Ravi Mehrotra

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Verified

Ravi verified their affiliation via an institutional email.

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• MD, DPhil FRCPath
• Adjunct Professor at Emory University

Breast cancer is the commonest malignancy among women globally. From being fourth in the list of most common cancers in India during the 1990s, it has now become the first. In this review, we examine the available literature to understand the factors that contributed to the high burden of breast cancer in the country. We also provide the landscape...

When it comes to addressing tobacco dependence, prevention and cessation go hand in hand. Until now, most tobacco cessation efforts have primarily focused on adults, emphasizing regular daily smokers.

Background : Smoking is the leading behavioural risk factor for mortality globally, accounting for more than 175 million deaths and nearly 4·30 billion years of life lost (YLLs) from 1990 to 2021. The pace of decline in smoking prevalence has slowed in recent years for many countries, and although strategies have recently been proposed to achieve t...

Recent strides in understanding the molecular underpinnings of head and neck cancers have sparked considerable interest in identifying precise biomarkers that can enhance prognostication and enable personalized treatment strategies. Immunotherapy has particularly revolutionized the therapeutic landscape for head and neck squamous cell carcinoma, of...

Background: The burden of cancer in India has been rising, yet testing for early detection remains low. This study explored inequalities in the uptake of breast cancer (BC) examination and cervical cancer (CC) among Indian women, focusing on socioeconomic, regional, and educational differences. Methods: Data from the 2019-21 National Family Health...

Objective This review presents an overview of the current knowledge on smokeless tobacco and oral cancer, with a specific focus on South and Southeast Asia. Method The recent literature on the association of smokeless tobacco and oral cancer, its biological mechanisms, and policies for prevention and control, was reviewed. In addition, its role in...

BACKGROUND Cigarette smoking is prevalent in many countries worldwide, especially in low- and middle-income countries, presenting an urgent public health challenge. Disseminating freely available smoking cessation treatments that effectively decrease cigarette smoking globally are urgently needed. OBJECTIVE Identify the highest impact and most cos...

Abstract Colorectal cancer (CRC) is the number two leading cause of cancer-related death after lung cancer. Lifestyle factors, inflammatory bowel disease, family history, and genetic syndromes are among the risk factors linked to the development of CRC. The therapies of CRC involve surgery, radiation therapy, and chemotherapy. New in the treatment...

ABSTRACT This chapter explores the intricate interplay of the gut microbiota and its tremendous effect on the tumor microenvironment (TME), which impacts cancer development and treatment responses. The previously tenuous connection between gut microbiota and cancer has been established, primarily through animal models. Modifying the microbiota, the...

The mind can have a major impact on your well-being and management of diseases. Complementary therapies may be able to address the psychological and physical side effects that radiation therapy, androgen deprivation therapy, or surgery may cause in the treatment of prostate cancer. A considerable segment of cancer patients employ supplementary medi...

The gut microbiome comprises bacteria, fungi, viruses, archaea, and their genetic materials. The gut microbiome influences the physiological and immunological functions of the body. When there is a change in the composition of microbiota in the gut, this is called dysbiosis. Dysbiosis is linked with several gastrointestinal and extra-gastrointestin...

The burden of cancer exerts a disproportionate impact across different regions and population subsets. Disease-specific attributes, coupled with genetic and socioeconomic factors, significantly influence cancer treatment outcomes. Precision oncology promises the development of safe and effective options for specific ethnic phenotypes and clinicodem...

Introduction Under the current policy landscapes, the lifetime health and economic burden of smokeless tobacco (ST) products, consumed by over 297 million ST users in South Asia, is unknown. The aim of this study was to estimate the lifetime health effects and costs attributable to current and future ST use in Bangladesh, India, and Pakistan where...

The recently published WHO Reporting System for Pancreaticobiliary Cytopathology (World Health Organization [WHO] System) is an international approach to the standardized reporting of pancreaticobiliary cytopathology, updating the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSC System). Significant change...

Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to...

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of D...

Recent advances in the field of immuno‐oncology have brought transformative changes in the management of cancer patients. The immune profile of tumours has been found to have key value in predicting disease prognosis and treatment response in various cancers. Multiplex immunohistochemistry and immunofluorescence have emerged as potent tools for the...

Abstract The nature of cervical cancer, its high incidence and mortality rate and the way it disproportionately affects low to middle income countries, makes t a large public health burden in these countries. One of the greatest challenges to the management and treatment of cervical cancer is the ability of the cancer to develop resistance to many...

Background The Global Breast Cancer Initiative (GBCI) Framework, launched by the World Health Organisation (WHO) in 2023, emphasises assessing, strengthening, and scaling up services for the early detection and management of breast cancer. This study aims to determine the feasibility of monitoring the status of breast cancer control in the 21 Asian...

A Working Group of 25 independent international experts, convened by the International Agency for Research on Cancer (IARC) between September and December 2021, reviewed the scientific evidence on primary and secondary prevention of oral cancer. Cancer of the lip and oral cavity ranks 16th in cancer incidence and mortality worldwide and is a common...

Tobacco use is a major cause of preventable morbidity and mortality globally. Tobacco products, including smokeless tobacco (ST), generally contain tobacco-specific N-nitrosamines (TSNAs), such as N0-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-butanone (NNK), which are potent carcinogens that cause mutations in critical genes i...

The International Academy of Cytology has joined with the International Agency for Research on Cancer and the World Health Organization (WHO) to develop international systems for reporting the cytopathology of lung, pancreas and biliary tract, lymph nodes, soft tissue, liver, breast, and kidney and adrenal gland. The WHO recently published the repo...

The clinical significance of the tumor-immune interaction in breast cancer is now established, and tumor-infiltrating lymphocytes (TILs) have emerged as predictive and prognostic biomarkers for patients with triple-negative (estrogen receptor, progesterone receptor, and HER2-negative) breast cancer and HER2-positive breast cancer. How computational...

Modern histologic imaging platforms coupled with machine learning methods have provided new opportunities to map the spatial distribution of immune cells in the tumor microenvironment. However, there exists no standardized method for describing or analyzing spatial immune cell data, and most reported spatial analyses are rudimentary. In this review...

The society we envision to live in for the future is one where scientific and technological innovations lead to human health innovations that merge cyberspace and physical space. In women’s health, this can be compared with an autonomous driving of these cyber services toward improved women’s health and early identification of diseases where strate...

We envisage living in a society where scientific and technological innovations lead to reforms in human health by merging cyber and physical spaces. The concept of Society 5.0 was first proposed in Japan. Society 5.0 is a smart, knowledge-based society, which uses digital information-based technologies such as artificial intelligence (AI), cloud co...

Non-neoplastic conditions of the salivary glands range from inflammatory processes to sialadenosis to reactive lymph nodes. Sialadenitis is the most common non-neoplastic condition and includes acute or chronic sialadenitis as well as granulomatous disease. The risk of malignancy (ROM) for aspirates of “Non-Neoplastic” salivary gland lesions is app...

Background: Smokeless tobacco, used by more than 300 million people globally, results in substantial morbidity and mortality. For smokeless tobacco control, many countries have adopted policies beyond the WHO Framework Convention on Tobacco Control, which has been instrumental in reducing smoking prevalence. The impact of these policies (within an...

e18686 Background: Breast cancer (BC) disparities are differences in cancer measures. Some of the disparities in BC among Black women and males include but are not limited to the disproportionate high mortality rates impacted by access to screening mammograms, the effect of breast density, access to genetic testing, genetic predisposition to triple...

In India, the number of older adults is steadily increasing and expected to reach around 200 million by 2030. Along with demographic change, India is experiencing a shift in family structure from multi-generational to nuclear families, affecting the social and psychological support available to older adults. The majority of hematological malignanci...

Background Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both suscept...

The International Academy of Cytology has joined with the International Agency for Research on Cancer to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This System aims to improve and standardize the reporting of cytopathology, facilitate communication between cytopatho...

Objectives: In resource-constrained settings, cancer epidemiology research typically relies on self-reported diagnoses. To test a more systematic alternative approach, we assessed the feasibility of linking a cohort with a cancer registry. Setting: Data linkage was performed between a population-based cohort in Chennai, India, with a local popul...

The World Health Organization (WHO), the International Academy of Cytology, and the International Agency for Research on Cancer have developed an approach to standardized reporting of pancreaticobiliary cytopathology. The WHO Reporting System for Pancreaticobiliary Cytopathology (WHO System) revises the Papanicolaou Society of Cytopathology (PSC) S...

Xenobiotic metabolic enzymes CYP1A1 and GSTM1 are known to increase the risk of head and neck cancer. However, their role in the development of oral potentially malignant disorders (OPMDs) in the Indian population is uncertain. This study aimed to investigate the CYP1A1 and GSTM1 gene polymorphism in the urban population of the state of Delhi as we...

The International Academy of Cytology has joined with the International Agency for Research on Cancer (IARC) to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This WHO System defines five categories for reporting lung cytopathology, that is, “Insufficient”/“Inadequate”/...

On January 13th and 14th 2022, the Center for Translational Cancer Research organized the virtual third IndianCancer Genome Atlas (ICGA) Conference 2022 “Biobanking to Omics – Collecting the Global Experience.” Thisconference was planned as the steppingstone to help ICGA understand the road ahead and the probableroadblocks in its preparatory phase...

The World Health Organization (WHO), the International Academy of Cytology, and the International Agency for Research on Cancer, with expert contributors from around the world, present an international approach to standardized reporting of pancreaticobiliary cytopathology. This reporting system is one of the first in a series from various body site...

Non-Communicable Diseases (NCDs) are a threat to public health and sustainable development. NCDs were equated to being a 'pandemic' before COVID-19 originated. Globally, NCDs caused approximately 74% of deaths (2019). India accounted for nearly 14·5% of these deaths. NCDs and COVID-19 have a lethal bi-directional relationship with both exacerbating...

Abstract Areca nut and tobacco are widely consumed across the world by ~600 million and 1.3 billion people due to their addictive properties, respectively. Globally, AN is the fourth most common psychoactive substance after caffeine, nicotine, and alcohol. It is not only a psychostimulant and addictive substance, but also a potential carcinogen as...

An expert panel review of strategies for preventing oral cancer report that the use of tobacco (both smoking and smokeless), areca nut exposure, and heavy alcohol consumption are major contributors to this illness.

Introduction Illicit smokeless tobacco (ST) trade has seldom been documented despite ST use in at least 127 countries across the world. Based on non-compliance with packaging regulations, we report the proportion of illicit ST products from samples on sale in Bangladesh, India and Pakistan where 85% of global ST users reside. Methods We purchased u...

Smokeless tobacco (SLT) use is a significant cause of lip and oral cavity cancers. Globally, oral cancer prevalence is strongly linked to the types of tobacco products used, their chemical composition, and their pattern of use. Except snus, all SLT products sold in different World Health Organization regions are strongly associated with oral cancer...

Background Smokeless tobacco (ST) is consumed globally by more than 350 million people, with approximately 85% of all users based in South and Southeast Asia. In this region, ST products are cheap and easily accessible. Evidence-based interventions to people quit ST use are lacking. This study aims to test the feasibility of conducting a future def...

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...

Malignant mesotheliomas (MM) are hard to treat malignancies with poor prognosis and high mortality rates. This cancer is highly misdiagnosed in Sub-Saharan African countries. According to literature, the incidence of MM is likely to increase particularly in low-middle-income countries (LMICs). The burden of asbestos-induced diseases was estimated t...

The fibroadenoma is considered as a manifestation of aberration in normal development and involution (ANDI); however, its exact etiopathogenesis is poorly understood. We investigated the role of oestrogen (ER) and progesterone receptors (PR) in Fibroadenoma, to assess the ER and PR expression in epithelium and stroma of fibroadenoma and to co-relat...

Background: The early detection of breast cancer (BrC) is associated with improved survival. We describe a blood-based breast cancer detection test based on functional enrichment of breast-adenocarcinoma-associated circulating tumor cells (BrAD-CTCs) and their identification via multiplexed fluorescence immunocytochemistry (ICC) profiling for GCDF...

Oral cancer is usually preceded by oral potentially malignant disorders (OPMDs) and early detection can downstage the disease. The majority of OPMDs are asymptomatic in early stages and can be detected on routine oral examination. Though only a proportion of OPMDs may transform to oral squamous cell carcinoma (OSCC), they may serve as a surrogate c...

Background & objectives: Lack of awareness is one of the major reasons for the high morbidity and mortality associated with cancers. The present study was aimed to evaluate the awareness of prevalent cancers among the rural population in a district of north India and its association specifically with mobile phone usage. Methods: Using a stratified...

When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Brea...

Background Areca nut (AN) is an addictive substance consumed in the Southeast region and is highly associated with oral premalignant lesions and oral cancer. The impact of AN use in the United States (US) is largely unknown, but the products are readily available and probably used by a significant fraction of Asian immigrants or descendants living...

India is considered a demographically young country with over 65% of the population aged below 35 years. However , improvements in maternal and child health, and infectious diseases, have created a rapid epidemiological transition with an aging population (8.6% in 2011) with a projected increase (19% by 2050), equating to 104 million. In addition t...

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic...

PURPOSE The rising cancer burden in low- and middle-income countries (LMICs) stresses already weak health care systems and poses unique challenges. In resource-constrained LMICs and in circumstances where most patients must pay out of pocket for diagnostic tests, these may not be available or affordable for many. Cytopathology provides a simple, in...

Incidence of human papillomavirus (HPV)-associated oral cancers is on the rise. However, epidemiological data of this subset of cancers are limited. Dental hospital poses a unique advantage in detection of HPV-positive oral malignancies. We assessed the utility of formalin-fixed paraffin-embedded (FFPE) tissues, which are readily available, for eva...

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this...

Purpose Cervical cancer is the second most common cancers of women in India, despite being largely preventable. This review traces the journey of formulation of the Operational Guidelines for the management of common cancers and its implementation. Methods A literature review was done to document the process of formulation of the guidelines, in ad...

The advent of immune-checkpoint inhibitors (ICI) in modern oncology has significantly improved survival in several cancer settings. A subgroup of women with breast cancer (BC) has immunogenic infiltration of lymphocytes with expression of programmed death-ligand 1 (PD-L1). These patients may potentially benefit from ICI targeting the programmed dea...

The influence of the naturally occurring population of microbes on various human diseases has been a topic of much recent interest. Not surprisingly, continuously growing attention is devoted to the existence of a gut brain axis, where the microbiota present in the gut can affect the nervous system through the release of metabolites, stimulation of...

Oral cancer is among the most common cancers in India. Tobacco, its primary risk factor, is widely consumed across the country, in both smoked and smokeless forms. The current study assessed the prevalence of tobacco use and associated oral lesions in a section of the New Delhi population. Population-based cross-sectional survey was used. House vis...

INTRODUCTION Smokeless tobacco (ST) remains poorly regulated in Bangladesh. This study describes the prevalence and trends of ST use in Bangladesh, presents ST-related disease burden, identifies relevant policy gaps, and highlights key implications for future policy and practice for effective ST control in Bangladesh. METHODS We analyzed secondary...

Adolescence and early adulthood are the most susceptible phase of life for tobacco initiation and its use during this period can have profound public health implications. Anti-smoking campaigns have helped in reducing the social acceptability of smoking; however, newer nicotine products are becoming increasingly popular, globally. Evidence suggests...

Incidence of human papillomavirus (HPV)–associated oral cancers is on the rise. However, epidemiological data of this subset of cancers is limited. Dental hospital pose a unique advantage in detection of HPV-positive oral malignancies. We assessed the utility of formalin-fixed, paraffin-embedded (FFPE) tissues, which are readily available, for eval...

Background A systematic understanding of the burden of neurological disorders at the subnational level is not readily available for India. We present a comprehensive analysis of the disease burden and trends of neurological disorders at the state level in India. Methods Using all accessible data from multiple sources, we estimated the prevalence or...

India has witnessed a major paradigm shift in the eld of breast cancer and its management over the past 4 decades. The discipline of medical oncology has evolved exponentially over this period-a growth that few other scientific disciplines have experienced. Interventions at the individual, institutional, and health-care delivery levels have signica...

Purpose Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to screening. Investigations are needed to understand the potential drivers of this trend. Methods An international team of experts convened to discuss the trends, environmenta...

This is a supplementary material for the article entitled "Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019"

Background: Tobacco consumption in India varies based on the place of residence (urban/rural). Minimal, exclusive information exists regarding the same for 'urban slum' dwellers. The current study determines the tobacco use pattern among such individuals in Noida, Uttar Pradesh (India). Methods: A cross-sectional study was conducted among the ur...

https://api.ltb.io/show/BFZDN AIM The scientific process is enhanced by high-quality research data management. Data should be available, accessible, discoverable, and usable to ensure maximum benefits to patients and the public, as well as the health research community. However, there are many challenges when working on projects spanning multiple...

Background Certain oral bacterial pathogens may play a role in oral carcinogenesis. We assessed the feasibility of conducting a population-based study in India to examine the distributions and levels of Porphyromonas gingivalis, Fusobacterium nucleatum and Prevotella intermedia in relation to oral leukoplakia (a potentially malignant disorder) and...

Prostate cancer (PCa) is one of the leading causes of deaths in men globally. This is a heterogeneous and complex disease that urgently warrants further insight into its pathology. Developed countries have thus far the highest PCa incidence rates, with comparatively low mortality rates. Even though PCa in the Asian population seems to have high inc...

Introduction In continuation to our concern about the harms of nicotine and smokeless tobacco products,1,2 through this letter we want to draw attention toward the new Tobacco Harm Reduction (THR) strategy which is designed to reduce the health risks associated with tobacco use. Modern Oral Products (MOPs), also referred to as tobacco-free nicotine...

Pictorial warnings

Breast cancer is the most frequently diagnosed cancer among women in both transitioned and transitioning countries and has become a major women’s health problem. Although recent advances in our understanding of the biological nature of cancer, improved awareness coupled with better early detection facilities, use of chemotherapy, hormone therapy, a...

Background: Smokeless Tobacco (ST) is consumed globally by more than 350 million people, with approximately 85% of all users based in South and Southeast Asia. In this region, ST products are cheap and easily accessible. Evidence-based interventions to people quit ST use are lacking. This study aims to test the feasibility of conducting a future de...

Breast cancer consists of various subtypes like Her2+, ER/PR + Her2-, ER/PR + Her2+, TNBCs (Triple-Negative Breast Cancers), TPBCs (Triple-Positive Breast Cancers), etc., according to hormonal receptors and Her2 profile. Among these, TNBCs have limited therapeutic interventions, due to lack of receptors for ER, PR and Her2. Apart from BRCA1 and BRC...