Cancer in India: A status report

Source: The post is based on the article “Cancer in India: A status report” published in Indian Express on 16th January 2023.

What is the News?

According to a report by the American Cancer Society, deaths due to cancer have declined by 33% in the United States since 1991. This has translated into 3.8 million fewer deaths. This success has been attributed to early detection, lower rates of smoking and improvements in cancer treatment.

This trend is yet to be reflected in India. Even with improvements in treatment, both the incidence of cancer and mortality continue to rise in the country.

What is the incidence of cancer and mortality in India currently?

As per data from the National Cancer Registry of the Indian Council of Medical Research (ICMR), an estimated 14.6 lakh new cancer cases were detected in 2022, up from 14.2 lakh in 2021 and 13.9 lakh in 2020.

Deaths due to cancer increased to an estimated 8.08 lakh in 2022 from 7.9 lakh in 2021 and 7.7 lakh in 2020. 

According to an ICMR study using data from population-based cancer registries, ​​one in nine Indians will develop cancer during their lifetime.

The incidence of cancer is higher among women — 103.6 per 100,000 in 2020 compared to 94.1 among men. 

Among men, the most common cancers were of the lung, mouth, prostate, tongue and stomach. For women, they were the breast, cervix, ovary, uterus and lung.

Why are some cancers on the decline and others continuing to rise?

The incidence of cervical cancer has dropped in India over the last 50 years from 45 to 10 per 100,000 population. At the same time, there is an increase in rates of breast cancer, especially in urban centres. 

Rates of cervical cancer have declined because of later marriages, fewer children, better hygiene, and vaccination. The incidence of breast cancer has gone up because of the same reasons — later age of marriage, having the first child at a later age, not breastfeeding and a high protein diet.

Have there been improvements in cancer treatments?

Yes, the cure rate for various cancers is rising. For instance, a) the cure rate for pancreatic cancer has doubled from 3% to 6%, b) Prostate cancer cure has gone up from 60% to 100%, c) For breast cancer it has improved from 50% to 90% with newer treatments.

But in order to reduce mortality, India has to ensure people get diagnosed early on and receive timely treatment.

What must be done to bring down overall mortality like in the US?

First, the intervention has to be screening: Screening for the three most common types of cancer — breast, cervical, and oral — has already started through the government’s upgraded health and wellness centres.

Secondly, screening should lead to treatment: The treatment has to be accessible and affordable. There are several programmes of the government that are working independently and in silos. They need to be coordinated so that once a person is screened, they do reach a hospital. 

Thirdly, there must be many more cancer care facilities: For instance, WHO says there should be 1 radiotherapy machine per million population in developing countries, so for India’s 1.4 billion people India need 1,400 machines. But India has only 700.