Tobacco-related cancers in Madras, India

Tobacco is the single most important cause of avoidable morbidity and early mortality in many countries. Tobacco-related cancer (TRC) cases constitute 48.2% in men and 20.1% in women of the total cancers seen in India per year. The age-adjusted rate (AAR) of TRC ranges from 44 to 67 among males and from 23 to 27 among females in different registries in India. Of these cases, only 15% were in the lung. The religion-specific risk ratio of the TRC sites in Madras suggests that when Muslims were compared with Hindus pharynx and lung were the two sites that showed higher risk in males, while the pharynx, lung and oesophagus had higher risk in females. When Christians were compared with Hindus, lung cancer was found to have higher risk and cancer of the oesophagus lower risk in males, while cancer of the mouth had lower risk in females. The overall percentage increase in AAR of TRCs in males was 39.7 and in females was 20.1 for the period 1987-91, compared with 1982-86, with variation in the percentage increase in all the TRC sites in Madras. The change in the incident rate of TRCs seen in Madras is consistent with the change in the per capita consumption of tobacco over the years.