Cancer has become a significant and growing challenge for society over the past few decades. This is primarily due to a sharp increase in the number of new cases and, more critically, the continued trend of patients presenting with advanced-stage diseases. The Apollo Hospitals Health of Nation 2024 report states that not only has the number of cancer cases in India increased dramatically, but the average age of incidence has also decreased noticeably. In India, the most frequent malignancies are found in the breast, cervix, and ovary in women and the lung, mouth, and prostate in men.
Why is this report shocking?
Compared to other nations, India has a lower median age at which cancer is diagnosed. The average age at which breast cancer is diagnosed in India is 52, whereas in the USA and Europe it is 63, according to Apollo research. In Apollo, lung cancer is diagnosed at an average age of 59, while in the west, it is diagnosed at an average age of about 70. Thirty percent of people with colon cancer are younger than 50 years. India still has very low cancer screening rates in spite of these trends. Compared to 82% in the USA, 70% in the UK, and 23% in China, breast cancer screening rates in India are 1.9%. India has a 0.9% cervical cancer screening rate, compared to 73% in the United States, 70% in the United Kingdom, and 43% in China.
Cancer has become a significant public health issue in India, with a worrisome rise in cases over the past few decades. This trend presents major challenges to the healthcare system and highlights the urgent need to address its root causes and implement effective solutions.
Key causes of rising cancer cases1. Tobacco consumption
Tobacco remains the leading preventable cause of cancer in India. According to the Global Adult Tobacco Survey India (2016-17), nearly 267 million adults (29% of the population aged 15 and above) use tobacco. Smokeless tobacco products such as Khaini, Gutkha, Betel quid with tobacco, and Zarda are most commonly consumed, alongside smoking forms like Bidi, Cigarette, and Hookah. All forms of tobacco contain carcinogenic substances, making tobacco use the foremost contributor to cancer incidence and mortality.
2. Unhealthy diet and physical inactivity
Poor dietary habits, including high consumption of processed foods, red meats, and sugary drinks, combined with sedentary lifestyles, have led to obesity and an increased risk of cancers such as colorectal, breast, endometrial, and pancreatic cancers.
3. Aging population and increased life expectancy
As life expectancy rises, the likelihood of developing age-related cancers such as prostate, breast, and colorectal cancers also increases.
4. Infections
According to Dr. Indu Aggarwal, Head of Department, Preventive Oncology, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), “Certain infections, particularly those caused by oncogenic viruses like Human Papillomavirus (HPV) and Hepatitis B and C, significantly contribute to cervical and liver cancers. Despite the availability of the HPV vaccine in India since 2008, its uptake remains critically low. Including it in the national immunization program could help improve coverage.”
5. Pollution
Urban pollution, with exposure to carcinogens like particulate matter, heavy metals, and industrial chemicals, is linked to cancers of the respiratory system, bladder, skin, and more.
6. Genetic predisposition
Family history and genetic mutations are critical factors in certain cancers. Raising awareness and implementing hereditary cancer screening programs can aid in early detection and prevention.
7. Late diagnosis
Limited awareness of cancer symptoms and the lack of organized screening programs for common cancers result in delayed detection, reducing treatment success rates.
What factors are driving the increase in cancer diagnoses across India?
According to Dr. Vineet Talwar, Director, Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), “The increase in cancer diagnoses across the country can be attributed to several key factors. Firstly, there has been significant progress in raising awareness and educating the population about cancer symptoms and risk factors, which has led to more cases being detected early. Secondly, the availability and accessibility of advanced diagnostic technologies have improved, allowing for quicker and more accurate diagnosis. Lastly, there is an increasing awareness among general practitioners who are better equipped to recognize and refer suspected cases for further investigation and treatment.”
There's hope for cancer patients
According to Dr. Harit Chaturvedi, Chairman of Max Institute of Cancer Care, "There is a significant increase in the population above 50 years of age. Better access to healthcare in general and diagnostic facilities in particular has led to better pickup of new cases compared to a decade ago. Insurance penetration and government schemes have made it possible for more people to get diagnosed and treated. Today, cancer patients are living longer and better. This has generated a sense of optimism, and more people are seeking better facilities. The awareness, infrastructure growth, and improved confidence that one can overcome the disease is contributing to picking up more new patients."
Measures to prevent and manage rising cancer cases in India
To reduce the cancer burden in India, a holistic approach focused on prevention, early detection, and advanced treatment is essential.
1. Public awareness and prevention
Increase awareness about cancer risk factors, symptoms, and the importance of regular health check-ups.
Implement stringent regulations on the advertising and sale of tobacco products.
Support cessation programs to help individuals quit tobacco.
Promote healthy dietary practices, including a diet rich in fruits, vegetables, and whole grains while reducing processed and sugary foods.
2. Organized screening programs
Develop and implement nationwide screening programs for oral, cervical, and breast cancers to enable early detection and timely treatment.
3. Vaccination programs
Promote widespread access to HPV and Hepatitis B vaccines to prevent infections that can lead to cancer.
4. Advanced treatment and technology
Allocate more funds to cancer treatment technologies such as immunotherapy, targeted therapy, and personalized medicine.
Expand access to cutting-edge treatments to reach a larger patient population.
5. Post-treatment support
Ensure access to quality post-treatment care, including rehabilitation services, mental health support, and survivorship programs, to improve the quality of life for cancer survivors.
6. Investment in research and innovation
Increase funding for cancer research and clinical trials to develop innovative treatments, improve patient outcomes, and advance the field of oncology.
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