Risk Assessment of Esophageal Cancer Prevalence in North East India

Background: The North East (NE) India region has a quite distinct gene pool with over 160 scheduled tribes and 400 other sub-tribal populations. This region is the fourth contributor to the gene pool of the Indian sub-continent, which has associations with Tibeto-Burman speakers and Austro-Asiatic speakers settled in East and NE-India with Asian ties. Methods: Literature search and studies have shown that in India, notwithstanding the lack of data on population coverage, there exists no such evidence for a decline in age-standardized mortality rates in cancer and the number of deaths mostly in individuals less than 70 years. Results: Analytical epidemiological studies using molecular markers are currently the need of NEIndia for prognostication of cancers in this region, which are quite different from the rest of India, such as esophageal cancer, lung cancer in females, stomach cancer, and nasopharyngeal cancers. In addition, there is a dire need for translational research in NE-India, as for cancer survival, it is not always feasible to generalize the current international guidelines for cancer to the population of NEIndia so that high survival rates are achieved just like the rest of India and high-income rich countries. Factors, such as difference in incidence rate, socioeconomic factors, tumor biology and availability of resource in this region, determine the survival rates. Conclusion: In this review, various factors involved in the high cancer burden in this region are discussed, particularly focusing on the genetic basis.