The incidence and survival rates of colorectal cancer in India remain low compared with rising rates in East Asia.
BACKGROUND
During the past 3 decades, the incidence of colorectal cancer was at a low level in urban and rural populations in India, in comparison with figures observed in developed countries of North America and Europe.


OBJECTIVE
The aim of this study was to describe the time trends of incidence and mortality, and the survival rates of colorectal cancer, as well, in India.


METHODS
This is an ecological study.


METHODS
The primary outcome measured is the incidence data extracted from selected Indian cancer registries in the volumes on cancer incidence in 5 continents.


RESULTS
Low and stable incidence and mortality rates from colon and rectum cancers were observed in India in both men and women. However, this low incidence rate was associated with a low 5-year relative survival rate.


CONCLUSIONS
It is likely that the prevailing environmental factors and lifestyle, including a reduced consumption of sugars, calories and fat-rich food, an increased consumption of vegetables and fruits, and an adequate physical activity with avoidance of overweight and obesity, are responsible for the low risk of colorectal cancers. In contrast, the low survival, even for localized cases, suggests severe deficiencies in early diagnosis and effective treatment in India. A strategy to control the disease in India, based on improving awareness of the risk factors for colorectal cancer while keeping the traditional lifestyle, and on investments in early diagnosis and adequate treatment should be implemented. However, an organized, population-based screening of colorectal cancer may not prove cost-effective, given the low burden of colorectal cancer.
All India Institute of Medical Sciences, New Delhi, India.
Sushmita
S
Pathy
René
R
Lambert
Catherine
C
Sauvaget
Rengaswamy
R
Sankaranarayanan
D000349:Africa / Q000453:epidemiology; D000569:Americas / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D017281:Cost of Illness; D005060:Europe / Q000453:epidemiology; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D012042:Registries; D015996:Survival Rate