A mega study and a global trial,to fight killer diseases better

Among lifestyle trends being investigated are vegetarianism and common spices in the Indian diet. The researchers will study whether these have a beneficial effect in lowering the risk of cancer. The researchers will also investigate if chewing tobacco,burning wood as a fuel indoors,and the adoption of Western lifestyles in Indian cities have a detrimental effect.

The study is part of a project initiated by the INDOX Cancer Research Network,a partnership between the University of Oxford and 12 of India’s top comprehensive cancer centres,says INDOX director Dr Raghib Ali. The study will involve as many as 30,000 people at 12 centres across India.

Dr Paul Sebastian,director of the Regional Cancer Centre at Trivandrum,says the basic idea is to collate data from the centres. The focus is on the common type of cancer and the age group it affects. Such data are practically nonexistent. Each centre has its own institutional review board,says Sebastian who is one of the investigators.

Cancer incidence in India is expected to increase by more than two-thirds over the next two decades to approximately 1.7 million new cases per year. “Cancer is increasing in India. Although it is increasing from a low level — because of India’s size — if it reaches levels seen in the West,many millions of people will be affected,” Ali says.

Cancer,often thought of as a disease of the West,is now the second leading cause of death in many low-income and middle-income countries,including India. Mortality rates are high in India because of factors such as the cost of treatment,social stigmas and lack of awareness. Most studies on cancer risks,however,have been in the West.

According to Dr K M Mohandas,director of the Centre for Cancer Epidemiology of Tata Memorial Centre,Mumbai,several factors like an increase in population,longevity,lack of physical activity and urbanisation of rural areas are like to double the number of cancer cases by 2030. Several studies are under way to understand the etiology of cancers.

Also involved in the study is Professor Vinod Raina,head of medical oncology at the Institute Rotary Cancer Hospital and AIIMS. He is among the co-founders of the INDOX Cancer Research Network.

The study will investigate lifestyle,diet and genetic factors associated with the most common cancers in India — breast,bowel,lymphoma,lung,stomach,gallbladder,oesophageal,cervical,and head and neck.

Two of these studies in breast and bowel cancer have already begun and are expected to be complete in two years’ time. The researchers will recruit a total of 10,000 people newly diagnosed with these two cancers,and a further 10,000 people as healthy controls.