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Home > Reports > Chapter 7 > Natural Background Radiation Registry, Karunagapally

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Natural Background Radiation Registry, Karunagapally
Centre Code : 201

Dr. M. Krishnan Nair, Principal Investigator

Mr. P. Gangadharan, Emeritus Medical Scientist and Co-Principal Investigator

Dr. P. Jayalekshmi, Officer In-Charge and Co-Principal Investigator

Dr. M. Krishnan Nair is the Principal Investigator, Mr. P. Gangadharan is the Emeritus Medical Scientist and Co-Principal Investigator and Dr. P. Jayalekshmi is the Officer In-Charge and Co-Principal Investigator.

Karunagapally is a coastal taluk in Kollam district. 100 Kms north of Thiruvananthapuram, the capital city of Kerala.

The cancer registry was started in 1990 to investigate whether the population exposed to high levels of radiation emitted by thorium bearing sands causes cancer in the population. Karunagapally taluk population was 400,000 in 2001 census. The area covered was 193 Sq. Km. 76% classified as rural. Fishing, fish processing, coir making, agriculture, cashew nut industry are major occupations of the people. Literacy rate is >85%. Male Female ratio was 0.95:1.

The study received support from the Department of Atomic Energy during 1990-1998.

Unique characteristics of the registry

a. The registry is a Rural Population Based Cancer Registry, the 1st Registry in Kerala.

b. The registry provides source data for the study of cancer in humans vis-à-vis chronic exposure to high natural radiation. It is known that exposure to radiation causes cancer but it is not known whether chronic exposure to high natural radiation has a similar effect.

The study is unique because nowhere else in the world has such high radiation produced naturally and where such a large population resides. Density of population is 2000+ per sq. km. This is thus a natural laboratory study and only we in India can conduct the study and further, it is our problem which presents an opportunity to make original scientific contributions. Whereas other population based registries in India contribute mainly to the magnitude of the problem and its variations, the Karunagapally registry utilizes the Registry Techniques to study an issue vital to the ever eluding problem of cancer causation.

The population based registry in Bhopal organized by ICMR-NCRP is also a special purpose registry investigating the cancer causing potential of exposure to MIC gas. These are the only two population based special purpose registries in the country and both have evolved special innovative techniques to study such issues. Thus these are model cancer registries of the country.

c. The registry has accumulated population-based data on socio-demographic life style factors by interviewing every resident of the taluk, which at the time of survey was 3,59,000. Follow up of the events and periodic analysis would give very valuable information on cancer epidemiology in rural Kerala.

d. This is the only cancer registry in India in a rural area where there are no cancer diagnostic treatment centres. No other registry in India functions in such a situation. We developed innovative methods to collect cancer patient data. The registry collects data on cancer in the study population visiting more than 60 sources including all deaths traced back to the address.

e. Information on radiation levels inside and outside of houses have been obtained for more than 70,000 houses.

Almost 50% of cancer in males are tobacco related. Cancer of certain sites like cervix, lung in men show increase in incidence according to radiation levels. Investigations and analysis are proceeding with a partial study-specific assistance from Japan (Terminating in 2004).

Along with the study, several cancer control activities are ongoing for which there is a heavy demand as there are no cancer hospitals in the area. Further as there is a high literacy rate, cancer awareness classes are regularly conducted with the cooperation of NGO's. Cancer screening camps are conducted in all wards of the 12 panchayats. Bimonthly follow-up check up clinics are organized for treated cancer patients in the taluk by oncologists from RCC. As there are no cancer detection facility, the registry has a free cytology service for the residents of the taluk.

Regular cancer detection facility (especially FNAC, sputum and pap smear) are conducted in the taluk head quarter hospital (2 days/week) and in two community health centres (1 per week) and in Govt. hospital. These are widely used by the clinicians and public in the area. A cancer Pain & Palliative Care service is conducted on 2 days by a trained doctor and home care service for advanced cancer patients is conducted on 3 days every week.

Summary of Number of Cancers

Year	Males	Females	Total
2001	239	214	453
2002	169	167	336
2001-2002	408	381	789

Table and Chart of Leading Sites of Cancers

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Number of Cancers by Five Year Age Group and Sites

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Tobacco Related Cancers

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ICD Code

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