The burden of cancer cases attributable to tobacco in India: case of Kerala and Bihar states

Background: For effective planning and administrative purpose, a precise estimate of burden due to tobacco and projection figure is essential. There were some studies in India, reporting tobacco-related cancers. However, there is no observable study in India, especially for these backward and forward state, attempting to assess cancers due to tobacco for measuring the geographical variations. Hence, this study tried to highlights geographic variation between one from developed state is as Kerala, and another one is from not so well-developed state as Bihar in India. Materials and methods: Tobacco prevalence, the relative risk of cancer due to tobacco, incidence rates of tobacco-related cancers, and population were obtained respectively from recent five rounds of Nation Sample Survey, our recently published study, reports of Population-Based Cancer Registries, and projections of Registrar General of India. Prasad and Dhar published generalised Population Attributable Risk method (2018) was used to assess cancer due to tobacco and regression method for prediction. Results: The burden of cancer cases due to tobacco was found highest in the state of Bihar (23,679), while in Kerala, it was 5,981 in the year 2015 and increased to 42,244 and 6,646 by 2025 in Bihar and Kerala respectively. Lung cancer is the leading cancer sites followed by mouth and tongue cancers. In Kerala, the proportion of smoking is found to be high and lead to the higher proportions of larynx cancers (61percent) followed by oropharynx (59 percent) and lung cancer (58 percent) and are likely to increase from 2015 to 2025 slightly. In Bihar, around three fourth of mouth cancers cases being due to chewing followed by oesophagus (59 percent), tongue (54 percent) and so on. Conclusion: Present study reports the absolute burden of cancer due to tobacco, Tobacco- Related Cancer as well as a percent change of it for Kerala and Bihar till 2025. It might be helpful to policy planners and administrators in decision making relating to anti-tobacco measures.