National Cancer Awareness Day: A call for action to tackle India’s cancer crisis

On November 7, India observes National Cancer Awareness Day to commemorate the birth anniversary of Nobel laureate Madame Curie, who made pioneering contributions to the field of cancer research. The day also serves as a reminder of the magnitude and impact of cancer in India, which is facing a “tsunami” of the disease. According to the latest estimates, India has over 14 million new cancer cases and over 8.5 million deaths every year, and these numbers are expected to double by 2040. India ranks third in the world in terms of cancer incidence, after China and the USA. One in nine Indians will develop cancer in their lifetime and one in 15 will die of it.

India’s cancer challenges

India’s cancer scenario is unique and complex, with several challenges that hinder the prevention, detection and treatment of the disease. Some of these challenges are:

• Lack of awareness: Many people in India are unaware of the risk factors, symptoms and screening methods for cancer. There is also a stigma and taboo associated with the disease, which prevents people from seeking timely help.
• Lack of screening: India does not have a robust nationwide screening programme for cancer, which can detect the disease at an early stage and improve the chances of survival. Only 1.1% of the population have been screened for cervical cancer and less than 1% for breast and oral cancer, according to the National Family Health Survey (NFHS-5).
• Lack of registries: India has only 38 population-based cancer registries (PBCRs) that cover only 10% of the population and are mostly located in urban areas. There is a need for more PBCRs, especially in rural areas, to collect accurate and comprehensive data on cancer incidence, prevalence, mortality and trends.
• Lack of infrastructure: India has only around 500 comprehensive cancer centres (CCCs) that provide all the modalities of cancer treatment under one roof. Most of them are private or trust-based and are concentrated in metros and state capitals. There is a huge gap in the availability and accessibility of cancer care facilities in rural and remote areas, where 70% of the population lives.
• Lack of affordability: Cancer treatment in India is expensive and often beyond the reach of the common man. Many patients have to bear the cost of treatment out of their own pocket, which pushes them into poverty and debt. There is a need for more government funding and insurance schemes to make cancer care affordable and accessible.

India’s cancer solutions

To address the cancer crisis in India, there is a need for a comprehensive and coordinated approach that involves the government, the industry, the civil society and the public. Some of the possible solutions are:

• Cancer prevention: About one-third to one-half of all cancers are preventable by avoiding exposure to carcinogens such as tobacco, alcohol, unhealthy diet, physical inactivity, radiation and infections. There is a need for creating awareness and implementing interventions for cancer prevention at the primary health care level, such as tobacco cessation, HPV vaccination, healthy lifestyle promotion and environmental protection.
• Cancer screening: Screening can detect cancer at an early stage and improve the chances of survival and quality of life. There is a need for scaling up the existing screening programmes for oral, cervical and breast cancers under the National Health Mission and the Ayushman Bharat Programme. There is also a need for introducing screening for other common cancers such as lung, colorectal and prostate cancers, based on the risk factors and the population profile.
• Cancer treatment: Treatment can cure cancer or prolong the life of the patient, depending on the stage and type of the cancer. There is a need for increasing the number and quality of CCCs in the country, especially in rural and remote areas, to provide multidisciplinary and evidence-based cancer care. There is also a need for leveraging technology and innovation to improve the accessibility and affordability of cancer treatment, such as telemedicine, mobile clinics, artificial intelligence and precision medicine.
• Cancer notification: Notification can help in collecting and reporting accurate and timely data on cancer cases and deaths, which can help in planning and evaluating cancer control programmes. There is a need for making cancer a “notifiable disease” in India, as recommended by the Parliamentary Standing Committee for Health and Family Welfare in September 2022.

National Cancer Awareness Day is a wake-up call for India to take urgent and concrete steps to tackle the cancer crisis, which is threatening the lives and livelihoods of millions of people. By focusing on prevention, screening, treatment and notification, India can reduce the cancer burden and improve the cancer outcomes for its citizens.