Why do women in India face higher cancer incidence but lower mortality than men?

While women have a higher cancer incidence rate than men, the mortality rate is greater among men, according to a new study published in JAMA Network. Between 2015 and 2019, India saw over 700,000 cancer cases, with women accounting for 51.1 per cent and men for 48.9 per cent. More than 200,000 people died in this period.

A higher proportion of deaths were registered among men (55 per cent), compared to women (45 per cent). The study reported that among women, breast, cervical and ovarian cancers were the most common, while for men, it was oral, lung and prostate cancers.

In 2024, the estimated number of new cancer cases among men in India was 780,000 with a crude incidence rate (CIR) of 107.4. The estimated number of new cancer cases for women was 781,277, with a CIR of 113.3. CIR is the number of new cases occurring in a specified population per year, usually expressed as the number of cases per 100,000 population at risk.

The study analysed a dataset that includes 43 population-based cancer registries (PBCR) representing 56 population groups with distinct genetic characterists. PBCRs, which have been in existence since the 1970s globally, provides information on cancer incidence in a defined population, while also identifying possible causes of cancer in the community and assesses the impact of cancer control activities.

The analysis showed that top five sites for age-adjusted incidence rate (AAIR) per 100,000 population among females were Aizawl, Mizoram, Kamrup Urban, Papumpare and Hyderabad. For men, the top five sites were Aizawl, East Kasi hills, Papumpare, Kamrup Urban and Mizoram. All these sites, except Hyderabad, are in northeast India.

AAIR is a statistical measure that allows groups of people to be compared in a way that the age distribution differences between the groups in a study do not affect what is being measured. This is important as older people are more likely to get ill than the younger. So age-adjustment can make studies more accurate. 

A previous 2023 study published in the Indian Journal of Public Health found that the cancer incidence rates in Mizoram’s Aizawl district were seven times higher in men and four times higher in women than in Osmanabad and Beed in Maharashtra.

There are several reasons why women in India face higher cancer risk. A 2022 study published in Cancer Epidemiology noted that dietary changes, physical inactivity, occupation, infections, tobacco use and alcohol can make women more susceptible. Other risk factors such as delayed child births, low economic parity and reproductive factors further contribute to the burden of cancer. 

“Hormone-related diseases like breast and ovarian cancer are rising because of increased exposure to cancer-causing agents, such as pollutants in the air, dangerous chemicals in cosmetics and processed food,” read a post published on the website of Jindal School of Government and Public Policy.

Still, mortality rate among men is higher. This could be because the most prevalent cancers among women, such as breast, cervical and ovarian, have higher chances of survival when identified and treated early. The five-year survival rate for breast cancer, when diagnosed early, is above 90 per cent, according to the American Cancer Society. This suggests that women who have that cancer are, on average, about 90 per cent as likely as women who do not have the condition to live for at least five years after being diagnosed, it added.

However, there is an alarming trend. A March 2025 study published in the Lancet Regional Health South Asia highlighted that cancer-related mortalities have increased faster among women than men over the past decade, and are expected to continue rising over the coming two decades.

Several factors can contribute to this, including misdiagnosis, limited access to high-quality healthcare, socioeconomic obstacles and biological inequalities, read the Jindal School post.