Every year nearly one million new cancer cases are diagnosed in India, the prevalence being 2.5 million. With mortalities of 6,00,000-7,00,000 a year, cancer causes six per cent of all adult deaths in the country.
The number of deaths per year is projected to shoot up to 1.2 million by 2035, according to a series of papers published in the Lancet Oncology journal.
Currently, people in the 30-69 age group account for over two-thirds of cancer deaths in India, with less than a third of the patients surviving more than five years after diagnosis.
The most common, nearly half of all, are cancers of the lung and oral cavity in men, and of the breast and cervix in women.
The rate of occurrence of lung cancer is 11 per 1,00,000 individuals and of oral cavity cancer, 10.1. The rates of occurrences of breast and cervical cancers are 25.8 and 22.
“Almost three of five cancer deaths in India are associated with tobacco or infectious diseases,” notes a paper by Richard Sullivan of King’s College London and others.
Tobacco use alone accounts for about 40 per cent of all cancers in India. “About 275 million Indians (35 per cent of adult population and 14.1 per cent of children aged 13-15 years) are tobacco users, mainly smokeless tobacco,” says a paper by Paul E. Goss of Harvard Medical School, Boston, and others.
With the direct and indirect costs of tobacco-related diseases touching nearly $5,000 million in 2002-2003, “the cost of tobacco consumption exceeds the total combined revenue and capital expenditure [budget estimates] by the government and the States on medical and public health, water supply and sanitation,” says a paper by C.S. Pramesh of the Mumbai-based Tata Memorial Centre.
The geographical distribution of cancers is quite varied across the country. Based on the data from Chennai, cervical cancer was more prevalent (22.7 per 100,000) than breast cancer in Tamil Nadu, while oral cancer accounted for 243 per 100,000 men in Kerala.
According to Dr. Goss, smoking (bidi) and chewing tobacco (smokeless tobacco) were the biggest risk factors in Kerala.
With a rate of 215 per 100,000 women, Delhi had the highest incidence of gall bladder cancer in women in the world. Consumption of fried foods and tobacco, gallstones, bacterial infections and residence in the Gangetic belt were risk factors, Dr. Goss says.
The incidence of certain cancers was found to be affected by the socio-economic status of individuals. For instance, oral cancer was widely prevalent in the low income group.
“Ninety per cent of rural patients with oral cancer are poor,” says Dr. Goss. Similarly, a study in southern India has found that women with breast cancer are from a low socio-economic background in rural areas.