Head and neck cancer dominance and emerging multi-site burden: a three-year hospital-based cancer registry analysis from central India (2022-2024)

Abstract

Background: Cancer registries provide epidemiological information for regional public health planning. Central India has a unique cancer burden driven by high tobacco use and limited early-detection infrastructure, yet the hospital-based cancer registries (HBCRs) data from this region remain scarce. This study characterised the site-specific distribution, sex-based disparities, age-group variation, and state-wise referral patterns of confirmed malignant cases at Cancer Hospital and Research Institute (CHRI), Gwalior, over three years (January 2022 – December 2024), to identify priority sites for region-specific cancer control interventions. Methods: A retrospective descriptive study was conducted on 25,692 Outpatient Department (OPD) records from CHRI, Gwalior, a regional cancer centre serving Madhya Pradesh (MP), Uttar Pradesh (UP), and adjacent states.  International Classification of Diseases -10 (ICD-10) was used to classify malignant cases (n = 20,062). They were analyzed by sex, cancer site, age group, state and year of registration. Results: Among the 20,062 malignant cases, males constituted the majority (n=12,394; 61.78%) versus females (n=7,665; 38.21%). Mouth (n=5,255; 26.04%) and tongue (n=2,746; 13.69%) were the most common sites. Gallbladder cancer ranked third overall (8.11%) with marked female predominance. Breast (7.42%) and cervical (5.74%) cancers predominated among females. Patients aged ≥50 years had the largest disease burden, though oral cancers appeared as early as 19-35 years. Conclusions: Head and neck cancers accounted for 46.59% of all malignant cases (9,347 /20,062), with the oral cavity and tongue representing the most frequently affected sites. The co-existing burdens of gallbladder, breast, and cervical cancers highlight the need for region-specific, multi-site cancer screening programmes.