New Delhi: Breast and lung cancers have emerged as the leading causes of cancer related deaths in India, even as the country grapples with a sharp rise in overall cancer incidence and mortality, according to a new Lancet report.
In this otherwise grim scenario, a ray of hope emerges from the finding that nearly 40 per cent of cancer deaths are linked to modifiable risk factors such as tobacco use, unhealthy diets, and elevated blood sugar levels.
Experts emphasise that targeted lifestyle changes and preventive interventions could significantly reduce the cancer burden in the years ahead.
As per the comprehensive global analysis published in The Lancet by the Global Burden of Disease (GBD) Cancer Collaborators, in 2023, India registered an estimated 5.43 million cancer cases arise from 1990, when the age-standardised cancer incidence rate stood at 84.8 per lakh population.
By 2023, this figure had risen by 26.4% to 107.2 per lakh. The age standardised mortality rate also grew from 71.7 to 86.9 per lakh during the same period, a 21.2% increase.
Globally, 2023 witnessed 18.5 million new cancer cases and 10.4 million deaths, reflecting a 105% and 74% increase, respectively, from 1990 levels.
Projections indicate a further rise to 30.5 million cases and 18.6 million deaths annually by 2050 an increase of over 60% and 75% respectively with the most pronounced impact expected in low and middle-income countries, including India.
Unlike many high-income nations where lung and colorectal cancers dominate, India shows a distinct pattern of cancer mortality. In 2023, breast cancer emerged as the deadliest form of cancer in India, accounting for 8.5 deaths per 100,000 population.
It was closely followed by lung cancer, including tracheal and bronchial variants, which recorded 8.4 deaths per 100,000. Oesophageal cancer claimed 8.2 lives per 100,000, while stomach cancer accounted for 6.9 deaths.
Oral cavity and lip cancers often linked to tobacco and betel quid use also posed a significant health challenge, resulting in 6.5 deaths per 100,000 population. These figures underline the dual burden of lifestyle related and environment linked cancers, particularly in urban and semi-urban populations.
Tobacco usage, air pollution, poor dietary patterns, and delayed diagnoses continue to be major contributors.
Experts caution that India’s fragmented health infrastructure could struggle to meet the growing demand for cancer care. “India has only 38 population based cancer registries, covering just 12% of the population,” said Prof. Rakhi Dandona of the Public Health Foundation of India, a co-author of the GBD analysis.
In 2022, India reported 1.4 million cancer cases and 910,000 cancer related deaths, as per official estimates figures likely to be underreported due to gaps in surveillance and diagnosis.
“Most of the increases in cases and deaths will be due to population growth and the rise of ageing populations. However, improvement is still far away from the UN Sustainable Development Goal (SDG) to reduce premature mortality due to non-communicable diseases, which include cancer, by a third by 2030,” lead author Dr Lisa Force from the Institute for Health Metrics and Evaluation (IHME), University of Washington, US, has warned in the report.
The GBD study attributes over 40% of cancer deaths to modifiable risk factors such as tobacco use, poor diet, high blood sugar, and air pollution.
"In India, oral and lung cancers have long been linked to smoking and smokeless tobacco, while breast and stomach cancers reflect lifestyle and nutritional transitions," said Dr. Rahul Bhargava, oncologist-haematologist from Fortis Hospital, Gurugram. “While the age-standardised death rates have declined marginally, the reduction is not sufficient to meet the UN Sustainable Development Goal (SDG) of reducing premature non-communicable disease deaths by one-third by 2030,” the report noted.
If current trends continue, India is expected to bear one of the world’s heaviest cancer burdens by 2050. Analysts say bolstering preventive healthcare, early detection systems, and equitable access to treatment must be national priorities.
The data, though stark, offers policymakers a window for action. Cancer control strategies, experts argue, must move beyond treatment and focus on upstream interventions such as tobacco cessation, vaccination against HPV, improved nutrition, and environmental safeguards.
