Burden and Trends of Obesity Related Selected Cancers in Sri Lanka: Review of National Cancer Registry Data

Full text: Introduction: Globally, cancer is a leading cause of morbidity and mortality. There are consistent evidences that higher amount of body fat are associated with increased risk of cancers including Breast (postmenopausal), Colon and Endometrial. With increasing average life expectancy, urbanization and the accompanying lifestyle changes, Sri Lankans are increasingly exposed to risk factors of Non communicable diseases such as sedentary lifestyle and unhealthy dietary habits. According to the STEP survey 2015 nearly 29% of Sri Lankan adults were estimated to be overweight or obese (95% CI 27.5 – 31.1) with 24.6% of men and 34.3% of women. Objective: To describe the Burden and trends of Breast, Colon and Endometrial cancers in Sri Lanka utilizing the cancer registry data of the National Cancer Control Programme. Methodology: Incidence data of Breast, Colon and Endometrial cancers were extracted from the database of the National Cancer Registry from 2000 to 2010 to assess the burden and trends of above mentioned cancers. National cancer registry collects data from 39 centers including 13 pathology laboratories island wide. The review was confined to the period of 2000 to 2010 since use of ICD-O classification was commenced in 2000 and last published data available only up to 2010. Results Female Breast cancer: The Age standardized Rate (ASR) of female breast cancer was 19.9 per 100,000 in 2000 which was increased by 1.15 fold in 2010 to 23 per 100,000. Further analysis of data shows there is a greater increase of post-menopausal (> 50 years) breast cancer from 58.1 to 75.9 per 100,000 compared to pre-menopausal (from 20 - 50 years) breast cancers which shows slight decline during the period from 20.8 to 19.4 per 100,000. Colon cancer: There were 217 colon cancers in year 2000 with the ASR of 1.5 almost equally distributed among males and females (109 and 108 respectively). The incidence rate of Colon cancer is gradually increased over the years and in 2010 there were 443 incident cases with ASR 2.3 per 100,000 population. (1.5 fold increase over the period). Endometrial cancers: Age specific rate of endometrial cancer in year 2000 was 2.27 per 100,000 and was not among the 10 leading cancers among females. However endometrial cancer incidence increased gradually and in 2010, the age standardized rate was 3.9 per 100,000 with 1.7 fold rise. Endometrial cancer was the 8th leading cancer among females in year 2010. Conclusion: There is a notable increase in incidences of post-menopausal breast cancers, Colon cancers and endometrial cancers over the period of 11 years in Sri Lanka. Improved reporting may partly contributed to this increase. However, as obesity shows an increasing trend among Sri Lankans, it is timely to conduct further research to determine the exact contribution of obesity and overweight for certain cancers among Sri Lankan adult population. (author)