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Cancer’s Big Five

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Cancer is one of the most dreaded ailments, and from amongst the very many types of cancer, there are a few that Indian women are predisposed to.

47.2 percent of cancer in women is accounted for amongst the five types. The surprising fact is that these cancers can be prevented by early screening. Early detection and treatment reduces not only the death rate but the quality of life post cancer treatment. Dr Neena Singh, Associate Director, Obstetrics & Gynecology, Fortis La Femme, Delhi sheds some light on this.

She reveals the following are the top five types of cancer in women in India:

  • Breast Cancer
  • Cervical Cancer
  • Uterine Cancer
  • Ovarian Cancer
  • Colorectal cancer

BREAST CANCER :

Breast cancer is the most common cancer in women in India and accounts for 27 percent of all cases of cancer in women. It is more common in urban areas than rural areas.

High risk factors:

  • Family history of breast cancer
  • Long period of OCP (Oral contraceptive pills)

Screening test for breast cancer:

Self-examination of the breasts. If any abnormality found like lump, pain or change in shape, consult a doctor who would examine clinically if it is cancer.

  • Mammography is done which can detect small lesions.
  • MRI Breast is done for staging the disease.
  • Treatment at early stages carries good prognosis.

CERVICAL CANCER

Cervical cancer is the second most common cancer in India in women accounting 22.86 percent of all cancer cases in women. It is more common in rural women than urban women.

Risk Factors:

  • Young age at first intercourse (less than 16 years)
  • Multiple Sexual partners
  • Cigarette smoking
  • Human papillomavirus infection (HPV)
  • Immunosuppression

Screening test for cervical cancer:

Any abnormal symptoms like abnormal vaginal bleeding, vaginal discharge and contact bleeding (bleeding after intercourse) report to a gynecologist who would do a clinical examination and do some test on cervix.

  • Visual inspection with acetic acid (VIA)
  • Visual inspection with legal Iodine (VILI)
  • Magnified VI! Under colposcopy
  • Exfoliative cytology (Pap smear)-is gold standard for screening.
  • HPV-DNA testing

Do Cervical biopsy for confirmation. Early detection and treatment have very good prognosis.

Prevention by prophylactic vaccinations in childhood.

UTERINE CANCER (CANCER OF UTERUS)

Uterine cancer is a type of cancer that begins in the uterus in its lining called the endometrium. Hence also named as endometrial carcinoma.

Risk Factors:

It is an estrogen dependent cancer. Persistent unopposed stimulation of endometrium with estrogen is the single most important factor for development of cancer endometrium:

Polycystic ovaries

  • Granulosa cell tumor of the ovary which secret estrogen
  • Hormone replacement therapy-unopposed estrogen therapy
  • Early onset of periods & late menopause (after the age of 50)
  • Age: – 75 percent women are post-menopausal

Nulliparity

  • Obesity, Hypertension & Diabetes (corpus cancer syndrome)
  • Tamoxifen therapy given in breast cancer
  • Endometrial hyperplasia especially atypical
  • Following radiation exposure to the pelvis
  • Family history of cancer uterus breast, ovary & colon

Screening test for uterine cancer:

If any irregularity in menstrual cycle, post-menopausal bleeding, contact bleeding and unhealthy vaginal discharge report to a gynecologist who would do

  • Clinical examination
  • Transvaginal sonography (TVS) to know endometrial thickness or irregularity.
  • MRI pelvis can be done for more details
  • Fractional curettage of uterus for histopathology examination or Hysteroscopy & directed biopsy from suspicious area. Early diagnosis & treatment has very good prognosis.

OVARIAN CANCER

Ovarian cancer constitutes 15-20 percent of all genital cancers. 85-90 percent of all cancers are epithelial in origin. Germ cell constitutes 5-7 percent.

Risk Factors:

Unfortunately, ovarian cancer doesn’t produce any specific symptoms. By the time symptoms appear its already in advanced stages. However, if patients have pain in the abdomen, back ache, indigestion, bloating not responding to basic treatment and lasts for more than two weeks then consult a gynecologist.

Screening test for uterine cancer:

No specific screening method is available. Doctor would do a pelvic examination to feel for ovarian mass.

  • Transvaginal sonography (TVS) to confirm ovarian mass solid or cystic.
  • Blood test like CA125 which is found raised in ovarian cancer.
  • CT Scan /MRI to know spread of cancer

Treatment:

Early diagnosis and treatment carry good prognosis.

COLORECTAL Cancer

When a cancerous growth originates in the colon and then spreads to the rectum, it leads to colorectal cancer. The risk of colorectal cancer is higher after the age of fifty years.

Risk Factors:

  • Smoking
  • Fat rich diet
  • Crohn’s disease
  • Colitis
  • Family history of colorectal cancer or polyp
  • Non residual diet
  • Chronic constipation

Screening test for Colon Cancer:

  • Frank blood in stools
  • Fecal occult blood test is positive
  • Double contrast barium enema (DCBE)
  • CT Scan
  • Colonoscopy
  • Stool DNA test
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Research and development activity to get hit as WD benefit to cease from FY21

According to experts, R&D activity is a key proponent of the ‘Make in India’ strategy and to further expand the manufacturing sector in the country.

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Research and development activity

New Delhi, Feb 19 : India Inc’s R&D activity might get adversely impacted as weighted deduction (WD) benefits, including those on capital expenses, stand withdrawn from the next fiscal.

Till now, the Income Tax Act allowed for weighted deduction for all R&D activities.

However, four years back a sunset provision was introduced in the Budget on the availability of weighted deduction from April 1, 2020.

This deadline was expected to have been extended in this year’s Budget. However, that did not happen.

“The weighted deduction was a key reason for entities to invest in R&D infra. This withdrawal will impact future investments in this area,” said Amarjeet Singh, Senior Partner, International Tax and Regulatory, KPMG in India.

According to experts, R&D activity is a key proponent of the ‘Make in India’ strategy and to further expand the manufacturing sector in the country.

Besides, R&D investments into India have grown with many MNCs establishing their research bases here.

“The ‘Make in India’ programme has got the booster of a reduced tax rate. Similarly, had the government continued with the weighted deduction for R&D, it would have surely ensured that India marched ahead both in manufacturing and in the corresponding R&D,” said Gukul Chaudhri, Partner, Deloitte India.

“So, while India may not lose its tag as the R&D lab of the world, the availability of weighted deduction would have ensured that India continued as one of the most attractive destinations for R&D in the world,” Chaudhri added.

The Finance Act, 2016, restricted the availability of expenditure incurred on scientific research to 150 per cent from April 1, 2017, and no weighted deduction from April 1, 2020.

“Globally, most countries are encouraging R&D activity as it generates new ‘intellectual property’ (IP), which in turn creates sustainable revenues. Such IP or new product gives rise to a new industry and other supporting activities,” said Samir Kanabar, Partner, Tax and Regulatory Services, Ernst & Young.

“In India, several sectors like auto, pharma etc. have invested substantially in R&D facilities to develop new IPs, patents and hence, a new tax regime to boost R&D was a major expectation,” Kanabar added.

However, Suman Chowdhury, President, Ratings, Acuite Ratings and Research, said that the reduction in weighted tax deduction will not have any significant effect on India Inc’s R&D activity.

“India’s R&D activity has held steady at 0.7 per cent of GDP over 5 years and no visible signs of positive outcomes were seen emanating from private enterprises despite such benefits,” Chowdhury said.

“Nevertheless, corporates now enjoy a reduced effective corporate tax structure, which should more than compensate for the loss, at least for the manufacturing sector. Service oriented enterprises, whose business model thrives on innovation, do not require incentives to do R&D in our opinion,” Chowdhury added.

(Rohit Vaid can be contacted at [email protected])

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AGR risk for GAIL, OIL and Powergrid stays: Fitch

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New Delhi, Feb 19 : India’s telecom-related regulatory dispute still is event risk for GAIL, OIL and Powergrid, Fitch Ratings said on wednesday.

Fitch Ratings continues to treat any payments that three India-based companies – GAIL (India) Limited (BBB-/Stable), Oil India Limited (BBB-/Stable) and Power Grid Corporation of India Ltd (BBB-/Stable) – may have to make under a demand notice from the Department of Telecom as an event risk for the companies’ ratings.

Fitch is not taking immediate rating action on the three companies, as the Supreme Court of India allowed the companies to withdraw their clarification applications on February 14, 2020, and resolve their dispute with Department of Telecom outside the court.

This is in stark contrast to the court’s decision to demand immediate payments from the telecom companies that are also involved in the dispute, Fitch added.

“We expect the three companies to eventually resolve the dispute, although resolution timing is uncertain. A speedy solution is important to prevent disrupting the companies’ investment plans and damaging their performance. The three companies are considering an appeal against the demand notices. We understand that they have the option to resolve the matter through alternate dispute-resolution mechanisms available to state-owned enterprises. This is in addition to the legal options available to telecom license holders in general,” it said.

The Department of Telecom has issued demand notices to GAIL, OIL and POWERGRID for Rs 1,831 billion, Rs 480 billion and Rs 220 billion, respectively.

The notices include license fees on non-telecom revenue and additional interest and penalties on the license fees. However, the three companies’ telecom-related revenue is insignificant, at around Rs 0.5 billion, Rs 0.01 billion and Rs 23 billion, respectively, for the same time period as the demand notices.

The three companies have created telecom infrastructure for internal use and have obtained national long distance and Internet service provider licenses to rent out spare capacity. They maintain that their licenses differ from the unified access licenses held by telecom companies, hence, the court’s decision on adjusted gross revenue for telecom companies does not apply to them.

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Kanpur tanneries asked to shut down again

Aftab Alam, a leather exporter, said the closure order would not only damage the business image of tanneries but would affect leather export too.

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UP tanneries Business

Kanpur, Feb 17 : The Regional Pollution Control Board of Uttar Pradesh has ordered 248 tanneries in Jajmau area of Kanpur to stop their operations from February 19 till further orders, without assigning any reason.

The tanneries, which remained closed for a period of 13 months on the charge of polluting Ganga, were allowed to start production on December 20 for two months only.

S.B. Franklin, regional pollution control board officer, said the time limit of two months is expiring on February 19.

Feroz Alam of Small Tanners’ Association said that on December 20 last year, the government, while granting permission to run the units with half capacity, had also stated that the tanners would be allowed to run their units till next year if they followed the necessary norms and standards fixed by the pollution control board.

He said, “During the last two months, not a single notice was issued to any tannery by the regional pollution control board because the tanneries did not flout the norms set by it.”

He said that the UP Pollution Control Board (UPPCB) had not given any reason for the closure order now.

Aftab Alam, a leather exporter, said the closure order would not only damage the business image of tanneries but would affect leather export too.

He said the tanneries which have got orders from foreign companies would suffer if they failed to supply the goods in time.

The tanners would also face problems in getting new orders in future, he added.

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