Dikshit RP, Kanhere S. Cancer patterns of lung, oropharynx and oral cavity cancer in relation to gas exposure at Bhopal

Population Based Cancer Registry, Department of Pathology, Bhopal, India.
Cancer Causes and Control (Impact Factor: 2.74). 12/1999; 10(6):627-36. DOI: 10.1023/A:1008930220304
Source: PubMed


In Bhopal, India, on 2 December 1984, a chemical disaster caused by a gas leak mostly of methyl isocyanate (MIC) from the Union Carbide Factory led to massive mortality and morbidity of the population. This is the first study to shed light on the cancer experience of the Bhopal population as a result of exposure to a mixture of gases which have highly toxic and potentially carcinogenic properties. To observe the effect of gas exposure, incidence rates of the three most common cancer sites (lung, oropharynx and oral cavity) from 1987 to 1992 among the municipal wards were studied in males.
Relative risks (RR) using cases from the cancer registry and controls from a tobacco survey were estimated for the gas-affected regions.
Based on a descriptive study the relative risks of 1.4, 1.3 and 0.7 for lung, oropharynx and oral cavity cancer, respectively, for gas-affected regions in the year 1992 in comparison to gas-unaffected regions and the year 1987-1990 combined were estimated. In the case-control study the RRs of 0.9, 1.4 and 1.2 for lung, oropharynx (adjusted for smoking) and oral cavity cancer, respectively, (adjusted for tobacco chewing) were estimated as the effect of the gas accident.
The full potential of excess risk, if any, may not manifest for 15-20 years after the accident.

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    • "ICMR registry is dedicatedly registering all the cancer cases residing inside Bhopal. This registry studied the most common cancer sites like lung, oropharynx and oral cavity in relation to gas exposure from 1987 to 1992 and recommended that the effect of gas exposure on cancer must be studied in future (Dikshit and Kanhere, 1999). "
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    ABSTRACT: The purpose of this study was to update both researchers and clinicians about the cancer incidence in methyl isocyanate (MIC) exposed long-term survivors and in their offspring, focusing on the etiological plausibility. In the time period 2006-2011, cancer morbidity was evaluated in the population surviving after exposure to (MIC) on December 3rd, 1984, in Bhopal. This descriptive study is based on hospital registration of 1261 cancer patients those are MIC gas victims and theirsubsequently born offspring. Morbidity status was studied on the basis of gender, age, organ and site with relative percentages. Cancers on specific sites, with special reference to breast (n=231) (18.31%), lung (n=103) (8.16%), tongue (n=103)(8.16%), buccal mucosa (n=94) (7.45%), cervix (n=72) (5.70%), and esophagus (n=68) (5.39%) were found in high proportions. Ovary (n=43) (3.40%), brain (n=42) (3.33%), larynx (n=40) (3.17%), non-Hodgkin's (n=31) (2.45%), gallbladder (n=29) (2.29%), stomach (n=28) (2.22%), head and neck (n=28) (2.22%), liver (n=27) (2.14%), acute lymphoid leukemia (n=24) (1.90%), rectum (n=20) (1.58%), colon (n=20) (1.58%), chronic myeloid leukemia (n=17) (1.34%), alveolus (n=17) (1.34%), Hodgkin's (n=14) (1.11%), uterus (n=14) (1.11%), multiple myeloma (n=14) (1.11%), and prostate (n=11) (0.87%) lesions were observed less frequently. Remarkably, gradual increase of cancers on different organs and sites were observed in the longterm survivors and their offspring. The present study observed some cancers which were not previously reported in this population. In addition, we also present the future research directions with systematic approaches to predict cancer risk in long-term survivors and their future generations. On the basis of this morbidity report, we suggest the need of biological surveillance through immune system biomonitoring and cytogenetic screening to predict the cancer risk in the MIC exposed population and their offspring.
    Asian Pacific journal of cancer prevention: APJCP 12/2011; 12(12):3443 -3452. · 2.51 Impact Factor
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    • ", 2003 ) . A cancer incidence study from 1987 to 1992 , 8 years after the Union Carbide Accident , found no evidence of increased risk for cancer of the lung , oropharynx , or oral cavity due to gas exposures ; however , the authors note that more time may be necessary for the effect to show ( Dikshit & Kanhere , 1999 ) . "
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    ABSTRACT: Events of mass trauma are relatively common global phenomena with widespread impact on human health. We conducted this systematic literature review using the National Library of Medicine's PubMed database. We investigated the effect of disasters on six main topic areas of interest: injury and mortality, health systems and infrastructure, mental health, infectious disease, chronic disease, and health behavior. This review covers 182 articles on both natural and man-made disasters, excluding war. We present the results by topic area, across disaster type. This work highlights the scope and heterogeneity of disaster research today, providing a contextual background in which to formulate interventions and disaster planning efforts.
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    • "The tragedy is among the world's worst known industrial disasters, which led to the leakage of methyl isocyanate (MIC) and its related toxic gas products resulting in mortality of 2500-6000, and debilitating over 200,000 people. The severity of exposure was extreme, and the survivors continue to experience increased multi-systemic morbidity (Dhara and Dhara, 2002; Mishra et al., 2008; Mishra et al., 2009a), including cancer (Ganesh et al., 2005), which clearly establishes a genetic link with MIC exposure (Dikshit and Kanhere, 1999). The poor prognosis and high incidence rates of GBC in the MIC-exposed population further necessitate a better insight into the molecular changes to develop effective early diagnostics and novel targeted therapeutic strategies. "
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    ABSTRACT: Gallbladder carcinoma is an uncommon, but highly malignant tumor, with poor prognostic, and diagnostic manifestations in early stages. The Indian Council of Medical Research reported increased incidence of gallbladder carcinoma in the surviving population of the Bhopal gas tragedy that involved exposure of more than 500,000 people to methyl isocyanate gas. The severity of exposure, and increased multi-systemic morbidity in the survivors stimulated us to examine the molecular changes leading to gallbladder carcinoma. Surgically resected samples (N = 40) of gallbladder carcinoma were studied for the p53, Rad50, and cyclin-E expression by immunohistofluorescence bioimaging. Among the 40 samples, 23, 11, and 10 showed p53, Rad50, and cyclin-E expression, respectively, in moderately differentiated adenocarcinomas, demonstrating the prevalence and invasiveness of this disease in the methyl isocyanate-exposed population (P = 0.0009). Nevertheless, co-expression of Rad50, and cyclin-E with p53 was absent in adenomas with dysplasia, demonstrating their independent roles. We conclude that there was altered expression of p53, Rad50, and cyclin-E in the malignant transformation of gallbladder carcinoma in this methyl isocyanate gas-exposed cohort. Hence, these proteins may be useful as markers to identify premalignant lesions that are likely to progress into malignant adenocarcinoma.
    Genetics and molecular research: GMR 01/2009; 8(4):1202-10. DOI:10.4238/vol8-4gmr653 · 0.78 Impact Factor
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