Cancer in India: A Status Report

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    • Recently, a report by the American Cancer Society stated that Deaths due to cancer have declined by 33% in the United States since 1991.

    Key Points

    • US:
      • Declining number of deaths: 
        • This has translated into 3.8 million fewer deaths.
      • Reason of decline: 
        • Early detection, 
        • Lower rates of smoking,
        • Improvements in cancer treatment.
      • Types of cancer:
        • A steep reduction of 65% in the rates of cervical cancer in women in their early 20s between 2012 and 2019.
        • The first cohort to receive the human papillomavirus vaccine (HPV) vaccine. 
    • India: 
      • Rising cases and deaths: 
        • Trend in India is not even close to similar.
        • Even with improvements in treatment, both the incidence of cancer and mortality continue to rise in the country.

    Image Courtesy: IE 

    • Types of cancer:
      • The rates of cervical and smoking-related cancers have gone down in India as well. 
      • However, the incidence of lung and breast cancers has increased.
    • Trends: 
      • One in nine Indians will develop cancer during their lifetime.
      • One in 68 men will develop lung cancer
      • One in 29 women will develop breast cancer.
    • Women v/s men: 
      • 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:
        • Lung, 
        • mouth, 
        • Prostate, 
        • Tongue, and 
        • stomach; 
      • For women, they were:
        • Breast, 
        • cervix, 
        • Ovary, 
        • Uterus, 
        • Lung.

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

    • Decline: 
      • The incidence of cervical cancer has dropped in India over the last 50 years from 45 to 10 per 100,000 population. Its rates have declined because of later marriages, fewer children, better hygiene, and vaccination.
        • It can be prevented with HPV vaccination, with vaccines becoming cheaper, the government plans a campaign soon to fight it off completely.
      • The rates of tobacco-related cancers — oral, oesophageal — cancers are also coming down. 
        • This is largely due to tobacco laws that have brought down smoking in public places.
    • Rise: 
      • There is an increase in rates of breast cancer, especially in urban centres. Its rate 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.
      • There is no specific intervention for breast cancers other than screening because what causes it is unknown.

    Improvements in Cancer Treatments and its Impact

    • The cure rate for various cancers is rising and the cases of people who have completely beaten cancer are also rising.
    • Types: 
      • The cure rate for pancreatic cancer has doubled from 3% 50 years ago to 6%. 
      • For prostate cancer, it has gone up from 60% to 100%. 
      • And for breast cancer it has improved from 50% to 90% with newer treatments.
    • 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. This, coupled with other government programmes, has meant people are reaching hospitals sooner.
      • Cervical, breast, and oral cancers account for 34% of cancers in India, so screening for them is good.
      • It has to be more focused in order to achieve mortality gains
      • Dual stain testing is the best tool for screening for cervical cancer, while a low-dose CT in those with a history of smoking is the best for lung cancer. 
      • Breast self-examination cannot be standard screening for breast cancer. 

    Way Ahead

    • Better screening and treatment centres are needed.
    • More comprehensive linkages between screening centres and hospitals are essential to reduce cancer mortality in the country.
    • In order to reduce mortality, it is important to ensure that people get diagnosed early on and receive timely treatment.
    • 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.
    • There must be many more cancer care facilities.

    Source: IE