Cancer Risk in Nepal: An Analysis from Population-Based Cancer Registry of Urban, Suburban, and Rural Regions.

Background: Cancer is one of the leading causes of death globally. The low and middle-income countries (LMICs) cover a major share of the global cancer burden; however, most of the LMICs including Nepal still lack national cancer control and prevention strategies. Since 1^st January 2018, the Nepal Health Research Council (NHRC) started the population-based cancer registry (PBCR) in urban, suburban, and rural regions to support evidence-based cancer control intervention in each geographical region.

Methods: Data regarding incidence and mortality was collected by the PBCR in Nepal. Indirect and direct methods were used to collect data from health facilities and communities, respectively. Registered cases of incidence and mortality from 1^st January 2019 to 31^st December 2019 were used. Each case was verified for correctness and duplication followed by residence confirmation via phone call. Guidelines and principles of the International Association of Cancer Registry were followed for the overall registration process including data quality control. Ethical approval was taken from the Ethical Review Board of the NHRC.

Result: Age-adjusted incidence (AAR) and mortality rates in Nepal were found 65.6 and 29 per 100,000 people, respectively. Every 1 in 14 men and 1 in 13 women were at risk of getting, and 1 in 28 men and 1 in 33 women were dying of cancer before age 75 in Nepal. The highest risk was found for lung cancer (1 in 80) followed by stomach and mouth among men, and in women, breast cancer (1 in 76) was the commonest among all followed by lung and cervix.

Conclusion: Cancer has been growing as one of the major public health burdens in Nepal. Screening with cost-effective technology, awareness, and vaccination against HPV should be a government priority including revision of treatment protocols for cancers that have higher mortality to prevent further preventable life loss from malignancies.