High tobacco use behind worrisome incidence of lung cancers in North Kerala districts


Kozhikode, Jan 24 – Tobacco use once again is proven as the villain, and a cause behind the high incidence of lung cancers in north Kerala districts of Kozhikode, Kannur and Kasargod, notes a recent study brought out by the Malabar Cancer Centre (MCC), a tertiary cancer centre in Kannur.

As much as 36 per cent of overall patients across these districts had the habit of smoking.  Patients from Kasargod were the most prone to smoking at 40 per cent; followed by Kannur at 34 per cent and Kozhikode at 33 per cent. The extent of smoking among Kerala adults, as per latest benchmark figures of Global Adult Tobacco Survey of Union Health Ministry, is 13.4 per cent.

Lung and breast cancer rank high among the various cancers across the three study districts. The distribution of lung and breast cancers in Kannur is 15 per cent. Lung cancers contribute to 11 percent and breast cancers are at 13 per cent in Kozhikode. In Kasargod, lung and breast cancers are 13 and 15 per cents respectively. 

The retrospective study ‘Geographical Distribution of Cancer in Northern Kerala, India: A Retrospective Analysis’ was conducted based on data of the hospital based cancer registry (HBCR) for the year 2011 in MCC and published in the Indian Journal of Applied Research. A total of 2,366 cancer patients – 1,259 males and 1,107 females – had registered at the MCC in 2011 from the districts of Kozhikode (457), Kannur (1670) and Kasargod (239). A semi-structured questionnaire was used to collect the information from patient’s medical records to understand the demographic factors, personal habits, and tumour staging.

The study also refers to harms of second-hand smoke or passive smoke as it found that 10 per cent of female registered patients were passive smokers. Citing scientific literature, it adds that second-hand smoke is linked to lung cancer and also lymphoma, leukaemia, brain tumours in children, cancers of breast, stomach and the brain, among others.

Dr Satheesan B, Director, Malabar Cancer Centre and the study’s principal investigator and co-author said, “The study findings yet again brings out the role of tobacco in cancers and underlines that tobacco control is the best way to prevent cancers. Things can no longer be left to chance as the combined burden that tobacco use causes on morbidity and mortality at micro and macro levels is enormous. Regular monitoring and consolidation of tobacco control measures taken at the district level should happen through monthly reviews of enforcement and awareness activities.” 

The high availability and consumption of tobacco both in smoking and chewing forms in north Kerala may also be attributed as a reason for high rate of tobacco related cancers in the area. “Provision of health-friendly alternative livelihoods to beedi workers which has been adopted by leading groups in the field is expected to change the scenario. But increasing the beedi prices to dissuade users would be welcome,” Dr Satheesan added.

Pan chewing among patients from Kannur, Kasargod and Kozhikode stands at 14, 19 and 16 per cents respectively.  The International Agency for Cancer Research (IARC) of the World Health Organisation, after scientific evaluations, has pronounced that chewing betel quid with and without tobacco is carcinogenic to humans.

Dr Saina Sunilkumar, Lecturer, Department of Cancer Registry and Epidemiology; Shri Ratheesan.K and Shri Subhradev Sen, Lecturers in Biostatistics collaborated for the study. Ends

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