeast Asia 2023; 12:100168. [PMID: 37384065 PMCID: PMC10305990 DOI: 10.1016/j.lansea.2023.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 06/30/2023]
Abstract
Background Rare cancers (RCs) are challenging to manage and are "forgotten cancers" though they collectively constitute a significant proportion of all cancers (∼20%). As a first step towards streamlining care, there is an unmet need to map the epidemiology of RCs in South Asian Association for Regional Collaboration (SAARC) countries. Methods The authors collected data from 30 Population-Based Cancer Registries (PBCR) of India and the published national registries of Nepal, Bhutan and Sri Lanka (SL) and compared them with the standard RARECAREnet RC list. Findings With the standard definition of crude incidence rates (CR) ≤6/100,0000 per population, 67.5%, 68.3%, 62.3% and 37% of all incident cancers qualify as RCs in India, Bhutan, Nepal and SL, respectively. An arbitrary cut-off CR ≤3 appears more appropriate with 43%, 39.5%, 51.8% and 17.2% of cancers identified as RCs, respectively, due to the lower cancer incidence.There are similarities and notable differences between the RC lists of the SAARC region with that of the European RC list. Oral cavity cancers are rare in Europe, while pancreas, rectum, urinary bladder and melanomas are common. In addition, uterine, colon and prostatic cancers are rare in India, Nepal and Bhutan. In SL, thyroid cancer is common. There are gender-related and regional differences in RC trends in the SAARC countries. Interpretation There is an unmet need in SAARC nations to capture epidemiological nuances in rare cancers. Understanding the unique issues in the developing world may guide policymakers to adopt appropriate measures to improve RC care and tailor public health interventions. Funding None.
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Affiliation(s)
- Sharada Mailankody
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajaraman Swaminathan
- Department of Epidemiology, Biostatistics and Cancer Registry, Cancer Institute (WIA), Chennai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Suraj Perera
- National Cancer Registry Program, Colombo, Sri Lanka
| | - Ugyen Tshomo
- Department of Gynecology, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu, Bhutan
- Principal Investigator of Cancer Registry, Thimphu, Bhutan
| | - Sonali Bagal
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Mahadev Bhise
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shripad D. Banavali
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Rajendra A. Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Annalisa Trama
- Department of Preventive and Predictive Medicine, Fondazione IRCSS, Milan, Italy
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Sivaranjini K, Oak A, Cheulkar S, Maheshwari A, Mahantshetty U, Dikshit R. Role of education and income on disparities of time-to-treatment initiation and its impact on cervical cancer survival. Indian J Public Health 2023; 67:235-239. [PMID: 37459018 DOI: 10.4103/ijph.ijph_1299_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Background In India, cervical cancer is the second-leading cause of cancer incidence among women. Socioeconomic factors play a vital role in cervical cancer survival. Objectives This study assessed the role of education and income on disparities in time-to-treatment initiation (TTI) and its impact on cervical cancer survival. Materials and Methods This was a retrospective facility-based record study conducted among newly treated cervical cancer patients registered in a tertiary medical care center in Mumbai between 2014 and 2016. Adjusted hazard ratio with a 95% confidence interval was reported. Results In total, 1947 cervical cancer patients with a mean age of 52.89 (±10.55) years were included. The average number of days for TTI among highly educated patients was 27 versus 35 days for patients with no formal education. An increasing trend in survival was observed as education levels shift from no formal to higher education category (75.54%, 77.30%, and 85.10%, P = 0.01). All cause mortality was lower in cervical cancer patients with secondary education and above than illiterates (hazard ratio [HR] = 0.63, P < 0.01), among those with higher income (HR = 0.78, P = 0.04) than lower income and among who started on treatment within 30 days (HR = 0.90, P = 0.29) than patients who started treated after 30 days. Conclusions Inferior survival is found for cervical cancer patients with lower education and income and who initiated treatment after 30 days. Hence, it is important to improve awareness and screening activities, especially among the lower socioeconomic groups, for early diagnosis and better treatment outcomes.
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Affiliation(s)
- K Sivaranjini
- Medical Officer-D, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Maharashtra, India
| | - Amey Oak
- Medical Officer-D, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Maharashtra, India
| | - Sandhya Cheulkar
- Scientific Assistant - E, Division of HBCR and POCSS, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Maharashtra, India
| | - Amita Maheshwari
- Professor and Head, Division of Gynaec Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Maharashtra, India
| | - Umesh Mahantshetty
- Director, Professor, Division of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Visakhapatnam, Andhra Pradesh, India
| | - Rajesh Dikshit
- Director, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
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8
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Gholap D, Dikshit R, Chaturvedi P, Chaturvedi AK, Manjrekar A, Mhatre S. Exclusive use of different types of tobacco products, exposure to secondhand tobacco smoke and risk of subtypes of head and neck cancer among Indian males. Int J Cancer 2023; 152:374-383. [PMID: 36054453 DOI: 10.1002/ijc.34258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 02/01/2023]
Abstract
Tobacco products are used in vary many forms in India. Although the risk of tobacco uses in developing head and neck cancer (HNC) is known, risk by exclusive use of different tobacco products on HNC and its subtypes is poorly understood. A case-control study was conducted at a tertiary cancer hospital, which receives cases from different geographical regions of India with use of different types of tobacco products. The study included 824 oral cavity (OC), 149 oropharynx (OPX) 104 hypopharyngeal (HPX) and 81 larynx (LX) cancer cases and 1206 visitor controls. Information on 11 different types of tobacco products and exposure to secondhand smoke was collected through structured questionnaires. Odds ratios (OR) and 95% confidence intervals (CI), for the association of various HNC subtypes with exclusive use of each tobacco product compared to nonusers of tobacco were estimated using logistic regression models, after adjusting for potential confounders. Exclusive use of any type of smokeless tobacco product was strongly associated with all subtypes of HNC. Gutka chewing (only) had highest risk (OR = 33.67; 95% CI = 19.8-57.0) while exclusive users of betel quid with tobacco (BQ + T), tobacco quid, Khaini, Mawa and Mishri users had a OR of 14.77, 24.20, 5.33, 2.96 and 3.32, respectively, for development of OC. Bidi smoking and secondhand smoke was independently associated with increased risk of HNC. Our study indicates that tobacco control policies should focus on product specific awareness messaging that switching between tobacco product types is not a safe alternative to complete cessation.
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Affiliation(s)
- Devyani Gholap
- Division of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
| | - Rajesh Dikshit
- Division of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Pankaj Chaturvedi
- Homi Bhabha National Institute, Mumbai, India.,Head and Neck Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Anil K Chaturvedi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Ankita Manjrekar
- Division of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Sharayu Mhatre
- Division of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
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9
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Chethi Reddy BR, Musale D, Kadam D, Lanjekar K, Ogale G, Bhise M, Gore S, Chaturvedi P, Dikshit R, Budukh A. Challenges faced by tobacco quitline services during the COVID-19 pandemic. Journal of Substance Use 2023. [DOI: 10.1080/14659891.2023.2167744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - Dinesh Musale
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Deepa Kadam
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Kalpita Lanjekar
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Ganesh Ogale
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Mahadev Bhise
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Suvarna Gore
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Mumbai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Mumbai, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Mumbai, India
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10
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Soerjomataram I, Cabasag C, Bardot A, Fidler-Benaoudia MM, Miranda-Filho A, Ferlay J, Parkin DM, Ranganathan R, Piñeros M, Znaor A, Mery L, Joko-Fru YW, Dikshit R, Sankaranarayanan R, Swaminathan R, Bray F. Cancer survival in Africa, central and south America, and Asia (SURVCAN-3): a population-based benchmarking study in 32 countries. Lancet Oncol 2023; 24:22-32. [PMID: 36603919 DOI: 10.1016/s1470-2045(22)00704-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Population-based cancer survival is a key measurement of cancer control performance linked to diagnosis and treatment, but benchmarking studies that include lower-income settings and that link results to health systems and human development are scarce. SURVCAN-3 is an international collaboration of population-based cancer registries that aims to benchmark timely and comparable cancer survival estimates in Africa, central and south America, and Asia. METHODS In SURVCAN-3, population-based cancer registries from Africa, central and south America, and Asia were invited to contribute data. Quality control and data checks were carried out in collaboration with population-based cancer registries and, where applicable, active follow-up was performed at the registry. Patient-level data (sex, age at diagnosis, date of diagnosis, morphology and topography, stage, vital status, and date of death or last contact) were included, comprising patients diagnosed between Jan 1, 2008, and Dec 31, 2012, and followed up for at least 2 years (until Dec 31, 2014). Age-standardised net survival (survival where cancer was the only possible cause of death), with 95% CIs, at 1 year, 3 years, and 5 years after diagnosis were calculated using Pohar-Perme estimators for 15 major cancers. 1-year, 3-year, and 5-year net survival estimates were stratified by countries within continents (Africa, central and south America, and Asia), and countries according to the four-tier Human Development Index (HDI; low, medium, high, and very high). FINDINGS 1 400 435 cancer cases from 68 population-based cancer registries in 32 countries were included. Net survival varied substantially between countries and world regions, with estimates steadily rising with increasing levels of the HDI. Across the included cancer types, countries within the lowest HDI category (eg, CÔte d'Ivoire) had a maximum 3-year net survival of 54·6% (95% CI 33·3-71·6; prostate cancer), whereas those within the highest HDI categories (eg, Israel) had a maximum survival of 96·8% (96·1-97·3; prostate cancer). Three distinct groups with varying outcomes by country and HDI dependant on cancer type were identified: cancers with low median 3-year net survival (<30%) and small differences by HDI category (eg, lung and stomach), cancers with intermediate median 3-year net survival (30-79%) and moderate difference by HDI (eg, cervix and colorectum), and cancers with high median 3-year net survival (≥80%) and large difference by HDI (eg, breast and prostate). INTERPRETATION Disparities in cancer survival across countries were linked to a country's developmental position, and the availability and efficiency of health services. These data can inform policy makers on priorities in cancer control to reduce apparent inequality in cancer outcome. FUNDING Tata Memorial Hospital, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer.
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Affiliation(s)
| | - Citadel Cabasag
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Aude Bardot
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | | | - Jacques Ferlay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Donald Maxwell Parkin
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France; The African Cancer Registry Network, Oxford, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Les Mery
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | | | | | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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11
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Rajput N, Gholap D, Mhatre S, Dikshit R. Epidemiological Review: Esophagus Squamous Cell Carcinoma in India. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1755445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractWorldwide the incidence of esophagus squamous cell carcinoma (ESCC), remains one of the most common causes of cancer death. ESCC is one of the leading types of cancer in the North and Northeast regions of India among both genders. Risk factors of ESCC include tobacco, alcohol, areca nut, hot beverages, low fruit diet, poor oral hygiene, unpiped water, and human papillomavirus infection. This review tries to elaborate on various modifiable risk factors for ESCC, which have been studied worldwide and need to be studied in India. PubMed was used as a search platform using keywords, such as “esophagus cancer,” “esophagus squamous cell carcinoma,” “epidemiology,” “India,” “incidence,” “mortality,” “risk factors,” “treatment,” “survival,” “prevention” and their corresponding Medical Subject Heading terms, were used in combination with Boolean operators “OR” and “AND.” Studies from India are mostly hospital-based case-control studies from the North region. Further research is required in India to understand the etiology, to design large-scale screening and prevention strategies.
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Affiliation(s)
- Nikita Rajput
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Devyani Gholap
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Sharayu Mhatre
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
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12
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Budukh A, Maheshwari A, Bagal S, Singh A, Deodhar K, Panse N, Palyekar V, Dikshit R, Badwe R. Factors influencing women to participate in cervical cancer screening by providing menstrual pads: A population-based study from rural areas of Maharashtra state, India. Indian J Cancer 2022; 59:462-468. [PMID: 34380839 DOI: 10.4103/ijc.ijc_910_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background India accounts for a quarter of the world cervical cancer burden. Cervical cancer is highly preventable. However, low level of participating women in screening is one of the major issues. The aim of this work was to study the factors that influence women to participate in cervical cancer screening by providing menstrual pads for human papillomavirus (HPV) testing. Methods Menstrual clothes were collected from two different populations from the rural areas of Maharashtra state for HPV testing to screen for cervical cancer. For this study, out of 945 participated women, 557 (58.9%) provided their menstrual pads. Multivariate logistic regression was applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Results The probability of providing the menstrual pads was high among the women who were highly educated compared to those with less education (OR: 1.4; 95% CI: 1.0-1.9), having mobile phone facilities as compared to those with no mobile phones (OR: 1.4; 95% CI: 1.0-2.0), who were using new cloths as menstrual pads compared to those who did not use the same (OR: 8.5; 95% CI: 5.0-14.3), who did not have tobacco habit as compared to those who had tobacco habit (OR: 1.4; 95% CI: 1.1-1.9) and in the village where health worker was stationed as compared to the village where health worker was not stationed (OR: 1.8; 95% CI: 1.4-2.5). Conclusion Factors including health worker availability, using mobile phones for communication and high education level facilitate women's participation. To improve the participation, there is need to apply special strategies for older age group, less educated women and women having tobacco habit.
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Affiliation(s)
- Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Amita Maheshwari
- Department of Gynecologic Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sonali Bagal
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Arpit Singh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kedar Deodhar
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nandkumar Panse
- Rural Cancer Registry, Nargis Dutt Memorial Cancer Hospital, Barshi, Maharashtra, India
| | - Vrushali Palyekar
- Department of Clinical Research, National Institute for Research and Reproductive Health, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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13
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Brown PE, Izawa Y, Balakrishnan K, Fu SH, Chakma J, Menon G, Dikshit R, Dhaliwal RS, Rodriguez PS, Huang G, Begum R, Hu H, D'Souza G, Guleria R, Jha P. Mortality Associated with Ambient PM2.5 Exposure in India: Results from the Million Death Study. Environ Health Perspect 2022; 130:97004. [PMID: 36102642 PMCID: PMC9472672 DOI: 10.1289/ehp9538] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Studies on the extent to which long-term exposure to ambient particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) contributes to adult mortality in India are few, despite over 99% of Indians being exposed to levels that the World Health Organization (WHO) considers unsafe. OBJECTIVE We conducted a retrospective cohort study within the Million Death Study (MDS) to provide the first-ever quantification of national mortality from exposure to PM2.5 in India from 1999 to 2014. METHODS We calculated relative risks (RRs) by linking a total of ten 3-y intervals of satellite-based estimated PM2.5 exposure to deaths 3 to 5 y later in over 7,400 small villages or urban blocks covering a total population of 6.8 million. We applied using a model-based geostatistical model, adjusted for individual age, sex, and year of death; smoking prevalence, rural/urban residency, area-level female illiteracy, languages, and spatial clustering and unit-level variation. RESULTS PM2.5 exposure levels increased from 1999 to 2014, particularly in central and eastern India. Among 212,573 deaths at ages 15-69 y, after spatial adjustment, we found a significant RR of 1.09 [95% credible interval (CI): 1.04, 1.14] for stroke deaths per 10-μg/m3 increase in PM2.5 exposure, but no significant excess for deaths from chronic respiratory disease and ischemic heart disease (IHD), all nonaccidental causes, and total mortality (after excluding stroke). Spatial adjustment attenuated the RRs for chronic respiratory disease and IHD but raised those for stroke. The RRs were consistent in various sensitivity analyses with spatial adjustment, including stratifying by levels of solid fuel exposure, by sex, and by age group, addition of climatic variables, and in supplementary case-control analyses using injury deaths as controls. DISCUSSION Direct epidemiological measurements, despite inherent limitations, yielded associations between mortality and long-term PM2.5 inconsistent with those reported in earlier models used by the WHO to derive estimates of PM2.5 mortality in India. The modest RRs in our study are consistent with near or null mortality effects. They suggest suitable caution in estimating deaths from PM2.5 exposure based on MDS results and even more caution in extrapolating model-based associations of risk derived mostly from high-income countries to India. https://doi.org/10.1289/EHP9538.
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Affiliation(s)
- Patrick E Brown
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Yurie Izawa
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Sze Hang Fu
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Joy Chakma
- The Indian Council of Medical Research, New Delhi, India
| | - Geetha Menon
- The Indian Council of Medical Research, New Delhi, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - R S Dhaliwal
- The Indian Council of Medical Research, New Delhi, India
| | - Peter S Rodriguez
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Guowen Huang
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Rehana Begum
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - George D'Souza
- St. John's Medical College, St. John's Research Institute, Bangalore, India
| | | | - Prabhat Jha
- Centre for Global Health Research (CGHR), St Michael's Hospital and Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
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14
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Bajpai J, Mailankody S, Budukh A, Swaminathan R, Dikshit R, Perera S, Dhimal M, Tshomo U, Bagal S, Bhise M, Banavali S, Gupta S, Chaturvedi P, Badwe R, Trama A. 1336P Epidemiology of rare cancers in South Asian Association for Regional Cooperation (SAARC) countries: Remembering the forgotten. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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15
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Chakravarti P, Maheshwari A, Tahlan S, Kadam P, Bagal S, Gore S, Panse N, Deodhar K, Chaturvedi P, Dikshit R, Budukh A. Diagnostic accuracy of menstrual blood for human papillomavirus detection in cervical cancer screening: a systematic review. Ecancermedicalscience 2022; 16:1427. [PMID: 36158979 PMCID: PMC9458266 DOI: 10.3332/ecancer.2022.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Priyal Chakravarti
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- https://orcid.org/0000-0003-2163-796X
| | - Amita Maheshwari
- Tata Memorial Hospital (TMH), Dr. E Borges Road, Parel, Mumbai 400012, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai 400094, India
- https://orcid.org/0000-0001-7655-1608
| | - Shweta Tahlan
- Homi Bhabha Cancer Hospital, Sangrur 148001, Punjab, India
- https://orcid.org/0000-0003-1655-684X
| | - Prithviraj Kadam
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- https://orcid.org/0000-0001-6241-9518
| | - Sonali Bagal
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- https://orcid.org/0000-0002-2510-1751
| | - Suvarna Gore
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- https://orcid.org/0000-0002-2866-5480
| | - Nandkumar Panse
- Rural Cancer Registry, Nargis Dutt Memorial Cancer Hospital, Barshi 413401, Maharashtra, India
- https://orcid.org/0000-0001-6043-3789
| | - Kedar Deodhar
- Tata Memorial Hospital (TMH), Dr. E Borges Road, Parel, Mumbai 400012, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai 400094, India
- https://orcid.org/0000-0002-6338-8191
| | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai 400094, India
- https://orcid.org/0000-0002-3520-1342
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai 400094, India
- https://orcid.org/0000-0003-4830-0486
| | - Atul Budukh
- Centre for Cancer Epidemiology (CCE), Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre (TMC), Kharghar, Navi Mumbai 410210, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai 400094, India
- https://orcid.org/0000-0001-6723-802X
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16
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Mhatre S, Lacey B, Sherliker P, Chatterjee N, Rajaraman P, Goel M, Patkar S, Ostwal V, Patil P, Shrikhande SV, Chitkara G, Badwe R, Lewington S, Dikshit R. Reproductive factors and gall-bladder cancer, and the effect of common genetic variants on these associations: a case-control study in India. Int J Epidemiol 2022; 51:789-798. [PMID: 34550362 PMCID: PMC9189936 DOI: 10.1093/ije/dyab197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In India, as elsewhere, the incidence of gall-bladder cancer (GBC) is substantially higher in women than in men. Yet, the relevance of reproductive factors to GBC remains poorly understood. METHODS We used logistic regression adjusted for age, education and area to examine associations between reproductive factors and GBC risk, using 790 cases of histologically confirmed GBC and group-matched 1726 visitor controls. We tested the interaction of these associations by genetic variants known to increase the risk of GBC. RESULTS Parity was strongly positively associated with GBC risk: each additional pregnancy was associated with an ∼25% higher risk {odds ratio [OR] 1.26 [95% confidence interval (95% CI) 1.17-1.37]}. After controlling for parity, GBC risk was weakly positively associated with later age of menarche [postmenopausal women, OR 1.11 (95% CI 1.00-1.22) per year], earlier menopause [OR 1.03 (95% CI 1.00-1.06) per year] and shorter reproductive lifespan [OR 1.04 (95% CI 1.01-1.07) per year], but there was little evidence of an association with breastfeeding duration or years since last pregnancy. Risk alleles of single-nucleotide polymorphisms in the ABCB4 and ABCB1 genetic regions had a multiplicative effect on the association with parity, but did not interact with other reproductive factors. CONCLUSIONS We observed higher GBC risk with higher parity and shorter reproductive lifespan, suggesting an important role for reproductive and hormonal factors.
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Affiliation(s)
- Sharayu Mhatre
- Section of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Sherliker
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Department of Biostatistics, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
- Department of Oncology, School of Medicine, John Hopkins University, Baltimore, MD, USA
| | - Preetha Rajaraman
- Office of Global Affairs, Department of Health and Human Services, Washington, DC, USA
| | - Mahesh Goel
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shraddha Patkar
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikas Ostwal
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Prachi Patil
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Gastroenterology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shailesh V Shrikhande
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Garvit Chitkara
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rajesh Dikshit
- Section of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
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17
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Chaturvedi P, Singh A, Bhattacharjee A, Tuljapurkar V, Nair D, Chaukar D, Dikshit R. Population-level Outcomes of Early Thyroid Cancers: A Need to Revisit Current Practice. Rambam Maimonides Med J 2022; 13:RMMJ.10467. [PMID: 35482460 PMCID: PMC9049149 DOI: 10.5041/rmmj.10467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Early thyroid cancers have excellent long-term outcomes, yet the word "cancer" draws unnecessary apprehension. This study aimed to define when the recommendations for observation and surveillance may be extended to early thyroid cancers at the population level. METHODS Non-metastasized thyroid cancers ≤40 mm diameter were identified from the 1975-2016 Surveillance, Epidemiology and End Results (SEER) database. Causes of death were compared across demographic data. Disease-specific outcomes were compared to the age-adjusted healthy United States (US) population. Survival estimates were computed using Kaplan-Meier and compared using the Cox proportional hazard model. Dynamic benchmarks impacting disease-specific overall survival were determined by decision tree modeling and tested by the Cox model. RESULTS Of the 28,728 thyroid cancers included in this study, 98.4% underwent some form of thyroid-specific treatment and were followed for a maximum of 10.9 years. This group had a 4.3% mortality rate at the end of follow-up (10.9 years maximum), with 13 times more deaths attributed to competing risks rather than thyroid cancer (stage T1a versus stage T1b, P=1.000; T1 versus T2, P<0.001). Among the untreated T1a or T1b tumors, the risk of disease-specific death was 21 times lower than death due to other causes. There was no significant difference between T1a and T1b tumors nor across sex. The age-adjusted risk of death for the healthy US population was higher than for the population with thyroid cancer. Dynamic categorization demonstrated worsening outcomes up to 73 years, uninfluenced by sex or tumor size. For patients over 73 years of age, only tumors >26 mm impacted outcomes. CONCLUSION Based on the current data, T1a and T1b nodules have similar survival outcomes and are not significantly impacted even when left untreated. Multi-institutional prospective studies are needed to confirm these findings so that current observation and surveillance recommendations can be extended to certain T1 thyroid nodules.
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Affiliation(s)
- Pankaj Chaturvedi
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Arjun Singh
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre and HBNI, Mumbai, India
- To whom correspondence should be addressed. E-mail:
| | - Vidisha Tuljapurkar
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Deepa Nair
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Devendra Chaukar
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre and HBNI, Mumbai, India
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18
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Gholap D, Mhatre S, Chaturvedi P, Nair S, Gheit T, Tommasino M, Dikshit R. Prevalence of human papillomavirus types in head and neck cancer sub-sites in the Indian population. Ecancermedicalscience 2022; 16:1358. [PMID: 35510141 PMCID: PMC9023304 DOI: 10.3332/ecancer.2022.1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
Although a subset of head and neck cancers (HNC) has been associated worldwide with mucosal high-risk human papillomaviruses (HPV), information on the prevalence of HPV-positive HNC in India is limited. In this study, we examined the prevalence of 21 subtypes of HPV in sub-sites of HNC (n = 175) in the western region of India. Type-specific multiplex genotyping assay was conducted at the Centre for Cancer Epidemiology, Tata Memorial Centre, to determine the prevalence of HPV subtypes. The HPV prevalence was observed to be 28.43%, 41.67%, 38.89% and 15.79% in the oral cavity, oropharynx, hypopharynx and larynx tumour tissues, respectively. The HPV 16 genotype was most common in all HNC tumour tissues (30.29%), followed by HPV 58 (0.57%).
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Affiliation(s)
- Devyani Gholap
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
- https://orcid.org/0000-0001-6406-4562
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
- Homi Bhabha National Institute, Mumbai 400094, India
| | - Pankaj Chaturvedi
- Homi Bhabha National Institute, Mumbai 400094, India
- Head and Neck Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Sudhir Nair
- Homi Bhabha National Institute, Mumbai 400094, India
- Head and Neck Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, CEDEX 08, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon, CEDEX 08, France
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
- Homi Bhabha National Institute, Mumbai 400094, India
- https://orcid.org/0000-0003-4830-0486
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19
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Patel KK, Chakravarti P, Chaturvedi P, Dikshit R, Budukh A. The fifth round of the National Family Health Survey of India 2019‐2021 reported low screening uptake alarming to strengthen the implementation of early detection services of the cervix, breast, and oral cancer. Int J Cancer 2022; 150:1734-1736. [DOI: 10.1002/ijc.33958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/18/2022] [Accepted: 01/28/2022] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology, Tata Memorial Centre Mumbai India
- Homi Bhabha National Institute Mumbai India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre Mumbai India
- Homi Bhabha National Institute Mumbai India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre Mumbai India
- Homi Bhabha National Institute Mumbai India
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20
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Castaño-Vinyals G, Sadetzki S, Vermeulen R, Momoli F, Kundi M, Merletti F, Maslanyj M, Calderon C, Wiart J, Lee AK, Taki M, Sim M, Armstrong B, Benke G, Schattner R, Hutter HP, Krewski D, Mohipp C, Ritvo P, Spinelli J, Lacour B, Remen T, Radon K, Weinmann T, Petridou ET, Moschovi M, Pourtsidis A, Oikonomou K, Kanavidis P, Bouka E, Dikshit R, Nagrani R, Chetrit A, Bruchim R, Maule M, Migliore E, Filippini G, Miligi L, Mattioli S, Kojimahara N, Yamaguchi N, Ha M, Choi K, Kromhout H, Goedhart G, 't Mannetje A, Eng A, Langer CE, Alguacil J, Aragonés N, Morales-Suárez-Varela M, Badia F, Albert A, Carretero G, Cardis E. Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study. Environ Int 2022; 160:107069. [PMID: 34974237 DOI: 10.1016/j.envint.2021.107069] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.
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Affiliation(s)
- G Castaño-Vinyals
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - S Sadetzki
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ministry of Health, Jerusalem, Israel
| | - R Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - F Momoli
- School of Epidemiology and Public Health, University of Ottawa, Canada; Risk Science International, Ottawa, Canada
| | - M Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - F Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | | | | | - J Wiart
- Laboratoire de Traitement et Communication de l'Information (LTCI), Telecom Paris, Institut Polytechnique de Paris, 91120 Palaiseau, France
| | - A-K Lee
- Radio Technology Research Department, Electronics and Telecommunications Research Institute (ETRI), Yuseong-gu, Daejeon, Korea
| | - M Taki
- Department of Electrical & Electronic Engineering, Graduate Schools of Science and Engineering, Tokyo Metropolitan University, Tokyo, Japan
| | - M Sim
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - B Armstrong
- School of Population and Global Health, The University of Western Australia, Perth 6009, Australia
| | - G Benke
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R Schattner
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H-P Hutter
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - D Krewski
- Risk Science International, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - C Mohipp
- University of Ottawa, Ottawa, Canada
| | - P Ritvo
- York University, Toronto, Ontario, Canada
| | - J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - B Lacour
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France; Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - T Remen
- Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - K Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - T Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - E Th Petridou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece; Dept of Hygiene and Epidemiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - M Moschovi
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - A Pourtsidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - K Oikonomou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - P Kanavidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - E Bouka
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - R Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
| | - R Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - A Chetrit
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Bruchim
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - E Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - G Filippini
- Scientific Director's Office, Carlo Besta Foundation and Neurological Institute, Milan, Italy
| | - L Miligi
- Environmental and Occupational Epidemiology Branch, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Mattioli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Italy
| | - N Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - N Yamaguchi
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Saiseikai Research Institute of Care and Welfare, Tokyo, Japan
| | - M Ha
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - K Choi
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - H Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - G Goedhart
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - A 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - A Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - C E Langer
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - J Alguacil
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - N Aragonés
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain
| | - M Morales-Suárez-Varela
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Valencia, Spain
| | - F Badia
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Cartogràfic i Geològic de Catalunya, Barcelona, Spain
| | - A Albert
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - G Carretero
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - E Cardis
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain.
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21
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Singh AG, Singhavi H, Sharin F, Lakdawala M, Mhatre S, Deodhar J, Chaturvedi P, Dikshit R. Cross-Sectional and Longitudinal Mental Health Status Prevailing among COVID-19 Patients in Mumbai, India. Indian J Community Med 2022; 47:55-60. [PMID: 35368483 PMCID: PMC8971876 DOI: 10.4103/ijcm.ijcm_928_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: The aim was to determine the prevalence and predictors of depression among less symptomatic COVID-19 patients. Methods: A questionnaire-based assessment was conducted among asymptomatic or mildly symptomatic COVID-19 patients when admitted in a COVID-19 facility (T1) and after 6 months (T2). Interviews were conducted using the Patient Health Questionnaire-9 instrument. Socio-demographic details and length of facility stay were recorded. Changes in scores between the two-time points T1 and T2 were compared. Factors predicting depression were determined using Chi-square and Mann–Whitney U test during facility stay, and those predicting worsening over time were obtained using multivariate regression models. Results: Among the 91.4% (n = 450) participants, prevalence of depression was 38.4% (95% confidence interval [CI] = 34.0–43.0) with a significant increase of 7.8-fold (95% CI = 4.8–12.8) in depression as the duration of stay increased beyond a median of 5 days. A significant association was observed between higher income and lower depression (odds ratios = 0.6, P = 0.03). 84% (n = 378) responded at the second timepoint assessment after a median of 6.62 months (T2). There was a significant difference observed between the 2.6% (n = 6) that worsened into depression at T2 and the 73.8% (n = 107) that improved out of depression at T2 (P ≤ 0.001). Age >45 years (P = 0.007), males (P = 0.011) and reinfection (P = 0.039) significantly led to worsening of depression. Conclusion: There is a need for actively detecting and managing depression in institutionally quarantined survivors, considering limiting such quarantine to no more than a week, and providing routine screening and care for depression beyond this period.
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Affiliation(s)
- Arjun Gurmeet Singh
- Tata Memorial Centre and HBNI, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Hitesh Singhavi
- Department of Head and Neck Oncology, Fortis Hospital Mulund, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Florida Sharin
- Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Muffazal Lakdawala
- Department of Head and Neck Oncology, Digestive Health Institute, Mumbai, Maharashtra, India
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology and HBNI, Mumbai, Maharashtra, India
| | - Jayita Deodhar
- Tata Memorial Centre and HBNI, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Tata Memorial Centre and HBNI, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology and HBNI, Mumbai, Maharashtra, India
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22
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Shetty A, Chatterjee G, Rajpal S, Srivastava T, Gardi N, Mirgh S, Gokarn A, Punatar S, Shetty N, Joshi A, Nair S, Murthy V, Khattry N, Tembhare P, Dikshit R, Chaturvedi P, More A, Kamtalwar S, Chavan P, Bhat V, Patil A, Dhumal S, Bhat P, Subramanian P, Gujral S, Badwe R, Patkar N, Gupta S. Genomic Analysis of AZD1222 (ChAdOx1) Vaccine Breakthrough Infections in the City of Mumbai. Int J Clin Pract 2022; 2022:2449068. [PMID: 35685574 PMCID: PMC9159196 DOI: 10.1155/2022/2449068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This manuscript describes the genetic features of SARS-CoV-2 mutations, prevalent phylogenetic lineages, and the disease severity amongst COVID-19-vaccinated individuals in a tertiary cancer hospital during the second wave of the pandemic in Mumbai, India. METHODS This observational study included 159 COVID-19 patients during the second wave of the pandemic from 17th March to 1st June 2021 at a tertiary cancer care centre in Mumbai. The cohort comprised of healthcare workers, staff relatives, cancer patients, and patient relatives. For comparison, 700 SARS-CoV-2 genomes sequenced during the first wave (23rd April to 25th September 2020) at the same centre were also analysed. Patients were assigned to nonvaccinated (no vaccination or <14 days from the 1st dose, n = 92), dose 1(≥14 days from the 1st dose to <14 days from the 2nd dose, n = 29), and dose 2 (≥14 days from the 2nd dose, n = 38) groups. Primary measure was the prevalence of SARS-CoV-2 genomic lineages among different groups. In addition, severity of COVID-19 was assessed according to clinical and genomic variables. RESULTS Kappa B.1.1671.1 and delta B.1.617.2 variants contributed to an overwhelming majority of sequenced genomes (unvaccinated: 40/92, 43.5% kappa, 46/92, 50% delta; dose 1: 14/29, 48.3% kappa, 15/29, 51.7% delta; and dose 2: 23/38, 60.5% kappa, 14/38 36.8% delta). The proportion of the kappa and delta variants did not differ significantly across the unvaccinated, dose 1, and dose 2 groups (p = 0.27). There was no occurrence of severe COVID-19 in the dose 2 group (0/38, 0% vs. 14/121, 11.6%; p = 0.02). SARS-CoV-2 genomes from all three severe COVID-19 patients in the vaccinated group belonged to the delta lineage (3/28, 10.7% vs. 0/39, 0.0%, p = 0.04). CONCLUSIONS Sequencing analysis of SARS-COV-2 genomes from Mumbai during the second wave of COVID-19 suggests the prevalence of the kappa B.1.617.1 and the delta B.1.627.2 variants among both vaccinated and unvaccinated individuals. Continued evaluation of genomic sequencing data from breakthrough COVID-19 is necessary for monitoring the properties of evolving variants of concern and formulating appropriate immune response boosting and therapeutic strategies.
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Affiliation(s)
- Arusha Shetty
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Gaurav Chatterjee
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sweta Rajpal
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Tuhina Srivastava
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Nilesh Gardi
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sumeet Mirgh
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Anant Gokarn
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sachin Punatar
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Nitin Shetty
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, India
| | - Amit Joshi
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sudhir Nair
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India
| | - Vedang Murthy
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India
| | - Navin Khattry
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Prashant Tembhare
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rajesh Dikshit
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
| | - Pankaj Chaturvedi
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India
| | - Ashwini More
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Sujeet Kamtalwar
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Preeti Chavan
- Department of Laboratory Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Vivek Bhat
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Microbiology, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Amar Patil
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Sachin Dhumal
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Prashant Bhat
- Department of General Medicine, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Papagudi Subramanian
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sumeet Gujral
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rajendra Badwe
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India
| | - Nikhil Patkar
- Haematopathology Laboratory, ACTREC, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sudeep Gupta
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
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Subedi R, Dhimal M, Budukh A, Chapagain S, Gyawali P, Gyawali B, Dahal U, Dikshit R, Jha AK. Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018. JCO Glob Oncol 2021; 7:443-452. [PMID: 33788597 PMCID: PMC8081507 DOI: 10.1200/go.20.00574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Although cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018. MATERIALS AND METHODS The PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software. RESULTS In the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex. CONCLUSION These findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.
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Affiliation(s)
- Ranjeeta Subedi
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Meghnath Dhimal
- Environmental Health Sciences, Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Atul Budukh
- Epidemiology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Sandhya Chapagain
- Radiation Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Pradeep Gyawali
- Clinical Pharmacology, Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Bishal Gyawali
- Departments of Oncology and Public Health Sciences, Division of Cancer Care and Epidemiology, Queen's University, Kingston, Canada
| | - Uma Dahal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Rajesh Dikshit
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Anjani Kumar Jha
- Radiation Oncology, Nepal Health Research Council (NHRC), Ramshahpath, Kathmandu, Nepal
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Budukh AM, Dikshit R, Chaturvedi P. Outcome of the randomized control screening trials on oral, cervix and breast cancer from India and way forward in COVID-19 pandemic situation. Int J Cancer 2021; 149:1619-1620. [PMID: 34152021 PMCID: PMC8427005 DOI: 10.1002/ijc.33712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Atul M Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Pankaj Chaturvedi
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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25
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Sekar A, Rajendra A, Noronha V, Mokal S, Patil VM, Menon N, Chopade S, Dikshit R, Banavali SD, Prabhash K. The epidemiological trend of esophageal cancer in Mumbai, India over the past two decades. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e16095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16095 Background: There has been a definite histopathological shift in esophageal cancer in the West over the past few decades, with adenocarcinoma overtaking squamous cell carcinoma as the commonest type. Asian countries with a high human development index like China have also reported an increased incidence of esophageal adenocarcinoma. Data on the epidemiology of esophageal cancer in India are limited. Methods: We retrospectively evaluated the data of all patients with histologically proven esophageal cancer at Tata Memorial Hospital, from 2003 to 2018. We excluded non-squamous and non-adenocarcinoma histologies. Results: Of a total of 7,874 patients with esophageal cancer, 5,092 (64.7%) were men, for a male to female ratio of 2.5:1. The median age was 57 years (IQR, 50-65); 4,465 (56.7%) were below 60 years old. Of the 4912 patients in whom a history of tobacco or alcohol use had been elicited, there were 1,360 (27.7%) patients with no history of substance use. The site of the primary was the upper third in 906 (12.8%), middle third esophagus in 2,942 (41.5%), lower third in 2,331 (32.8%) and gastroesophageal junction in 917 (12.9%) patients. The predominant histology was squamous cell carcinoma in 6,413 (81.4%) patients and adenocarcinoma in 1461 (18.6%). There was no change in the histologic pattern over the period of the study; squamous cell carcinoma constituted 78.5% of the cases in 2003, and 85.5% in 2018; Chi square test for the year wise trend in histologic patterns was not significant, p=0.143. Evaluation of the histologic subtype according to sex revealed that in the male patients, there were 3890 (76.4%) squamous and 1202 (23.6%) adenocarcinoma cases, while in female patients, there were 2523 (90.7%) squamous and 259 (9.3%) adenocarcinoma cases. On a uni variate analysis, male sex (p<0.001), a history of tobacco or alcohol use (p<0.001), and the presence of comorbidity (p<0.007) were associated with an increased risk of squamous cell carcinoma. Multivariate analysis by logistic regression model revealed that female sex and use of tobacco or alcohol were positively associated with squamous cell carcinoma, while the presence of comorbities and primary in lower esophagus/GEJ were positively associated with adenocarcinoma. Conclusions: Squamous cell carcinoma continues to be the commonest esophageal cancer histologic subtype in over 80% Indian patients. The mid esophagus is the most common site (42%). There is no evidence of an epidemiological shift or an increase in the occurrence of adenocarcinoma or of lower esophageal/GEJ malignancy over the past two decades.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kumar Prabhash
- Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, India
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26
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Subedi R, Budukh A, Chapagain S, Gyanwali P, Gyawali B, Khadka K, Thakur C, Dahal U, Dikshit R, Jha AK, Dhimal M. Differences in cancer incidence and pattern between urban and rural Nepal: one-year experience from two population-based cancer registries. Ecancermedicalscience 2021; 15:1229. [PMID: 34158833 PMCID: PMC8183641 DOI: 10.3332/ecancer.2021.1229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Indexed: 11/26/2022] Open
Abstract
Variations in cancer incidence, mortality and pattern exist in rural and urban areas. Understanding these differences helps in developing targeted cancer prevention and control strategies. However, no previous studies have explored the differences in cancer demographics between the rural and urban areas of Nepal. The data of Kathmandu Valley (urban area) Population-Based Cancer Registry (PBCR) and Rukum (rural area) PBCR were analysed to identify the differences in cancer pattern in rural and urban areas. The age-adjusted incidence rate (AAR) in Kathmandu was higher than that in Rukum (1.6 times among males and 1.9 times among females). The top two leading sites in males were lungs and stomach in both the regions; however, the rates were higher in Kathmandu. The incidence rate for cancer of the urinary bladder among males in Kathmandu was particularly higher - 4.4 times that of Rukum. In females, the leading site of cancer in Kathmandu was breast, which was eight times higher compared to Rukum, whereas the incidence rate of cervix cancer in Kathmandu is 30% less than in Rukum. The incidence of tobacco-related cancer was found to be higher in Kathmandu compared to Rukum. These findings reveal the need for different policy priorities for cancer control in the urban versus rural regions of Nepal, based on the different demographics of cancer in the two areas. Similar studies from other regions of Nepal are needed to develop a targeted cancer control strategy.
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Affiliation(s)
- Ranjeeta Subedi
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
| | - Atul Budukh
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai 400012, India
| | - Sandhya Chapagain
- National Academy of Medical Sciences, Bir Hospital, Kathmandu 44600, Nepal
| | - Pradip Gyanwali
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
| | - Bishal Gyawali
- Departments of Oncology and Public Health Sciences, Division of Cancer Care and Epidemiology, Queen’s University, Kingston K7L 3N6, Canada
| | - Kopila Khadka
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
| | - Chanda Thakur
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
| | - Uma Dahal
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
| | - Rajesh Dikshit
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai 400012, India
| | - Anjani Kumar Jha
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
| | - Meghnath Dhimal
- Nepal Health Research Council, RamshahPath, Kathmandu 44600, Nepal
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de Souza R, Mhatre S, Qayyumi B, Chitkara G, Madke T, Joshi M, Bharmal R, Asgaonkar DS, Lakhani P, Gupta S, Chaturvedi P, Dikshit R, Badwe R. Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study. BMJ Open 2021; 11:e042943. [PMID: 33958335 PMCID: PMC8103559 DOI: 10.1136/bmjopen-2020-042943] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India. DESIGN Observational study with follow-up. SETTING Data extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India. PARTICIPANTS 689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020. PRIMARY AND SECONDARY OUTCOME MEASURES In-hospital mortality; joint effect of comorbidity and age on the risk of dying. RESULTS A total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men. CONCLUSIONS In-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries. TRIAL REGISTRATION Not applicable (observational study, not a clinical trial).
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Affiliation(s)
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
| | | | - Garvit Chitkara
- Department of Breast Oncology, Tata Memorial Hospital, Mumbai, India
| | - Tushar Madke
- Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India
| | - Mohan Joshi
- Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India
| | - Ramesh Bharmal
- Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India
| | - D S Asgaonkar
- Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India
| | - Prem Lakhani
- Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India
| | - Sudeep Gupta
- Medical Oncology, Tata Memorial Centre, Mumbai, India
- Medical Oncology, Homi Bhabha National Institute, Mumbai, India
| | | | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
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28
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Affiliation(s)
- Rajendra A. Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400 012, Maharashtra, India
| | - Rajesh Dikshit
- Department of Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400 012, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400 012, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400 012, Maharashtra, India
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29
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Mhatre S, Rajaraman P, Chatterjee N, Bray F, Goel M, Patkar S, Ostwal V, Patil P, Manjrekar A, Shrikhande SV, Badwe R, Dikshit R. Mustard oil consumption, cooking method, diet and gallbladder cancer risk in high- and low-risk regions of India. Int J Cancer 2020; 147:1621-1628. [PMID: 32142159 DOI: 10.1002/ijc.32952] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 03/25/2024]
Abstract
The current study aimed to investigate the role of cooking with mustard oil and other dietary factors in relation to gallbladder cancer (GBC) in high- and low-incidence regions of India. A case-control study was conducted including 1,170 histologically confirmed cases and 2,525 group-matched visitor controls from the largest cancer hospital in India. Dietary data were collected through a food frequency questionnaire. For oil consumption, we enquired about monthly consumption of 11 different types of cooking oil per family and the number of individuals usually sharing the meal to estimate per-individual consumption of oil. Information about method of cooking was also requested. Odds ratios (ORs) and 95% confidence intervals (CIs) quantifying the association of GBC risk consumption of different types of oil, method of cooking, and dietary food items, were estimated using logistic regression models, after adjusting for potential confounders. High consumption of mustard oil was associated with GBC risk in both high- and low-risk regions (OR = 1.33, 95% CI = 0.99-1.78; OR = 3.01, 95% CI = 1.66-5.45), respectively. An increased risk of GBC was observed with deep frying of fresh fish in mustard oil (OR = 1.57, 95% CI = 0.99-2.47, p-value = 0.052). A protective association was observed with consumption of leafy vegetables, fruits, onion and garlic. No association was observed between consumption of meat, spicy food, turmeric, pulses or with any other oil as a cooking medium. The effect of high consumption of mustard oil on GBC risk, if confirmed, has implications for the primary prevention of GBC, via a reduced consumption.
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Affiliation(s)
- Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha national institute (HBNI), Mumbai, India
| | - Preetha Rajaraman
- Office of Global Affairs, Department of Health and Human Services, Washington, District of Columbia, USA
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Department of Biostatistics, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, USA
- Department of Oncology, School of Medicine, John Hopkins University, Baltimore, Maryland, USA
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Mahesh Goel
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shraddha Patkar
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Clinical Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikas Ostwal
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Prachi Patil
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Medical Gastroenterology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ankita Manjrekar
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
| | - Shailesh V Shrikhande
- Homi Bhabha national institute (HBNI), Mumbai, India
- Division of Cancer Surgery, GI & HPB Surgical Services, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Homi Bhabha national institute (HBNI), Mumbai, India
- Tata Memorial Centre-Surgical Oncology, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha national institute (HBNI), Mumbai, India
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Bhattacharjee A, Roy G, Budukh A, Dikshit R, Patil VM, Joshi A, Noronha V, Prabash K, Roy P. A competing risk analysis of death patterns in male genitourinary cancer. Cancer Rep (Hoboken) 2020; 3:e1174. [DOI: 10.1002/cnr2.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/26/2018] [Accepted: 12/26/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
- Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Gaurav Roy
- Molecular Genetics Laboratory, Institute of Medical Genetics and GenomicsSir Ganga Ram Hospital New Delhi India
| | - Atul Budukh
- Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Rajesh Dikshit
- Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Vijay M. Patil
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Kumar Prabash
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Papai Roy
- Biochemical Genetics LaboratoryInstitute of Medical Genetics and Genomics, Sir Ganga Ram Hospital New Delhi India
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31
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Singhavi HR, Singh A, Bhattacharjee A, Talole S, Dikshit R, Chaturvedi P. Alcohol and cancer risk: A systematic review and meta-analysis of prospective Indian studies. Indian J Public Health 2020; 64:186-190. [PMID: 32584303 DOI: 10.4103/ijph.ijph_529_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Alcohol increases risk of cancer of oral cavity and pharynx, esophagus, colorectal, liver, larynx, and female breast. Objectives The objective of this study was to determine the relationship of alcohol and cancer in India by meta-analysis. Methods Systematic Medline searches were performed to identify all the published literature associating alcohol and cancer in India. Initially, we retrieved 1509 studies, but after applying inclusion and exclusion criteria, only 29 studies were found eligible for our meta-analysis. Results Our meta-analysis shows that alcohol consumption increases the risk of cancer with the odds ratio (OR) of 2.32 (95% confidence interval [CI]: 1.50-3.47) in case-control studies and relative risk of 1.52 (95% CI: 0.97-2.51) in cohort studies. It also shows that risk of oral cavity cancer increases by two times (OR: 1.92, 95% CI: 1.54-3.96) in the population consuming alcohol. Publication analysis showed that studies included in the meta-analysis had wide variation, suggesting good representation all over the country. Conclusion The result from our meta-analysis supports our hypothesis that alcohol consumption increases the risk of cancer, implying immediate cessation of the habit for cancer risk reduction.
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Affiliation(s)
- Hitesh Rajendra Singhavi
- Fellow, Department of Head and Neck Surgery, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Arjun Singh
- Fellow, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Atanu Bhattacharjee
- Assitant Professor, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sanjay Talole
- Scientific Officer-E, Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Director, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Professor, Department of Head and Neck Surgery, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
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32
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Bhattacharjee A, Patil VM, Dikshit R, Prabhash K, Singh A, Chaturvedi P. Should we wait or not? The preferable option for patients with stage IV oral cancer in COVID-19 pandemic. Head Neck 2020; 42:1173-1178. [PMID: 32329953 PMCID: PMC7264597 DOI: 10.1002/hed.26196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 01/28/2023] Open
Abstract
Background The coronavirus infection is rapidly spreading, putting a strain on health care services across the globe. Patients with oral cancer are susceptible often immunosuppressed due to the disease and/or the treatment received. Methods We performed a simulation of the currently available data using a multistate and hazards model to provide an objective model for counseling and decision making for health care workers. Results Stage IV patients with oral cancer who did not receive treatment had progression of disease and an increased mortality rate compared to patients who receive treatment but did not contract COVID‐19. The patients who received treatment and got affected with COVID‐19 had a far worse impact and higher mortality rate than all other groups. Conclusion Isolation and deferring treatment for stage IV patients with oral cancer, so as to avoid hospital visits and contraction of COVID‐19, is an advisable strategy based on this model.
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Affiliation(s)
- Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Rajesh Dikshit
- Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Arjun Singh
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Oncology, Tata Memorial Centre and HBNI, Mumbai, India
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33
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Bhattacharjee A, Rajendra J, Dikshit R, Dutt S. HER2 borderline is a negative prognostic factor for primary malignant breast cancer. Breast Cancer Res Treat 2020; 181:225-231. [PMID: 32236825 DOI: 10.1007/s10549-020-05608-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND HER-(human epidermal growth factor receptor 2) gene amplification and protein overexpression are important predictive, prognosis markers, and therapeutic target for breast cancer, emphasizing the importance of categorizing patients into HER2 positive and negative. However, from immunohistochemistry scores, 2% patients are neither HER2 + nor -ve, but borderline called HER2B. To make informed treatment decisions of these patients, it is important to know how different this group is compared to HER-2 positive/negative. METHODS We analyzed n = 104,668 breast cancer patient samples from Surveillance, Epidemiology, and End Results (SEER) database. Survival analysis was performed using open source R (Cran project R version 3.5.0) "survival" package. Hazard ratio with confidence intervals was computed using coxph function. RESULTS Of n = 104,668, 2239 (2.13%) patients were HER2 borderline, 87,157 (83.26%) HER2-negative, and 15,272 (14.6%) HER2-positive. The breast cancer as primary malignancy was observed in 84,944 (81.16%) patients. In primary malignant breast cancer (PMBC) patients, the hazard ratio among HER2-negative patients was significantly higher than HER2-positive patient samples (HR = 0.772, 95% CI 0.715-0.833, p = < .001), whereas HER2 negative status was not significantly favorable in PMBC negative patients in HER2-positive (HR = .919, 95% 0.797-1.06, p = .248). Most importantly in PMBC patients, the HR for HER2-borderline was poor in comparison to HER2 negative (HR = 1.354, 95% CI 1.126-1.627, p = < .001). CONCLUSION This is the first report with large cohort of patient samples and significant statistical power to demonstrate that HER2 borderline represents a negative prognostic factor for PMBC. Thus providing rationale for controlled clinical trial for HER2-targeted therapies in HER2-borderline patients.
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Affiliation(s)
- Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar Navi, Mumbai, 410210, India.,Homi Bhabha National Institute, Anushakti Nagar, Mumbai, 400085, India
| | - Jacinth Rajendra
- Shilpee Dutt Laboratory, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi, Mumbai, Maharashtra, 410210, India.,Training School Complex, Homi Bhabha National Institute, Anushakti Nagar, Mumbai, 400085, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Shilpee Dutt
- Shilpee Dutt Laboratory, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi, Mumbai, Maharashtra, 410210, India. .,Training School Complex, Homi Bhabha National Institute, Anushakti Nagar, Mumbai, 400085, India.
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Pasqual E, Castaño-Vinyals G, Thierry-Chef I, Kojimahara N, Sim MR, Kundi M, Krewski D, Momoli F, Lacour B, Remen T, Radon K, Weinmann T, Petridou E, Moschovi M, Dikshit R, Sadetski S, Maule M, Farinotti M, Ha M, 't Mannetje A, Alguacil J, Aragonés N, Vermeulen R, Kromhout H, Cardis E. Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study. Neuroepidemiology 2020; 54:343-355. [PMID: 32200380 DOI: 10.1159/000506131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. METHODS MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. RESULTS Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. CONCLUSIONS There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.
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Affiliation(s)
- Elisa Pasqual
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Castaño-Vinyals
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Isabelle Thierry-Chef
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Noriko Kojimahara
- Department of Public Health, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, Ottawa, Ontario, Canada.,Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Franco Momoli
- Ottawa Hospital Research Institute, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France.,Inserm U1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris, France.,Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Thomas Remen
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France.,Inserm U1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris, France.,Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Eleni Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Unit of Clinical Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Maria Moschovi
- Haematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Siegal Sadetski
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Milena Maule
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mariangela Farinotti
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Andrea 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Juan Alguacil
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Roel Vermeulen
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hans Kromhout
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain, .,Universitat Pompeu Fabra (UPF), Barcelona, Spain, .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,
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Abstract
Background: Few traditions in South Asia have the antiquity and universal acceptance of betel quid and areca nut chewing. Its popularity dates back to ancient times in the South-Asian community with a foundation based on four factors, i.e. social acceptability, religious beliefs, perceived health benefits and addiction. We aim to provide an overview of its use in the South Asian region. Methods: We performed an electronic search on Medline, Embase and Google Scholar to identify the origins of the various betel quid and areca nut practices pertaining to the South Asian region along with their social and cultural influences. We also studied the prevalence across the region and the health effects, especially carcinogenic, along with the impact of diverse immigration today. Results: Other than the debate of where it originates, there is a diverse plethora of terms and methods of use of areca nut and betel quid in the region. Although established as a known carcinogen, the incidence is high, especially in the Indian subcontinent, with very few studies focusing on its use alone (without tobacco). The effect of globalization and increased movement of Asians across borders is resulting in changes in the patterns of diseases as well due to wider dissemination of areca nut and betel quid use. Conclusions: There is a huge loss of lives due to the addiction that areca nut causes. Governments need to tightly regulate the laws and set up tailored programs to tackle this specific issue in this region.
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Affiliation(s)
- Arjun Singh
- Department of Head and Neck Oncology, Tata Memorial Center, Mumbai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Center, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Oncology, Tata Memorial Center, Mumbai, India
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Kumar A, Mhatre S, Godbole S, Jha P, Dikshit R. Optimization of extraction of genomic DNA from archived dried blood spot (DBS): potential application in epidemiological research & bio banking. Gates Open Res 2019; 2:57. [PMID: 31815249 DOI: 10.12688/gatesopenres.12855.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Limited infrastructure is available to collect, store and transport venous blood in field epidemiological studies. Dried blood spot (DBS) is a robust potential alternative sample source for epidemiological studies & bio banking. A stable source of genomic DNA (gDNA) is required for long term storage in bio bank for its downstream applications. Our objective is to optimize the methods of gDNA extraction from stored DBS and with the aim of revealing its utility in large scale epidemiological studies. Methods: The purpose of this study was to extract the maximum amount of gDNA from DBS on Whatman 903 protein saver card. gDNA was extracted through column (Qiagen) & magnetic bead based (Invitrogen) methods. Quantification of extracted gDNA was performed with a spectrophotometer, fluorometer, and integrity analyzed by agarose gel electrophoresis. Result: Large variation was observed in quantity & purity (260/280 ratio, 1.8-2.9) of the extracted gDNA. The intact gDNA bands on the electrophoresis gel reflect the robustness of DBS for gDNA even after prolonged storage time. The extracted gDNA amount 2.16 - 24 ng/µl is sufficient for its PCR based downstream application, but unfortunately it can't be used for whole genome sequencing or genotyping from extracted gDNA. Sequencing or genotyping can be achieved by after increasing template copy number through whole genome amplification of extracted gDNA. The obtained results create a base for future research to develop high-throughput research and extraction methods from blood samples. Conclusion: The above results reveal, DBS can be utilized as a potential and robust sample source for bio banking in field epidemiological studies.
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Affiliation(s)
- Abhinendra Kumar
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, 410210, India.,Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400094, India
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, 410210, India.,Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400094, India
| | - Sheela Godbole
- Department of Biostatistics and Epidemiology, National AIDS Research Institute, Pune, Maharashtra, 411026, India
| | - Prabhat Jha
- Li Ka Shing Knowledge Institiute, St Michael's Hospital, Center for Global Health Research, Toronto, ON, Canada
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, 410210, India.,Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400094, India
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Kumar A, Mhatre S, Godbole S, Jha P, Dikshit R. Optimization of extraction of genomic DNA from archived dried blood spot (DBS): potential application in epidemiological research & bio banking. Gates Open Res 2019; 2:57. [PMID: 31815249 PMCID: PMC6883222 DOI: 10.12688/gatesopenres.12855.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Limited infrastructure is available to collect, store and transport venous blood in field epidemiological studies. Dried blood spot (DBS) is a robust potential alternative sample source for epidemiological studies & bio banking. A stable source of genomic DNA (gDNA) is required for long term storage in bio bank for its downstream applications. Our objective is to optimize the methods of gDNA extraction from stored DBS and with the aim of revealing its utility in large scale epidemiological studies. Methods: The purpose of this study was to extract the maximum amount of gDNA from DBS on Whatman 903 protein saver card. gDNA was extracted through column (Qiagen) & magnetic bead based (Invitrogen) methods. Quantification of extracted gDNA was performed with a spectrophotometer, fluorometer, and integrity analyzed by agarose gel electrophoresis. Result: Large variation was observed in quantity & purity (260/280 ratio, 1.8-2.9) of the extracted gDNA. The intact gDNA bands on the electrophoresis gel reflect the robustness of DBS for gDNA even after prolonged storage time. The extracted gDNA amount 2.16 – 24 ng/µl is sufficient for its PCR based downstream application, but unfortunately it can’t be used for whole genome sequencing or genotyping from extracted gDNA. Sequencing or genotyping can be achieved by after increasing template copy number through whole genome amplification of extracted gDNA. The obtained results create a base for future research to develop high-throughput research and extraction methods from blood samples. Conclusion: The above results reveal, DBS can be utilized as a potential and robust sample source for bio banking in field epidemiological studies.
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Affiliation(s)
- Abhinendra Kumar
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, 410210, India.,Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400094, India
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, 410210, India.,Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400094, India
| | - Sheela Godbole
- Department of Biostatistics and Epidemiology, National AIDS Research Institute, Pune, Maharashtra, 411026, India
| | - Prabhat Jha
- Li Ka Shing Knowledge Institiute, St Michael's Hospital, Center for Global Health Research, Toronto, ON, Canada
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, 410210, India.,Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400094, India
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Abstract
Purpose Identifying infectious pathogens by collecting intravenous blood (IVB) is a well-established procedure, however, the collection of IVB in field epidemiological study is challenging. The dried blood spot (DBS) as an alternative to IVB has been introduced, although, there is a limited study to demonstrate the utility of DBS stored at various storage conditions and transported at different periods. This is an observational study, which evaluates the effectiveness of DBS in field epidemiological studies to identify infectious pathogens. Materials and Methods A total of 264 paired DBS samples prepared from IVB, stored at 4°C, -20°C after period 24, 48 and 72 h. Serologically, enzyme-linked immunosorbent assay [ELISA] IgG antibody detected against Helicobacter pylori infection from DBS and compared with IVB. Results Quantitatively, IgG antibody reactivity showed >87% correlation between IVB and DBS samples stored at 4°C or -20°C within 48 h of transport duration. DBS stored at 4°C shows, equal sensitivity 87.5% and specificity 95% before 48 h of transport duration, while at -20°C storage similar sensitivity 87.5% observed but slightly less specificity 86.36% observed as compared to 24 h of transport duration. One-way analysis of variance showed, nonsignificant difference at both (-20°C and 4°C) the stored condition with P value (P > 0.851) and (P > 0.477). Kappa values showed good inter-rater reliability between DBS and IVB in a range (0.77-0.81). Conclusion No significant difference was observed in detecting H. pylori when ELISA was conducted using IVB or DBS stored at 4°C and transported even after 48 h. This confirms that DBS collected even in compromised conditions in the field can be used for detecting infection.
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Affiliation(s)
- Abhinendra Kumar
- Centre for Cancer Epidemiology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre; Homi Bhabha National Institute (HBNI), Training School Complex, Anushaktinagar, Mumbai, Maharashtra, India
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre; Homi Bhabha National Institute (HBNI), Training School Complex, Anushaktinagar, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre; Homi Bhabha National Institute (HBNI), Training School Complex, Anushaktinagar, Mumbai, Maharashtra, India
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Bhattacharjee A, Budukh A, Dikshit R. Prostate cancer survival estimates: An application with piecewise hazard function derivation. South Asian J Cancer 2019; 8:150-159. [PMID: 31489286 PMCID: PMC6699225 DOI: 10.4103/sajc.sajc_245_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The hazard function is defined as time-dependent. However, it is an overlooked area of research about the estimation of hazard function within the frame of time. The possible explanation could be carried by estimating function through the changes of time points. It is expected that it will provide us the overall idea of survival trend. This work is dedicated to propose a method to work with piecewise hazard rate. It is a data-driven method and provides us the estimates of hazard function with different time points. Methods: The proposed method is explored with prostate cancer patients, registered in the Surveillance, Epidemiology, and End Results Program and having aged at diagnosis with range 40–80 years and above. A total of 610,814 patients are included in this study. The piecewise hazard rate is formulated to serve the objective. The measurement of piecewise hazard rate is compared with Wald-type test statistics, and corresponding R function is provided. The duration of follow-ups is split into different intervals to obtain the piecewise hazard rate estimates. Results: The maximum duration of follow-up observed in this study is 40 years. The piecewise hazard rate changes at different intervals of follow-ups are observed almost same except few later intervals in the follow-up. The likelihood of hazard in earlier aged patients observed lower in comparison to older patients. The hazard rates in different grades of prostate cancer also observed separately. Conclusion: The application of piecewise hazard helps to generate statistical inference in a deeper manner. This analysis will provide us the better understanding of a requirement of effective treatment toward prolonged survival benefit for different aged patients.
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Affiliation(s)
- Atanu Bhattacharjee
- Centre for Cancer Epidemiology, The Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharastra, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, The Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharastra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, The Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, Maharastra, India
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40
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Kumar A, Mhatre S, Godbole S, Jha P, Dikshit R. Optimization of extraction of genomic DNA from archived dried blood spot (DBS): potential application in epidemiological research & bio banking. Gates Open Res 2019; 2:57. [DOI: 10.12688/gatesopenres.12855.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2019] [Indexed: 11/20/2022] Open
Abstract
Background:Limited infrastructure is available to collect, store and transport venous blood in field epidemiological studies. Dried blood spot (DBS) is a robust potential alternative sample source for epidemiological studies & bio banking. A stable source of genomic DNA (gDNA) is required for long term storage in bio bank for its downstream applications. Our objective is to optimize the methods of gDNA extraction from stored DBS and with the aim of revealing its utility in large scale epidemiological studies. Methods:The purpose of this study was to extract the maximum amount of gDNA from DBS on Whatman 903 protein saver card. gDNA was extracted through column (Qiagen) & magnetic bead based (Invitrogen) methods. Quantification of extracted gDNA was performed with a spectrophotometer, fluorometer, and integrity analyzed by agarose gel electrophoresis. Result:Large variation was observed in quantity & purity (260/280 ratio, 1.8-2.9) of the extracted gDNA. The intact gDNA bands on the electrophoresis gel reflect the robustness of DBS for gDNA even after prolonged storage time. The extracted gDNA amount 2.16 – 24 ng/µl is sufficient for its PCR based downstream application, but unfortunately it can’t be used for whole genome sequencing or genotyping from extracted gDNA. Sequencing or genotyping can be achieved by after increasing template copy number through whole genome amplification of extracted gDNA. The obtained results create a base for future research to develop high-throughput research and extraction methods from blood samples.Conclusion:The above results reveal, DBS can be utilized as a potential and robust sample source for bio banking in field epidemiological studies.
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Jha P, Kumar D, Dikshit R, Budukh A, Begum R, Sati P, Kolpak P, Wen R, Raithatha SJ, Shah U, Li ZR, Aleksandrowicz L, Shah P, Piyasena K, McCormick TH, Gelband H, Clark SJ. Automated versus physician assignment of cause of death for verbal autopsies: randomized trial of 9374 deaths in 117 villages in India. BMC Med 2019; 17:116. [PMID: 31242925 PMCID: PMC6595581 DOI: 10.1186/s12916-019-1353-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/28/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Verbal autopsies with physician assignment of cause of death (COD) are commonly used in settings where medical certification of deaths is uncommon. It remains unanswered if automated algorithms can replace physician assignment. METHODS We randomized verbal autopsy interviews for deaths in 117 villages in rural India to either physician or automated COD assignment. Twenty-four trained lay (non-medical) surveyors applied the allocated method using a laptop-based electronic system. Two of 25 physicians were allocated randomly to independently code the deaths in the physician assignment arm. Six algorithms (Naïve Bayes Classifier (NBC), King-Lu, InSilicoVA, InSilicoVA-NT, InterVA-4, and SmartVA) coded each death in the automated arm. The primary outcome was concordance with the COD distribution in the standard physician-assigned arm. Four thousand six hundred fifty-one (4651) deaths were allocated to physician (standard), and 4723 to automated arms. RESULTS The two arms were nearly identical in demographics and key symptom patterns. The average concordances of automated algorithms with the standard were 62%, 56%, and 59% for adult, child, and neonatal deaths, respectively. Automated algorithms showed inconsistent results, even for causes that are relatively easy to identify such as road traffic injuries. Automated algorithms underestimated the number of cancer and suicide deaths in adults and overestimated other injuries in adults and children. Across all ages, average weighted concordance with the standard was 62% (range 79-45%) with the best to worst ranking automated algorithms being InterVA-4, InSilicoVA-NT, InSilicoVA, SmartVA, NBC, and King-Lu. Individual-level sensitivity for causes of adult deaths in the automated arm was low between the algorithms but high between two independent physicians in the physician arm. CONCLUSIONS While desirable, automated algorithms require further development and rigorous evaluation. Lay reporting of deaths paired with physician COD assignment of verbal autopsies, despite some limitations, remains a practicable method to document the patterns of mortality reliably for unattended deaths. TRIAL REGISTRATION ClinicalTrials.gov , NCT02810366. Submitted on 11 April 2016.
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Affiliation(s)
- Prabhat Jha
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Dinesh Kumar
- Department of Community Medicine, Pramukhswami Medical College, Anand, Gujarat, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Rehana Begum
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Prabha Sati
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Patrycja Kolpak
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Richard Wen
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Utkarsh Shah
- Department of Community Medicine, Pramukhswami Medical College, Anand, Gujarat, India
| | | | | | - Prakash Shah
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kapila Piyasena
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tyler H McCormick
- Department of Statistics, University of Washington, Seattle, USA.,Department of Sociology, University of Washington, Seattle, USA
| | - Hellen Gelband
- Centre for Global Health Research, St Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Samuel J Clark
- London School of Hygiene & Tropical Medicine, London, UK.,Department of Sociology, Ohio State University, Columbus, USA
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Budukh A, Maheshwari A, Palayekar V, Bagal S, Purwar P, Deodhar K, Dikshit R, Badwe R. Prevalence and nonsexual transmission of human papilloma virus (HPV) in the adolescence girls from rural area of Maharashtra state, India. Indian J Cancer 2019; 55:336-339. [PMID: 30829266 DOI: 10.4103/ijc.ijc_188_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To find out the prevalence of human papilloma virus (HPV) in adolescent girls and to access the nonsexual transmission of HPV from their mother by using the same old cloth used by their mother. METHOD Menstrual pads were collected from the women of age group years to find out the presence of HPV and whether it can be used as a cervical cancer screening tool. The results of the said study have been published in the European Journal of Cancer Prevention. During this study, menstrual pads of the daughters of participating women were collected to see the nonsexual transmission of HPV. After conducting the health education and obtaining the informed consent, we interviewed 57 mothers (age group 30-50, married, sexually active) and daughters [age group 12-18, unmarried (not exposed to sex)] from the rural area of Pune district of Maharashtra state, India. The menstrual pads were collected and transported to Mumbai for polymerase chain reaction (PCR) testing. HPV testing was carried out by PCR. RESULTS Out of 57, 28 (49%) daughters and 23 (40.4%) mothers provided menstrual pad. Out of 23 mothers, one was HPV positive [4.3%: 95% confidence interval (CI) 0.2-23.0] and out of 28 girls, 3 (10.7%: 95% CI 2.0-33.0) were HPV positive. The daughter, whose mother was HPV positive, had negative result for HPV. CONCLUSION The HPV prevalence in adolescence girls was 10.7%. There may be other nonsexual medium that might have caused HPV in adolescence girls, which needs further research.
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Affiliation(s)
- Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Amita Maheshwari
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vrushali Palayekar
- National Institute for Research and Reproductive Health, Mumbai, Maharashtra, India
| | - Sonali Bagal
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Pallavi Purwar
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kedar Deodhar
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Centre for Cancer Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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43
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Budukh A, Singh A, Chaturvedi P, Dikshit R. Systematic review on telephonic Quitline and its effects on smokeless tobacco. Int J Non-Commun Dis 2019. [DOI: 10.4103/jncd.jncd_26_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gomes M, Begum R, Sati P, Dikshit R, Gupta PC, Kumar R, Sheth J, Habib A, Jha P. Nationwide Mortality Studies To Quantify Causes Of Death: Relevant Lessons From India's Million Death Study. Health Aff (Millwood) 2018; 36:1887-1895. [PMID: 29137507 DOI: 10.1377/hlthaff.2017.0635] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Progress toward the United Nations 2030 Sustainable Development Goals requires improved information on mortality and causes of death. However, causes of many of the fifty million annual deaths in low- and middle-income countries remain unknown, as most of the deaths occur at home without medical attention. In 2001 India began the Million Death Study in 1.3 million nationally representative households. Nonmedical staff conduct verbal autopsies, which are structured interviews including a half-page narrative in local language of the family's story of the symptoms and events leading to death. Two physicians independently assess each death to arrive at an underlying cause of death. The study has thus far yielded information that substantially altered previous estimates of cause-specific mortality and risk factors in India. Similar robust studies are feasible at low cost in other low- and middle-income countries, particularly if they adopt electronic data management and ensure high quality of fieldwork and physician coding. Nationwide mortality studies enable the quantification of avoidable premature mortality and key risk factors for disease, and provide a practicable method to monitor progress toward the Sustainable Development Goals.
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Affiliation(s)
- Mireille Gomes
- Mireille Gomes is a scientist at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto, in Ontario
| | - Rehana Begum
- Rehana Begum is director of operations at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto
| | - Prabha Sati
- Prabha Sati is associate director for program outreach at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto
| | - Rajesh Dikshit
- Rajesh Dikshit is a professor of epidemiology at the Tata Memorial Centre, in Mumbai, India
| | - Prakash C Gupta
- Prakash C. Gupta is managing director of the Healis Sekhsaria Institute for Public Health, in Mumbai
| | - Rajesh Kumar
- Rajesh Kumar is dean (academic) of the Post Graduate Institute of Medical Education and Research, in Chandigarh, India
| | - Jay Sheth
- Jay Sheth is an associate professor in the Department of Community Medicine at Ahmedabad Municipal Corporation's Medical Education Trust Medical College, in Ahmedabad, India
| | - Asad Habib
- Asad Habib is a project manager and senior software systems developer at the Centre for Global Health Research, St. Michael's Hospital and University of Toronto
| | - Prabhat Jha
- Prabhat Jha ( ) is director of the Centre for Global Health Research, St. Michael's Hospital and University of Toronto, and a professor of global health and epidemiology, also at the University of Toronto
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Adhikari A, Dikshit R, Karia S, Sonavane S, Shah N, De Sousa A. Neutrophil-lymphocyte Ratio and C-reactive Protein Level in Patients with Major Depressive Disorder Before and After Pharmacotherapy. East Asian Arch Psychiatry 2018; 28:53-58. [PMID: 29921741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) level are useful biomarkers of inflammation. This study aimed to assess NLR and CRP level in patients with major depressive disorder before and after pharmacotherapy to determine whether NLR or CRP could be used as biomarkers of severity of major depression and whether there was any sex difference. METHODOLOGY Patients with major depression who received no pharmacotherapy 1 month prior to the study were included. Their haemoglobin, total white blood cell count, neutrophil and lymphocyte counts, NLR, and CRP levels were evaluated at baseline and 12 weeks post pharmacotherapy, as were the Montgomery Asberg Rating Scale for Depression, the Scale for Impact of Suicidality Management and Assessment and Planning of Care (SIS-MAP), and the Clinical Global Impression Scale - Severity. RESULTS 24 male and 26 female patients were included. At 12 weeks after pharmacotherapy, males had a higher haemoglobin level (p = 0.025), higher total white blood cell count (p = 0.018), and lower percentage of neutrophils (p = 0.019) than females. There was no sex difference in NLR or CRP. From baseline to 12 weeks, males had no significant change in any blood parameter, but females had a significantly greater increase in the percentage of neutrophils (p = 0.0001) and decrease in the percentage of lymphocytes (p = 0.012), resulting in a significantly increased NLR (p = 0.001). Both males and females had significant improvement on all 3 scales (p < 0.001). At 12 weeks, in males, the increase in NLR positively correlated with CRP as well as the Montgomery-Asberg Depression Rating Scale and the SIS-MAP, but not the Clinical Global Impression-Severity Scale. In females, the increase in NLR did not correlate with CRP or any of the scales. CONCLUSION In female patients, the NLR increased in response to antidepressant therapy while CRP remained unchanged. This indicated that inflammation has a role in the pathogenesis of major depression.
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Affiliation(s)
- A Adhikari
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - R Dikshit
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - S Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - S Sonavane
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - N Shah
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - A De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
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Budukh A, Dikshit R, Thakur JS, Kadam P, Dora T, Sancheti S, Chaudhary D, Badwe RA. Linkage of cancer registration with cancer treatment in predominantly rural district: A model form Sangrur district, Punjab state, India. Int J Non-Commun Dis 2018. [DOI: 10.4103/jncd.jncd_19_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mhatre S, Chatterjee N, Dikshit R, Rajaraman† P. Genetics of gallbladder cancer – Authors' reply. Lancet Oncol 2017; 18:e297. [DOI: 10.1016/s1470-2045(17)30353-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022]
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Mhatre S, Wang Z, Nagrani R, Badwe R, Chiplunkar S, Mittal B, Yadav S, Zhang H, Chung CC, Patil P, Chanock S, Dikshit R, Chatterjee N, Rajaraman P. Common genetic variation and risk of gallbladder cancer in India: a case-control genome-wide association study. Lancet Oncol 2017; 18:535-544. [DOI: 10.1016/s1470-2045(17)30167-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/17/2017] [Accepted: 01/26/2017] [Indexed: 02/03/2023]
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Agarwal J, Krishnatry R, Chaturvedi P, Ghosh-Laskar S, Gupta T, Budrukkar A, Murthy V, Deodhar J, Nair D, Nair S, Dikshit R, D'Cruz AK. Survey of return to work of head and neck cancer survivors: A report from a tertiary cancer center in India. Head Neck 2017; 39:893-899. [DOI: 10.1002/hed.24703] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 11/11/2016] [Accepted: 12/06/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jaiprakash Agarwal
- Department of Radiation Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Rahul Krishnatry
- Department of Radiation Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Sarbani Ghosh-Laskar
- Department of Radiation Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Tejpal Gupta
- Department of Radiation Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Ashwani Budrukkar
- Department of Radiation Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Vedang Murthy
- Department of Radiation Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Joyita Deodhar
- Department of Psychiatry; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Deepa Nair
- Department of Surgical Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Sudhir Nair
- Department of Surgical Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Rajesh Dikshit
- Department of Biostatistics; Tata Memorial Hospital; Mumbai Maharashtra India
| | - Anil K. D'Cruz
- Department of Surgical Oncology; Tata Memorial Hospital; Mumbai Maharashtra India
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Nagrani R, Mhatre S, Rajaraman P, Chatterjee N, Akbari MR, Boffetta P, Brennan P, Badwe R, Gupta S, Dikshit R. Association of Genome-Wide Association Study (GWAS) Identified SNPs and Risk of Breast Cancer in an Indian Population. Sci Rep 2017; 7:40963. [PMID: 28098224 PMCID: PMC5241870 DOI: 10.1038/srep40963] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/05/2016] [Indexed: 01/24/2023] Open
Abstract
To date, no studies have investigated the association of the GWAS-identified SNPs with BC risk in Indian population. We investigated the association of 30 previously reported and replicated BC susceptibility SNPs in 1,204 cases and 1,212 controls from a hospital based case-control study conducted at the Tata Memorial Hospital, Mumbai. As a measure of total susceptibility burden, the polygenic risk score (PRS) for each individual was defined by the weighted sum of genotypes from 21 independent SNPs with weights derived from previously published estimates of association odds-ratios. Logistic regression models were used to assess risk associated with individual SNPs and overall PRS, and stratified by menopausal and receptor status. A total of 11 SNPs from eight genomic regions (FGFR2, 9q31.2, MAP3K, CCND1, ZM1Z1, RAD51L11, ESR1 and UST) showed statistically significant (p-value ≤ 0.05) evidence of association, either overall or when stratified by menopausal status or hormone receptor status. BC SNPs previously identified in Caucasian population showed evidence of replication in the Indian population mainly with respect to risk of postmenopausal and hormone receptor positive BC.
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Affiliation(s)
- Rajini Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Preetha Rajaraman
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, USA
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, USA
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, USA
- Department of Oncology, School of Medicine, Johns Hopkins University, USA
| | - Mohammad R. Akbari
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Paolo Boffetta
- Institute For Translational Epidemiology, Mount Sinai Hospital, One Gustave L.Levy Place New York, NY, USA
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX, France
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sudeep Gupta
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
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