A STATISTICAL ANALYSIS AND DATA

VISUALIZATION OF CANCER PATIENTS OF

INDIA OVER BY POWER BI

CAPSTONE
PROJECT
REPORT

MASTER OF MANAGEMENT STUDIES

NANDINI SHEKHAR COUNDER

OPERATIONS

2019 - 2021

ROLL NO. 004

SIES COLLEGE OF MANAGEMENT STUDIES NERUL,

NAVI MUMBAI 400706
A STATISTICAL ANALYSIS AND DATA
VISUALIZATION OF CANCER PATIENTS OF INDIA
OVER BY POWER BI

CAPSTONE
PROJECT REPORT

SUBMITTED

AS A PARTIAL FULFILMENT OF THE CURRICULUM

FOR THE DEGREE

MASTERS OF MANAGEMENT STUDIES (MMS)

SIES COLLEGE OF MANAGEMENT

STUDIES NERUL, NAVI MUMBAI

BY
NANDINI S. COUNDER

ROLLNO: 004

SPECIALIZATION- OPERATIONS

2019-2021

i
DECLARATION

I, Ms. NANDINI S. COUNDER, studying in the second year of MASTERS OF

MANAGEMENT STUDIES (MMS) at SIES College of Management Studies, Nerul,
Navi Mumbai, hereby declare that I have completed the Capstone Project titled “A
STATISTICAL ANALYSIS AND DATA VISUALIZATION OF CANCER
PATIENTS OF INDIA OVER BY POWER BI” as a part of the course requirements
for MASTERS OF MANAGEMENT STUDIES (MMS) Program.

I also declare that the work undertaken by me is original and has not been copied from
any sources. I further declare that the information presented in this project is true and
original and has not been submitted to SIESCOMS or any other Institute for any other
examination.

Signature of the student

Date: 18th April 2021

Name of the student: Nandini S. Counder

Roll No: 004

i
CERTIFICATE BY FACULTY GUIDE

This is to certify that Ms. NANDINI S. COUNDER, studying in the second year of
MASTERS OF MANAGEMENT STUDIES (MMS) at SIES College
of Management Studies, Nerul, Navi Mumbai, has completed the Capstone Project
titled “A STATISTICAL ANALYSIS AND DATA VISUALIZATION OF
CANCER PATIENTS OF INDIA OVER BY POWER BI” as a part of the course
requirements for MASTERS OF MANAGEMENT STUDIES (MMS) Program.

Signature of the Faculty Guide

Name: Dr. Vilas Chaudhary
Date: 18th April 2021

i
ACKNOWLEDGEMENTS

I, the undersigned would like to thank the University of Mumbai and my college for
giving me this opportunity. The success and final outcome of this project required a lot
of guidance and assistance from many people and I am extremely fortunate to have got
this all along the completion of my project work

This research was supported by Project Guide Prof. Dr. Vilas Chaudhary. I thank him
for his constant support and guidance throughout the course of this project.

I thank my colleagues from SIES College of Management Studies who provided

insight and expertise that greatly assisted the research.

My appreciation is also to my institution and the faculty members without whom this
project for their timely support.

Signature

(NANDINI S. COUNDER)

Date: 18th April 2021

v
EXECUTIVE SUMMARY
Cancer is a generic term for a large group of diseases that can affect any part of the body.
Other terms used are malignant tumours and neoplasms. One defining feature of cancer is the
rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then
invade adjoining parts of the body and spread to other organs; the latter process is referred to as
metastasis. Metastases are the primary cause of death from cancer.

The state wise distribution of different cancer patients in India .A perusal of this Figure clearly
shows that lung cancer is the most common cancer in various states. The most effected states of
India due to this cancer are Jammu & Kashmir, Himachal Pradesh, Delhi, Uttarakhand,
Rajasthan, Maharashtra, Jharkhand, West Bengal, Andhra Pradesh, Kerala, Tripura and Manipur.
It is also clear from this Figure that cervical cancer is the second most common form of
malignancy in female population of Himachal Pradesh, Haryana, Rajasthan, Goa, Tamil Nadu,
West Bengal while it stands at third position in females of Punjab, Andhra Pradesh and Uttar
Pradesh.

The systematic collection of data on cancer is being performed by various population-based

cancer registries (PBCRs) and hospital-based cancer registries (HBCRs) across India under the
National Cancer Registry Programme–National Centre for Disease Informatics and Research of
Indian Council of Medical Research since 1982.

This study examined the cancer incidence, patterns, trends, projections, and mortality from 28
PBCRs and also the stage at presentation and type of treatment of patients with cancer from 58
HBCRs (N = 667,666) from the pooled analysis for the composite period 2012-2016. Time
trends in cancer incidence rate were generated as annual percent change from 16 PBCRs (those
with a minimum of 10 years of continuous good data available) using Join point regression.

This study provides a framework for assessing the status and trends of cancer in India. This shall
guide appropriate support for action to strengthen efforts to improve cancer prevention and
control to achieve the National NCD targets and the sustainable development goals. The data
also provide leads to key research questions.

v
INDEX

Sr. no. Title Page no.

1 INTRODUCTION 1
1.1 Cancer worldwide 2
1.2 Cancer in India 3
1.3 Causes and Risk of Cancer 3
1.4 State wise distribution in India 4
The National Cancer Registry Programme -
1.5 An Overview 6

2 LITERATURE REVIEW 7 to 10

3 METHODOLOGY
3.1 Methodology 12
3.2 Objectives 12
3.3 Types of data and analysis 12
3.4 Source 12
3.5 Tools used: Power BI 13 to 15

4 DATA ANALYSIS 16 to 21

5 RESULTS AND DISCUSSION 22 to 27

6 CONCLUSION 28

7 REFERENCE 30
CHAPTER 1
INTRODUCTION
INTRODUCTION

Cancer is a disease in which there is unregulated cell growth in any organ systems
occurring in humans of all age groups, irrespective of age, sex, nationality, ethnicity, economic
status, educational strata, geological and geographic distributions. In its presentation, it could be
acute (sudden onset), sub-acute (slow onset), or chronic (long period of time). In its symptoms, it
is known to present itself in the most insidious non-speciic presenting symptoms like fever,
diarrhoea or weight loss to the symptoms like bleeding, obstructive symptoms, growths. As a
disease it has the potential to restrain a person from achieving full physical, physiological,
psychological and economic potential. It’s a major concern for the patient, his/her family, the
clinician, the healthcare provider and the tax-payer.

The aetiology of cancer is multi-factorial: genetic predisposition, exposure to tobacco,

certain chemicals, infections, radiation, inappropriate lifestyle factors (alcohol, Inappropriate
diet, physical inactivity, high body mass index, diabetics and metabolic syndrome) have all been
implicated in the causation of cancer. Yet, the cause remains undetermined in a large proportion
of patients. This is important since much of the preventive strategies are based on some of the
known factors. Associations have also been made on the degree of exposure, dose of exposure,
duration of exposure, age (vulnerability) of the exposed and the like. All these factors have come
from deductive reasoning of epidemiological data and an insight into the possible causative
mechanisms. There have been remarkable successes in the evolving treatment modalities which
have strengthened the fight against cancer.

1.1. Cancer Worldwide

Cancer is a generic term for a large group of diseases that can affect any part of the body.
Other terms used are malignant tumours and neoplasms. One defining feature of cancer is the
rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then
invade adjoining parts of the body and spread to other organs; the latter process is referred to as
metastasis. Metastases are the primary cause of death from cancer.

The problem

Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in
2020 (1). The most common in 2020 (in terms of new cases of cancer) were:

breast (2.26 million cases);

1
lung (2.21 million cases);
colon and rectum (1.93 million cases);
prostate (1.41 million cases);
skin (non-melanoma) (1.20 million cases); and
stomach (1.09 million cases).1

The most common causes of cancer death in 2020 were:

lung (1.80 million deaths);

colon and rectum (935 000 deaths);
liver (830 000 deaths);
stomach (769 000 deaths); and
breast (685 000 deaths).

1.2. Cancer in India

The National Cancer Registry Programme in Bangalore used data from 105 hospitals and
private clinics in 82 of the 593 districts in India to map the incidence of cancer, as part of a
project funded by the World Health Organization.

The survey included more than 200 000 patients with histopathologically confirmed cancers,
whose details were sent to the registry through the internet.

Previously, the registry, which was launched in 1981, had covered just a few cities and a
single village and had relied on hospital records and death certificates to estimate the burden
of cancer. It used to take up to five years to submit the information. Data analysis for the
atlas took just 15 months.

1.3. What causes cancer?

Cancer arises from the transformation of normal cells into tumour cells in a multi-stage
process that generally progresses from a pre-cancerous lesion to a malignant tumour. These
changes are the result of the interaction between a person's genetic factors and three categories of
external agents, including:

physical carcinogens, such as ultraviolet and ionizing radiation;

chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food
contaminant), and arsenic (a drinking water contaminant); and
biological carcinogens, such as infections from certain viruses, bacteria, or parasites.
2
WHO, through its cancer research agency, the International Agency for Research on
Cancer (IARC), maintains a classification of cancer-causing agents.

The incidence of cancer rises dramatically with age, most likely due to a build-up of risks
for specific cancers that increase with age. The overall risk accumulation is combined with the
tendency for cellular repair mechanisms to be less effective as a person grows older.

Risk factors for cancers

Tobacco use, alcohol use, unhealthy diet, physical inactivity and air pollution are risk
factors for cancer (and other noncommunicable diseases).

Some chronic infections are risk factors for cancer; this is a particular issue in in low- and
middle-income countries. Approximately 13% of cancers diagnosed in 2018 globally were
attributed to carcinogenic infections, including Helicobacter pylori, human papillomavirus
(HPV), hepatitis B virus, hepatitis C virus, and Epstein-Barr virus (3).

Hepatitis B and C viruses and some types of HPV increase the risk for liver and cervical
cancer, respectively. Infection with HIV substantially increases the risk of cancers such as
cervical cancer.

1.4.State wise distribution in India

The state wise distribution of different cancer patients in India is shown in Figure 1. A
perusal of this Figure clearly shows that lung cancer is the most common cancer in various
states. The most effected states of India due to this cancer are Jammu & Kashmir, Himachal
Pradesh, Delhi, Uttarakhand, Rajasthan, Maharashtra, Jharkhand, West Bengal, Andhra Pradesh,
Kerala, Tripura and Manipur. It is also clear from this Figure that cervical cancer is the second
most common form of malignancy in female population of Himachal Pradesh, Haryana,
Rajasthan, Goa, Tamil Nadu, West Bengal while it stands at third position in females of Punjab,
Andhra Pradesh and Uttar Pradesh.

Breast cancer is the most common form of cancer in the women of Himachal Pradesh,
Delhi, Rajasthan, Nagaland and Goa, and the second most common form of malignancy in
females of Punjab, Maharashtra and Gujarat. In Tripura, breast cancer represents the third most
common form of cancer in women folks. This Figure also dictates that stomach cancer is the
third commonly reported cancer in Sikkim, Arunachal Pradesh, Tamil Nadu, Mizoram and Goa
sates. It is the second most common cancer in Andhra Pradesh and Nagaland and the third most
common type of malignancy in Jammu & Kashmir.

3
Oral cancer stands at second and third positions in Goa and Assam states, respectively.
Head and neck cancer patients have been observed in Tripura. Oesophageal cancer is a common
type of malignancy after lung cancer in Jammu & Kashmir, Assam and Karnataka. Of course,
Gall bladder cancer is not frequent in India but it has been diagnosed in certain parts of Punjab,
Uttar Pradesh and Bihar. Tongue cancer is the most common type of cancer in Madhya Pradesh;
especially in Bhopal while it stands at second position in Goa.

Oropharyngeal cancer is prevalent in Haryana and Meghalaya. This Figure also shows
that some other types of cancers viz. skin, laryngeal and non-Hodgkin’s lymphoma are rare in
India but some cases have been diagnosed in Chhattisgarh and Uttarakhand. Cancers of ovary,
prostate and brain have been reported only at some places in Rajasthan. The prostate and brain
cancers were also found in males of Rajasthan.

Figure 1: State wise distribution in India For male and female sexes, all ages

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1.5..The National Cancer Registry Programme - An Overview

In India, the National Cancer Registry Programme (NCRP) under the Indian Council of
Medical Research (ICMR) with its network of cancer registries was started in December 1981
with the co-ordinating centre at Bengaluru. Presently it is operated by the ICMR-NCDIR,
Bengaluru. This provides the data on cancer incidence, mortality, pattern, trend and geo-
pathological distribution of cancers. It also helps to formulate and implement policies and
programmes, monitor and evaluate the cancer control activities. There are two types of cancer
registries under the programme. Population Based Cancer Registries (PBCRs) record all the new
cancer cases occurring in a deined population within a geographic area. The Hospital Based
Cancer Registries (HBCRs) record information on cancer patients attending a particular hospital,
with focus on clinical care, treatment and outcome. Cancer Atlas approaches have also been used
for speciic short-term purposes.

NCRP started with a network of three PBCRs in Bangalore, Chennai and Mumbai and
three HBCRs in Chandigarh, Dibrugarh and Thiruvananthapuram. The number of registries
working under the programme have expanded greatly from the time of inception and presently
there are 36 PBCRs and 236 HBCRs registered under NCRP. Since cancer is not a notiiable
disease, cancer registration in India is active and staff of all registries visit hospitals, pathology
laboratories and all other sources of registration of cancer cases on a routine basis. Death
certiicates are also scrutinized from the local government units like municipal corporation and
panchayat raj institutes and information is collected on all cases where cancer is mentioned as a
cause of death on the death certiicates. The information that is collected on a core form is entered
into a software provided by ICMR - NCDIR. The data is further transmitted to ICMR - NCDIR.

Over the years, the registries and the ofice of the NCRP have used modern advances in
electronic information technology to enter the data, checking of the data, veriication of
duplicates and matching of mortality and incidence records. The software applications
developed by NCDIR have further evolved and so has the data submission methodology and
overall support. Data quality is assessed at the coordinating unit under different dimensions like
comparability, validity, timeliness and completeness. Frequent training and re-training programs
are conducted for cancer registry investigators and staff to maintain quality of work. Interaction
with local health and other stakeholders is undertaken by the registries to keep them informed
and to irm up partnerships.

5
CHAPTER 2
LITERATURE REVIEW

6
(1) Cancer Statistics, 2020: Report From National Cancer Registry Programme, India
National Centre for Disease Informatics and Research, Bengaluru, India

The systematic collection of data on cancer is being performed by various population-based

cancer registries (PBCRs) and hospital-based cancer registries (HBCRs) across India under the
National Cancer Registry Programme–National Centre for Disease Informatics and Research of
Indian Council of Medical Research since 1982.

This study examined the cancer incidence, patterns, trends, projections, and mortality from 28
PBCRs and also the stage at presentation and type of treatment of patients with cancer from 58
HBCRs (N = 667,666) from the pooled analysis for the composite period 2012-2016. Time
trends in cancer incidence rate were generated as annual percent change from 16 PBCRs (those
with a minimum of 10 years of continuous good data available) using Joinpoint regression.

Aizawl district (269.4) and Papumpare district (219.8) had the highest age-adjusted incidence
rates among males and females, respectively. The projected number of patients with cancer in
India is 1,392,179 for the year 2020, and the common 5 leading sites are breast, lung, mouth,
cervix uteri, and tongue. Trends in cancer incidence rate showed an increase in all sites of cancer
in both sexes and were high in Kamrup urban (annual percent change, 3.8%; P < .05). The
majority of the patients with cancer were diagnosed at the locally advanced stage for breast
(57.0%), cervix uteri (60.0%), head and neck (66.6%), and stomach (50.8%) cancer, whereas in
lung cancer, distant metastasis was predominant among males (44.0%) and females (47.6%).

This study provides a framework for assessing the status and trends of cancer in India. It shall
guide appropriate support for action to strengthen efforts to improve cancer prevention and
control to achieve the national noncommunicable disease targets and the sustainable
development goals.

7
(2)National Cancer Registry Programme

Indian Council of Medical Research

The report contains 5 years (2012-2016) data from the network of cancer registries working
under the National Cancer Registry Programme (NCRP). Number of data points and network of
registries under the programme have expanded greatly since the start of the programme in 1982.
The present report has included data from 28 Population Based Cancer Registries (PBCRs) and
58 Hospital Based Cancer registries (HBCRs) in India based on its completion and
verification.The aim of cancer registry is to create evidence on the burden, pattern and
distribution of cancer. Incidence rates are one of the best indicators available to measure the
burden of cancer. PBCRs measure the incidence rates for a deined population. Along with
contributing to PBCRs, HBCRs provide data on the clinical presentation, diagnosis and care of
cancer. Compared to past NCRP reports, for the irst time has the data of both PBCRs and
HBCRs been provided in a single report. The data of all the HBCRs is pooled and analysed
rather than providing hospital wise information. The data of PBCR and HBCR is presented
under North, South, East, West, Central and North East regions so as to characterize regional
variations.Snapshot of cancer registries provides the details of cancer registries region-wise. The
location of each registry, establishment year, coverage area, leading site of cancer and sources of
registration for each PBCR is illustrated. The names of HBCRs, their established year and top 5
leading sites of cancer in the HBCR is listed.

(3)Patterns of cancer incidence in India – What next?

The registry study rightly highlights that the proportion of preventable cancers is high – for
instance, oral cancer from tobacco abuse. Tobacco and alcohol continue to remain the greatest
threats to public health. Moreover, obesity and lifestyle diseases are contributing to the rising
cancer burden (breast, endometrial, and colorectal cancers). What steps can be taken to reduce
the cancer incidence in India via reducing the exposure to these risk factors? Greater awareness
of cancer risk factors and early signs of cancer and premalignant conditions is crucial. For that,
dissemination of information and education in regional languages and through social media
platforms must be adopted. Meanwhile, we must also conduct implementation research for some
of the current strategies being used in cancer awareness programs. For instance, does pictorial
representation of the dangers of oral tobacco use result in tobacco cessation? Has an increase in
sales tax for tobacco products reduced tobacco use.

Encouragingly, India has launched the national clinical screening program though this has not
been implemented nationwide.[10] This will include organized screening for all men and women
above the age of 30years for oral, breast, and cervix cancers. The challenges remain the

8
infrastructure, trained personnel, capacity building, robust referrals, and the diagnostic
pathway.[11]

The key stakeholders must focus on screening and early diagnosis with investment in early
multidisciplinary diagnostic centers as part of the rapid diagnostic and referral pathways as
piloted by the NHS.[12,13] While we can now reliably get cancer incidence data from these
registries, we still do not have high-quality information on the survival outcomes. Our national
registry program should next focus its attention on generating such data as well. The NCRP 2020
is an excellent start to presenting systemic information on the patterns of care, and hopefully, we
can build on these data.

(4)Cancer Scenario in India with Future Perspectives

Among various diseases, cancer has become a big threat to human beings globally. As per
Indian population census data, the rate of mortality due to cancer in India was high and
alarming with about 806000 existing cases by the end of the last century. Cancer is the second
most common disease in India responsible for maximum mortality with about 0.3 million deaths
per year. This is owing to the poor availability of prevention, diagnosis and treatment of the
disease. All types of cancers have been reported in Indian population including the cancers of
skin, lungs, breast, rectum, stomach, prostate, liver, cervix, esophagus, bladder, blood, mouth
etc. The causes of such high incidence rates of these cancers may be both internal (genetic,
mutations, hormonal, poor immune conditions) and external or environmental factors (food
habits, industrialization, over growth of population, social etc.). In view of these facts, the
present article describes the status of various types of cancers in India and its comparison at
global level. Besides, attempts have been made to describe the main causes of cancer along with
their preventive measures. In addition to this, efforts have also been made to predict the effect
of increasing number of cancer patients on the Indian economy.

9
CHAPTER 3
METHODOLOGY

1
3.1. Methodology

The research method consists of how the researcher collects, analyzes, and interprets the data
in the stud. Secondary analysis is a systematic method with procedural and evaluative steps,
yet there is a lack of literature to define a specific process, therefore this paper proposes a
process that begins with the development of the research questions, then the identification of
the dataset, and thorough evaluation the dataset.

3.2. Objectives:

• To study about the various stakeholders in the Banking Sector

• To study about the importance of various departments and roles in the Banking Sector
• To highlight the importance of operations management in the Banking Sector

3.3. Type of data and analysis:

Qualitative analysis is carried out with the help of secondary data using various research
papers and articles.
The information collected through these sources are analyzed and interpreted to obtain
reasonable conclusions.
Companies and their industries are studied with regards to their activities and initiatives.

3.4.Source:
The secondary data about the organizations’ contributions and initiatives are sourced through
various websites (mentioned in the reference section).

3.5. Tools used: POWER BI

The business world is increasingly data driven. Small and large businesses alike use data to
make decisions about sales, hiring, goals, and all areas for which they have data. While most
businesses have access to data of one type or another, it can be intimidating to try to
understand without a background in data analytics or statistics. Even if you do understand the
data, a challenge may arise in displaying the data in an easy to understand way and
communicating it to other relevant people. Power BI takes the intimidation and hassle out of
data analysis and visualization. By connecting to one or more of the hundreds of existing data
sources and using a secure, easy to understand interface, you can quickly and simply interact
with and understand your data to influence all business systems.

1
What is Power BI?

From customer and employee data, metrics for company goals, to sales and acquisitions,
business are drowning in data, but this data is only as good as your ability to interpret and
communicate its meaning. That's where Power BI (Business Intelligence) comes into play.

Microsoft Power BI is a collection of software services, apps, and connectors that work together
to turn your unrelated sources of data into coherent, visually immersive, and interactive insights.
Whether your data is a simple Microsoft Excel workbook, or a collection of cloud-based and on-
premises hybrid data warehouses, Power BI lets you easily connect to your data sources, clean,
and model your data without affecting the underlying source, visualize (or discover) what's
important, and share that with anyone or everyone you want.

A Power BI report is one or more pages of visualizations such as line charts, maps, and treemaps.
Visualizations are also called visuals. You can create reports from scratch within Power BI,
import them with dashboards that colleagues share with you, or Power BI can create them when
you connect to datasets from Excel, Power BI Desktop, databases, and SaaS applications. For
example, when you connect to an Excel workbook that contains Power View sheets, Power BI
creates a report based on those sheets. And when you connect to a SaaS application, Power BI
imports a pre-built report.

Dashboards

A dashboard is something you create in the Power BI service or something a colleague creates
in the Power BI service and shares with you. It is a single canvas that contains zero or more
tiles and widgets. Each tile pinned from a report or from Q&A displays a single visualization that
was created from a dataset and pinned to the dashboard. Entire report pages can also be pinned to
a dashboard as a single tile. There are many ways to add tiles to your dashboard; too many to be
covered in this overview topic.

1
Why do people create dashboards? Here are just some of the reasons:

To see, in one glance, all the information needed to make decisions.

To monitor the most-important information about your business.
To ensure all colleagues are on the same page, viewing and using the same information.
To monitor the health of a business or product or business unit or marketing campaign,
etc.
To create a personalized view of a larger dashboard and show all the metrics that matter
to them.

Data modeling and visualizations

When you launch Power BI Desktop, the Getting Started dialog box will appear, which
provides useful links to forums, blogs, and introductory videos.

In Power BI Desktop, you will begin to build reports in the Report view. You will be working
in five main areas:

1
1. Ribbon - Displays common tasks that are associated with reports and visualizations.
2. Report view, or canvas - Where visualizations are created and arranged.
1. The Data view allows you to view all of your data available in your report.
This is an easy way to quickly check data types and validate data.
2. The Model view allows you to visually set the relationship between tables or
elements. A relationship is where two or more tables are linked together because
they contain related data. This enables users to run queries for related data across
multiple tables.
3. Pages tab - Located along the bottom of the page, this area is where you would select
or add a report page.
4. Visualizations pane - Where you can change visualizations, customize colors or
axes, apply filters, drag fields, and more.
5. Fields pane - Where query elements and filters can be dragged onto the Report view or
dragged to the Filters area of the Visualizations pane.

1
CHAPTER 4
DATA ANALYSIS

1
DATA ANALYSIS

In the given table below, the total number of new cases registered as on 2020 as presented
They are presented in No. of cases in males and females and both male and female together
Types Both Males Females
Breast 178361 0 178361
Lip, Oral cavity 135929 104661 31268
Cervix uteri 123907 0 123907
Lung 72510 51675 20835
Colorectum 65358 40408 24950
Stomach 40686 40686 0
Ovary 45701 0 45701
Oesaphagus 40183 40183 0
Other Cancers 748348 368417 274196

Table 1: No. of cases in males and females and both sexes

Figure 2: Number of Cases in 2020, both sexes, all ages

1
Figure 3: Number of Cases in 2020, Males, all ages

Figure 4: Number of Cases in 2020, Females, all ages

1
Year Males Female Total no of cases
2004 390809 428545 819354
2005 424578 470438 895016
2006 432144 479826 911970
2007 439710 489214 928924
2008 447276 498602 945878
2009 454842 507990 962832
2010 462408 517378 979786
2011 477461 536053 1013514
2012 487834 548924 1036758
2013 498208 561795 1060002
2014 508581 574665 1083246
2015 518954 587536 1106490
2016 529328 600407 1129734
2017 539701 613277 1152979
2018 550075 626148 1176223
2019 560448 639019 1199467
2020 570822 651889 1324413
2021 581195 664760 1381558
2022 591569 677631 1455653
2023 601942 690501 1529748
2024 612316 703372 1603843
2025 622689 716243 1677938

Table 2: Total number of cases in males and females over year 2004- year 2025
Note: From 2021 to 2025, Analysis is done using Excel

1
Average annual number of patients for all sites of cancer with incidence rate, cumulative
risk by sex, and mortality rate according to different regions in India between 2012 and 2016
are given in Table 1. PBCRs in the NE showed the highest incidence rate in both sexes.

It was also observed that Aizawl district had the highest AAR (269.4) and mortality
(152.7) rate among males. One of every 4 males in Aizawl district, Papumpare district, East
Khasi Hills district, and Kamrup urban are likely to develop cancer in the age group of 0-74
years. One of every 4 females in the Papumpare district and 1 of 5 females in Mizoram state are
likely to develop cancer in the age group of 0-74 years.
Among females, Papumpare district (219.8) had the highest AAR. In the rest of the regions
(excluding NE), Delhi had highest AAR (147.0), followed by Thiruvanathapuram district (137.8)
among males; Bangalore (146.8) had highest AAR, followed by Delhi (141.0) among females

Comparison of all cancer sites’ age-adjusted incidence rates (AARs) of all population-based cancer registries, 2012-
2016 (International Statistical Classification of Diseases and Related Health Problems, 10th revision: C00-C97

Among males, lung, mouth, esophagus, and stomach were the most common cancer sites.
Among females, breast cancer, followed by cervix uteri and ovary cancer, were the most
common sites across the PBCRs. Thyroid cancer was the second most common cancer in the

1
PBCRs of Thiruvananthapuram and Kollam, whereas lung cancer was seen in Manipur and
Mizoram state. In the NE region, the third most common cancers were stomach and gallbladder
(Data Supplement). The decadal changes in leading sites of cancer from 6 older PBCRs (Barshi
rural, Bangalore, Bhopal, Chennai, Delhi, and Mumbai) were observed for the first 10 and last 10
years of data (Data Supplement).

Relative proportion (%) of patients according to clinical extent of disease, 2012-2016 (proportion [%] may not total
100% because of rounding).

The projected incidence of patients with cancer in India among males was 679,421 (94.1
per 100,000) and among females 712,758 (103.6 per 100,000) for the year 2020. One in 68 males
(lung cancer), 1 in 29 females (breast cancer), and 1 in 9 Indians will develop cancer during their
lifetime (0-74 years of age. The projected 5 most common cancers in 2020 for males (lung,
mouth, prostate, tongue, and stomach) constitute 36% of all cancers and for females (breast,
cervix uteri, ovary, corpus uteri, and lung) constitute 53% of all cancers (Data Supplement).

2
CHAPTER 5
RESULT AND DISCUSSION

2
RESULTS

Cancer of the breast and cervix uteri were the most common cancers in women. The highest
burden of breast cancer was observed in metropolitan cities. There is an increase in the trend of
incidence of breast cancer, whereas cervix uteri cancer is on the decline. A steady increase in
breast cancer in most of the PBCRs including newer PBCRs, poses a great health challenge to
women in India.24 Presently, breast cancer and cervix uteri are the leading sites of cancer among
women in India, posing an important public health problem that needs important input from
various health and other agencies to tackle.25 A multidisciplinary approach to breast cancer,
including awareness programs, preventive measures, screening programs for early detection, and
availability of treatment facilities, are vital for reducing both incidence and mortality of cancer
in Indian women.26

The incidence rate of thyroid cancer among women is increasing, and it is most common
in the districts of Thiruvananthapuram and Kollam in Kerala. The high burden of thyroid cancer
in Kerala could be due to overdiagnosis,27 as was observed even in high-income and low- and
middle-income countries. There are cancers of several anatomic sites known to be associated
with the use of tobacco.29 Based on PBCR data, almost one third of the cancers were known to
be associated with the use of tobacco in India. India state-level disease burden initiative cancer
collaborators estimated that tobacco use was the highest contributing risk factor for cancer in
India. In India, lung cancer can be attributed to tobacco use and air pollution, which are the
leading risk factors.30 Approximately 70% of cancers in India were potentially preventable
through modifiable risk factors.31

2
Power BI Dashboard:

Figure 5: Dashboard created by me using Power BI presenting data collected (refer Result)

Figure 6: Dashboard created by me using Power BI presenting data collected (refer Result)

2
Figure 7: Dashboard created by me using Power BI presenting data collected (refer Result)

Figure 5: Dashboard created by me using Power BI presenting data collected (refer Result)

2
DISCUSSION

India exhibits heterogeneity in cancer. The incidence rates of Aizawl district were
observed to be 7 times and 4 times that of Osmanabad and Beed district PBCRs in males and
females, respectively. The highest cancer incidence rate was observed in the NE region (6
PBCRs for males and 4 PBCRs for females) than other areas in the country. The leading sites of
cancer in the NE region were nasopharynx, hypopharynx, esophagus, stomach, liver,
gallbladder, larynx, lung, breast, and cervix uteri.

Lung (9 PBCRs), mouth (9 PBCRs), esophagus (5 PBCRs), stomach (4 PBCRs), and

nasopharynx (1 PBCR) cancers were the most common cancers in men. Lung cancer was the
leading site in metropolitan cities and the southern region, whereas mouth cancer was the leading
site in the West and Central regions. Lung cancer and oral/mouth cancer were the most common
cancers among males in the Indian subcontinent.22 Cancers of the esophagus, stomach, and
nasopharynx were the leading sites in the NE region of India. Here, the cancer incidence pattern
is different from the rest of India. There are similarities in the cancer incidence pattern with the
Southeast Asian region.23 Overall, these findings on patterns of cancer were similar to previously
published reports under NCRP.8

Because it is difficult to obtain information on the clinical extent of disease and treatment
from PBCRs, the hospital database was used for such analysis.10 The majority of breast and
cervix uteri cancers were diagnosed at a locally advanced stage.

Less than one fifth of lung and stomach cancers were diagnosed as localized only.
Systemic therapy was the most common type of treatment given for lung and stomach cancer. A
previous report on HBCR results showed similar findings.8a A hospital-based study from
northern India showed that 90% of patients with lung cancer were diagnosed at an advanced
stage of the disease, and there was a delay in diagnostic evaluation and treatment.35 Creating
cancer awareness, preventing risk factors, and improving access to care among people would
result in downstaging of cancer.

The projected incidence of patients with cancer is higher for females (712,758) than
males (679,421) for the year 2020. The projected national cancer incidence burden in 2020 will
be 98.7 per 100,000 population (1,392,179 patients) as a conservative estimate. It is assumed that
the observed rate of 2012-2016 will remain unchanged until 2020. The time trend in rate was not
used to avoid uncertainty in the projection for a populous country like India. NCRP has
estimated a slightly higher number of patients with cancer compared with IACR/IARC and
GLOBOCAN for all sites of cancer in 2018. This may be because of a difference in
methodology and use of recent data (1,392,179 v 1,157,294).22 This is the first such attempt in
the country and will be further updated on availability of the next data set and census
information. The influencing factors, such as risk factors/behavior, case finding procedure,
screening program, and

2
improved techniques for detecting patients with cancer, are likely to influence the projected
number of patients.

PBCRs in this study covered 100 million average annual person-years, accounting for
coverage close to 10% of the population in India. Cancer registration in India faces several
challenges because it is not a notifiable disease, posing challenges to data collection.39-42 The
mortality registration system has several gaps, including incomplete and inaccurate certification
of cause of death.43,44 Registering through passive notification by health care providers to report
cancer occurrence in India would improve the coverage with limited resources. Linking of cancer
registry data with Ayushman Bharat,45 mortality databases, and the Hospital Information System
would improve cancer registration, follow-up, and outcome data.

This study provides a framework for assessing the status and trends of cancer in India.
This shall guide appropriate support for action to strengthen efforts to improve cancer
prevention and control to achieve the National NCD targets and the sustainable development
goals.46,47 The data also provide leads to key research questions.

2
CHAPTER 6
CONCLUSION

2
CONCLUSION

A careful reading of the above discussion in this article clearly indicates an increased
number of cancer patients every year in India. Various factors responsible for cancer genesis
have been discussed, which need to be controlled for their eradication. India is a growing
country playing a crucial role in the development of the whole world, and, hence, needs special
attention on this issue. We should create awareness among public about the cancer havoc and its
prevention. The different programs should be started by Government and NGOs for creating
awareness among Indian public. The diet and living style are important factors to control the
spreading of cancers and, hence, Indians should be careful about these facts. Briefly, cancer is
disturbing the growing economy of the country, which can be saved by proper handling of this
disease. In view of these facts, it is very important to eradicate this havoc. Let us hope for the
best future of this country, which is playing an essential role in the development of the whole
world.

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CHAPTER 7

REFERENCE

2
REFERENCE

1. WHO: World Health Statistics 2019: Monitoring Health for the SDGs. Geneva,
Switzerland, World Health Organization, 2018. [Google Scholar]
2. National Centre for Disease Informatics and Research: Consolidated Report of Population
Based Cancer Registries, 2006-2008, 2009-2011, 2012-2014 Bengaluru, India, National Cancer
Registry Programme (NCRP-ICMR) https://ncdirindia.org/Reports.aspx.
3. National Centre for Disease Informatics and Research: Consolidated Report of Hospital
Based Cancer Registries, 2004-2006, 2007-2011, 2012-2014 Bengaluru, India, National Cancer
Registry Programme (NCRP-ICMR) https://ncdirindia.org/Reports.aspx.

REFERENCE LINK

1. https://ascopubs.org/doi/full/10.1200/GO.20.00122
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392737/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392737/table/T1/?report=objectonly
4. https://theprint.in/india/27-1-of-indias-all-cancer-cases-in-2020-will-be-tobacco-related-
icmr-report-estimates/484724/
5. https://gco.iarc.fr/today/data/factsheets/populations/356-india-fact-sheets.pdf
6. https://www.ncdirindia.org/All_Reports/Report_2020/resources/NCRP_2020_2012_16.p
df#page=5&zoom=auto,-107,728