Experts Say Adulteration, Tobacco, Pollution, Socio-economic Status Plaguing Cancer Burden

India is witnessing a steady rise in the number of cancer cases with the latest figures from the national cancer registry showing a 4.7 per cent rise in the span of two years from 2020 to 2022. 

According to the National Cancer Registry Programme, India registered 14.61 lakh cancer cases in 2022 compared to 13.92 lakh cases in 2020. The figures were revealed in a written reply in parliament by Union Minister of State for Health and Family Welfare, SP Singh Baghel. 

With the mortality due to cancer mirroring this trend, the mortality rate rose by 4.9 per cent in 2022 over 2020 when cancer took 7.70 lakh lives. In 2022 over 54 per cent of people diagnosed with cancer succumbed to the disease with total deaths around 8.08 lakh. 

“The availability and accessibility of cancer diagnostic cum treatment facilities and oncology specialists are not uniform across the country. This leads to delayed or inadequate treatment for patients leading to suboptimal outcomes and more mortality. Moreover, non-oncology specialists treating cancer patients also add to the figures of increased mortality,” stated Dr Sandeep Batra, Director, Cancer Care, Max Super Speciality Hospital. 

Clinical experts in India believe that cancer cases are rising due to a host of issues attacking the Indian population all at once subsuming adulteration in the food chain, tobacco consumption, environmental pollution and an ageing population.

“Steady rise in cancer cases is mainly due to adulteration in food chain, unprocessed low-quality food, overeating, obesity, unhealthy lifestyle and rising use of pesticides and chemicals in our environment besides other genetic factors,” said Dr Sumeet Aggarwal, Radiation Oncologist, American Oncology Institute.  

Uttar Pradesh topped the charts in mortality with over 1.16 lakh people dying in a single year followed by Maharashtra with over 66 thousand deaths, West Bengal with over 62 thousand deaths, Bihar with over 60 thousand deaths and Kerala with over 50 thousand deaths in 2022.  

Explaining the surge Dr Batra said that access to quality care at an affordable price is a big gap to be bridged before we can really see a significant change towards the positive side in mortality rates and treatment outcomes. 

“Literacy  and awareness about diseases including cancer go hand in hand while socioeconomic factors also have a bearing on the cancer incidence and treatment outcomes,” Dr Batra added. 

According to Globocan 2020, the most prevalent cancer in India is breast cancer constituting 13.5 per cent of all cases, and is followed by other cancers such as oral 10.3 per cent, cervical 9.4 per cent, lung 5.4 per cent and colorectal 4.9 per cent. 

“The most common cancers that we see in our practice are Breast Cancer, cancer of the oral cavity, Lung cancer, Cervical cancer, Stomach and Colorectal cancer and Ovarian cancer.  With regard to Breast cancer which is the most common cancer in India, we see that the average age is around 50 years as compared to the western population where it occurs in a much older age group,” said Dr Nitin Yashas Murthy, Consultant, Medical Oncologist and Hemato Oncologist, Manipal Hospital.

Challenges In Cancer Care 

Clinicians say accessing cancer care in India poses certain challenges for patients such as late detection, affordability, awareness and skilled healthcare professionals. 

Dr Ankur Bahl, Senior Director Medical Oncology and Hemato-oncology at Fortis Memorial Research Hospital stated that cancer patients in India face various challenges, including financial burdens, limited access to specialised care, and inadequate support systems. 

Dr Bahl further explained, “The high cost of treatment and limited insurance coverage further compounds patient struggles. Additionally, emotional and psychological support for patients and their families are crucial needs that should be addressed.”

Doctors also say that lack of proper guidance can also lead to patients availing unscientific treatments and making effective diagnosis and treatments delayed. Dr Aggarwal stated that the main challenge patients face these days is a lack of proper guidance on cancer treatment owing to a lack of oncological services and dedicated centres. 

“Poor education and awareness in the community make them opt for alternative treatments instead of scientifically proven treatment,” Dr Aggarwal pointed out. 

Glimmer Of Hope

With advancing cancer cases, treatments are also advancing say clinicians, and new treatment techniques such as radiation therapy, immunotherapy coupled with chemotherapy and surgery are being utilised as multidisciplinary treatment options to enhance outcomes for patients. 

“There is definitely a glimmer of hope as the treatment of Cancer continues to evolve. A multidisciplinary approach of chemotherapy, radiation and surgery has led to improved outcomes and better survival in most cancers,” stated Dr Yashas.

Dr Yashas further said that the advent of Immunotherapy and Targeted therapy has revolutionised the treatment of cancer particularly in Stage 4 malignancies where a subset of those who respond to these treatments go on to have survival in years. 

Talking about the government’s role in increasing access to cancer care going forward, Dr Aggarwal said that the Government should run a campaign on cancer awareness and screening regularly, adding that it should also provide comprehensive state of art cancer treatment services at least in each district and should have a referral and screening program in smaller villages and town so that those patients should get free of cost treatment in higher centres.