Ahmedabad’s urban PBCR had a higher survival rate of 61.5 per cent followed by Thiruvananthapuram (58.8 per cent) and Kollam (56.1 per cent). Tripura had the lowest survival rate of 31.6 per cent, the researchers said in their study published in the journal The Lancet Regional Health Southeast Asia. A total of 5591 cervical cancer cases from 11 PBCRs diagnosed between 2012 and 2015 were studied.
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The overall survival rate of 52 per cent was about 6 per cent higher than that recorded in the previous SurvCan survey-3, which was 46 per cent. The survey presented a 5-year cancer survival assessment for selected PBCRs in India from 1991 to 1999.
SurvCan 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.
The research team in this study included scientists from the National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, and other Indian institutes.
The team further found that the estimated incidence rate for cervical cancer in 2020 was 10.9 per 1,00,000, even as both urban and rural PBCRs in India showed a declining trend in cervical cancer incidence. However, despite decreasing incidence rates, cervical cancer is the second most common female cancer in India, accounting for about 10 per cent of all female cancers, they said in their study. Covering 65 million person-years female population from various geographical regions in India, the study was the largest population level comparative survival study on cervical cancer, the researchers said.
Survival was found to be low in India’s northeastern (NE) region, particularly in PBCRs in Tripura, Pasighat and Kamrup urban, with the region’s survival rate being lower than the national or pooled average, the researchers said, adding that a hospital-based survival study from the region revealed a lower 5-year overall survival rate of 40.7 per cent.
The access to diagnostic and effective treatment services has varied across the populations which could explain the disparity in survival rates across the population, the researchers said.
Distance from a clinical care facility, travel costs, co-morbidity, and poverty all increase the likelihood of not undergoing a follow-up examination and completing treatment, resulting in lower survival, the researchers analysed.
The NE region has lacked health care infrastructure, treatment facilities, and human resources with PBCRs in Tripura, Pasighat, Manipur, Sikkim, Mizoram and Wardha each having less than 5 major sources of secondary and tertiary level hospitals, the researchers said.
The PBCRs in Thiruvananthapuram, Kollam, Ahmedabad urban, Kamrup urban, and Mumbai each had more than 10 such sources, they said.
The researchers concluded saying that the observed disparity in cervical cancer survival could explain the overall effectiveness of the health care system.
Emphasising the importance of promoting awareness, early detection and improvements in the health-care system, the researchers said that their findings help inform policymakers to identify and address inequities in the health system.
