What is driving cancer so high in Nagaland? 

Kohima: Cancer is among the top five leading causes of death in Nagaland, and the state ranks 11th in the country for cancer incidences and the second highest in the world for nasopharynx cancer. So, what is driving cancer so high in Nagaland? 

Oncopathologist Dr Vinotsole Khamo on Monday said that cancer has become a burden in the state and the number of new cases registered every year is around 700 (cases registered at hospitals in Nagaland) and the average number of cancer deaths is 126 per year. 

The cancer incidence rate in male is 124.5 Ave-Adjusted Incidence Rate (AAR) per 1 lakh population and in female is 88.2 AAR. 

Also Read | Why Northeast India has high prevalence of cancer cases 

In Nagaland, the proportion of nasopharyngeal cancer at 14.3% is highest among males, followed by stomach cancer at 12.6% and cancer of the oesophagus at 10.6%. In females, the cervix uteri is the leading cancer site at 16.6% followed by breast (12.2%) and stomach (11.3%). Over a third (39.3%) of cancers in male and 11.5% in females are tobacco-related cancers, among which oesophagus (10.6%) and lung (3.7%) were leading sites in males and females. 

To understand why cancer is high in Nagaland, the report on monitoring survey of cancer risk factors and health system response in Northeast Region (NER) was released by state health at the Secretariat conference hall in Kohima on Monday. The report was conducted between November 2019 and December 2020 by a team of experts headed by Dr Khamo as the principal investigator. 

The key findings of the report showed that the prevalence of current tobacco use (smoked or smokeless) was 39.3% where the prevalence of smokeless tobacco use at 35% is higher than smoked tobacco use which stands at 13.2%.

In this regard, more than 30% of current tobacco users were daily users and the mean age of initiation is 20.3 years. The average duration of tobacco use among past users is 8.7 years. More than 13.8% of smoked tobacco users made self attempts to quit smoking while 3.2% were advised to quit it by doctors and health care workers. 

The study also showed that over 67.9% people reported exposure to secondhand tobacco within 30 days, either at home, during travel or at workplace. 

The findings also showed that 28.9% were current users of non-tobacco betel products in the form of pan masala, areca nut or betel quid. The use of areca nut is highest among current users at 16.0%.

It also revealed that 6.1% of it’s respondents were engaged in heavy episodic drinking and only 2.4% were advised to quit alcohol. 

Prevalence of raised blood pressure is reported to be 37.8% in males and 30.1% in females, and over 54.7% were pre-hypersensitive. 

According to the WHO cut off values, 28.7% were overweight while 6.8% were obese. The prevalence of obesity is higher in females (8.8%) than males (5.1%). Close to 40% reported to have central obesity. 

The finding also revealed that none of the community health centres (CHCs) in Nagaland provided cancer screening services. 

At least 57% of cancer patients sought medical care outside the state, 75% we’re availing treatment at private facilities, 60.7% were self financing and 10.7% were covered by health insurance. 

Cancer survivor and social activist Neidonuo Angami, who is a Padma Shri awardee, also took a brief moment to share about battling cancer. She informed that a cancer survivor fellowship is formed where the survivors, patients and families affected by cancer, conglomerate to provide help to one another. 

Pointing out the poor condition of the only oncology ward at the Naga Hospital Authority Kohima (NHAK), she stressed on the need to have proper facilities. In this regard, she repeatedly highlighted the lack of proper infrastructure in the state to treat cancer patients. 

Director of the National Centre for Disease Informatics and Research, ICMR, Dr Prashant Mathur, over a video conference informed that about 50% of such reported cancers in the state of Nagaland are preventable and can be avoided. 

He said that the right intervention at present can reduce the cancer burden by the next decade. To this, he suggested that the state government make cancer a notifiable disease. Highlighting that 15 Indian states have made cancer a notifiable disease, he said that it should be a possibility for the state of Nagaland as well. 

The doctor also recommended the need to have state policy to prevent and control cancer. Further, he assured the ICMR’s commitment to provide solution to policy makers to mitigate the burdens of cancer. 

Health minister Pangnyu Phom lauded the team for conducting the first of it’s kind study to help in the elimination and battle against cancer. He also admitted to the need to introduce better health care services for cancer, and that cancer screening should be made a priority. 

The minister also suggested that all concerned government departments must cooperate and come out with an action plan to address the issue. 

Also read | Nagaland: AR inaugurates ‘Centre of Excellence’ to honour Kargil martyr

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