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RESEARCH 

Five year record on Cancer Incidence from 

a Diagnostic Centre in Mizoram, Northeast 

India 

Mary Vanlalhruaii Tonsing1, Souvik Ghatak1, Freda Lalrohlui1, Nachimuthu Senthil Kumar1 

and John Zohmingthanga2* 

1Department of Biotechnology, Mizoram University, Aizawl -796004, Mizoram, India 
2Office of the Medical Superintendent, Civil Hospital, Aizawl -796001, Mizoram, India 

*Corresponding author email: johnzo05@yahoo.co.in, nskmzu@gmail.com.  

 

ABSTRACT 
Cancer has become leading cause of death in Northeast Indian population. The main reason being 

poor knowledge of prevention and diagnosis combined with modern lifestyle of the Mizo population. 

All cancers have been reported in Mizo population including the cancers of stomach, cervix, lungs, 

breast, oesophagus, rectum, prostate, liver, bladder, oral etc. The cause of such high incidence rates of 

these cancers may be inherited or genetic and environmental factors such as life style and food habits, 

especially high consumption of tobacco and alcohol. A peculiar habit of tobacco smoke-infused water 

(Tuibur) is also in practice in this population. In view of these facts, the present article describes the 

status of various types of cancers in Mizo population. Besides, attempts have been made to describe 

the main causes of cancer in this population with their frequency and grading. In this study, increasing 

number of cancer patients in different age group was observed from 2011 – 2015. The highest incidence 

of cancer was observed in the patients with age group 50 - 60, followed by age groups above 60 years. 

In age group 20-30 years, the breast and cervix cancers were more prevalent from 2011 – 2015. In 

middle age group (30-40 and 40-50 years), the cervix, stomach and oesophagus cancers were more 

prevalent. The common type of cancer in female includes cervical cancer, followed by breast cancer 

which is shown to be increasing with age of the patients and also increasing each year within this 5 year 

period from 2011 – 2015. In 2014 and 2015, adenocarcinoma (AC) and squamous cell carcinoma (SCC) 

are both commonly seen. This study will help in understanding the etiology of cancer and also in 

developing preventive measures in future. 

KEYWORDS: Cancer Prevalence, life style habits, Adenocarcinoma, Squamous cell carcinoma, Mizo 

Population, Northeast India 

Citation: Tonsing MV et al (2019) Five year record on cancer incidence from a diagnostic centre in 

Mizoram, Northeast India. Cancer Health Disparities 3:e1-e15. doi:10.9777/chd.2019.1003. 

 

mailto:johnzo05@yahoo.co.in


 
 
 
 
 

 

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RESEARCH 

INTRODUCTION 
Cancer is a major public health problem in India. 

Cancer is the second and third most common 

cause of death in the developed and developing 

countries, respectively [Bener et al.,2008]. A large 

network of population based cancer registries in 

India, provides valuable data for cancer. 

Population-based survival comparisons for cancer 

between nine Asian countries showed that India 

has the lowest 5-year survival for most cancer 

sites; 5-year survival for breast cancer was 52% 

and for colorectal cancer was 28%, compared with 

82% and 44% in China. Breast cancer (145000 

cases per year), tobacco-related head and neck 

cancers (141000), cervical cancer (123000), lung 

cancer (70000), large bowel cancer (64000), and 

stomach cancer (63000) account for more than 

half of the burden, implying that prevention, along 

with early detection and treatment, are important 

interventions for cancer control [Bener et al.,2008]. 

About 70% cancer cases have been diagnosed, 

with little survival of the patients, over the last 

decades. The poor prospects of cancer survival 

indicates inadequate health care financing, and 

also because cancer diagnosis and treatment are 

becoming increasingly unaffordable for health-

care systems in India as well as in many low-

income and middle-income countries since it has 

centred on expensive diagnostic and staging 

investigations such as imaging, and on specialised 

treatments and costly drugs. Most frequently 

observed cancers in Indian population are lungs, 

breast, colon, rectum, stomach and liver [NCRP, 

2010; Rao, 1998; Murthy et al., 2004]. It is 

important to study the status of cancers in India so 

that advance measures may be taken to control 

this havoc in near future. In view of these facts, 

attempts have been made to study the status of 

cancers in India including its causes, preventive 

measures, effect on Indian economy and 

comparison with global scenario. 

DATA SOURCES AND METHODS 

Study area 

The study area Mizoram is flanked by Bangladesh 

on the west and Myanmar on the east and south. 

The total area is 21,081 sq. km. It mainly consists of 

8 districts, namely Aizawl, Lunglei, Champhai, 

Lawngtlai, Mamit, Kolasib, Serchhip and Saiha. The 

total population of the State is 10,97,206 with 

about 5,55,339 males and 5,41,867 females as per 

the 2011 census. Patients from other districts also 

visit the capital city, Aizawl for diagnosis and 

treatment. 

Data collection 

Genesis Laboratory, Aizawl acts as the major 

diagnostic facility of cancer. Ethical approval was 

obtained from the Institutional Ethics Committee. 

The study subjects included 1,477 cancer patients 

diagnosed/registered in Genesis Laboratory, 

Aizawl between 2011 – 2015. This data included 

different types of cancer and the type of cells 

being affected both in males and females, within 

different age groups and its staging on the basis 

of clinical symptoms and histopathology at the 

Genesis Laboratory, Aizawl, Mizoram. The patients 

coming from all the different districts of Mizoram 

were included in this analysis. 

Statistical analysis 

The frequencies of the collected data were 

represented according to their age group, type of 

cancer, staging and sex ratio. The association in 

each group was estimated using odds ratios (ORs) 

and 95% confidence intervals (CIs). The association 

of various cancers and stages of the patients was 

tested for Hardy–Weinberg equilibrium by a chi-

square test with one degree of freedom (df). 

 

 

 



 
 
 
 
 

 

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RESEARCH 

Table 1. List of various cancers year wise, stratified by age group. 

Age group Cancer type No (%) Male Female ORs (95% CI) P value 

2011 

20-30 Breast
a 

Liver
b
 

Colon
b 

3 (60) 

1 (20) 

1 (20) 

0 

0 

0 

3 

1 

1 

2.00 (0.42 - 9.33) 

0.20 (0.03 – 1.29) 

0.20 (0.03 – 1.29) 

 0.0497 

 

 

31-40 Breast
ab 

Uterus
b 

Cervix
a 

Endometrium
b 

Colon
b 

Stomach
b 

 6(24) 

 1(4) 

 10(40) 

 2(8) 

 1(4) 

 1(4)  

0 

0 

0 

0 

0 

1 

6 

1 

10 

2 

1 

1 

0.31 (0.12 – 0.76) 

0.92 (0.42 – 1.98) 

0.13 (0.04 – 0.42) 

0.08 (0.02 – 0.33) 

0.04 (0.007 - 0.24) 

0.04 (0.007– 0.24) 

0.0159 

41-50 Cervix
a 

Tongue
c 

Stomach
a 

Oesophagus
ab 

Pyriform fossa
bc 

Breast
abc 

Nasopharynx
bc 

Liver
abc 

Lung
abc 

13(22.4) 

1(1.72) 

13(22.4) 

11(18.96) 

3(5.17) 

4(6.89) 

3(5.17) 

4(6.89) 

5(8.62) 

0 

1 

6 

10 

3 

0 

1 

3 

3 

13 

0 

7 

1 

0 

4 

2 

1 

2 

0.08 (0.03 – 0.18) 

0.26 (0.15 – 0.45) 

0.12 (0.06 – 0.25) 

0.01 (0.002– 0.06) 

0.17 (0.09 – 0.32) 

0.03 (0.01 – 0.11) 

0.03 (0.01 – 0.11) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.0001 

51-60 Oesophagus
c 

Pharynx
ab 

Breast
abc 

Uterus
a 

Cervix
c 

Lung
c 

Stomach
c 

Nasopharynx
c 

Tonsil
c 

Endometrium
c 

Liver
c 

Pyriform fossa
c 

1(2.56) 

13(33.33) 

7(17.94) 

14(35.89) 

1(2.56) 

3(7.69) 

3(7.69) 

1(2.56) 

1(2.56) 

1(2.56) 

1(2.56) 

1(2.56) 

0 

2 

7 

13 

1 

2 

2 

1 

1 

1 

0 

0 

1 

11 

0 

1 

0 

1 

1 

0 

0 

0 

1 

1 

0.04 (0.01 – 0.12) 

0.20 (0.11 – 0.37) 

0.10 (0.04 – 0.21) 

0.22 (0.12 – 0.40) 

0.01 (0.002– 0.07) 

0.04 (0.01 – 0.12) 

0.04 (0.01 – 0.12) 

0.01 (0.002– 0.07) 

0.01 (0.01 – 0.07) 

0.01 (0.01 – 0.07) 

0.01 (0.01 – 0.07) 

0.01 (0.01 – 0.07) 

0.0016 

> 60 Stomach
a 

Oesophagus
ab 

Nasopharynx
ab 

Tonsil
b 

Breast
ab 

Cervix
ab 

Pyriform fossa
b
 

Tongue
b 

Urinary Bladder
b 

Epiglottis
b 

Lung
b 

Liver
a 

26(29.88) 

3(3.44) 

3(3.44) 

1(1.14) 

3(3.44) 

3(3.44) 

1(1.14) 

1(1.14) 

1(1.14) 

1(1.14) 

26(29.88) 

18(20.68) 

14 

3 

3 

1 

0 

0 

1 

1 

1 

1 

14 

11 

12 

0 

0 

0 

3 

3 

0 

0 

0 

0 

12 

7 

0.10 (0.03 – 0.30) 

0.03 (0.005– 0.18) 

0.73 (0.37 – 1.45) 

0.10 (0.03 – 0.30) 

0.06 (0.01 – 0.24) 

0.03 (0.005– 0.18) 

0.10 (0.03 – 0.30) 

0.03 (0.005– 0.18) 

0.03 (0.005– 0.18) 

0.03 (0.005– 0.18) 

0.03 (0.005– 0.18) 

0.03 (0.005– 0.18) 

0.0715 

2012 

20-30 Breast
a 

Stomach
a 

Colon
a 

Cervix
a 

Nasopharynx
a
 
 

1(12.5) 

2(25) 

1(12.5) 

 3(37.5) 

1(12.5) 

 0 

0 

0 

0 

0 

1 

2 

1 

3 

1 

0.05 (0.01 – 0.34) 

0.12 (0.03 – 0.48) 

0.05 (0.01 – 0.34) 

0.05 (0.01 – 0.34) 

1.25 (0.50 – 3.07) 

0.0119 

31-40 Liver
ab 

6(19.35) 2 4 0.09 (0.03 – 0.29)  0.0012 



 
 
 
 
 

 

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RESEARCH 

Cervix
a 

Breast
abc 

Tongue
c 

Stomach
bc 

Oesophagus
a 

Uterus
c 

Tonsil
c 

Thyroid
c 

Pyriform fossa
c 

Pharynx
c 

7(22.58) 

3(9.6) 

1(3.22) 

2(6.45) 

7(22.58) 

1(3.22) 

1(3.22) 

1(3.22) 

  1(3.22) 

1(3.22) 

0 

0 

1 

1 

6 

0 

1 

0 

1 

1 

7 

3 

0 

1 

1 

1 

0 

1 

0 

0  

0.13 (0.04 – 0.36) 

0.25 (0.11 – 0.58) 

0.03 (0.005– 0.17) 

0.03 (0.005– 0.17) 

0.06 (0.01 – 0.23) 

0.03 (0.005– 0.17) 

0.06 (0.01 – 0.23) 

0.03 (0.005– 0.17) 

0.41 (0.20 – 0.85) 

0.03 (0.005– 0.17) 

41-50 Liver
a 

Lung
abcd 

Oesophagus
ab 

Stomach
abc 

Nasopharynx
bcd 

Cervix
abcd 

Vocal Cord
d 

Tonsil
d 

Larynx
d 

Uterus
d 

Pyriform fossa
d 

Breast
d 

Mouth
d 

Colon
cd 

10(17.24) 

5(8.62) 

9(15.51) 

8(13.79) 

3(5.17) 

7(12.06) 

1(1.72) 

1(1.72) 

1(1.72) 

1(1.72) 

1(1.72) 

7(12.06) 

1(1.72) 

2(3.44) 

5 

5 

8 

8 

2 

0 

1 

1 

1 

0 

1 

0 

1 

2 

5 

0 

1 

0 

1 

7 

0 

0 

0 

1 

0 

7 

0 

0 

0.18 (0.09 – 0.36) 

0.18 (0.09 – 0.36) 

0.20 (0.10 – 0.40) 

0.01 (0.003– 0.10) 

0.03 (0.009– 0.13) 

0.05 (0.01 – 0.16) 

0.03 (0.009– 0.13) 

0.01 (0.003– 0.10) 

0.01 (0.003– 0.10) 

0.01 (0.003– 0.10) 

0.09 (0.03 – 0.22) 

0.11 (0.05 – 0.26) 

0.03 (0.009– 0.13) 

0.03 (0.009– 0.13) 

0.0001 

51-60 Lung
bc 

Liver
c 

Stomach
a 

Tongue
c 

Pyriform fossa
c 

Caecum
c 

Oesophagus
ab 

Nasopharynx
c 

Thyroid
c 

Pharynx
c 

Tonsil
c 

Cervix
c 

Uterus
c 

Colon
c 

Breast
bc 

Epiglottis
c 

9(9.57) 

4(4.25) 

29(30.85) 

2(2.12) 

4(4.25) 

2(2.12) 

20(21.27) 

1(1.06) 

1(1.06) 

2(2.12) 

3(3.19) 

3(3.19) 

1(1.06) 

1(1.06) 

7(7.44) 

3(3.19) 

5 

2 

17 

2 

4 

2 

18 

0 

0 

2 

2 

0 

1 

0 

1 

3 

4 

2 

12 

0 

0 

0 

2 

1 

1 

0 

1 

3 

0 

1 

6 

0 

0.10 (0.05 – 0.21) 

0.47 (0.30 – 0.74) 

0.35 (0.21 – 0.57) 

0.05 (0.01 – 0.13) 

0.02 (0.006– 0.09) 

0.02 (0.006– 0.09) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.02 (0.006– 0.09) 

0.07 (0.03 – 0.17) 

0.03 (0.01 – 0.11) 

0.01 (0.002– 0.06) 

0.02 (0.006– 0.09) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.0001 

>60 Lung
a 

Liver
b 

Nasopharynx
b 

Stomach
b 

Cervix
b 

Epiglottis
b 

Oesophagus
b 

Breast
b 

Pyriform fossa
b 

37(33.33) 

10(9.00) 

4(3.60) 

36(32.43) 

5(4.50) 

2(1.80) 

10(9.00) 

3(2.70) 

2(1.80) 

15 

5 

3 

23 

0 

1 

10 

0 

2 

22 

5 

1 

13 

5 

1 

0 

3 

0 

0.04 (0.01 – 0.15) 

1.08 (0.62 – 1.87) 

0.25 (0.12 – 0.49) 

0.06 (0.02 – 0.19) 

0.04 (0.01 – 0.15) 

0.02 (0.003– 0.11) 

0.08 (0.03 – 0.23) 

0.02 (0.003– 0.11) 

0.02 (0.003– 0.11) 

0.0779 

2013 

20-30 Stomach
a 

Breast
a 

Tongue
a 

3(50) 

1(16.67) 

2(33.33) 

0 

0 

2 

3 

1 

0 

0.20 (0.03 – 1.29) 

1.00 (0.23 – 4.33) 

0.50 (0.10 – 2.33) 

0.1889 



 
 
 
 
 

 

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RESEARCH 

31-40 Cervix
ab 

Nasopharynx
c 

Oesophagus
abc 

Tongue
bc 

Stomach
bc 

Breast
a 

Larynx
c 

Tonsil
c 

Uterus
bc 

12(21.42) 

1(1.78) 

8(14.28) 

4(7.14) 

5(8.92) 

14(25.00) 

1(1.78) 

1(1.78) 

4(7.14) 

0 

0 

7 

3 

3 

0 

1 

0 

0 

12 

1 

1 

1 

2 

14 

0 

1 

4 

0.38 (0.21 – 0.71) 

0.85 (0.49 – 1.47) 

0.11 (0.45 – 0.27) 

0.02 (0.003– 0.11) 

0.02 (0.003– 0.11) 

0.02 (0.003_ 0.11) 

0.04 (0.01 – 0.15) 

0.04 (0.01 – 0.15) 

0.02 (0.003– 0.11) 

0.0002 

41-50 Lung
b 

Liver
b 

Cervix
ab 

Stomach
ab 

Caecum
b 

Uterus
b 

Breast
ab 

Oesophagus
a 

Pharynx
b 

Bladder
b 

4(4.30) 

5(5.37) 

17(18.27) 

14(15.05) 

1(1.07) 

2(2.15) 

12(12.90) 

27(29.03 

1(1.07) 

1(1.07) 

0 

2 

0 

10 

0 

0 

0 

23 

1 

0 

4 

3 

17 

4 

1 

2 

12 

4 

0 

1 

0.31 (0.17 – 0.57) 

0.61 (0.36 – 1.03) 

0.20 (0.10 – 0.40) 

0.01 (0.003– 0.10) 

0.01 (0.003– 0.10) 

0.05 (0.01 – 0.16) 

0.01 (0.003– 0.10) 

0.01 (0.003– 0.10) 

0.07 (0.02 – 0.19) 

0.01 (0.003– 0.10) 

0.0001 

51-60 Lung
b 

Liver
b 

Stomach
a 

Epiglottis
b 

Oesophagus
a 

Tongue
b 

Cervix
b 

Skin
b 

Gall Bladder
b 

Tonsil
b 

Pharynx
b 

Breast
b 

Pyriform fossa
b 

Tongue
b 

Colon
b 

Nasopharynx
b 

Bladder
b 

13(9.55) 

10(7.35) 

37(27.20) 

2(1.47) 

35(25.73) 

1(0.73) 

14(10.29) 

1(0.73) 

1(0.73) 

1(0.73) 

2(1.47) 

6(4.41) 

6(4.41) 

1(0.73) 

4(2.94) 

2(1.47) 

1(0.73) 

7 

5 

17 

2 

30 

1 

0 

1 

0 

1 

2 

0 

6 

1 

2 

2 

1 

6 

5 

20 

0 

5 

0 

14 

0 

1 

0 

0 

6 

0 

0 

2 

0 

0 

0.06 (0.02 – 0.14) 

0.25 (0.15 – 0.42) 

0.54 (0.35 – 0.83) 

0.06 (0.02 – 0.14) 

0.04 (0.01 – 0.12) 

0.02 (0.006– 0.08) 

0.02 (0.006– 0.08) 

0.02 (0.006– 0.08) 

0.02 (0.006– 0.08) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.07 (0.03 – 0.16) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.02 (0.006– 0.08) 

0.0033 

>60 Lung
ab 

Liver
b 

Stomach
a 

Pyriform fossa
b 

Nasopharynx
b 

Tongue
b 

Colon
b 

Bladder
b 

Cervix
b 

Breast
b 

Oesophagus
b 

40(25.64) 

8(5.12) 

64(41.02) 

1(0.64) 

2(1.28) 

3(1.92) 

5(3.20) 

7(4.48) 

1(0.64) 

4(2.56) 

19(12.17) 

23 

5 

49 

1 

1 

1 

3 

2 

0 

1 

9 

17 

3 

15 

0 

1 

2 

2 

5 

1 

3 

10 

0.08 (0.01 – 0.49) 

0.18 (0.04 – 0.73) 

0.18 (0.04 – 0.73) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.08 (0.01 – 0.49) 

0.2237 

2014 

20-30 

 

Oesophagus
ab 

Cervix
a 

Breast
ab 

Colon
b 

2(22.22) 

4(44.44) 

2(22.22) 

1(11.11) 

2 

0 

0 

0 

0 

4 

2 

1 

0.22 (0.05 – 0.91) 

1.20 (0.38 – 3.70) 

0.10 (0.01 – 0.60) 

0.10 (0.01 – 0.60) 

0.0265 

31-40 Liver
b 

1(2.85) 1 0 0.20 (0.08 – 0.48) 0.0037 



 
 
 
 
 

 

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RESEARCH 

Breast
ab 

Colon
ab 

Oesophagus
b 

Cervix
a 

Stomach
ab 

Pyriform fossa
ab 

Nasopharynx
b 

7(20.00) 

3(8.57) 

1(2.85) 

12(34.28) 

9(25.71) 

2(5.71) 

1(2.85) 

1 

2 

1 

0 

3 

1 

1 

6 

1 

0 

12 

6 

1 

0 

0.75 (0.38 – 1.44) 

0.25 (0.11 – 0.55) 

0.06 (0.01 – 0.22) 

0.02 (0.005– 0.17) 

0.02 (0.005– 0.17) 

0.06 (0.01 – 0.22) 

0.02 (0.005– 0.17) 

41-50  Liver
bc 

 Cervix
a 

Oesophagus
ab 

Mouth
c 

Epiglottis
c
 

Breast
abc 

Stomach
ab 

Colon
bc 

Larynx
c 

Pyriform fossa
bc 

Uterus
bc 

Penis
c 

7(8.33) 

22(26.19) 

16(19.04) 

1(1.19) 

1(1.19) 

10(11.90) 

16(19.04) 

3(3.57) 

1(1.19) 

3(3.57) 

2(2.38) 

1(1.19) 

6 

0 

15 

0 

0 

0 

13 

2 

1 

3 

0 

1 

1 

22 

1 

1 

1 

10 

3 

1 

0 

0 

2 

0 

0.13 (0.06 – 0.25) 

0.48 (0.30 – 0.75) 

0.16 (0.08 – 0.29) 

0.07 (0.03 – 0.16) 

0.22 (0.13 – 0.39) 

0.03 (0.01 – 0.10) 

0.03 (0.01 – 0.10) 

0.04 (0.01 – 0.12) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

<0.0001 

51-60 Lung
c 

Liver
c 

Ovary
c 

Cervix
bc 

Oesophagus
ab 

Stomach
a 

Epiglottis
c 

Nasopharynx
c 

Pyriform fossa
c 

Uterus
c 

Gall bladder
c 

Breast
c 

3(2.80) 

8(7.47) 

4(3.73) 

10(9.34) 

30(28.03) 

31(28.97) 

1(0.93) 

1(0.93) 

5(4.67) 

2(1.86) 

2(1.86) 

5(4.67) 

2 

5 

1 

0 

26 

24 

1 

0 

5 

0 

2 

0 

1 

3 

3 

10 

4 

7 

0 

1 

0 

2 

0 

5 

0.06 (0.02 – 0.14) 

0.16 (0.08 – 0.29) 

0.36 (0.22 – 0.58) 

0.62 (0.40 – 0.95) 

0.03 (0.01 – 0.10) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.02 (0.006– 0.08) 

0.03 (0.01 – 0.10) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

0.01 (0.002– 0.06) 

 <0.0001 

>60 Lung
ab 

Liver
bc 

Stomach
a 

Vocal Cord
c 

Nasopharynx
c 

Pyriform fossa
c 

Colon
c 

Oesophagus
bc 

Cervix
c 

Breast
c 

Epiglottis
c 

Anus
c 

Vaginal Wall
c 

33(25.00) 

10(7.57) 

45(34.09) 

1(0.75) 

2(1.51) 

1(0.75) 

6(4.54) 

13(9.84) 

8(6.06) 

4(3.03) 

2(1.51) 

2(1.51) 

2(1.51) 

12 

7 

29 

1 

2 

1 

6 

12 

0 

0 

2 

0 

1 

21 

3 

16 

0 

0 

0 

0 

1 

8 

4 

0 

2 

1 

0.03 (0.01 – 0.10) 

0.10 (0.05 – 0.19) 

0.85 (0.58 – 1.25) 

0.01 (0.005– 0.07) 

0.15 (0.08 – 0.26) 

0.10 (0.05 – 0.19) 

0.07 (0.03 – 0.14) 

0.03 (0.01 – 0.10) 

0.009(0.001-0.05) 

0.009(0.001-0.05) 

0.01 (0.005– 0.07) 

0.009(0.001-0.05) 

0.009(0.001-0.05) 

0.0008 

2015 

20-30 Cervix
a 

Thyroid
b 

Stomach
b 

Breast
b 

Ovary
b 

5(45.45) 

2(18.18) 

1(9.09) 

2(18.18) 

1(9.09) 

0 

0 

1 

0 

0 

5 

2 

0 

2 

1 

0.14 (0.03 – 0.56) 

1.00(0.38 – 2.57) 

0.14 (0.03 – 0.56) 

0.14 (0.03 – 0.56) 

0.14 (0.03 – 0.56) 

0.1132 

31-40 Liver
ab 

Breast
ab 

Thyroid
b 

4(16.00) 

4(16.00) 

2(8.00) 

4 

0 

1 

0 

4 

1 

0.34 (0.17 – 0.67) 

1.15 (0.63 – 2.07) 

0.07 (0.02 – 0.22) 

<0.0001 



 
 
 
 
 

 

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RESEARCH 

Pyriform fossa
b 

Bladder
b 

Uterus
b 

Cervix
a 

Stomach
b 

Caecum
b 

1(4.00) 

1(4.00) 

1(4.00) 

9(36.00) 

2(8.00) 

1(4.00) 

1 

1 

0 

0 

1 

1 

0 

0 

1 

9 

1 

1 

0.13 (0.05 – 0.32) 

0.04 (0.01 – 0.18) 

0.02 (0.004– 0.13) 

0.02 (0.004– 0.13) 

0.02 (0.004– 0.13) 

0.04 (0.01 – 0.18) 

41-50 Liver
ab 

Lung
b 

Oesophagus
a 

Stomach
ab 

Breast
ab 

Cervix
b 

Endometrium
b 

Urinary Bladder
b 

Mouth
b 

Epiglottis
b 

Uterus
b 

7(12.28) 

3(5.26) 

14(24.56) 

8(14.03) 

14(24.56) 

4(7.01) 

3(5.26) 

1(1.75) 

1(1.75) 

1(1.75) 

1(1.75) 

4 

2 

14 

5 

0 

0 

0 

1 

1 

1 

0 

3 

1 

0 

3 

14 

4 

3 

0 

0 

0 

1 

0.21 (0.13 – 0.34) 

0.38 (0.25 – 0.57) 

0.33 (0.22 – 0.50) 

0.12 (0.06 – 0.21) 

0.02 (0.008– 0.07) 

0.008 (0.001-0.04) 

0.04 (0.01 – 0.10) 

0.008 (0.001-0.04) 

0.04 (0.01 – 0.10) 

0.008 (0.001-0.04) 

0.01 (0.004 – 0.06 

<0.0001 

51-60 Liver
ab 

Lung
abc 

Stomach
a 

Breast
bc 

Thyroid
bc 

Oesophagus
a 

Pyriform fossa
bc 

Gall Bladder
c 

Endometrium
bc 

Bladder
bc 

Tongue
c 

Cervix
bc 

Pharynx
c 

Epiglottis
c 

11(13.92) 

9(11.39) 

15(18.98) 

5(6.32) 

2(2.53) 

16(20.25) 

4(5.06) 

1(1.26) 

3(3.79) 

2(2.53) 

1(1.26) 

4(5.06) 

1(1.26) 

1(1.26) 

4 

4 

8 

0 

1 

16 

4 

0 

0 

2 

1 

0 

1 

0 

7 

5 

7 

5 

1 

0 

0 

1 

3 

0 

0 

4 

0 

1 

0.06 (0.03 – 0.14) 

0.18 (0.10 – 0.30) 

0.30 (0.20 – 0.47) 

0.11 (0.06 – 0.20) 

0.009(0.001-0.05) 

0.02 (0.009– 0.08) 

0.22 (0.13 – 0.35) 

0.05 (0.02 – 0.12) 

0.07 (0.03 – 0.15) 

0.01 (0.005– 0.06) 

0.05 (0.02 – 0.12) 

0.009(0.001-0.05) 

0.009(0.001-0.05) 

0.009(0.001-0.05) 

<0.0001 

>60 Liver
bc 

Lung
a 

Epiglottis
c 

Stomach
ab 

Oesophagus
bc 

Caecum
c 

Breast
c 

Larynx
c 

Pharynx
c 

Bladder
c 

Colon
c 

Pyriform fossa
c 

Cervix
c 

Ureter
c 

Gall Bladder
c 

11(11.70) 

28(29.78) 

1(1.06) 

25(26.59) 

11(11.70) 

1(1.06) 

2(2.12) 

1(1.06) 

1(1.06) 

1(1.06) 

4(4.25) 

2(2.12) 

3(3.19) 

1(1.06) 

2(2.12) 

8 

15 

1 

15 

8 

0 

0 

1 

1 

1 

3 

2 

0 

1 

1 

3 

13 

0 

10 

3 

1 

2 

0 

0 

0 

1 

0 

3 

0 

1 

0.03 (0.01 – 0.10) 

0.64 (0.43 – 0.95) 

0.10 (0.05 – 0.19) 

0.17 (0.10 – 0.29) 

0.15 (0.08 – 0.26) 

0.01 (0.005– 0.07) 

0.02 (0.009– 0.08) 

0.01 (0.005– 0.07) 

0.009(0.001–0.05) 

0.01 (0.005– 0.07) 

0.009(0.001-0.05) 

0.009(0.001-0.05) 

0.009(0.001-0.05) 

0.01 (0.005– 0.07) 

0.03 (0.01 – 0.10) 

0.2267 

OR – Odds Ratio CI – Confidence Interval 

a, b, c, ab, bc – level of significance using Duncan’s ANOVA Test 

RESULTS 

A total of 1,477 patients with malignancy reported 

to Genesis Laboratory (Aizawl) from 2011 – 2015. 

The highest incidence of cancer was observed in 

the patients with age group 50 - 60 (423), followed 

by age groups above 60 (399). This shows an 

increase in the disease with increase in age. There 

was a statistical significance observed between the 



 
 
 
 
 

 

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RESEARCH 

age group and different types of cancers. In 2011, 

2012 and 2014, the age group 20-30, 30-40, 40 – 

50 and 50 to 60 are shown to be significant, 

whereas in 2013 and 2014 the age group 30-40, 

40-50 and 50-60 shows significance (Table 1). 

Remarkably, only in 2014 the age group more than 

60 years of age was significant with different 

cancer types. In age group 20-30, breast and 

cervix cancer were more prevalent, throughout all 

the years. In middle age group (30-40 and 40-50) 

cervix, stomach and oesophagus cancer were 

more prevalent, throughout all the years. In older 

age group (41 to 60 and >60), stomach cancer was 

the leading cancer followed by oesophagus cancer 

in throughout all the years. Cancer is dominant in 

Females (778) than in males (710). The common 

type of cancer in female includes cervical cancer, 

followed by breast cancer which is shown to be 

increasing with age of the patients and also 

increasing each year within this 5 year period from 

2011 – 2015 (Figure 1). In males, stomach cancer is 

the most prevalent type of cancer followed by 

oesophagus cancer. Both the type of cancers are 

found commonly in the patients with age 40 yrs 

and above. 

 

Figure 1. Various Cancer Frequency based on Age group for the years 2011 (A), 2012 (B), 2013 (C), 2014 (D), 

2015 (E). 



 
 
 
 
 

 

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RESEARCH 

Different types of cells were involved with the different types of cancers. In 2011, Squamous cell carcinoma 

(SCC) was the most common pathological variety of cancer in males, followed by Adenocarcinoma (AC). In 

2013, Moderately Differentiated Squamous Cell Carcinoma (MDSCC) had the highest percentage of 

occurrence. In 2014 and 2015 AC and SCC are both commonly seen. In the year 2011 the adenocarcinoma 

stomach and squamous cell carcinoma oesophagus showed prevalence in older age group, but in middle 

age group the squamous cell carcinoma cervix was the leading cancer group (Figure 2). Adenocarcinoma 

stomach and squamous cell carcinoma oesophagus were the ladder of all the cancer types for the year of 

2012. In 2013 the older age group had significant growth than other age group, because the 

adenocarcinoma stomach and moderately differentiated squamous cell carcinoma in oesophagus were 

the leading cancer. The same prevalence was also observed for the year of 2014 and 2015. But for 2015 

other types of cancers prevalence was also observed. 

 



 
 
 
 
 

 

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RESEARCH 

 

 

Figure 2. Frequency of cancer prevalence and status in Mizo population for the years 2011 (A), 2012 (B), 

2013 (C), 2014 (D), 2015 (E). 



 
 
 
 
 

 

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RESEARCH 

AC – Adenocarcinoma; IDC – Invasive Duct Carcinoma; SCC – Squamous Cell Carcinoma; MDAC – 

Moderately Differentiated Adenocarcinoma; MDSCC – Moderately Differentiated Squamous Cell 

Carcinoma; PDAC – Poorly Differentiated Adenocarcinoma; WDSCC – Well Differentiated Squamous Cell 

Carcinoma; NKSCC – Non – Keratinising Squamous cell carcinoma. 

DISCUSSION 

Our studies reveal that Cancer is diagnosed more 

in women than in men. It also shows an increase in 

occurrence of cancer with increase in age. Women 

are showing high rate of cancer because of the 

alarming increase in cervical and breast cancer for 

the last five years. Cervical cancer is caused by 

human papillomavirus infection. Human 

papillomavirus promotes uncontrolled cell division 

and accumulation of genetic damage. Other 

cancers attributed to human papillomavirus 

infection include those of vagina (70%), penis 

(50%), vulva (43%), and oropharynx (26%) (Table 

1)[Hariri et al.,2011]. Breast cancer occurrence is 

highest after 35 years of age. The possible risk 

factor for occurrence of breast cancer was 

contributed by stress in the form of higher 

education and occupation, late menopause, 

history of induced abortion, first-degree family 

history of the disease and body mass index [Thapa 

et al.,2016]. The most common type in males is 

stomach cancer, followed by oesophageal. 

Tobacco smoking and use of smokeless tobacco, 

chewing tobacco and tuibur coupled with 

unhealthy food items such as smoked meat and 

vegetables and fermented soyabean and pork etc. 

may attribute to the high incidence of cancer in 

Mizoram [Ghatak et al.,2016]. 

The food habits of Mizoram are known to 

contribute to various different types of cancers. 

Smoke-drying and preservation leads to formation 

of N-nitroso compounds. Nitrite reacts with 

amines and amides found in meats and other 

proteins to form N-nitroso compounds, which are 

animal carcinogens and possible human 

carcinogens. Furthermore, although salt is not a 

carcinogen, it is thought to increase the risk of 

gastric cancer through direct damage to the 

gastric mucosa, which results in gastritis, increased 

DNA synthesis, and cell proliferation. This indirectly 

contributes to the development of chronic 

atrophic gastritis, leading to the development of 

stomach cancer. Because of the presence of both 

salt and nitrite in processed fish and meats, its role 

in the development of stomach cancer cannot be 

ignored, as was found by Phukan et al. [Phukan et 

al.,2006]. Frequent consumption of sa-um was 

found to be associated with the risk of developing 

stomach cancer. This is a food material uniquely 

consumed in Mizoram. Dietary intakes of total or 

saturated fat have been shown to be associated 

with stomach cancer. Boiled pork fat, in addition to 

being a rich source of saturated fat, may form 

carcinogenic compounds during long storage, as 

in other stored meats. Use of soda was shown to 

be a risk factor. Indigenous people of the 

northeastern region of India use soda (alkali) or 

other alkaline preparations frequently as food 

additives. 

The consumption of tobacco is the leading cause 

of cancers in India. The regular use of tobacco via 

smoking, chewing, snuffing etc. in Mizoram, which 

is responsible for 65 to 85% cancer incidences in 

men and women, respectively. The various cancers 

produced by the use of tobacco are of oral cavity, 

pharynx, esophagus, larynx, lungs and urinary 

bladder. Smoking is the most notorious factor for 

the causation of lung cancer [Hammond et 

al.,1966]. Approximately, 87 and 85% males and 

females have been found to have lung cancer due 

to tobacco smoking in the form of local Zozial (a 

thin South Asian cigarette type structure filled with 

tobacco flake and wrapped in a white paper, tied 

with a string at one end) [Behera et al.,2004] and 

cigarette in India [Jayant et al.,1991]. The severe 

carcinogenic nature of Asian local made cigarette 

has been proved by the studies of Jussawalla and 

Jain [Jussawalla et al.,1979] and [Pakhale et 

al.,1990]They observed that the unrefined form of 

tobacco used in bidis (WHO, 1999) and the 



 
 
 
 
 

 

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RESEARCH 

frequency with which a bidi needs to be puffed 

per minute may be responsible for its relatively 

higher carcinogenic effects as compared to 

cigarettes [Bano et al.,2009]. Bidi smoking at two 

puffs per minute produces about equal amounts 

of carcinogens (steam volatile phenols, hydrogen 

cyanide and benzopyrene) as produced by one 

puff per minute of unfiltered cigarette [Pakhale et 

al.,1990 ] Hookah (a special cigar used in Mizoram 

using raw tobacco) smoking causes lung cancer; as 

reported by Nafae et al. [Nafae et al.,1973] In 

Mizoram, North-eastern India high incidences of 

stomach cancer are attributed to the consumption 

of smoked meat and chewing of tobacco. High 

incidences of stomach cancer in Mizoram are the 

result of the excessive use of tuibur (water filterate 

of tobacco). 

Similarly, the consumption of Areca nut, Pan 

Masala, Opium and Bhang (leaves and flower 

powder of female cannabis plant) has been 

recognized as the major cause of mouth cancer in 

Mizoram. The daily consumption of the number 

betel leaves by an individual is about 15-25 in 

various districts of Mizoram, which continuously 

acts as an irritant to the buccal mucosa [Mehrotra 

et al.,2003]. One of the most important factors 

responsible for the oropharyngeal malignancy in 

Mizoram is the chewing of raw betel nut [Wahi et 

al.,1965]. Among various risk factors for the 

occurrence of oesophageal cancer in Mizoram, 

betel quid chewing carries a relative risk of 1.5 to 

3.5%. The salted cooked vegetables made by 

adding sodium bicarbonate has shown to possess 

a high methylation activity and may lead to the 

endogenous formation of nitrosamine [Malkan et 

al.,1997] and that can lead to stomach cancer. 

Alcohol consumption has been considered as one 

of the major causes of colorectal cancer as per a 

recent monograph of WHO [Baan et al.,2007]. 

Annually, about 9.4% new colorectal cancer cases 

are attributed to the consumption of alcohol, 

globally [Parkin et al.,2006]. An increased risk of 

10% was observed with consumption of more than 

two drinks per day, which suggests a causative role 

of alcohol consumption in colorectal cancer 

[Toriola et al.,2008]. Recently, a study revealed that 

an increased risk of colorectal cancer was limited 

to consumption of more than 30.0 g of alcohol per 

day [Longnecker et al.,1990]. Relationship between 

alcohol consumption and high risk of oesophageal 

cancer was first known in 1910 [Tuyns et al.,1979]. 

However, chronic alcohol consumption has been 

found to be a risk factor for the cancers of the 

upper respiratory and digestive tracts, including 

oral cavity, hypopharynx, larynx and oesophagus 

as well as liver, pancreas, mouth and breast 

cancers [Tuyns,1979;Maier,1994;Seitz et al.,2004]. A 

10.0 g/day intake of alcohol by a woman increases 

its relative risk of breast cancer by 7.1% [Doll et 

al.,1981]. The mechanism of carcinogenesis due to 

alcohol consumption is not exactly known, 

however, it is thought that ethanol being a co-

carcinogen might play a crucial role in the 

carcinogenesis [Poschl et al.,2004]. The metabolic 

products of ethanol are acetaldehyde and free 

radicals. The free radicals are responsible for 

alcohol assisted carcinogenesis through their 

binding to DNA and proteins, which destroy foliate 

leading to secondary hyper proliferation [Anand et 

al.,2008]. 

Non–tobacco risk factor includes infections, dietary 

factors, alcohol use, physical activities and body 

composition. Other risk factors include exposure to 

asbestos, air pollution (indoor and outdoor), 

occupational exposures and exposure to radiation. 

Consumption of alcohol is shown to be associated 

with cancers of the mouth, pharynx, larynx, 

oesophagus, colo-rectum (men) and breast (pre- 

and post- menopausal). Aflatoxins causes liver 

cancer. Arsenic in drinking water and beta-

carotene supplements are known to contribute to 

lung cancer. Colo-rectum is known to be caused 

by excess consumption of red and processed meat 

in our diet. Associations between infections and 

cancer: HPV(Human Papilloma Virus) infection and 

cervical cancer, Epstein Barr Virus(EBV) and Burkitt 

Lymphoma as well as Non-Hodgkin and Hodgkin 

Lymphoma, Hepatitis-C virus and hepatocellular 



 
 
 
 
 

 

www.companyofscientists.com/index.php/chd                   e13                                              Cancer Health Disparities 

RESEARCH 

carcinoma, Kaposi Sarcoma Herpes Virus (KSHV) 

and Kaposi Sarcoma [Harford et al.,2012]. 

Acknowledgements 

The authors thank Bioinformatics Infrastructure 

(BT/BI/12/060/2012 (NERBIF-MUA), and DBT- 

DeLCON Facility at Mizoram University sponsored 

by the Department of Biotechnology (DBT), New 

Delhi, Govt. of India. The authors thank Mary K 

Zothanpari for her help during data collection. 

Conflict of interest 
The authors declare that no competing or conflict of 

interests exists. The funders had no role in study 

design, writing of the manuscript, or decision to 

publish. 

Authors’ contributions 
JZ and NSK conceptualized the study; MVT and FL 

collected the primary data; MVT, SG and FL did the 

analysis and interpretation of the data; MVT, SG, NSK 

and JZ wrote the manuscript.  

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