Breast Cancer Trends in Indian Residents and Emigrants Portend an Emerging Epidemic for India

Abstract

Purpose: As developing nations such as India become increasingly Westernized, incidence rates will increasefor many cancers. Presently, breast cancer is the leading cancer site in female residents of India, but rates areconsiderably lower than in Western countries. Trends observed in Indian immigrants to the West may helppredict changes expected in India. <br/><b>Methods</b>: Data were obtained from Indian cancer registries, the SEERprogram in the USA, IARC scientific database, and published studies. Incidence, age at diagnosis, stage atdiagnosis, and hormone receptor status in these three populations were compared for the period 1993-1999.<br/><b>Results</b>: Age-adjusted (to world standard population) incidence rates (per 100,000) in Indian immigrants (47.0-61.0) were higher than in Indian residents (7.2-33.4) but lower than in Western whites (83.1-112.0). Comparedto Indian residents, Indian immigrant cases tended to be older (49 years +), diagnosed at an earlier stage, andmore often hormone receptor positive, sharing similarities with Western white women. <br/><b>Conclusions</b>: Theintermediate breast cancer trends exhibited by Indian immigrants may help predict future incidence trendsamongst Indian (particularly urban) residents, which have major public health implications for India asurbanization and Westernization continue. We suggest adding demographic variables to cancer registry data,and additional studies on immigrant Indian populations.