Abstract 40P
Background
Previous studies have predicted that there will be over ten million cancer related annual mortalities worldwide by 2020 and more than 50% of these will be from developing countries. Punjab is considered to be one of the most prosperous states of India since its success during the green revolution. More than 65% of the population of Punjab reside in rural areas and are directly or indirectly involved in farming or related practices. The local people are vulnerable to dust, carcinogens (through heavy pesticides), solar radiation, zoonotic viruses and unhygienic conditions which increases their risk of cancer. Over the last decade, increased incidence of cancer cases had been reported in the rural landscapes of Punjab.
Methods
A detailed cross-sectional study was designed and carried out in 22 districts of Punjab covering an area of 50362 sq km. The districts were further grouped according to socio-economic conditions, cropping pattern and source of drinking water. Household surveys (by trained surveyors) and laboratory investigations for heavy metals and pesticide residual analysis in water, vegetables, fruits, blood and urine were conducted from April 2018 to March 2019.
Results
It was observed that the cancer of the female reproductive system, i.e., breast, cervix and ovary, was overall the highest prevailing cancer category throughout Punjab, followed by cancers of bones, blood & lymphatic system. Data on the relative characteristics of individuals from the locations where cancer or cancer-related deaths existed, showed that involvement in cultivation with pesticide use, alcohol consumption and smoking were prevalent among almost all the regions of the study area. The qualitative analysis confirmed the presence of higher levels of As, Cr, Se and Hg in drinking water, and heptachlor & chlorpyrifos in vegetables, blood and surface water in significant districts (n = 19) of Punjab. Various camps and public awareness programmes were organized to discourage the indiscriminate use of pesticides and alcohol for cancer prevention.
Conclusions
Cancer cases and deaths are significantly higher in some districts of Punjab compared to the National average of India, probably due to a mix of risk factors as mentioned above.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Department of Science and Technology.
Disclosure
All authors have declared no conflicts of interest.