In earlier decades, stomach, penile and cervical cancer were more common, while in the recent decade, breast, lung and prostate are the most prevalent cancers in India. Cancer incidence has been rising in India due to increased detection and awareness.
WOMEN
Among women, the incidence of breast cancer is rising rapidly. In 2020, breast cancer accounted for 13.5% of all cancers and around 10.6% of all cancer-related deaths.
Recent epidemiological studies show that the incidence is increasing particularly among Indian women under the age of 40.
The country is home to the world’s second-largest number of tobacco users (over 28% of all adults in India). Of these, at least 12 lakh die every year from tobacco-related diseases including cancer.
CANCER BURDEN
According to the Indian Council of Medical Research recent data more. than 40% of India’s cancer burden is, contributed by the seven most common types of cancer — lung (10.6%), breast, (10.5%), oesophagus (5.8%), mouth, (5.7%), stomach (5.2%), liver (4.6%), and cervix, uteri (4.3%).
As per World Health Organisation’s 2020 report the estimated incidence of cancer cases in India (13,24,413) accounts for the third highest number of cancer cases after China (45,68,754) and the United States of America (22,81,658).
While the incidence rate of cancer in India is lower, when compared to developed countries, the mortality rate is higher due to late diagnosis.
DIAGNOSIS
However, the absolute number of new cases is increasing due to population growth and better diagnostic, facilities. It has been estimated that around 20 lakh people will be affected by 2040 due to this disease and almost 10 lakh cancer deaths shall be observed.
In 2020, 8.5 lakh Indians died due to cancer. Death due to breast cancer accounted for the highest share (11%) followed by lip, oral cavity (9%), cervix uteri (9%) and lung cancer (8%).
60% of India’s population, is not covered under any insurance scheme as the patient battles cancer, one of the costliest ailments.
Treatment options are often costly not only because of expensive medicines and surgeries, but also due to the inaccessibility of local, specialised treatment centres. Due to this, the patient and family members often need to travel to another city where they would have to stay for months to complete the treatment.
HOSPITALS
India currently has 39 specialised. government-run cancer care hospitals. Ten more are planned to be set up. In addition, more than 250 cancer centres, including six dedicated cancer hospitals like the Tata Memorial Centre, Mumbai , function as a part of a grid run by the Department of Atomic Energy. Specialised cancer treatment units have been approved in all the 22 new AIIMS and 13 government medical colleges have been selected for upgrades to include cancer treatment.
But the numbers are gravely inadequate for a country of 1.4 billion people, and the facilities are out of reach for a large part of the rural population.
About 60% of cancer patients, especially from the rural background, come for a medical consultation only once the disease has progressed beyond cure. This is mostly due to a lack of awareness about the availability of effective cancer treatment. They sometimes rely on ineffective alternative medicines which promise miracle cures.
SCREENING AND TREATMENT
Cancer is emerging as a public health problem and regular cancer screening, especially for breast and cervical cancer, is the need of the hour to tackle the rising disease burden.
Unfortunately, without regular screening, breast cancer is commonly detected at third and fourth stages only.
Cancer treatment can become very expensive, and even an insurance policy may not be sufficient to cover such expenses. To overcome this,
it is essential to get cancer- specific add- ons and covers that will provide lump-sum payments.These generally are affordable and can protect a person against a very big financial risk. Flagging inadequate insurance coverage, the Parliamentary panel had also noted that insurance companies bank on the maximisation of profit and all cancer treatments are not covered in health insurance schemes.They pointed out that besides the devastating effect of cancer in terms of morbidity, the cost involved in managing the disease put unbearable economic burdens on individuals and their families. One-third of households with individuals with cancer are estimated to spend more than half of their per-capita annual household expenditure on hospitalisation.
The panel recommended innovative health insurance packages to ensure adequate financial coverage for cancer treatment.
(Dr Naresh Purohit is Advisor- National Cancer Control Programme. The views and opinion expressed in this article are those of the author)
