Health

India’s cancer burden: Cases & deaths increased last decade, COVID-19 widens screening gap

Globally, cancer cases increased 21% and deaths 26% from 2010-2019

 
By Rohini Krishnamurthy
Published: Wednesday 05 January 2022
India's cancer burden: Cases, deaths increase in 10 years, COVID-19 widens screening gap

Cancer cases in India increased at an average annual rate of 1.1-2 per cent from 2010-2019, according to a new report. Deaths from cancer in the country also went up at an average rate of 0.1-1 per cent in the same period, the paper showed. 

The growth rates are among the global highest, according to the analysis by the Institute for Health Metrics and Evaluation (IHME), University of Washington School of Medicine published in JAMA journal December 30, 2021. 

As many as 1,392,179 people in India had cancer in 2020, projections from another study showed. The five leading sites of the disease were breast, lung, mouth, cervix, uteri and tongue, researchers found. 

Among men, the projected incidence was 94.1 per 100,000 individuals and for women, it was 103.6 per 100,000 individuals for 2020, according to the Cancer Statistics Report, 2020.

Globally, the picture is not very different, going by the IHME study Global Burden of Disease Study 2019 analysis. New cancer cases jumped to over 23 million in 2019 from 18.7 million in 2010. Cancer deaths reached 10 million in 2019 from 8.29 million in 2010. These figures represent an increase of 20.9 per cent and 26.3 per cent respectively.

The authors of the report analysed data from 204 countries and territories from 2010 through 2019 to assess cancer burden across locations and time. They found that tracheal, bronchus and lung (TBL) cancer was the leading cause of cancer globally, followed by colon and rectum, stomach, breast and pancreatic cancer respectively. 

In 2019, the disease was the leading cause of deaths globally after cardiovascular diseases, the report showed. TBL cancer was the top cause of cancer deaths among males in 119 countries and territories and females in 27 countries and territories. 

The study compared cancer burden across regions to understand how the number of cases, the impact of the illness on quality of life, premature deaths and mortality rates are changing across the world due to the disease.

The researchers analysed cancer burden based on the socio-demographic index (SDI), a composite measure of income per capita, average years of education and total fertility rate for people younger than 25 years of age.  

SDI is classified into five categories: Low, low-middle, middle, high-middle and high. Pankaj Bhardwaj, additional professor, community medicine and family medicine coordinator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, told Down To Earth

India falls in the low-middle category. In lower-middle countries, the findings show that there is definitely an increase in incidence (new cases) as well as mortality. 

Dr Bhardwaj is one of the study’s collaborators, who helped the IHME team with research methodology and the interpretation of data.

Cancer cases and deaths were the highest in low and low-middle SDI countries and regions. By 2040, researchers predict that more than two-thirds of the world’s cancer cases will occur in low- and middle-income countries.

Pandemic disrupts cancer care 

The ongoing novel coronavirus disease (COVID-19) pandemic may have slowed progress in cancer care, according to the IHME study. Delays and reductions in cancer screening, diagnosis and treatment were likely to have been the major impediments, the report said. 

In India, cancer services such as new patient registrations, outpatient services, hospital admissions and major surgeries had dropped between March and May 2020, compared to the same period in 2019, according to a May 2021 Lancet study.

These disruptions could lead to 83,600-111,500 patients requiring cancer services for more advanced diseases over the next two years, it found. Excess cancer-related deaths in the next five years could be 98,650-1,31,500, the report said. 

Cancer screening has completely stopped in the last two years when the pandemic was raging, said Bhardwaj. “A huge chunk of the cases will go undetected and will create repercussions in the years to come.”

Screening should be prioritised as much as infectious diseases, he added. Population mapping done during the pandemic should be used to carry out screening extensively, the expert suggested. “Now, because of COVID-19, we have big data with us, which was lacking earlier.”

Data from CoWIN, India’s vaccine registration portal and COVID-19 database, may also help, Bhardwaj said. 

Data should be used, through ethical practices, in different programmes to identify people from higher age groups for screening; strategies can be devised later, the expert added.

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