Cancer burden, its pattern and survival in Muzaffarpur: findings from first population-based cancer registry of Bihar state, India.

Background: The first population-based cancer registries (PBCRs) in Bihar state, India was established at Muzaffarpur by the Tata Memorial Centre (TMC), Mumbai. This article presents the cancer burden, its pattern for the years 2018-2021 and population-based survival for the years 2018 cases followed till 2023. Methods: The registry follows an active method of case finding which includes visits to the hospital, diagnostic and treatment facilities centres, birth and death registration office. Cases were collected through village visit, community interaction and verbal autopsy. After quality and consistency checks by senior staff of TMC, Mumbai; data are entered into the CanReg5 software. The cancer registry has faced several challenges in data collection, such as poor maintenance of medical records noncooperation of the hospital and patient's relatives reluctant to share the cancer case information. Most patients travel long distances for diagnosis and treatment. The challenges faced by the registry were overcome with the help of the administrative support of the district authorities.The rates were calculated using standard registry methods. The survival of 2018 incidence cases (followed till 31st December 2023) was calculated by using the Kaplan-Meier and Pohar Perme method. Results: In the period 2018-2021, a total of 2,916 cancer cases (Male: 1,436 (49.2%) and Female: 1,480 (50.7%)) were registered. The incidence rates for males and females were 40.2 and 46.8 per 100,000 population, respectively. Whereas 2,076 cancer deaths (Male: 1,049 (50.5%) and Female: 1,027 (49.5%)) were registered and mortality rates were 29.6 and 32.6 per 100,000 for males and females, respectively. The leading cancer sites for males are mouth (AAR 6.0), tongue (2.6), prostate (2.0), gallbladder (1.9), liver (1.6); and for females, breast (11.1), cervix uteri (6.3), gallbladder (5.2), lung (1.9) and ovary (1.6).Among men, 5-year age-standardised relative survival (age 0-74 years) of mouth, prostate and tongue cancer cases were 25.59%, 30.41% and 31.90%, respectively. Similarly, among females, it was 32.39% of breast, 20.73% of cervix uteri. None of the gallbladder cases survived after 3 year and 5 years of diagnosis. Conclusion: The population-based cancer registry has successfully generated good-quality data, which can be utilised to plan cancer control programs, enhance the infrastructure for cancer care and facilitate etiological research in this population. Given the poor survival of leading sites in Muzaffarpur, emphasis must be laid on strengthening effective cancer control strategies for these cancers.Due to several challenges faced by the registry, we have noted underreporting. In the coming years, due to improvements in the infrastructure and raising awareness about the use of registry data in planning cancer care services, we are expecting an improvement in cancer registration.