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Mumbai, India

Sirohi B.,Narayana Health | Savio G.B.,Medicity | Chacko R.T.,Christian Medical College | Parikh P.M.,Indian Cancer Society | And 8 more authors.
Indian Journal of Medical and Paediatric Oncology | Year: 2014

This consensus statement was produced along with the gastric cancer discussions as stomach is the most common site for gastrointestinal stromal tumor (GIST). The recommendations apply to treatment of GIST.Evaluation of a patient with newly diagnosed GIST should include essential tests: A standard white light endoscopy with 6-8 biopsies (c-KIT testing on immunohistochemistry) from the tumor for confirmation of the diagnosis, a computed tomography (CT) scan (multi-detector or helical) of the abdomen and pelvis for staging with a CT chest or chest X-ray, and complete blood counts, renal function tests and liver function tests. Endoscopic ultrasonography (EUS)/magnetic resonance imaging (MRI)/positron emission tomography (PET)-CT are not recommended for all patients.For localized and resectable disease, surgery is recommended. The need for adjuvant treatment with imatinib would be guided by the risk stratification on the histopathological analysis of the resected specimen.For localized but borderline resectable tumors, upfront surgery may be considered only if complications due to the tumor are present such as major bleeding or gastric outlet obstruction. In all other patients, neoadjuvant imatinib should be considered to downstage the disease followed by surgery (with a curative intent, if feasible) in those with stable or partial response. This may be followed by adjuvant imatinib. In those patients with a poor response, further imatinib with dose escalation or sunitinib may be considered.Patients with metastatic disease must be assessed for treatment with imatinib as first-line therapy followed by sunitinib as second-line therapy versus best supportive care on an individual basis.

Pednekar M.S.,Sekhsaria Institute for Public Health | Gupta P.C.,Sekhsaria Institute for Public Health | Gupta P.C.,University of South Carolina | Yeole B.B.,Indian Cancer Society | And 2 more authors.
Cancer Causes and Control | Year: 2011

Objective: Bidis are hand-rolled cigarettes commonly smoked in South Asia and are marketed to Western populations as a safer alternative to conventional cigarettes. This study examined the association between bidis and other forms of tobacco use and cancer incidence in an urban developing country population. Methods: Using data from the large, well-characterized Mumbai cohort study, adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed from Cox proportional hazards regression models in order to compare the relative effect of various forms of tobacco use on cancer incidence. Results: During 649,228 person-years of follow-up 1,267 incident cancers occurred in 87,222 male cohort members. Incident oral cancer in bidi smokers (HR = 3.55; 95% CI = 2.40,5.24) was 42% higher than in cigarette smokers (HR = 2.50;95% CI = 1.65,3.78). For all respiratory and intrathoracic organs combined, the increase was 69% (HR = 5.54; 95% CI = 3.46,8.87 vs. HR = 3.28; 95% CI = 1.99,5.39); for lung and larynx, the increases were 35 and 112%, respectively. Smokeless tobacco use was associated with cancers of the lip, oral cavity, pharynx, digestive, respiratory, and intrathoracic organs. Conclusions: Despite marketing claims to the contrary, we found that smokeless tobacco use and bidi smoking are at least as harmful as cigarette smoking for all incident cancers and are associated with increased risk of oral and respiratory/intrathoracic cancers. © 2011 Springer Science+Business Media B.V.

Dey S.,Indian Institute of Public Health | Pahwa P.,CARE India | Mishra A.,Indian Institute of Public Health | Govil J.,Indian Cancer Society | Dhillon P.K.,Center for Chronic Conditions and Injuries
Journal of Obstetrics and Gynecology of India | Year: 2016

Objectives: Burden of cervical cancer (CC) is highest for women in low- and middle-income countries (LMICs). Human papillomavirus (HPV) is implicated as the necessary cause of CC although a number of other factors aid the long process of CC development. One among them is the presence of reproductive tract infections (RTIs). This study investigated the associations between RTIs and CC from India. Methods: This study utilized secondary data from the Cancer Detection Centre of the ICS, Delhi. Data were accessed from MS access database and were analyzed using MS Excel and SPSS 16.0. Multivariate analysis using unconditional logistic regression produced odds ratios (ORs) and 95 % confidence intervals (CIs). Results: This study used data from 11,427 women over a period of 2000–2012. Women with RTIs had Candida, Trichomonas vaginalis (TV) or coccoid infections with all having similar prevalence (~4–5 %). 9.4 % of women had premalignant lesions of cervix; ASCUS was most common (7.9 %) followed by LSIL (1.3 %). TV was significantly associated with ASCUS, LSIL and all premalignant lesions of cervix (P < 0.001). Regression discovered an important association of TV with premalignant lesions of cervix (OR 2.79; 95 % CI 2.14, 3.64). Conclusions: Earlier studies have depicted associations between TV and HPV with possible enhancement of HPV virulence due to TV. Lack of awareness and hygiene, and limited access to gynecologists in LMICs lead to frequent and persistent RTIs which aid and abet HPV infection and CC occurrence. These also need to be addressed to reduce CC and RTIs among women in LMICs. © 2016 Federation of Obstetric & Gynecological Societies of India

Abba E.J.,Indian National Environmental Engineering Research Institute | Unnikrishnan S.,Indian National Institute of Engineering | Kumar R.,Indian National Environmental Engineering Research Institute | Yeole B.,Indian Cancer Society | Chowdhury Z.,San Diego State University
International Journal of Environmental Health Research | Year: 2012

Exposure to fine particles has been shown to cause severe human health impacts. In the present study, outdoor fine particles as well as elemental and organic carbon concentrations were measured in four locations within Mumbai city, India, during 2007-2008. The average outdoor PM 2.5 mass concentrations at control, kerb, residential and industrial sites were 69±21, 84±32, 89±34, 95±36 μg/m 3. In addition, fine particle PAHs were measured during the post monsoon season. The sum of PAHs in PM 2.5 at same above four sites were 35.27±2.10, 42.96±2.49, 175.76±8.95 and 90.78±4.74 ng/m 3, respectively. Estimating the carcinogenic potential of PAHs with equivalents of Benzo(a)pyrene (BaPE). The maximum value of BaPE (18.8) was reported in the residential site. A trend of lung cancer cases in Mumbai city is also presented. This was a preliminary study in understanding the health effects of PAHs in Mumbai city. © 2012 Taylor & Francis.

Shridhar K.,Center for Chronic Conditions and Injuries | Dey S.,Indian Institute of Public Health | Bhan C.M.,Indian Cancer Society | Bumb D.,Indian Cancer Society | And 2 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: In India, cancer accounts for 7.3% of DALY's, 14.3% of mortality with an age-standardized incident rate of 92.4/100,000 in men and 97.4/100,000 in women and yet there are no nationwide screening programs. Materials and Methods: We calculated age-standardized and age-truncated (30-69 years) detection rates for men and women who attended the Indian Cancer Society detection centre, New Delhi from 2011-12. All participants were registered with socio-demographic, medical, family and risk factors history questionnaires, administered clinical examinations to screen for breast, oral, gynecological and other cancers through a comprehensive physical examination and complete blood count. Patients with an abnormal clinical exam or blood result were referred to collaborating institutes for further investigations and follow-up. Results: A total of n=3503 were screened during 2011-12 (47.8% men, 51.6% women and 0.6% children <15 years) with a mean age of 47.8 yrs (±15.1 yrs); 80.5% were aged 30-69 years and 77.1% had at least a secondary education. Tobacco use was reported by 15.8%, alcohol consumption by 11.9% and family history of cancer by 9.9% of participants. Follow-up of suspicious cases yielded 45 incident cancers (51.1% in men, 48.9% in women), consisting of 55.5% head and neck (72.0% oral), 28.9% breast, 6.7% gynecological and 8.9% other cancer sites. The age-standardized detection rate for all cancer sites was 340.8/100,000 men and 329.8/100,000 women. Conclusions: Cancer screening centres are an effective means of attracting high-risk persons in low-resource settings. Opportunistic screening is one feasible pathway to address the rising cancer burden in urban India through early detection.

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