Apart from tobacco smoking and ambient air pollution, high prevalence of smokeless tobacco public health concern in South Asian countries
'Khaini'. Photo: iStock India ranked second in terms of cancer burden in Asia in 2019. The country recorded 1.2 million new cases and 929,600 deaths, according to a study published by The Lancet Regional Health Southeast Asia journal.
China had the highest cancer burden in the continent in 2019 — 4.8 million new cases and 2.7 million deaths. Japan ranked third with 887,300 new cases and 437,700 deaths.
Further, the researchers examined cancer disability-adjusted life years (DALYs) and deaths attributable to 34 risk factors between 1990 and 2019.
One DALY represents the loss of the equivalent of one year of full health, according to the World Health Organization. This is calculated as the sum of the years of life lost either due to premature mortality and or the years lived with a disability due to an illness.
Of 49 countries surveyed in the Asian continent, 15 had a DALYs count of more than 1 million led by China (67.3 million DALYs) and India (27.1 million DALYs).
Overall, cancer seems to be a major public health threat in Asia. The continent recorded 9.4 million new cases and 5.6 million deaths in 2019, doubling from and up from 2.8 million in 1990, respectively.
The burden of cancers measured in terms of DALYs increased to 144.7 million in 2019, from 86.2 million in 1990.
“Tracheal, bronchus, and lung cancer (both sexes), breast cancer (among females), colon and rectum cancer (both sexes), stomach cancer (both sexes), and prostate cancer (among males) were among top five cancers in most Asian countries,” the researchers said. This was estimated in terms of age-standardised mortality rate or the mortality rate per 100,000 people in a population.
When the study looked at risk factors for both sexes combined, smoking was the topmost. Smoking-related cancers caused 33.1 million DALYs. This was followed by alcohol use and then ambient particulate matter (PM) pollution in 2019.
“Apart from tobacco smoking and ambient air pollution, high prevalence of smokeless tobacco such as khaini, gutkha, betel quid, and paan masala is a public health concern in South Asian countries such as India, Bangladesh, and Nepal,” the study said.
“As per our study results, India alone accounted for 32.9 per cent of global deaths and 28.1 per cent of new cases of lip and oral cavity cancer in 2019. As per the global adult tobacco survey (GATS), 199.4 million adults in India consumed smokeless tobacco,” the researchers added.
Notably, more than 50 per cent of the oral cancer burden is caused directly as a result of SMT, with the incidence growing in South Asia, including India. SMT also increases the risk of esophageal and pancreatic cancer.
“SMT control policies such as taxes and regulatory mechanisms seem to be either inadequate or poorly implemented in South Asia, resulting in the unabated burden of SMT-induced diseases, including oral cancers,” the study added.
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