Global Cancer Cases Rise Alarmingly Since 1990; Experts Urge Urgent Action In India

An alarm on the global rise in cancer cases since 1990 has been sounded by experts at the Global Burden of Disease Study Cancer Collaborators, in the hope that governments, economic actors and the average citizen will act urgently on prevention, detection and treatments.

The report of the group published in the journal The Lancet informs policymakers that without emergent steps, the increase in population and the high incidence will lead to a heavy burden of deaths and lost quality of life for millions by mid-century. If stronger public health policies are put in place, they could have a beneficial impact on 40% of cancer deaths currently linked to risk factors, such as tobacco smoking, alcohol consumption, obesity, and physical inactivity.

These factors are also responsible for other non-communicable diseases. India’s record on new cases and deaths shows a rising graph between 1990 and 2023, rising by an estimated 26% for incidence and 21% for mortality, despite medical advances. This is partly because the campaigns to address diabetes, alcohol and tobacco use suffer from policy flaws.

The inability to introduce plain packaging of cigarettes, for instance, goes back more than a decade. On the other hand, the tobacco industry has been able to work around the ban on advertising by introducing kiosks near restaurants with digital displays to promote cigarettes; it has also been tackling higher tobacco taxes by tweaking its offerings to suit the purse.

Strict restrictions on availability, higher taxation of traditional tobacco products like bidis and chewing leaf, and strong enforcement are needed, as in China, to reduce tobacco use.

It is significant that many other modifiable factors linked to cancer, such as unhealthy diet, high alcohol use, occupational risks and air pollution, can be addressed through policy measures. Appropriate labelling of foods with high salt, sugar and unhealthy fat has been held up due to intense lobbying by industry, while a lot of packaged food consumed by millions continues to be made with unhealthy fat, such as palm oil and vanaspati.

New York’s ban on trans fat, with a cascading effect on other regions in the US, is a good example of how to fill a policy gap. Air pollution remains a major unaddressed factor in Indian cities today due to, among other things, excessive automobile use, road dust and smoke from biomass—India finds a place in the top five most-polluted countries on fine particulate matter (PM 2.5).

Most risk factors are relevant to women too. The Lancet report points to the need for prioritised funding, stronger health systems, reduction of inequalities, and investments in robust cancer control, besides more research. Unfortunately, in spite of robust economic growth, India’s public health system is severely underfunded. Vastly higher funding and a political commitment to universal healthcare is called for to reduce cancer cases and mortality within a meaningful time frame.