Citation: Mathew A, Kalavathy MC, George PS, Jagathnath Krishna KM and Sebastian P. Urban-Rural Disparities in Female Cancer Incidence and Mortality in Trivandrum, South India. Ann Transl Med Epidemiol. 2017; 4(1): 1011. Ann Transl Med Epidemiol - Volume 4 Issue 1 - 2017 ISSN: 2472-3649 | www.austinpublishinggroup.com Mathew et al. © All rights are reserved Annals of Translational Medicine & Epidemiology Open Access Abstract Background: Cancer incidence and mortality have been observed higher among females in urban than rural around the world. This study assessed the pattern of cancer incidence and mortality among females in urban and rural populations of Trivandrum, South India. Methods: Crude (CR) and Age-Standardised (ASR) incidence and mortality rates, Rate Ratios (RR) and 95% conidence interval (CI) by urban vs. rural were calculated using Trivandrum population-based cancer registry data for 2012- 2014. Results: Combination of all cancer incidence rates (per 10 5 ) were 177.2 (ASR: 137.7) in urban and 142.6 in rural (ASR: 112) and showed a higher incidence (RR: 1.23; CI: 1.2-1.3) and mortality (RR: 1.09; CI: 1.01-1.18) and lower fatality (mortality/incidence) in urban (29.2% urban vs. 33.1% rural). Common cancers in urban were breast (CR: 55.4, ASR: 42.2), thyroid (CR: 15.1, ASR: 12.5), ovary (CR: 11.1, ASR: 8.6) and colo-rectum (CR: 10.6, ASR: 8.0), and in rural, these were breast (CR: 38.8, ASR: 29.9), thyroid (CR: 16.5, ASR: 13.7) and cervix uteri (CR: 9.4, ASR: 7.0). Striking higher incidence in urban were for corpus uteri (RR: 1.85, CI: 1.5-2.3), breast (RR: 1.41, CI: 1.3-1.5), ovary (RR: 1.40, CI: 1.2-1.7) and colo-rectum (RR: 1.35; CI: 1.1-1.6). Conclusion: A distinction is drawn in cancer incidence and mortality between urban and rural women in Trivandrum. Higher incidence of breast, corpus uteri and colo-rectal cancers might be due to some changes in life-style factors and improved health care access in urban population. Keywords: Cancer incidence; Mortality; Urban-Rural differences; Cancer control Cancer incidence particularly breast cancer among women in Kerala, South India, is a growing threat to public health. In urban Trivandrum other cancers such as corpus uteri, colo-rectum and kidney are also reported as the highest in the country (NCRP 2016). In Kerala, urban-rural diference according to education among women is minimal (literacy rate: 84.6% urban vs. 81.6% rural) (Census of India 2011) and the distances by road between the main oncology centers in Trivandrum and the rest of the regions are small. It is therefore possible to hypothesize that urban-rural diferences in health care access is minimal. However, the magnitude and pattern of cancer incidence and mortality may difer by type of residence due to the diference in socio-demographic and life-style factors. Here we describe a descriptive epidemiological study concerning urban-rural gradients of female cancer incidence and mortality and assess inequalities in the quality of data by making use of data from district cancer registry, Trivandrum for the year 2012-2014. his is to derive speciic epidemiological information and establish a working hypothesis based on indings. his approach would allow the characterization of health inequalities across the rural/urban axis and would give an opportunity for dynamic health policy formulation targeted at improved health care access and health education among women. Introduction Signiicant diferences in cancer incidence between urban and rural women have been reported and for the same type of cancer, rural women are generally diagnosed at a later stage and have decreased survival rates as opposed to their urban counterparts [1,2]. his has been shown for cancers such as breast, colo-rectum in both developed and developing countries [3,4]. Rural women may sufer signiicant inequalities in terms of access to medical care and health awareness and these women tend to be less educated with lower economic means. Poorer hygienic conditions tend to aggravate physical threats in rural areas. Conversely, mechanized life-style, stress and air pollution are more widespread in urban environment. Currently, lifestyle homogenization, particularly in developed countries, and the increased opportunities to healthcare access in rural population, has led to a minimal diference in cancer pattern. However, within Asia, large diferences in cancer pattern are found between urban and rural population. Incidence rates of cancers such as cervix uteri, esophagus, stomach etc. are generally low in urban than rural population. In contrast to this, cancers such as breast, corpus uteri, ovary, colo-rectum etc. incidence rates are higher in urban than rural [5]. Special Article - Cancer Epidemiology Urban-Rural Disparities in Female Cancer Incidence and Mortality in Trivandrum, South India Mathew A 1 *, Kalavathy MC 1 , George PS 1 , Jagathnath Krishna KM 1 and Sebastian P 2 1 Division of Cancer Epidemiology & Bio-statistics, Regional cancer Centre, Trivandrum, India 2 Director, Regional Cancer Centre, Trivandrum, India *Corresponding author: Aleyamma Mathew, Professor and Head, Division of Cancer Epidemiology & Bio-Statistics, Regional cancer Centre, Trivandrum, India Received: January 23, 2017; Accepted: February 14, 2017; Published: February 16, 2017