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LATEST NEWS UPDATES | Urban Indians shun doctors, risk death from cancer-Malathy Iyer

Urban Indians shun doctors, risk death from cancer-Malathy Iyer

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published Published on Mar 30, 2012   modified Modified on Mar 30, 2012

By selectively borrowing habits from the West, the urban Indian has worsened his chances with cancer. Doctors say that while the city-bred Indian has willingly adopted a western diet, lapping up high-fat foods and shunning high-fibre content, he or she hasn't picked up the healthy western attitude of detecting and treating cancer early. 

The end-result, as the India's Million Death Study (MDS) reported on Thursday shows, is that urban Indians are not only more prone to cancer, they are more liable to die from the disease than their western counterpart. 

"Indians, including those from urban centres, falter at the first step. They fail to get their cancers detected early," says Dr Surendra Shastri, who heads the preventive oncology department at Tata Memorial Hospital, Parel. 

The MDS study, which was done by Tata Memorial Hospital along with the Centre for Global Health Research, says that almost six lakh Indians succumb to cancer every year. The study was published in the Lancet medical journal on Wednesday. 

While more urban than rural Indians suffer from cancer, the death rate in both the segments is almost the same, says India's Million Death Study (MDS). The study was done by Tata Memorial Hospital along with the Centre for Global Health Research. 

"Age-standardized cancer mortality rates per 1,00,000 were similar in rural (men 95.6 and women 96.6) and urban areas (men 102.4 and women 91.2)," says MDS. 

An Indian pecularity crops up here. As MDS says that cancer deaths were two times higher in the least educated than in the most educated adults, it would follow that educated Indians living in cities and enjoying better access to cancer care should be able to beat the disease. But this is clearly not the case. "Women won't come to hospitals to show a lump in their breast because it's not painful. Men won't get themselves checked despite losing weight drastically . This is true in both urban and rural India," says a senior doctor. The problem, analyzes Dr Shastri, is that greater awareness in urban areas hasn't really translated into attitudinal changes. "People in urban areas, too, visit doctors only when their cancer is advanced . Therefore, the death rate is high in cities despite the availability of world-class treatment." 

Doctors point out that the incidence of cancer is three times higher in some western countries, but the death rate wasn't as high as in India. "People there are not only aware about cancers, but also actively seek detection and treatment," adds a doctor. 

Rising incidence of cancer among Indians is another area of concern. Says medical oncologist Dr Sudeep Gupta from Tata Memorial Hospital, "The main reason for this is the aging of our population. Earlier, our population was younger but it is not so now." He also blames lifestyle factors such as late marriages , late motherhood and lack of exercise for growing incidence of breast cancer. "We are adopting a Western lifestyle," Dr Gupta adds. 

Cancer surgeon Dr P Jagannath, who consults at Lilavati Hospital, says that better access to tobacco in the city also worsens the statistics. "People in urban areas use lifts, don't exercise and are obese, which is emerging as one of risk factors for cancers." 

However, he says there is a need to take a closer look at the causes of high mortality in urban hubs as reported in MDS. "Urban centres have better detection and treatment facilities . Hence, we need to ensure that all these reported deaths were indeed due to cancer and not a case of a cancer patient suffering a heart attack." 

Reasons contributing to rising incidence of cancer in cities 

Changing composition of diet 

Intake of animal source food-meat , fish and milk-is rising rapidly Diets' energy density is rising rapidly Oil consumption has risen rapidly Food supply has become sweeter Food preparation time has shortened Consumption of food away from home has increased Portions or serving sizes are bigger 

Reduction in physical activity 

Major shift away from manual labour or energy-intense work (like agriculture) to sedentary roles (like the service sector) General reduction in physical activity linked to most occupations Changes in transport from physical (walking, cycling, public transport) to motorized (car/motorcycle ) Greater mechanization of tasks at home Limited facilities for physical activity and recreation in overcrowded cities and towns 

What families can do... 

Children and young adults should eat regular meals, including breakfast, in a pleasant, sociable environment - without distractions such as television Parents should eat with children - with all family members eating the same food Parents should encourage active play - for example, dancing and skipping Try to be more active as a family. For example, walking and cycling to school and shops, going to the park or swimming Gradually reduce sedentary activities - such as watching television or playing video games - and consider active alternatives such as dance, football or walking Encourage children to participate in sport or other active recreation, and make the most of opportunities for exercise at school 

(Union for International Cancer Control, 2009)


The Times of India, 30 March, 2012, http://timesofindia.indiatimes.com/india/Urban-Indians-shun-doctors-risk-death-from-cancer/articleshow/12463658.cms


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