ISSN: 2224-5618
Volume 2, Issue 2 (Sep, 2012), Poster No. 09, Pages No. 61-65
Comparative analysis of ovarian cancer incidence and CA125 marker with Gangetic zone of Bihar, India A. Nath , J. K. Singh, Priyanka, S. Ezhil Vendan and Shailendra Kumar Research Centre, Mahavir Cancer Sansthan, Patna – 801 505, India.
Presented at:
International Conference on Reproductive Health with Emphasis on Strategies for Family Planning (ISSRF – 2012)
Venue:
New Delhi, India
Date:
19.02.2012 - 21.02.2012
.
Abstract Ovarian cancer is one of the leading causes of death among gynaecological malignancies in India. Ovarian cancer incidence data of a period of May 2010 to April 2011 were obtained from the National Cancer Registry, Mahavir Cancer Sansthan (Hospital & Research Centre), Patna. Quantitatively estimated CA125 (cancer marker) levels in serum of patients were taken from the medical records of 200 patients treated at the Mahavir Cancer Sansthan, Patna. Obtained data of incidence and CA125 were categorised in Gangetic and nonGangetic zones. Cancer incidence was varied between different districts of Bihar. CA125 level in the serum was not correlated with tumour stage and it was highly varied between different individuals. Previously, we reported that prostate and gall bladder cancer incidence was correlated to Gangetic zone with high prevalence. In the present study, it was concluded that there was no relationship between ovarian cancer incidence, CA125 level and Gangetic zone. Keywords: Cancer Prevalence; Ovarian Cancer; CA125 Marker; Arsenic; Endocrine Disturbing Chemica; Xenoestrogen.
Introduction Ovarian cancer is the sixth most common cancer in women worldwide and is one of the leading causes of death among gynaecological malignancies in India. In United States, it is estimated that 21,880 new cases were diagnosed and 13,850 women died of ovarian cancer (Montes et al., 2010). The exact cause of ovarian cancer remains unknown. It has been seen that ovarian cancer is more common in industrialized nations, where as low in developing countries (Parkin, 1993). In general, geography, environmental factors and epigenetic changes being interrupt the genetic factors and influence the initiation and progression of reproductive cancers. During the last 50 years, reproductive cancer incidence was drastically increased in the industrialized world. Endocrine disturbing chemicals plays major role in endocrine gland disturbance, hormonal changes and reproductive cancer in human. The present study was aimed to assess ovarian cancer prevalence, high risk factors and prognostic marker CA125 in ovarian cancer patients of Bihar, India. 61
Material & Methods Case file study was carried out to assess cancer incidence, CA125 level in the serum of cancer patients and other risk factors for ovarian cancer. Case files of a period of May 2010 to April 2011 were obtained from the National Cancer Registry, Mahavir Cancer Sansthan, Patna. Age, residential area and tumour stage of ovarian cancer patients were recorded from the case files. Quantitatively estimated CA125 levels in serum of patients were taken from the medical records of 200 patients. Obtained data of cancer incidence and biomarker level were categorised into Gangetic and non-Gangetic zones. CA125 level in serum was analysed in different stages of ovarian cancer for knowing the prognostic significance. Discussion and Conclusions Ovarian cancer incidence was varied between different districts of Bihar. Among the 38 districts of Bihar, maximum incidence was recorded in Patna district and remarkable incidence was recorded in the following districts; Begusarai, Bhojpur, Buxar, Chapra, Gaya, Gopalganj, Khagaria, Madhepura, Muzaffarpur, Patna, Samstipur, Siwan, Saupal and Vaishali. Previously, we reported (Nath et al., 2012 & Nath, 2012) from our laboratory that prostate and gall bladder cancer incidence was higher in Gangetic zone than in Non-Gangetic zone. Whereas in the present study, it was observed that there was no relationship between ovarian cancer incidence and zone. Nearly, 50% of incidence was recorded in both zones i.e., Gangetic zone and NonGangetic zone. Maximum incidence was recorded in the age group of 36-45 years at the rate of 27%. Most of the ovarian cancer patients were visited to the hospital at early tumour stages for treatment. In all the stages; low, median and elevated level of CA125 in serum of different individuals was recorded. Accordingly, CA125 level in serum was not progressively correlated with the stage of cancer. In addition, there was no association was found between the CA125 level in serum of cancer patients and Gangetic zone of Bihar. In conclusion, the present study suggests that there was no correlation between ovarian cancer incidence, CA125, tumour stage and Gangetic zone of Bihar.
Results
8 4 0
Araria Aurangabad Banka Begusarai Betiah Bhagalpur Bhojpur Buxar Chapra Darbhanga EastChamparan Gaya Gopalganj Jahanabad Jamui Kaimur Katihar Khagaria Koshi Kishanganj Lakhisarai Madhepura Madobani Munger Muzaffarpur Nalanda Nawada Pashchim Patna Purnia Rohtas Samastipur Saran Shekhpura Sitamarhi Siwan Supaul Vaishali
Incidence (%)
12
Districts
Fig. 1. Prevalence of ovarian cancer in different districts of Bihar.
62
100
Incidence (%)
80 60 40
51.25
48.75
20 0 Gangetic zone
Non-Gangetic zone Region
Fig. 2. Comparison of ovarian cancer incidence in Gangetic zone with non-Gangetic zone of Bihar, India.
50
Incidence (%)
40 30 20 10 0 16-25
26-35
36-45
46-55
56-65
66-75
Age group (years)
Fig. 3. Comparison of ovarian cancer incidence with different age groups.
I
II
III
IV
12.28 42.11 22.81 22.81
Fig. 4. Ovarian cancer patients visit at different stages in Mahavir Cancer Sansthan hospital. 63
0-35
36-100
101-1000
CA125 (IU/ml)
80
Cases (%)
60 40 20 0 I
II
III
IV
Stage
Fig. 5. Comparative analysis of three different level of CA-125 with the stage of ovarian cancer.
CA125 (IU/ml)
200
150
100
171.96
166.39
Gangetic
Non Gangetic
50
0
Zone
Fig. 6. Mean level of CA125 marker in Gangetic and Non Gangetic zone of Bihar, India.
Acknowledgements The authors are thankful to Department of Science and Technology (DST), Govt. of India, New Delhi, India for financial support (No. DST (SSTP)/Bihar/2K8/12).
References 1. Nath, A., Singh, J. K., et al. (2012). Elevated level of prostate specific antigen among prostate cancer patients and high prevalence in Gangetic zone of Bihar, India. Asian Pacific Journal of Cancer Prevention. 13, 451-453 2. Nath, A. (2012). Estimation of pesticides and heavy metals in people of Bihar with the linkage of cancer. Annual Report. DST.(SSTP)/Bihar/2K8/12. DST, Ministry of Science & Technology, New Delhi. 3. Montes, A.F., Gomez, J.G., et al. (2010). Epidemiology and etiology of ovarian cancer. Ovarian Cancer – Basic Science Perspective. 1-16. From www.cdn.intechweb.org/pdfs/28393.pdf 4. Parkin, D.M., Pisani, P., et al. (1993). Estimates of the worldwide incidence of eighteen major cancers in 1985. International Journal of Cancer. 554, 594-606 64
Correspondence Contact Details Prof. (Dr.) A. Nath E.mail:
[email protected] Ph : +91-0612-2250127 Fax: +91-0612-22553957
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