Mumbai Cohort Study (MCS)

The MCS was the first large study (~150,000 persons) to employ house-to-house recruitment as well as follow-up using hand-held computers. The study not only demonstrated successful methods to conduct large cohort studies in low-resource countries but ensured very high response rate (~95% after an average 5.5 years of follow-up). The study reported for the first time about the excess all-cause and cause-specific mortality from various forms of tobacco use other than cigarette smoking. The study concluded for the first time that bidi smoking is no less hazardous than cigarette smoking, and smokeless tobacco use may also result in significantly increased mortality. Although, TB is less common in industrialized countries, it is a major burden in developing countries, including India. MCS examined the association between smoking and TB and concluded that ~32% of TB deaths could be attributable to bidi smoking. In addition to the individual effect of tobacco use, we were the first to report from developing countries that body mass and all-forms of tobacco use had independent as well as multiplicative joint effects on all-cause and cancer mortality. One of the well known advantage of cohort design is one can study multiple exposure and multiple outcome, therefore, using MCS we also studied the association between extremes of relative body weight, BP, force expiratory volume, alcohol use and education with all-cause and cause-specific mortality. Using existing MCS cross-sectional phase I and Phase II data we were able to study the prevalence and patterns of tobacco use alcohol use, hypertension and BMI. Additionally, we had also reported the relationship of overall tobacco use with; age, religion, and mother tongue; alcohol use; BMI and education and occupation. The cross-sectional data were also used to study association of different exposures with the self reported health outcomes such as TB and diabetes. Using MCS cross-sectional data we have successfully demonstrated the feasibility of linking Population Based Cancer Registry (PBCR) data with MCS data and studied the association of tobacco habits with overall and site specific cancer incidence in Mumbai. Methodological details have been published earlier.

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