Treatment: Surgical removal is possible for early stage lung cancer. Chemotherapy and radiation therapy can be used at any stage and often accompany surgery. Research: Researchers are working to identify the cellular properties that make some lung cancer cells resistant to treatment. So far, they've uncovered a protein that is critical to chemo-resistance, called DAPK3. If presence of this protein is regulated within the tumor cell, then the chances of recovery increase.
Usually originating in the milk ducts or milk glands, breast cancer affects hundreds of thousands of women in the U. Survival rates, as with other cancers, increase dramatically if detected early. Risk factors: Unlike skin or lung cancer, there are fewer clear risk factors with breast cancer. Family history and genetics play a leading role.
Use of oral birth control, physical activity, and alcohol use have also been shown to have a minor impact on the likelihood of developing breast cancer. Treatment: Surgical removal is the most common treatment for breast cancer, often accompanied by radiation or chemotherapy. Knowledge of these genes can help doctors to identify at-risk patients early in life, perform regular screenings and take other prevention measures.
While breast cancer nearly always affects women, prostate cancer exclusively affects men. It is especially common in older men and about 1 in 6 men can expect to receive a prostate cancer diagnosis during his lifetime. Fortunately, the vast majority of men diagnosed with prostate cancer do not die from it. Family history, height, weight, and diet also play a role. Interestingly, where you live may also impact your likelihood of prostate cancer, men who receive less sunlight throughout their lives have a higher risk.
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The survival rate is very high if prostate cancer is detected while still localized; however, it drops dramatically if it spreads to nearby lymph nodes. Treatment: There are several treatments for prostate cancer, including surgical removal or radiation, hormone, and chemotherapy.
Surgery is often used to remove early stage prostate cancer, while chemotherapy is used in later stages. This study is based on nationally representative data from Social Consumption : Health survey 71 st round of India. A key objective of Social Consumption : Health survey is to obtain data on aspects of morbidity, treatment-seeking and financing of hospitalization inpatient and ambulatory outpatient care services for the reference period of days and 15 days respectively.
The ailments for which such medical care is sought, the extent of use of Government hospitals, and the expenditure incurred on treatment received from public and private sectors, is also available through this survey. Additionally, the survey provides household level information on demographics and access to services and utilities as well as individual level data on age, sex, education, monthly per capita expenditure and primary occupation of households.
The Social Consumption : Health Survey interviews are conducted with a representative sample of households randomly selected through a stratified multi-stage survey design covering India. Selection of first stage units is based on the principle of probability proportional to size with circular systematic sampling of census-identified villages in the rural sector and urban frame survey blocks in the urban sector of each district.
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Second-stage sampling constituted the households belonging to only two of these hamlet-groups, selected circular systematically in case of sample villages, and one randomly selected sub-block in the case of sample blocks. Households within a village are categorized in two strata based on affluence. From these strata, households are circular systematically selected to constitute the final sample.
This cross-sectional survey data was collected during January to June The 71 st round of Morbidity and Healthcare Survey covers a sample of 65, households and , individuals. First, we present the self-reported prevalence of cancer across socioeconomic groups. For analytical purposes, prevalence of cancer refers to any person suffering from any type of cancer or received cancer inpatient or outpatient treatment or both. These estimates are presented along with the percentage of cancer patients undergoing treatment in public and private healthcare facilities separately.
Further, the estimates for average out of pocket OOP medical and total expenditure on cancer inpatient care across SES groups are also reported. The total expenditure is the summation of medical expenditure and transport charges for patient, food transport on others, expenditure on escorts and their lodging charges. It is observed that the number of sample cases for cancer outpatient care is almost negligible whereas most of the cancer patients have reported receipt of hospitalization care. Therefore, the expenditure analysis specifically focuses on hospitalization expenditure related to cancer treatment across socioeconomic groups.
A high reliance on OOP spending is a major concern and hence it can potentially jeopardize the customary living standards of the households [ 44 — 45 ]. To unravel such concerns, we present an analysis of incidence of catastrophic expenditure by examining proportion of households that incur greater OOP expenditure as a share of their household expenditure.
We employ conventional expenditure thresholds of 10, 20 and 40 percent of gross annual per capita household expenditure to discern the magnitude and socioeconomic patterns of such catastrophic expenditure related to cancer inpatient treatment.
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Furthermore, we also investigate percentage of households largely relying on distress financing mechanisms to receive cancer treatment. The survey elicits information regarding the major source of financing to capture whether bulk of the out of pocket expenditure was incurred via distressed means or not.
The component such as borrowings with or without interest , contribution from friends and relatives with or without repaying option and sale of assets is combined defined as distressed financing [ 27 , 46 ]. We focused on three SES indicators: household monthly per capita expenditure MPCE quintile, education and social group of the cancer patient. Significant milestones of the Indian education system were followed to categorize the patients as illiterate no formal schooling , primary education or below 1—5 years , middle school education or below 6—10 years , secondary education 11—12 years and higher education graduate school and above.
In addition, we also include information on household location urban vs. We report levels of cancer prevalence as well as treatment expenditure across socioeconomic categories.
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The concentration index CI is used to discern the socioeconomic gradient in cancer prevalence and its healthcare utilization [ 47 — 48 ] with focus on public and private hospitals separately. Further, we employ multilevel logistic regression adjusting for state and community level random effects to understand the mutually adjusted associations of cancer prevalence with various SES factors in a multivariate framework. In addition, we have also analysed regression estimates adjusted for age and gender interaction [ 49 — 50 ].
The logistic regressions estimates are reported in the form of Odds Ratio OR along with respective 95 percent confidence interval. These odds ratios are the relative measure of effect which allows comparisons of group relative to the reference group. The analysis was carried out in Stata 12 and MLwiN version 2. All the analysis use sampling weights as prescribed by the NSSO [ 54 ]. The self-reported cancer prevalence at national level and its distribution across socioeconomic groups by rural and urban areas is presented in Table 1.
The gradient across MPCE quintiles is further confirmed through the concentration index of inpatient Index value: 0. Besides, the incidence of cancer displays huge inter-state variations with high prevalence across south Indian states S2 Table. We use multilevel logistic regression to examine the association between socioeconomic correlates and cancer prevalence Table 2. Age of an individual is strongly associated with cancer and elderly cohort has almost five-time higher prevalence OR: 4.
In addition, the probability of cancer prevalence among reproductive age cohort 15 to 49 years is higher for females OR: 1. The odds of cancer prevalence among individuals from highest MPCE quintiles are 3. The adjusted regression estimates reveal a significant gradient across educational categories whereby individuals with higher education display lower risk of cancer OR 0.
Therefore, reciprocal adjustment is critical to confirm the simple cross-tabulation based association and suggests that in India for a given age and income level, an individual having lower education is at a higher risk of cancer.
dustsulimo.tk Further, about 61 percent of cancer inpatient cases are utilizing private facilities in urban areas S3 Table. Female patients have greater use of private hospitals for inpatient care and it is even higher 76 percent for those from reproductive ages. The regression estimates further substantiates the observed socioeconomic gradient in healthcare utilization Table 2. For instance, the odds of seeking private hospitalization are higher for patients from richer households i. In addition to this, the probability of getting private inpatient care is significantly higher for households with self-employed OR: 2.
Table 3 reports the average OOP medical and total expenditure and distressed financing for cancer inpatient care in public and private sector separately. The total expenditure for males Rs. As expected, OOP expenditure is much higher for richer households. For instance, total expenditure for highest income quintile Rs. The overall medical expenditure is estimated to be around 80 to 90 percent of total expenditure on cancer inpatient treatment.
The non-medical expenditure also emerges as a significant component of total cancer care expenditure. The incidence of distressed financing is significantly high for both public and private hospitals across all wealth quintiles Fig 1. About 50 percent of low-income households raise greater proportion of the cancer treatment expenditure via such distressed means.
Clearly, the incidence of distressed financing is more visible among those getting treatment in private facilities across all socio-economic groups except for highest MPCE quintile. Although no clear socioeconomic gradient is observed, but the incidence of resorting to distressed means is substantially higher among poor households. At national level, more than 40 percent household resort to distress means as the main source of financing cancer treatment in public hospitals S4 Table.
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A higher proportion of households 50 percent endure such financial hardships while seeking cancer treatment in private hospitals S4 Table. There is an overwhelming incidence of distressed financing in rural areas with Finally, it is observed that a significant proportion of cancer patient households spend more than 10, 20 and 40 percent of their annual per capita household expenditure on inpatient treatment Table 4. Overall, about The incidence of catastrophic expenditure is highly concentrated among poor households.
For instance, more than 50 percent patients from low income households are reported to be spending more than 10 and 20 percent of per capita household expenditure whereas, about 26 percent of richer households are reported to be spending more than 10 and 20 percent of their annual income. The catastrophic effects are substantially high for those seeking treatment in private hospitals Table 4. The present analysis, however, is sensitive to the following limitations.
First, the cross-sectional nature of data and survey design does not allow us to infer causality. Second, the results presented here are based on self-reported household survey information. Due to data limitations, we are also not able to assess the respective contributions of different types of sources of financing in total out of pocket expenditure.
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