NEW DELHI: More women are dying of cancer as compared to men in the last 19 years in India, the latest study has found.
The first national-level cancer mortality study found that the cancer mortality trend in India has dipped by 0.19% annually among men but has increased by 0.25% among women, indicating an increase of 0.02% among both sexes.
The analysis of mortality trends of 23 major cancers in the Indian population, which killed 12.85 million Indians between 2000 and 2019, found that the highest annual increase in mortality was observed in pancreatic cancer among both sexes at 2.7% (2.1% among men and 3.7% in women).
The study, conducted by Amrita Hospital, Kochi, in collaboration with the International Agency for Research on Cancer, a division of the World Health Organisation (WHO), was published in JCO Global Oncology, a journal affiliated with the American Society of Clinical Oncology.
The study found increasing mortality trends among cancers of the lung, breast, colorectum, lymphoma, multiple myeloma, gallbladder, pancreas, kidney, and mesothelioma between 2000 and 2019.
However, the stomach, oesophagus, leukaemia, larynx, and melanoma cancers showed a declining cancer mortality trend irrespective of sex.
The cancer mortality was high among men than women for all common cancers except thyroid (0.6) and gallbladder (0.6) cancers.
Larynx cancer had almost a six-fold high mortality among men than women, followed by lung (2.9), melanoma (2.5), urinary bladder (2.3), mouth and oropharynx (2.2), and liver (1.9), while stomach and colorectal cancer mortality was relatively similar among both sexes.
The most common lethal cancers were mouth and oropharyngeal (15.6%), stomach (10.6%), lung (9.6%), breast (9%), and colorectal (8%) cancers.
Female cancers of the cervix, corpus uteri, ovary, and breast contributed to 17.6% of deaths, while male cancers of the prostate and testis contributed to only 3.7%, the study said.
“This estimation-based study might be a substitute for constructing precise and efficient health care infrastructure to acquire better cancer control programs in India in the absence of a national cancer registry or countrywide cancer mortality data,” Ajil Shaji, Head of Cancer Registry at Amrita Hospital, Kochi, and one of the authors, said.
Dr Vijaykumar DK, Head of Dept. Breast and Gynec Oncology, Amrita Hospital, Kochi, said: “We wanted to investigate how the number of cancer-related fatalities has changed in India over the past two decades. The study has shown that the cancer mortality trend among men in India has shown a slight yet statistically significant decrease over time."
“In contrast, the increase in cancer mortality among women and both sexes combined has been minor and not statistically significant. Among all common malignancies, women had a higher rate of gallbladder and thyroid cancer mortality than men; meanwhile, a yearly significant increase of pancreatic cancer mortality was seen among both sexes, with a higher increase in women.”
Dr Pavithran K, Head of Dept. Medical Oncology, Amrita Hospital, Kochi, said: ‘The study highlights the need for a multi-pronged approach to address the rising cancer mortality rates in India, including awareness on cancer symptoms, cancer prevention policies, improved health infrastructure, and specifically dedicated human resources.”
A multi-faceted strategy is required to tackle India’s rising cancer mortality rates.
“Lack of knowledge about cancer symptoms delays treatment for preventable cancers. We need better infrastructure, dedicated human resources, and expanded cancer screening programs. The best long-term strategy could be implementing awareness of cancer symptoms among the population and cancer prevention policies with improved health infrastructure and specifically dedicated resources,” he said.
Globally, cancer is the second most lethal non-communicable disease after cardiovascular disease, accounting for about 9.9 million deaths in 2020.
Around 9% of all cancer deaths occurred in the Indian population.
While cancers of the lung, breast, colorectum, lymphoma, multiple myeloma, gallbladder, pancreas, kidney, ovary, and mesothelioma showed substantial increases in mortality in India, the cancers of the stomach, oesophagus, leukaemia, larynx, liver, brain, testis, prostate, cervix, corpus uteri, and melanoma decreased over time.
“In India, more than 70% of cases of cancer are diagnosed at advanced stages because of decreased cancer awareness and lack of organized breast, oral, or cervical cancer screening programs. This fact explains the high cancer mortality rate,” the study said.
It added that prevention through screening and awareness could reduce the burden of preventable cancers worldwide and in India since more than 30% of cancer deaths are due to modifiable risk factors, including tobacco and alcohol use.
