Occurrence of Cancer in Arsenic Contaminated Area, Ronpibool District, Nakorn Srithmmarat Province, Thailand

摘要

Arsenic contamination in Ronpibool district, Nakorn Srithammarat, the southern province of Thailand, has been discovered more than 10 years ago. However, the evidence of human cancer in this population has not been thoroughly studied. This study aimed to assess the prevalence of cancer from two main methods: (a) analysis of secondary data from 5-years (1994-1998) cancer registry of the Prince of Songkhla University, (b) investigation of causes of death using verbal autopsy and hospital records in 1998. When comparing 5-year prevalence of cancer from the cancer registry, Ronpibool district (2.2 per 1000 population) ranked fifth among the 23 districts. When comparing cancer sites among the first 5 high-prevalence districts, Hausai (3.19/1000), Lansaka (2.29/1000), Phomkiri (2.23/1000), Kanom (2.23/1000) and Ronpibool (2.20/1000), lung cancer was the highest in Hausai, Lansaka and Phomkiri, while cancer of the oral cavity (includes cancer of tongue, palate, mouth, saliva gland, parotid gland and tonsil) was found the highest in Kanom. For Ronpibool district lymphoma (includes Hodgkin's, follicular node, diffuse non-Hodgkin's, T-cell and other lymph-oma) and breast cancer had the highest proportion (13.5followed by lung cancer (10.2districts, however among the top five districts, Ronpibool had the highest proportion of skin cancer (3.4in females in four of these five Districts. The study to verify causes of death in Nakorn Srithammarat province in 1998 found a different pattern. The highest death rate from cancer was in Kanom District (120.5 per 100,000), followed by Chalermprakiet (69.7), Hausai (56.7) and Lansaka (57.4). Ronpibool district ranked 12 with a cancer death rate of 31.1 per 100,000. In every District, most cancer patients died at the age of 45 and over, and males had a higher number of deaths than females in these age groups. Details of the evidences will be discussed.