Risk of Prostrate Cancer in Eastern India
A total of 3747 cases were assessed to understand the prostrate cancer profile in the population of West Bengal from 2003-2010. Present investigation revealed that prostate cancer rate was climbing with 5.71% incidence and the ignorance is partially responsible for that alarmingly high incidence in elder males particularly from 51-70 years age group. The level of PSA (Prostate Specific Antigen) in the blood was high (<4 ng mL-1) in men having prostate cancer. The cancer frequency was moderate during 2003 to 2006, but it rises drastically from 2007 (17.76%) and reached maximum peak (28.97%) in 2010. Prostate cancer was most prevalent in group A, followed by group B and group O. The absolute number of new cancer cases was increasing rapidly, due to growth in size of the population and increase in the proportion of elderly persons as a result of improved life expectancy. The risk of developing prostate cancer was related to age, genetics, race, diet, lifestyle, medications and other factors. This peak cancer scenario can be altered in a positive direction by regular screening and by training the prevention measures of life style modification in a wide scale through proper way.
Received: November 04, 2011;
Accepted: February 07, 2012;
Published: March 21, 2012
Cancer of the prostate is now recognized as one of the principal medical problems
facing the male population and more often affects elderly men (Aly,
2005; Tawfiek et al., 2010). It is a bigger
health concern in developed countries having 15% incidence among all male cancers,
in contrast to developing countries in which 4% of male malignancies are prostate
cancer (Parkin et al., 2001). In most countries
a slight increase in prostate cancer mortality has been seen since 1985 (Quinn
and Babb, 2002). In the year 2005 there were an estimated 230,000 new cases
of prostate cancer and 30,000 deaths due to prostate cancer in USA (IARC,
2001). Prostate cancer frequency is lower in India as compared to Western
countries (Sinha et al., 2003). The male sex
hormone testosterone aids the growth of prostate cancer cells. Regional differences
and racial predisposition are another factor; incidence of prostate cancer is
highest in Blacks and lowest in Asians. Many factors, including genetics, environmental
and dietary factors are involved in the development of prostate cancer (Avci
et al., 2005; Sinha et al., 2003).
In India the majority of cancer is diagnosed in the advanced stage and hence
morbidity remains high. Beside this cancer mortality rates are under-reported
due to poor recording of the cause of death. Incorporating screening, detection
and treatment of diseases like cancers into peripheral health infrastructure
has a significant effect on reducing mortality from these diseases (Johnson,
2006; Murthy and Mathew, 2004). The measurement
of PSA, an organ-specific kallikrein-like serine protease produced almost exclusively
by the epithelial cells of the prostate, has revolutionized the diagnosis of
prostate cancer (Polascik et al., 1999; Stamatiou
et al., 2007). Keeping in view the paucity of reliable data in a
country with wide socio-cultural diversity, the present investigation was aimed
to study the prostate cancer incidence in a part of eastern India for the last
MATERIALS AND METHODS
A demographic study on 3747 male cancer cases were assessed for prostate carcinoma
from the patients attending to Barasat Cancer Research and Welfare Centre, a
prime health centre covering many districts of eastern India, for the period
2003 to 2010. The malignancy was diagnosed by symptoms, physical examination
and various investigations like radio-imaging, cytology, histo-pathological
examinations, PSA test or biopsy by physicians. The data of the prostate cancer
staging, extent of metastasis, age, ABO blood grouping and patho-physiological
status of the cancer patients were collected. Written informed consent was obtained
from all in accordance with the guidelines from hospital center review board.
Among the entire 3747 cancer patients, 214 males (5.71%) showed prostate carcinoma. The level of PSA in the blood was high (<4 ng mL-1) in men having prostate cancer (Table 1). In most cases it is slow-growing and symptom free. There was variation in the site-wise distribution within the population. In some region a certain types of cancers are pronounced in groups and seem to show one kind of association in them due to similar environmental status. This multiple neoplastic syndrome was common for cancers of prostate-lung-bone and others in this population.
The present investigation revealed that the cancer frequency was moderate during 2003 to 2006, but it rises drastically from 2007 (17.76%) and reached maximum peak (28.97%) in the last year (Table 2 and 3). Comparative analysis of prostate cancer in different age groups revealed that cancer frequency was common for age group 41 to 80 years and the frequency was alarmingly high particularly from 51-70 years (Table 2). The result also highlighted that men below 40 years of age never showed prostate cancer incidence. The frequency of prostate cancer was only 5.61% at age group 41-50 years. After that the frequency drastically increased and reached 30.37% for the age group 51-60 years and showed maximum peak at 61-70 years of age with 44.39% incidence. Further decline in incidence pattern was observed after 70 years of age among the men with 18.69% incidence at 71-80 years of age.
|| Detection of prostate cancer by PSA test
|*Border line: 4.01-10.01 ng mL-1, +: Present -:
|| Distribution of prostate cancer in different age groups
|The digit in parenthesis represents the frequency value
|| Distribution of prostate cancer in different blood groups
|The digit in parenthesis represents the frequency value
Frequency distribution of prostate cancer in different blood groups showed that prostate cancer was most prevalent in group A (37.85%), followed by group B (28.97%) and group O (20.09%). The blood group AB was the least frequent class having only 13.08% cases of prostate cancer in the studied population (Table 3).
The demographic study highlighted that in the studied population among different
types of malignant conditions the incidence of prostate carcinoma was threatening
among males. This observation was in line with the early investigation that
in this population the cancer of prostate forms a largest group for men (Chatterjee,
2011). Since it is hard to prove, the jury is still out on many of these,
may be due to the environmental pollution, lifestyle and dietary toxicants which
are vulnerable carcinogens causing cancers world wide (Kumar
et al., 2011; Mahajan et al., 2009).
The observation also supported the fact that prostate cancer tends to develop
in men over the age of 50 and the average age at the time of diagnosis is 70
(Hankey et al., 1999). The frequency was alarmingly
high particularly from 51-70 years as similar to report facts of urinary bladder
cancer (Ahmed et al., 2006). This investigation
was at per with the study that prostate carcinoma was increasingly high in blood
group A followed by group B, as was observed by early research (Chatterjee
and Mukherjee, 2009).
The present study was concerned with malignancy of prostate, the incidence
of which was increasing due to various factors of different activities. The
ignorance is partially responsible for that prevalence. Evidence from epidemiological
studies supports protective roles in reducing prostate cancer for dietary selenium,
vitamin E, lycopene, soy foods and recommended lifestyle changes by lowered
intake of animal fat and increased intake of fruit, cereals and vegetables in
order to decrease the risk (Khorshid, 2009; Hafidh
et al., 2009; Schulman et al., 2000).
Daily use of anti-inflammatory medicines, cholesterol-lowering drugs may also
decrease prostate cancer risk (Jacobs et al., 2005;
Shannon et al., 2005). The risk of developing
prostate cancer is related to age, genetics, race, diet, lifestyle, medications
and other factors (Sinha et al., 2003). The present
study highlighted that the risk increased with age more rapidly than any other
cancer. Men who had a history of prostate cancer in their family, especially
a close relative such as father or brother, were at an increased risk. The absolute
number of new cancer cases was increasing rapidly, due to growth in size of
the population and increase in the proportion of elderly persons as a result
of improved life expectancy following control of communicable diseases (Murthy
and Mathew, 2004). Moreover, the proper treatment of malignant conditions
is much costly and also not available properly at all places. Due to lack of
necessary infrastructure and low literacy rates, the incidence is high in countries
like India (Murthy and Mathew, 2004). Therefore, the
early diagnosis and prevention of cases are of paramount importance to reduce
the incidence of the malignant conditions in the society. Active surveillance
is useful for suspect an early stage, slow-growing prostate cancer and also
prevention for the risks of surgery, radiation therapy, or hormonal therapy.
This prevalent cancer scenario can be altered in a positive direction by regular
screening and by training the prevention measures of life style modification
in a wide scale through proper way.
It can be concluded that in this population the cancer of prostate forms a largest group for men. Many factors, including genetics, environmental and dietary factors are involved in the development of prostate cancer. In India the majority of cancer is diagnosed in the advanced stage and hence morbidity remains high. Beside this cancer mortality rates are under-reported due to poor recording of the cause of death. Incorporating screening for cancers into peripheral health infrastructure has a significant effect on reducing mortality from these diseases. The present investigation gave a deep sight in this regard on the incidental risk of prostate cancer in eastern India.
The author is presently working as Assistant Professor in Barasat College, Kolkata 700126, India and thankful to the administration of the college for giving the permission to complete the research work. Author is grateful to the Secretary and Assistant Secretary (Admin.) of Barasat Cancer Research and Welfare Centre for the financial support to do the study and to Dr. S. Roy, Mr. T. K. Karan and Mr. S. Sarkar of this health centre for their help to collect data and other technical supports.
Ahmed, K., S.M. Shahid, M. Jawed, Z. Islam and F. Hatim, 2006.
An evaluation of urinary bladder carcinoma with respect to age, sex, stage and grade. Int. J. Cancer Res., 2: 219-223.CrossRef | Direct Link |
Aly, M.S., 2005.
HER-2/neu gene amplification in prostate cancer by fluorescence in situ
hybridization. Int. J. Cancer Res., 1: 5-9.CrossRef | Direct Link |
Avci, A., M. Kacmaz, M. Kavutcu, E. Gocmen and I. Durak, 2005.
Effects of an antioxidant extract on adenosine deaminase activities in cancerous human liver tissues. Int. J. Cancer Res., 1: 53-56.CrossRef | Direct Link |
Chatterjee, A. and G. Mukherjee, 2009.
Relationship and susceptibility of ABO blood groups with various malignant disorders found in West Bengal. Sci. Cult., 75: 133-136.
Chatterjee, A., 2011.
Study on the enraging severity of cancer in West Bengal, India from 2003 to 2010. Asian J. Epidemiol., 4: 23-27.CrossRef | Direct Link |
Hafidh, R.R., F. Abas, A.S. Abdulamir, F. Jahanshiri, F. Abu Bakar and Z. Sekawi, 2009.
A review: Cancer research of natural products in Asia. Int. J. Cancer Res., 5: 69-82.CrossRef | Direct Link |
Hankey, B.F., E.J. Feuer, L.X. Clegg, R.B. Hayes and J.M. Legler et al
Cancer surveillance series: Interpreting trends in prostate cancer-part I: Evidence of the effects of screening in recent prostate cancer incidence, mortality and survival rates. J. Natl. Cancer Inst., 91: 1017-1024.PubMed |
Worldwide Cancer Incidence Statistics-Prostate: JNCI Cancer Spectrum. Oxford University Press, USA
Jacobs, E.J., C. Rodriguez, A.M. Mondul, C.J. Connell, S.J. Henley, E.E. Calle and M.J. Thun, 2005.
A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence. J. Natl. Cancer Inst., 97: 975-980.PubMed |
Johnson, D.B., 2006.
The effects of an abnormal cancer screening test on health related quality of life. Int. J. Cancer Res., 2: 277-289.CrossRef | Direct Link |
Khorshid, F.A., 2009.
Potential anticancer natural product against human lung cancer cells. Trends Med. Res., 4: 8-15.CrossRef | Direct Link |
Kumar, N.P., H.S. Shankaregowda and R. Revathy, 2011.
An assessment of preventable risk factors for chronic non-communicable diseases in an adult population. Asian J. Epidemiol., 4: 9-16.CrossRef | Direct Link |
Mahajan, D.C., S.S. Birari, G.S. Khairnar, Y.P. Patil, V.J. Kadam and Y.M. Joshi, 2009.
Prevalence of non-communicable diseases risk factors in two groups of urban populations. Asian J. Epidemiol., 2: 1-8.CrossRef | Direct Link |
Murthy, N.S. and A. Mathew, 2004.
Cancer epidemiology, prevention and control. Curr. Sci., 86: 518-527.Direct Link |
Parkin, D.M., F.I. Bray and S.S. Devesa, 2001.
Cancer burden in the year 2000: The global picture. Eur. J. Cancer, 37: S4-S66.
Polascik, T.J. J.E. Oesterling and A.W. Partin, 1999.
Prostate specific antigen: A decade of discovery what we have learned and where we are going. J. Urol., 162: 293-306.PubMed |
Quinn, M. and P. Babb, 2002.
Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: International comparisons. BJU Int., 90: 162-173.PubMed |
Schulman, C.C., A.R. Zlotta, L. Dennis, F.H. Schroder and W.A. Sakr, 2000.
Prevention of prostate cancer. Scand. J. Urol. Nephrol., 34: 50-61.Direct Link |
Shannon, J., S. Tewoderos, M. Garzotto, T.M. Beer, R. Derenick, A. Palma and P.E. Farris, 2005.
Statins and prostate cancer risk: A case-control study. Am. J. Epidemiol., 162: 318-325.PubMed |
Sinha, R., D.E. Anderson, S.S. McDonald and P. Greenwald, 2003.
Cancer risk and diet in India. J. Postgraduate Med., 49: 222-228.PubMed |
Stamatiou, K., V. Papadimitriou, E. Michail, D. Delakas, E. Michalodimitrakis and F. Sofras, 2007.
Identification of insignificant prostrate cancers. Int. J. Cancer Res., 3: 162-166.
Tawfiek, H.M., D.M. Abd El-Rehim, Y.M. Elsherbny and E.R. Tawfik, 2010.
Expression of macrophage inhibitory cytokine-1 in benign and malignant prostatic tissues: Implications for prostate carcinogenesis and progression of prostate cancer. Int. J. Cancer Res., 6: 141-153.CrossRef | Direct Link |