Context:

Cancer has gradually emerged as one of the leading public health concerns in India, both in terms of disease burden and mortality. Once considered a relatively rare condition, it is now a common challenge affecting millions of families every year. Data from 43 population-based cancer registries coordinated by the ICMR–National Centre for Disease Informatics and Research (NCDIR) show that the lifetime risk of developing cancer in India is 11%. In 2024 alone, the country reported 15.6 lakh new cancer cases and 8.74 lakh deaths.

• • The importance of understanding this crisis lies in the systematic data collected through population-based cancer registries, which provide valuable insights into incidence patterns, gender differences, regional disparities, and risk factors. These registries cover a significant portion of India’s population and help policymakers design effective responses. At the same time, the findings underline the gaps in awareness, infrastructure, and affordability that continue to worsen the challenge.
  • India’s cancer response, therefore, cannot be limited to treatment alone. It requires a comprehensive approach combining prevention, early detection, financial protection, advanced therapies, and community-level awareness. In this context, examining registry data alongside India’s policy initiatives gives a clearer picture of both the scale of the problem and the direction of solutions.

Key Findings from Cancer Registries:

1. Gender Patterns in Cancer Burden

• • • Women account for 51.1% of cancer cases but only 45% of cancer deaths, largely because breast and cervical cancers—which together make up 40% of all cancers in women—are easier to detect and treat if identified early.
    • Men face higher mortality as lung and gastric cancers dominate, both associated with poor survival rates due to late detection and aggressive disease progression.

2. Rising Oral Cancer in Men

• • • Oral cancer has overtaken lung cancer as the most common cancer among Indian men.
    • This rise is paradoxical, as tobacco use has declined (34.6% in 2009–10 → 28.6% in 2016–17).
    • Possible reasons:
      • Long latency of tobacco-related cancers (effects showing up years later),
      • Alcohol consumption,
      • Compounded risk from dual alcohol-tobacco use.

3. Regional Disparities – Northeast Most Affected

• • • Mizoram has the highest lifetime cancer risk in India: 21.1% for men and 18.9% for women (compared to 11% national average).
    • The Northeast overall reports high rates of cervical, lung, and oral cancers, driven by:
      • Very high tobacco use,
      • Dietary habits such as fermented pork fat, smoked dried meat/fish, and very spicy foods,
      • Consumption of very hot beverages,
      • Carcinogenic infections including Helicobacter pylori, hepatitis viruses, HPV, and typhoid.

4. Common Cancer Sites in India

• • • Women: Breast and cervical cancers remain dominant.
    • Men: Oral cancer is most common, followed by lung and gastric cancers.
    • Prostate cancer is emerging as a growing burden, particularly in urban and ageing populations.

Significance of Findings:

The registry findings emphasise the urgency of region-specific interventions. Broad national schemes are useful, but strategies must adapt to local realities. Key takeaways include:

• • Screening programmes for breast, cervical, and oral cancers should be prioritised at the primary care level.
  • Tertiary care infrastructure needs expansion, especially in underserved regions like the Northeast.
  • Awareness campaigns must focus on linking lifestyle (diet, tobacco, alcohol), infections, and cancer risk.
  • Integration of cancer services within larger schemes such as Ayushman Bharat will make care more accessible and affordable.

India’s Multi-Pronged Strategy to Fight Cancer:

India’s response combines prevention, treatment, financial aid, infrastructure strengthening, research, and public awareness.

1. National-Level Programmes

• • • NPCDCS (National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke): Focuses on early detection of oral, breast, and cervical cancers with strong emphasis on screening, awareness, and primary care strengthening.
    • Strengthening of Tertiary Care for Cancer Scheme: Supports 19 State Cancer Institutes and 20 Tertiary Cancer Centres to decentralise advanced treatment.
    • Ayushman Bharat Yojana (PM-JAY): Provides free cancer treatment (chemotherapy, radiotherapy, surgery) to poor families. Over 90% of registered cancer patients are covered under the scheme.
    • Health Minister’s Cancer Patient Fund (HMCPF): Offers up to ₹15 lakh financial assistance per patient in 27 Regional Cancer Centres.
    • National Cancer Grid (NCG): World’s largest cancer care network with 287 centres treating 7.5 lakh new patients annually, ensuring standardised, evidence-based treatment protocols.

2. Budget & Infrastructure Support

• • • Union Budget 2025–26 allocated nearly ₹1 lakh crore for healthcare, including plans for Day Care Cancer Centres in every district.
    • Customs duty exemptions on 36 life-saving cancer drugs to reduce treatment costs for patients.

3. Research & Innovation

• • • NexCAR19 CAR-T Cell Therapy (2024): India’s first indigenous gene therapy for blood cancers, developed by IIT Bombay, Tata Memorial Centre, and ImmunoACT.
    • Quad Cancer Moonshot (2024): India, the US, Japan, and Australia collaborate to eliminate cervical cancer through HPV vaccination and enhanced screening.
    • ACTREC Expansion (2025): Major upgrade at the Advanced Centre for Treatment, Research and Education in Cancer to strengthen research and training.

4. Awareness & Lifestyle Interventions

• • • Campaigns: Eat Right India, Fit India Movement, and Yoga-based initiatives encourage lifestyle changes to lower cancer risk.
    • Mass Awareness Days: National Cancer Awareness Day and World Cancer Day are leveraged to engage the public and spread key messages on prevention.

Challenges in Tackling Cancer in India:

• • Low registry coverage (only 18% of population covered by registries).
  • Late detection due to poor awareness and inadequate screening.
  • Healthcare access disparities, especially in rural areas and the Northeast.
  • Socio-cultural barriers including stigma, taboos, and low health literacy.
  • High financial burden: Even with Ayushman Bharat, out-of-pocket costs for diagnostics, medicines, and long-term care remain significant.

Way Forward:

1.       Expand Cancer Registries: Work toward national coverage by integrating digital health records for real-time tracking.

2.      Strengthen Primary Healthcare: Embed cancer screening into Health and Wellness Centres.

3.      Scale Up HPV Vaccination: Universal vaccination of adolescent girls should be prioritised.

4.     Awareness & Behaviour Change: Launch regionally tailored campaigns focusing on tobacco, alcohol, diet, and infections.

5.     Affordable Treatment: Expand Regional Cancer Centres, reduce diagnostic costs, and broaden PM-JAY coverage.

6.     Boost Research & Innovation: Invest in indigenous low-cost diagnostics, personalised therapies, and innovative treatment models.

Conclusion:

India’s cancer registries highlight a dual challenge: a growing national burden with 11% lifetime risk and regional disparities, particularly in the Northeast. Yet, the policy response has been multi-dimensional—ranging from NPCDCS and Ayushman Bharat to CAR-T therapies and HPV vaccination campaigns. Cancer is no longer seen as an inevitable death sentence. With 30–50% of cancers preventable, the real focus must be on prevention, early detection, and equitable access to treatment. If India sustains its current momentum and addresses existing gaps, it can transform cancer from a devastating health crisis into a manageable public health challenge.