Survey on cancer incidence around Chengannur, Kerala, with focus on major risk factors
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20261791Keywords:
Cancer statistics, Alappuzha, Lifestyle risk, Gender-specific, Regional cancer burdenAbstract
Background: Community awareness regarding the specific risk factors that enhance susceptibility to cancer is limited. This survey was undertaken to examine the prevalence of cancer cases in and around Chengannur, including the Alappuzha and Pathanamthitta districts of Kerala, with special attention to risk factors.
Methods: Cancer cases were identified through direct and indirect interviews with cancer patients and their relatives. Hospital records at the Government Hospital, Kozhencherry and the Health Centre, Chengannur, were also examined for data collection.
Results: A total of 285 cases were analysed with 26 cancer types recorded. The highest number of cases was observed with cancers of the breast (18.2%), followed by lungs (15.1%). Females comprised 52.6%, while males accounted for 47.4%. Chi-Square test (p<0.001) confirmed a significant association between cancer type and gender, with lungs, oral, brain and liver largely affecting males, while breast, cervix and ovary were female dominant. A peak of incidence of cancer was observed within the 40–60 years age group. Tobacco use was found to be the predominantly contributing risk factor (37.2%), followed by alcohol consumption (32.6%) and was strongly associated (p<0.001) with specific cancer types. Age, certain chemicals, family history, poor diet and certain hormones were also significant, comprising 17.5%, 16.8%, 14.7%, 12.6% and 10.9%, respectively.
Conclusions: The study provides valuable perspectives into cancer profiles of the Chengannur region, predominantly driven by lifestyle factors. Findings recommend community campaigns on cancer awareness focusing on midlife surges, gender-specific patterns and sustainable lifestyle shifts to reduce cancer risk.
References
Dare AJ, Knapp GC, Romanoff A, Olasehinde O, Famurewa OC, Komolafe AO, et al. High-burden cancers in middle-income countries: A review of prevention and early detection strategies targeting at-risk populations. Cancer Prev Res (Phila). 2021;14(12):1061-74.
Indian Council of Medical Research. ICMR-NCDIR National Cancer Registry Programme estimates 12.8 lakh new cancer cases in 2020 New Delhi: ICMR. 2020. Available at: https://www.icmr.gov.in/icmrobject/custom_data/1702893085_icmr_press_release_ncrp_18082020.pdf. Accessed on 3 December 2025.
Economic Times Health. New study warns of rising cancer burden in Kerala. Economic Times. 2025. Available at: https://health.economictimes.indiatimes.com/news/industry/kerala-faces-alarming-rise-in-cancer-cases-new-study-reveals/122140405. Accessed on 13 November 2025.
Mathur P, Sathishkumar K, Das P, Santhappan S, Sankarapillai J. National Cancer Registry Programme Investigator Group, Cancer incidence and mortality across 43 cancer registries in India. JAMA Netw Open. 2025;8(8):2527805.
Jackson JH, Schraufstatter IU, Hyslop PA, Vosbeck K, Sauerheber R, Weitzman SA, et al. Role of oxidants in DNA damage. Hydroxyl radical mediates the synergistic DNA damaging effects of asbestos and cigarette smoke. J Clin Invest. 1987;80(4):1090-5.
Kobets T, Iatropoulos MJ, Williams GM. Mechanisms of DNA-reactive and epigenetic chemical carcinogens: applications to carcinogenicity testing and risk assessment. Toxicol Res (Camb). 2018;18:8(2):123-45.
Koo MM, Swann R, McPhail S, Abel GA, Elliss-Brookes L, Rubin GP, et al. Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. Lancet Oncol. 2020;21(1):73-9.
Kale SR, Karande G, Gudur A, Garud A, Patil MS, Patil S. Recent trends in liver cancer: Epidemiology, risk factors and diagnostic techniques. Cureus. 2024;16(10):72239.
American Cancer Society. Cancer facts and figures 2023. Atlanta, GA: American Cancer Society. 2023. Available at: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2023-cancer-facts-figures.html. Accessed on 31 December 2025.
Meena J, Kumar J, Yadav K, Mehrotra R. Implementing cancer prevention strategies in India: progress, persistent challenges and future directions. Cancer. 2025;19:2042.
Ninan PJ, Sivaramakrishnan R, Bindu SM. Study of cancer trends in Government T.D. Medical College Alappuzha during the year 2016-2017 and comparison with trend a decade ago. Gal Int J Health Sci Res. 2020;5(3):67-74.
Sunilkumar S, Bindu T, Kumbakara R, Balasubramanian S. Patterns of cancer at a tertiary cancer center in Kerala, India, based on 10-years of hospital based cancer registry data: A retrospective observational study. Cancer Res Stat Treat. 2024;7:185-92.
Mathew G, Sebastian SR, Benjamin AI, Goyal V, Joseph J, Sushan A, et al. Community-based burden, warning signs and risk factors of cancer using public-private partnership model in Kerala, India. J Family Med Prim Care. 2020;9(2):745-50.
Washbrook E. Risk factors and epidemiology of breast cancer. Women's Health Medicine. 2006;3(1):8-14.
Amma JP, Sebastian PJ. Burden of cancers: Registry based data from Kerala, India. Health Systems. 2017. Available at: http://jhs.healthequity.co.in/2017/03. Accessed on 13 October 2025.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J for Clinicians. 2018;68 (6):394-424.
National Cancer Registry Programme. Three year report of population based cancer registries: 2012-2014. Report of 27 PBCRs. Bangalore: Indian Council of Medical Research, National Centre for Disease Informatics and Research. 2016.
Nayar KR, Nair RRK. Smoking and lung cancer paradox in Kerala: An epidemiological epiphany. BMJ Med Human. 2012;2:365.
Indian Council of Medical Research-National Centre for Disease Informatics and Research. Clinicopathological Profile of Cancers in India: A Report of the Hospital Based Cancer Registries. 2021. Available at: https://ncdirindia.org/All_Reports/HBCR_2021/Default.aspx. Accessed on 6 December 2025.
Moreno-López LA, Esparza-Gómez GC, González-Navarro A, Cerero-Lapiedra R, González-Hernández MJ, Domınguez-Rojas V. Risk of oral cancer associated with tobacco smoking, alcohol consumption and oral hygiene: a case-control study in Madrid, Spain. Oral Oncol. 2000;36(2):170-4.
Tominaga S. Major avoidable risk factors of cancer. Cancer letters. 1999;143:19-23.
Hu J, Mao Y, Dryer D, White K, Canadian Cancer Registries Epidemiology Research Group. Risk factors for lung cancer among Canadian women who have never smoked. Cancer Detect Prevention. 2002;26(2):129-38.
Thorling EB. Obesity, fat intake, energy balance, exercise and cancer risk a review. Nutrition Res. 1996;16(2):315-68.
Llewellyn CD, Linklater K, Bell J, Johnson NW, Warnakulasuriya S. An analysis of risk factors for oral cancer in young people: a case-control study. Oral Oncol. 2004;40(3):304-13.