"Various Addiction Patterns, Dietary Habits, Associated Medical Problems And Socioeconomic Status In Gastro-IntestinalMalignancies: A Prospective Study In Rural Area Of Maharashtra, India".

Various addiction patterns, dietary habits, associated medical problems and socioeconomic status in gastro-intestinal malignancies: A prospective study in rural area of Maharashtra, India. Jain Vandana S., MD, Professor & Head Kawale Darshana, MBBS, Senior Resident Jain Shailendra M., MD, Professor Waghmare Chaitali, MD, Associate Professor Pemmaraju Gopal, MBBS, Senior Resident Abstract Background: Gastro intestinal (GI) malignancies (from Esophagus to anus) are increasing with advancing age, various addictions and poor dietary habits. Early detection is difficult till patient notices symptoms. Primary prevention by knowing various risk factors and early symptom awareness will help in the healthier outcome. Objectives: This study is carried out to see various addiction patterns, dietary habits, associated medical problems and socioeconomic status with various sites involved in GI malignancies, in a tertiary care teaching hospital of Western Maharashtra, India. Materials and Methods: This prospective study is designed to know about various addiction patterns, dietary habits, associated medical problems and socioeconomic status, along with age, sex, various sites and the stage at first visit of all histopathologically proven cases of gastrointestinal malignancies reporting in the Department of Radiotherapy & Oncology for treatment. Oral cavity to cricopharyngeal carcinomas is included in head and neck malignancies. Carcinoma esophagus, carcinoma stomach, carcinoma small intestine, colorectal (colon and Rectum) and anal canal carcinomas are considered in gastrointerstitial malignancies (and for this study). Data collection was done from Feb 2016 to Dec 2016 for the period of eleven months. A detailed questionnaire was filled after taking written informed consent from the patient. Once the target of 100 patients was achieved all the data was compiled and analyzed for the study. Patients unable to provide or not willing to give desired information are excluded from the study. Results and Conclusions: In this study out of total 100 registeredcases of GI malignancy, 61 were males and 39 were females, which show male preponderance. Most of the patients belonged to lower and upper lower class (64%) as per modified B G Prasad classification. Various histopathological types recorded were Squamous cell carcinoma (35), Adenocarcinoma (60), Adenosquamous carcinoma (2), Basaloid carcinoma (2) and Gastro intestinal stromal tumor (GIST (2)). Associated medical illnesses were rarely observed (only two cases with Diabetes Mellitus and three with Hypertension) and they were on regular treatment. One patient was on anti- retroviral therapy for HIV, two were positive for HBsAg and one for VDRL. The commonest site involved was Esophagus (41) followed by Recto sigmoid, colon & caecum, stomach & anal canal (29, 14, 13 & 2 respectively). Mean age was 59.1 years. The youngest patient was 28 years and oldest was 86 years old. 45 cases were above 60 years and only five were below 30 years of age. 85% of cases were in advanced stage of disease (III & IV). Details of various addictions alone and in combinations with duration of consumption are shown in table no-1. Commonest addiction for all sites was smokeless tobacco (SLT). 81% of cases were non-vegetarian; only 16% were pure vegetarian, details of dietary habits is shown in table-2. Gastrointestinal malignancy is showing increasing trends in India. This study gives an idea about various risk factors for the increasing trends of gastro-intestinal malignancy. The present study shows that carcinoma Esophagus is the commonest & cancer recto sigmoid in second commonest GI malignancy. Mostly the cases were addicted to one or other addiction and were taking regularly nonvegetarian diet. Awareness program for harmful effects of various addictions, the importance of vegetarian diet (high fiber) and about the early symptoms of GI malignancy will help in health promotion, prevention of various malignancies & early diagnosis of disease as well as better treatment outcome. [ABSTRACT FROM AUTHOR]