Our Team > Epidemiology & Biostatistics

Division of Cancer Epidemiology and Biostatistics

Overview

The Division of Cancer Epidemiology and Biostatistics applies, develops, and teaches the skills needed to understand the determinants of cancer and implements dedicated initiatives to:

  • Increase knowledge and application of modern epidemiological and bio-statistical techniques among postgraduate students and researchers
  • Increase the quality and output of research in RCC
  • Provide bio-statistical consulting and statistical analysis for their scientific publication & thesis preparation
  • Conduct Cancer Epidemiological Research projects in collaboration with Scientific Organizations.
  • Provide reliable and a high quality cancer intelligence service through hospital and population-based cancer registries.
  • Contribute methodological services to individual research projects from protocol development to project finalization
  • Conduct Density mapping and environmental factors of cancer in South Kerala using Geographic Information System (GIS).

    • Programmes
      Functioning of Cancer Registries
          o New patient Registration RCC, Thiruvananthapuram
          o Hospital based cancer registry (HBCR), RCC, Thiruvananthapuram
          o Population Based Cancer Registry (PBCR), Thiruvananthapuram, Kollam, Pathanamthitta, Alappuzha and Kottayam Districts

      Conducting surveillance programmes
          o Pattern of Care and Survival Studies (POCSS)
          o Population Based Cancer Survival studies (PBCSS)

      Conducting Epidemiologic studies
          o Risk factor assessment
          o Cancer density mapping using Geographic Information system(GIS)
      Conducting Biostatistics studies
          o Data mining Techniques-Artificial Neural Network, Decision Tree Models
          o Joint frailty model, Multi-State Frailty Model
      Conducting Doctoral Programmes
          o Epidemiology/ Cancer Epidemiology
          o Statistics /Biostatistics
      Providing Teaching & Training
          o Epidemiology
          o Biostatistics
          o Cancer Registry Operations
      Providing Statistical Consultancy
      Generating Reports

      i) Cancer Registry

      Provides reliable and a high quality cancer intelligence service through hospital and population-based cancer registries, surveillance and screening programmes. These programmes play an essential role in the improvement of health and healthcare through the implementation and monitoring of national and state cancer policy. The Division of Epidemiology and Biostatistics which includes both Hospital Based Cancer Registry since 1982 and Population Based Cancer Registry Thiruvananthapuram and are included under the network of National Cancer Registry Programme of Indian Council of Medical Research, (ICMR) and thus has one of the oldest cancer registries in the country.

        a. New Patient Registration & Epidemiological data Collection
        The Cancer Registry Division has taken up the New Patient Registration from January, 2019. The basic patient information, socio-economic status, family history of cancers, habits and anthropometric measurements will be collected using a self-administered questionnaire, both new patients registration form and Epidemiologic factors related to the development of cancer are collected and computerized at the time of registration of patient RCC, Thiruvananthapuram. This information will form the basic inputs for Hospital based Cancer registration system and Epidemiological studies.
        b. Hospital based Cancer Registry (HBCR)
        The Hospital-Based Cancer Registry (HBCR), Regional Cancer Centre Thiruvananthapuram started in 1982 under the network of National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR) with objectives to generate data on cancer patient care parameters such as demographic, diagnostic, stage at diagnosis, treatment, follow-up and survival.

        General Objectives:

      • Assess Patient Care
      • Participate in Clinical Research to Evaluate Therapy
      • Provide an idea of the patterns of cancer in the area
      • Help plan hospital facilities.

        • Specific Objectives:

      • Contribute to active follow-up of the cancer patient.
      • Describe length and quality of survival in relation to anatomical site, clinical stage and aspects of types of treatment.
      • Contribute to the Population Based Cancer Registry (PBCR) in the given area.
      • Undertake epidemiological research through short-term case control studies.
      • Show time trends in proportion of early to late stages at the time of diagnosis.

        • c. Population Based Cancer Registry (PBCR)
        The basic methodology for Population Based Cancer Registry (PBCR) envisages capturing core patient information including permanent residential address of all cancers reported/registered in the geographical defined population from multiple sources. Population Based Cancer Registries have a unique role in planning and evaluating cancer control programmes. The occurrence of cancer in a defined population provides a framework for assessing and controlling the impact of cancer in the community. Cancer registry covering the Thiruvananthapuram Taluk and Kollam has been included under the network of national cancer registry programme (NCRP) of Indian council of medical research (ICMR) since 2006. The Taluk registry has been expanded as District registry and has been included it under the network of NCRP since 2012. Pathanamthitta and Alapuzha district have been under this network since 2018. Kottayam District is also covered since 2021.

        Aims of the PBCR

        Aim of the registry is to assess the magnitude and pattern of cancer incidence and mortality rates as well as estimating survival of various cancers among the population in Thiruvananthapuram, Kollam, Alappuzha, Pathanamthitta & Kottayam districts.

        Specific objectives


        1. To estimate annual cancer incidence and mortality in the above districts.
        2. To estimate cancer pattern (site and type of cancer) in the districts.
        3. To estimate urban-rural differences in cancer incidence and mortality in the districts.
        4. To estimate stage at diagnosis of various cancers in the districts.
        5. To estimate survival of various types of cancers in the districts.

        ii) Surveillance programmes
        Survival of cancer reflects the aggressiveness of the disease, the effectiveness of treatment and biological factors such as age. Monitoring the survival over a period of time will give evidence on whether a particular prevention programme is working. In this division the following cancer surveillance programmes are continuing.
        a. Pattern of Care & Survival Studies (POCSS)
        Hospital based cancer survival rates are used to evaluate the care provided in the hospital and it is named as, Pattern of Care and Survival Studies (POCSS). Systematic data abstraction on patterns of care and survival in cancers of the uterine cervix, breast and head and neck cancer patients reporting to the RCC has been started since 2006 in collaboration with the NCRP of ICMR and expanded to obtain survival of ovarian cancer by the NCRP in 2017. This programme includes a detailed cancer patient data abstraction (diagnostic, stage, treatment and follow-up details. The data abstraction has been made by using a procedure manual provided by the NCRP. Follow-up is updated through active follow-up at the RCC. Losses to follow-up cases are contacted through telephone enquiry, postal enquiry (if telephone numbers are not available) and finally house visits.

        Presently the POCSS programme covers the following cancer sites

            o Breast Cancer
            o Head & Neck Cancers
            o Gynecological Cancers
        For each of the above mentioned cancer sites, different proforma are used to collect the information.

        b. Population Based Cancer Survival Studies (PBCSS)

        Population based cancer survival (PBCS) provides an idea of the effectiveness of the overall cancer control strategy in the registry area. It gives a baseline on impact of cancer and its treatment on the population and help plan health services facilities for improvement of survival. Population Based Cancer Survival Study on Cancers of the Breast, Cervix, Head & Neck is started in the division in 2017 in collaboration with NCRP of ICMR.

        iii) Epidemiologic studies

        Epidemiology is the study of the distribution of health and disease in populations and of the factors that influence that distribution. The knowledge gained from epidemiologic studies can be used to understand disease processes and to develop programs intended to improve the health status of populations.

        Ongoing studies

        The following studies are ongoing in this division.

            o Comparative study of Genetic, Clinical and Epidemiological factors of Breast Cancer in Indian population
            o Density Mapping and Environmental factors of Cancer in South Kerala using Geographic Information System (GIS)
            o The Impact of Socioeconomic Status (SES) on Stage and Survival of Gastrointestinal Cancer: A Comparative Study of Canada and South India.
            o Population Attributable Fraction due to Tobacco and Alcohol for Cancers in Kerala

        iv) Biostatistics studies

        Biostatistics is a scientific discipline that focuses on study design and collection, analysis, and interpretation of data to improve human health. Faculty members in this division are actively engaged in biostatistics research. The areas of research include: Survival Analysis, Data Mining, Artificial Neural Network Model, Decision Tree Model, Bayesian methods, Longitudinal data analysis, Spatial statistics, Methods for the Analysis of Screening and Diagnostic Tests; Methods for the Analysis of Observational Data; Statistical Methods in Epidemiology; Mixture Models etc.


        Ongoing studies

        The following studies are ongoing in this division

            o Pattern and Risk Assessment among patients with history of cancer in the family using Decision Tree Model: Data Mining Technique for an Epidemiologic study in Head and Neck and Lung cancers
            o Artificial Neural Network Model based on Geographical Information System for Predicting Spatial Distribution of Cancer Incidence and Mortality in South Kerala.
            o Modeling Recurrent and Terminal Events in Cancer survival due to non-proportionality in follow up and hazards.
            o Joint frailty modeling of longitudinal Time−to−Event data in cancer survival
            o Joint Multi-State Frailty Modeling for Longitudinal Time-to-Event Data
            o Attributing death to cancer: Relative survival estimation in Kerala.

        v) Doctoral Programmes

        The division offers two doctoral level programs
        1. Epidemiology
        2. Biostatistics

        Currently provides guidance to six doctoral students in Epidemiology and one doctoral student in Biostatistics.

        vi)Teaching & Training:

      • Teaching bio-statistics to the post-graduates at RCC
      • Conducting Short term training on Epidemiology, Biostatistics, and Cancer Registry Operations.

        vii) Statistical consultancy


        The statistical consultation is offered to the students in the data analysis of their Dissertation/Doctoral thesis. The department also conducts few projects in collaboration with Scientific Organizations. The faculty of the department provides statistical support for various projects, thesis, paper publications of the students & Faculty of the Institute.

        viii) Reports

        1. Population Based Cancer registry Thiruvananthapuram District Cancer incidence & Mortality 2012-2014
        2. Hospital Based Cancer Registry 30 year consolidated Report 1982-2011
        3. Hospital Based Cancer Registry Annual Report for the year 2016
        4. Hospital Based Cancer Registry Annual Report for the year 2015
        5. Hospital Based Cancer Registry Annual Report for the year 2014
        6. Hospital Based Cancer Registry Annual Report for the year 2013
        7. Hospital Based Cancer Registry Annual Report for the year 2012
Epidemiology Team »