New Delhi, March 28: The risk of dying from cancer is highest in the Northeast and the lowest in Bihar, Jharkhand and Odisha, according to a new study described as the first to provide direct nationally-representative estimates of cancer deaths across the country.

The study by researchers at the Centre for Global Health Research at the University of Toronto, Canada, and Indian institutions has shown large variations in cancer risk across the states but suggests that the risk of dying from cancer declines with education.

Their analysis shows that a 30-year-old man in the Northeast had the highest chance (11 per cent) of dying from cancer before the age of 70 years in contrast to the risk of less than 3 per cent for men in Bihar, Jharkhand and Odisha. The new findings are published today in the journal Lancet.

“This is a big puzzle — tobacco may explain part of this pattern, but we really do not understand why the Northeast has a cancer mortality nearly four times higher than the rates in the neighbouring states of Bihar, Jharkhand, or Odisha,” said Prabhat Jha, director of the Centre for Global Health Research.

Cancer epidemiologists say the study is significant because it is the first to provide direct estimates of cancer deaths in rural and urban areas. All previous national data on cancer mortality was based on 24 registries run by the Indian Council of Medical Research but only two of these are in rural areas.

The findings are based on what has been dubbed the Million-Death-Study an effort to document the causes of child and adult deaths and their risk factors in India through a process of “verbal autopsies” — individual narratives obtained from household members of the circumstances of deaths.

The study has estimated that in the Northeast, 138 people among 100,000 adults between the ages of 30 and 69 would die of cancer, in contrast to 68 in Bihar, 63 in Odisha and 53 in Jharkhand. The figure for Bengal was 110 per 100,000 population in that age group.

“These variations in cancer patterns across the states tell us there is something we need to investigate in the Northeast,” said Rajesh Dixit, professor of epidemiology at the Tata Memorial Hospital, Mumbai, a member of the research team.

“We need to understand whether diet of infections may be playing a role in the Northeast,” Dixit told The Telegraph.