2nd Highest Cancer Deaths In 30 Years: Can India Prioritise Health?

India reported about 12 lakh new cancer cases and 9.3 lakh deaths in 2019, making it the country with the second-highest cases in Asia, according to a study in Lancet. The study revealed that India was among the three leading countries in Asia, the others being Japan and China, in terms of the number of new cases and deaths that year. Altogether, the three nations recorded  94 lakh new cases and 56 lakh deaths in 2019, making cancer a highly significant health threat. Tobacco, alcohol consumption, and ambient particulate matter (air pollution) remained dominant among the 34 risk factors for cancer, the researchers found.

The study was conducted by scientists from the National Institute of Technology, Kurukshetra and All India Institute of Medical Sciences (AIIMS), Jodhpur and Bathinda. "We examined the temporal patterns of 29 cancers in 49 Asian countries between 1990 and 2019 using estimates from the Global Burden of Disease, Injuries and Risk Factors 2019 Study (GBD 2019)," they said in the paper.

Which Cancers Affect India The Most?

The Lancet study found that tracheal, bronchus, and lung (TBL) cancer was the highest cause of death in 2019. TBL, breast cancer, colon and rectum cancer (CRC), stomach cancer and non-melanoma skin cancer were among the five most frequent cases recorded that year.

Specifically among women, cervical cancer was the second-highest in several Asian countries. According to the Centres for Disease Control and Prevention, more than 9 of every 10 cases of cervical cancer are caused by human papillomavirus (HPV).

The researchers said that the HPV vaccine, introduced in 2006, has proved effective in preventing and treating the fatal disease. Last year, India introduced a newly-developed variation to the HPV vaccine and the government undertook a nationwide immunisation drive for girls aged between 9 and 14.

South Asian countries such as India, Bangladesh, and Nepal are at high risk of lip and oral cavity cancer. India alone accounted for 32.9% of global deaths and 28.1% of new cases of this cancer in 2019.

What Are The Leading Contributors To Cancer?

Researchers found that high rates of consumption of smokeless tobacco (SMT) such as khaini, gutkha, betel quid and paan masala is a major health concern in South Asian countries. "More than 50% of the oral cancer burden has been attributed to smokeless tobacco, whose prevalence has grown in recent times in South Asia, including India," the team wrote. SMT also causes a high risk of pancreatic cancer.

Moreover, the increasing smoking culture and air pollution in these countries are also risking public health. The study noted that five of the world's top 10 countries with the worst ambient air quality in 2019 are present in Asia-- India, Nepal, Qatar, Bangladesh and Pakistan. The scientists cited data in the 2019 annual State of Global Air Report.

Who Are Worst Affected?

Owing to the growing development of countries, scientists noticed a reduced burden of cancers such as leukaemia among those under 5 years of age from 1990 to 2019. However, with increasing life expectancy, they noticed an increasing risk of prostate, pancreatic and breast cancer over the same period.

The Lancet report identified that in the low and medium-income countries (LMICs) of Asia, oncologic infrastructure is either scarce or unaffordable, especially in rural areas. "Combined with a weak referral system, patients end up getting delayed diagnosis and treatment, leading to lower survival rates," the researchers said, adding, "Mere availability of screening might not improve the survival rates if cancer treatments are either unavailable or unaffordable."

The NIT and AIIMS researchers concluded the report stating, "Along with timely availability of cancer screening and treatment, its cost-effectiveness or coverage of treatment expenses must also be a policy priority."