Report of 
Development of an Atlas of Cancer in Punjab State 
Report for the years 2012 - 2013
Introduction
1. Introduction:

The main objectives of this study were:

(i) to obtain an overview of patterns of cancer in the state of Punjab;

(ii) to calculate estimates of cancer incidence wherever feasible.

The First report for the combined years 2012 and 2013 for districts and centres gives an idea of the prevailing patterns of cancer by district in Punjab State. The data may be near complete in some districts whereas it could be far from complete in other places. There is also an additional problem of small numbers of cases. For all these reasons the patterns have to be interpreted with caution. However, certain sites of cancer in some districts show relatively high incidence rates compared to the rates published in the Population Based Cancer Registries. Pointers like these in the earlier project give important leads to the geographical pathology of cancer in India. Likewise these leads would have to be pursued and investigated.

Table 2.1 gives the list of collaborating centres. This report is divided into three main parts apart from overall plan and methods. Table 3 gives the distribution and patterns of cancer in selected Punjab districts. Table 4 provides an idea of the cancer patterns within the collaborating centres. Table 5 provides the district wise comparison of AAR with the Population Based Cancer Registries.

Overall Plan and Methods:
The overall plan and Methods were along the lines of the earlier project on ‘Development of an Atlas of Cancer in India’. A brief summary of the method is given below.

Initially, an invitation was sent to all medical institutions (which included medical colleges, major hospitals and pathology labs as well as cancer hospitals) in the state of Punjab. Also hospitals in outside Punjab state were also contacted. The list of collaborating centres is given in Tables 2.1.

A registration form was sent to these institutions for information regarding various details like – name and address of the institution, the names of potential principal investigators, the possible method to interview and record residential address of the patients diagnosed as cancer, the number of malignancies reported per annum, computer facilities available and budgetary requirements.

Training workshops were conducted and also visits were made to several of these centres. Guidance was provided in basic principles and techniques of cancer registration and coding according to the International Classification of Diseases. The important issues in completion of the core proforma namely, residential address and primary site of tumour was emphasized.

The collaborating centres were given an individual login ID and password for transmission of data through the website www.canceratlaspunjab.org”. The usual checks on the data and processing were done at the Coordinating Unit of NCRP in Bangalore.

The district wise results and centre wise patterns of cancer is provided in the following pages. The Age Adjusted incidence Rate (AAR) was calculated. This was compared with the AAR of the Population Based Cancer Registries (PBCR).

Distribution and Patterns of Cancer in Selected Districts:

Table 3 provides a summary of cancer patterns in 19 districts. The basis of selection of the districts is microscopically AAR of at least 40 per 100,000. District wise population according to the 5 year age group was estimated by the ‘Difference Distribution Method’ followed for the PBCRs. Accordingly; this was calculated for 1st July 2012 and 1st July 2013 for each of the districts for each year. Tables 3.1(a) to 3.14(a) show the centrewise distribution of each district and Tables 3.1(b) to 3.14(b) show the population, no. of cases, Crude Incident rates, Age Adjusted Incident rates and Truncated Incident rates. The first five leading sites of cancer by gender are depicted in figures 3.1 to 3.14.

Profile of Cancers in Collaborating Centres

This chapter gives a summarized account of the cancer patterns in each of the centres that have collaborated and contributed information of cancer cases.

This is basically a hospital based account of the cancers in each of these centres minus the data of cases covered by the area under the population based cancer registry Patiala. Tables 4.1(a) to 4.24(a) show the no. of cases received from each centre and 4.1(b) to 4.24(b) show the district wise distribution of cancer in each centre. The first 5 leading sites of cancer in these institutes are given in Figure 4.1 to 4.24.

District wise Comparison of Cancer Patterns:

Chapter 5 provides the comparison of the age adjusted incidence rates of the districts in this report with those obtained through the population based cancer registries for 2009– 2011. The map of Punjab state displayed as units is also portrayed. Depending on the Aar of that site for a given district, graded shading, of each of the district is done. The higher the AAR the darker the shade. Where data is sparse gray shading is done.

Table 2.1 : List of Collaborating Centres
Name of the Collaborating Centre District / City
Sardana Labs Jalandhar
Dr. Monika's Lab Bathinda
Christian Medical College & Hospital Ludhiana
Dayanand Medical College & Hospital Ludhiana
Mohan Dai Oswal Multispeciality and Cancer Hospital Ludhiana
Patel Cancer and Superspeciality Hospital Jalandhar
Grecian Super-Speciality Hospital Mohali
SGRD Institute of Medical Sciences & Research Amritsar
Dr Sheena's Path Lab Bathinda
Behgal Hospital S.A.S. Nagar
Government Medical College Amritsar
Indus Super Speciality Hospital Mohali
Guru Gobind Singh Medical College Faridkot
Adesh Institute of Medical Sciences and Research Bathinda
Mittal Labs & Hormone Centre Bathinda
Kanwal Lab & Diagnostic Centre Bathinda
Max Super Speciality Hospital Bathinda
Max Super Speciality Hospital Mohali
Fortis Hospital Mohali
IVY Hospital Mohali
Punjab Institute of Medical Sciences Jalandhar
Ashok Clinical Laboratory Patiala
Gian Sagar Medical College & Hospital, Ram Nagar, Banur
Other than Punjab State
PGIMER, Chandigarh
Govt. Medical College & Hospital , Chandigarh
Acharya Tulsi Regional Cancer Treatment and Research Institute, Bikaner
Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, New Delhi
Rajiv Gandhi Cancer Institute and Research Centre, New Delhi
Medanta Cancer Centre, Gurgaon
Table 3: District wise Distribution of Cancers
Sl No District Name Year - (2012-2013)
Expected Cases # %
1 Bathinda 2453 3099 126.3
2 Faridkot 1082 1167 107.9
3 Mohali 1780 1902 106.9
4 Jalandhar 3816 3625 95.0
5 Ludhiana 6138 5824 94.9
6 Mansa 1345 1258 93.5
7 Sangrur 2899 2224 76.7
8 Muktsar 1592 1201 75.4
9 Rupnagar 1191 835 70.1
10 Kapurthala 1424 987 69.3
11 Hoshiarpur 2749 1899 69.1
12 Fatehgarh Sahib 1050 688 65.5
13 Moga 1735 1121 64.6
14 Amritsar 4387 2703 61.6
15 Barnala 1046 620 59.3
16 SBS Nagar 1062 622 58.6
17 Firozpur + Fazilka 3773 1849 49.0
18 Gurdaspur + Pathankot 4209 1692 40.2
19 Tarn Taran 1985 523 26.3
20 Other's / District Unknown - 101 -
Total 45716 33940 74.2