Cancer in Women
Authors: Mathew Aleyamma 
Published: May 2020

Cancer is emerging as a public health problem among an array of non-communicable diseases. The common cancers in women are breast, cervix uteri, colo-rectum, ovary, corpus uteri, lung and oral cavity. Breast cancer (BC) is the common cancer (20-30% of all cancers in women) and the leading cause of cancer death in women worldwide. About half of the BCs and 60% of the deaths are estimated to occur in economically developing countries. In most of the registries in India, BC is the commonest cancer with the highest incidence of nearly 50 per 100,000 women in Trivandrum. Half of this cancer is reported in <50 years of age and it exercises adverse influence on the productive role of women in the society. The factors that contribute to the international variation in BC incidence rates are largely due to the differences in reproductive and hormonal factors and the availability of early detection services.

Gynecological cancers account 15-30% of all cancers in women. Cervix uteri cancer (CC) is the 3rd most common cancer affecting women worldwide, the most common cancer among women in several less developed countries and 2nd common cancer in India. During last few decades, this cancer incidence has been decreased in India. Significant declines in CC are likely due to changes in marriage and family planning, supported by underlying improvements in education and socioeconomic status. In spite of decreasing incidence of this cancer, gynecologic cancers have increased in India. Among these, ovary and corpus uteri cancers are the major contributors. Ovarian cancer (OC) has emerged as one of the common malignancies affecting women in India and is the 5th common cancer in India (4th common in Trivandrum). A steady increase has been observed in OC incidence in several registries including Trivandrum. More than 50% of women with OC are under the age of 50 years. The risk of it increases in women who have ovulated more over their lifetime. This includes those who begin ovulation at a younger age or reach menopause at an older age. Other risk factors include hormone therapy after menopause, fertility medication and obesity. Factors that decrease risk include hormonal birth control, tubal ligation, and breast feeding. Efforts are to be made to detect ovarian cancer at an early stage by educating population about the risk factors. Corpus uteri cancers (CUC) are most common in western countries but are becoming more common in Asia. In India, the highest CUC incidence rates are observed in Trivandrum and its incidence has been increasing. Presently, it is the 5th common cancer among women in Trivandrum, 75% of women are over the age of 50 years. The risk factors of CUC include obesity, diabetes mellitus, BC, use of tamoxifen, never having had a child, late menopause and high levels of estrogen.

Colo-rectal cancer (CRC) is the 2nd most common cancer in women world-wide. The burden of CRC has risen rapidly in some economically developed Asian countries like Japan, South Korea and Singapore. In India, the highest CRC incidence rates are observed in Trivandrum and its incidence has been increasing. Presently, it is the 5th common cancer among women in Trivandrum. The major factors include certain dietary practices and family history of cancer. Individuals with a family history of colon cancer, especially if more than one relative has had the disease, are at increased risk of CRC. Other common cancers in women are tobacco-related cancers such as oral cavity (lip, tongue and mouth) and lung. Declining trends in mouth cancer has been reported in India.

Results on the burden, trends in incidence & mortality, risk factors of breast, cervix uteri, ovary and corpus uteri colo-rectal, lung and oral cavity cancers will be presented.