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The alarming rise in cancer cases across the country has positioned the nation at the forefront of a global health crisis. Recent data from the World Health Organization (WHO) indicates that India has surpassed other countries with unprecedented rise in cancer cases. This surge not only highlights the escalating incidence rates but also casts a spotlight on the urgent need for comprehensive cancer care and robust healthcare policies in the country.
A recent study by Apollo Hospitals has unveiled alarming statistics, pointing towards the decline in the overall health of general population. Almost 14 Lakh people in India had cancer in 2020, and the number is expected to rise to 15.7 lakh by 2025, according to the report. Breast, cervix and ovarian cancers are frequent in women, while lung, mouth and prostate cancer are predominant among men. The report also mentions the escalating cases of non-communicable diseases (NCDs) including diabetes, hypertension, cardiovascular diseases and mental health issues.
The rising diseases have emphasized the importance of regular screening, which according to the report is a significant hurdle in India’s battle against cancer. The inadequate screening rates play an important role in the alarming rise of cancer in the country. The Apollo report highlights a concerning rise in mental health disorders, notably among individuals aged 18 to 40, with depression emerging as a significant issue. One in five people aged 18 to 25 has depression, it added, reflecting the declining health in the country. Furthering chronic stress, obesity contributes to a rise in hypertension and diabetes. About 66 percent of individuals in India are classified as pre-hypertensive, one in three has prediabetes, and 20 per cent below 45 years of age are affected by prediabetes.
The high incidence of cancer in India stems from a confluence of lifestyle, environmental, and socioeconomic challenges. Rampant tobacco use, both smoking and smokeless varieties, significantly elevates the risk of lung, oral, and throat cancers, Furthermore, air pollution from vehicles and industries exposes vast swathes of the population to carcinogenic substances, increasing the risk of various cancers. The shift towards processed foods and declining physical activity levels contribute to rising obesity rates, which in turn are linked to breast, colorectal, and endometrial cancers.
As per the WHO data, in 2022, there were an estimated 20 million new cancer cases and 9.7 million deaths. The estimated number of people who were alive within 5 years following a cancer diagnosis was 53.5 million. About 1 in 5 people develop cancer in their lifetime, approximately 1 in 9 men and 1 in 12 women die from the disease. Among the cancers, Lung cancer was the most commonly occurring cancer worldwide with 2.5 million new cases accounting for 12.4% of the total new cases. Female breast cancer ranked second (2.3 million cases, 11.6%), followed by colorectal cancer (1.9 million cases, 9.6%), prostate cancer (1.5 million cases, 7.3%), and stomach cancer (970 000 cases, 4.9%).
Lung cancer was the leading cause of cancer death (1.8 million deaths, 18.7% of the total cancer deaths) followed by colorectal cancer (900 000 deaths, 9.3%), liver cancer (760 000 deaths, 7.8%), breast cancer (670 000 deaths, 6.9%) and stomach cancer (660 000 deaths, 6.8%). Lung cancer’s re-emergence as the most common cancer is likely related to persistent tobacco use in Asia.
For women, the most commonly diagnosed cancer and leading cause of cancer death was breast cancer, whereas it was lung cancer for men. Breast cancer was the most common cancer in women in the vast majority of countries (157 of 185). For men, prostate and colorectal cancers were the second and third most commonly occurring cancers, while liver and colorectal cancers were the second and third most common causes of cancer death. For women, lung and colorectal cancer were second and third for both the number of new cases and of deaths.
The escalation of cancer cases in India is multifaceted, with many contributing factors at play, of which several important risk factors and causes have already been mentioned above.
Primary Prevention and Screening Programs
Primary prevention is the most cost effective prevention program as it aims to reduce the incidence of cancer by risk factor modification. 50% of all cancers in males are tobacco related and a large proportion of them can be prevented by anti-tobacco programs. Teenage students need to be educated, and counseled as most of them pick up these habits at this time; School curricula should involve messages for a healthy lifestyle and warn about the harmful effects of tobacco and alcohol.
Legislation has to be enforced for prohibiting tobacco advertisement and sale of tobacco to youngsters. Importance of a healthy diet rich in green and yellow vegetables and fruits has to be highlighted. Cancer of the uterine cervix can be controlled to a certain extent by practicing genital hygiene and safe sexual practices. Cervical cytology (pap smear) screening programs were found to be successful in reducing cervical cancer incidence and women in the age group 35 to 64 years should undergo regular pap smear screening.
Mammographic screening for breast cancer may not be cost effective in India at present, but regular breast self examination needs to be promoted for early detection of breast cancer. Cancer prevention needs to be considered as part of the Non Communicable Diseases prevention programme as it will make it more effective and feasible. The risk factors like Alcohol, Tobacco, Bad Diet and Physical inactivity are the main contributors for most of the Non Communicable Diseases and have to be approached together as lifestyle modification.
The Designation of India as the ‘World’s new cancer capital’ by a new study released by the Indian multinational healthcare group, Apollo Hospitals, is a wakeup call for action for all policymakers, healthcare providers etc. Besides a response to treat and manage the issue, the most important is to address the underlying rootlets of the disease and prevent future cases.
In this growing challenge to fight with the disease, it’s important for all stakeholders to come together to foster a healthier environment; promote effective and affordable care to all. If we continue to ignore the issue, it’s not far when India will transform this health matter into a health crisis.
As we face this challenge of battling cancer, let it be a catalyst that unites us in action and compassion, which will remind us that the health of each citizen provides the base of strength for the whole nation.
(Author is a medical doctor and health columnist. Feedback: [email protected])