Rising Cancer Burden in India Despite Global Decline

Why in the News?

1. A new study published in The Lancet shows a striking contrast: while cancer incidence and mortality rates are declining globally, both are rising in India.
2. This indicates a growing public health challenge for low- and middle-income countries (LMICs) like India, where health systems are not fully equipped to handle the rising burden.

Key Highlights

1. Global Decline Since 1990
   220. Cancer incidence globally fell from 6 per 100,000 (1990) to 205.1 per 100,000 (2023) and is projected to decline further to 192.9 per 100,000 by 2025.
   221. Cancer mortality also declined worldwide from 7 per 100,000 (1990) to 114.6 per 100,000 (2023) and is expected to drop to 107.9 by 2025.
   222. This decline reflects better prevention, early detection, and improved therapies in high-income countries (HICs).
2. The Indian Contrast
   84. Incidence in India rose from 8 per 100,000 (1990) to 107.2 per 100,000 (2023) → about 15 lakh new cases annually.
   85. Mortality in India increased from 7 per 100,000 (1990) to 86.9 per 100,000 (2023) → about 12.1 lakh deaths annually.
   86. Thus, while the global curve bends downward, India’s curve bends upward, signalling systemic vulnerabilities.
3. Future Projections (2050 Outlook)
   30. Globally, cancer cases will rise to 30.5 million and deaths to 18.6 million by 2050.
   31. This increase is not due to higher risk per person but due to population growth and ageing.
   32. LMICs like India will bear the disproportionate share, with over half the new cases and two-thirds of deaths expected here.
4. Why India is More Vulnerable
   1. Screening programmes are present but focus mainly on detection, not comprehensive diagnosis and treatment.
   2. Awareness is low, with myths delaying care-seeking.
   3. Cancer is multi-organ in nature, but interventions have been oncologist-led only. Multi-specialty and multi-stakeholder engagement is missing.
   4. Health systems remain underfunded, leading to late detection, high costs, and poor survival outcomes.
5. The Role of Modifiable Risk Factors
   1. Globally, ~42% of cancer deaths are due to modifiable risks.
   2. In India, the number is far higher: ~70% of cancers can be linked to risks that are preventable.
   3. Common Indian risk factors:
      1. High tobacco use (smoking + chewing tobacco).
      2. Infections (HPV, Hepatitis B, H. pylori).

• Rising obesity and diabetes.

1. Air pollution as an additional risk.

1. This suggests that behavioural and policy interventions could significantly reduce India’s cancer burden.

Key Terms

1. Cancer Incidence: Number of new cancer cases per 100,000 population in a given time. Tracks disease trends.
2. Cancer Mortality Rate: Number of cancer deaths per 100,000 population. Reflects both disease burden and system efficiency.
3. Global Burden of Disease (GBD) Study: Large research programme providing data-driven estimates of diseases and risk factors, used by policymakers.
4. Modifiable Risk Factors: Risks that can be controlled/changed (tobacco, alcohol, obesity, infections, pollution).
5. Non-Communicable Diseases (NCDs): Chronic, non-infectious illnesses like cancer, diabetes, heart disease, respiratory diseases. Major focus of SDG 3.

Implications for India

1. Public Health Challenge: Rising cancer cases could overwhelm India’s already strained health system.
2. Economic Costs: Cancer care is highly expensive, pushing households into catastrophic health expenditures.
3. Equity Concerns: LMICs like India face higher mortality rates due to limited access to advanced therapies.
4. Preventive Opportunity: Since 70% of cancers are linked to modifiable risks, India has a window for prevention.
5. Global Commitments: If unchecked, cancer could derail India’s targets for Universal Health Coverage (UHC) and SDG 3 (Health & Wellbeing).

Challenges and Way Forward

Conclusion

While India is witnessing a rising cancer burden, this challenge also presents a transformative opportunity. With nearly 70% of cancers linked to preventable factors, India has the chance to turn the tide by strengthening awareness, promoting healthier lifestyles, and embedding prevention into public policy. A multi-stakeholder approach—involving government, medical professionals, communities, and individuals—can build a resilient health system that goes beyond treatment to emphasize early detection, affordable care, and long-term survivorship support.

If India invests today in prevention, research, and health system strengthening, it can not only reduce future cancer cases but also emerge as a global example in combating non-communicable diseases (NCDs). Far from being an impending crisis, the fight against cancer can become a story of resilience, innovation, and public health leadership for India.