Trends in mouth cancer incidence in Mumbai, India (1995–2009): An age-period-cohort analysis. (June 2016)

• Record Type: Journal Article
• Authors: Shridhar, Krithiga; Rajaraman, Preetha; Koyande, Shravani; Parikh, Purvish M.; Chaturvedi, Pankaj; Dhillon, Preet K.; Dikshit, Rajesh P.
• Is Part Of: Cancer epidemiology. Volume 42(2016:Jun.)
• Page Start: 66
• Page End: 71
• Publication Date: 2016-06
• Subjects: Mouth cancer -- Cancer trend -- India -- Age-period-cohort analysis -- Cancer registry -- Age-specific rate -- Age standardized rate -- Risk factors -- Mumbai -- Net drift; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2016.03.007
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: We conducted an age-period-cohort (APC) analysis of mouth cancer in Mumbai, India. An overall upward trend was observed in 1995–2009 for men but not women. The increase was mainly in younger men (aged 25–49 years). A suggestive increase was also seen in younger women (aged 25–49 years). Our data suggest a need for focused tobacco control efforts in younger cohorts. Abstract: Introduction: Despite tobacco control and health promotion efforts, the incidence rates of mouth cancer are increasing across most regions in India. Analysing the influence of age, time period and birth cohort on these secular trends can point towards underlying factors and help identify high-risk populations for improved cancer control programmes. Methods: We evaluated secular changes in mouth cancer incidence among men and women aged 25–74 years in Mumbai between 1995 and 2009 by calculating age-specific and age-standardized incidence rates (ASR). We estimated the age-adjusted linear trend for annual percent change (EAPC) using the drift parameter, and conducted an age–period–cohort (APC) analysis to quantify recent time trends and to evaluate the significance of birth cohort and calendar period effects. Results: Over the 15-year period, age-standardized incidence rates of mouth cancer in men in Mumbai increased by 2.7% annually (95% CI:1.9 to 3.4), p < 0.0001) while rates among women decreased (EAPC = −0.01% (95% CI:−0.02 to −0.002), p = 0.03). APC analysis revealed significant non-linear positive period and cohort effects in men, with higher effects among younger men (25–49 years). Non-significant increasing trends were observed in younger women (25–49 years). Conclusions: APC analyses from the Mumbai cancer registry indicate a significant linear increase of mouth cancer incidence from 1995 to 2009 in men, which was driven by younger men aged 25–49 years, and a non-significant upward trend in similarly aged younger women. Health promotion efforts should more effectively target younger cohorts.