Cancer kills Indians at a young age, says a multi-centre study, the first of its kind in the country. Cancer strikes at an age as young as 30 for Indians

Syed Akbar
Hyderabad:  Cancer kills Indians at a young age, says a multi-centre study, the 
first of its kind in the country. Cancer strikes at an age as young as 30 for Indians.

Though India maintains a national cancer registry, its data is based mainly on cancer 
cases reported in major cities. Cancer deaths in small towns and villages do not go into 
the National Cancer Registry. To find out the real scenario of cancer in both urban and 
rural areas, Bill and Melinda Gates Foundation and the US National Institutes of Health 
funded a "million deaths" study involving as many as 130 expert physicians. The study was 
published in the scientific journal, Lancet.

According to the study in which doctors from Bengaluru, Mumbai, Kolkata, Chennai and 
Delhi participated, the team studied the cause of death of at least 1.22 lakh people in 
different parts of India during early 2000. Of the 1.22 lakh people who died of various causes, 7131 
people died due to cancer. When the figure was compared with the data in 2010, when 5.56 
lakh people died due to cancer, about 3.95 lakh or 71 per cent were cancer deaths. The 
figures pertain to people between the ages 30 and 69 years.

The Lancet study pointed out that at 30—69 years, the three most common fatal cancers 
were oral (including lip and pharynx) 22·9 per cent, stomach 12·6 per cent, and lung 
(including trachea and larynx, 11·4 per cent in men, and cervical 17·1 per cent, stomach 
14·1 per cent, and breast 10·2 per cent in women.

Tobacco-related cancers represented 42·0 per cent of male and 18·3 per cent of female 
cancer deaths and there were twice as many deaths from oral cancers as lung cancers. 
Cervical cancer
was far less common in Muslim than in Hindu women.

Prevention of tobacco-related and cervical cancers and earlier detection of treatable 
cancers would reduce cancer deaths in India, particularly in the rural areas that are 
underserved by cancer services. The substantial variation in cancer rates in India 
suggests other risk factors or causative agents that remain to be discovered. Cancer is 
one of the leading causes of adult deaths worldwide. In India, the International Agency 
for Research on Cancer estimated indirectly that about 6.35 lakh people died from cancer 
in 2008, representing about 8 per cent of all estimated global cancer deaths and about 6 
per cent of all deaths in India. The absolute number of cancer deaths in India is 
projected to increase because of population growth and increasing life expectancy.

Rates of cancer deaths are expected to rise, particularly, from increases in the 
age-specific cancer risks of tobacco smoking, which increase the incidence of several 
types of cancer. India is a culturally diverse country, with huge regional and 
rural-to-urban variation in lifestyles and in age-specific adult death rates. Thus, 
understanding the geographical and social distribution of specific cancers is essential 
to target cancer control programmes and spur further research into the causes of cancer, 
the researchers noted.

"In our analysis, we focused on deaths in individuals aged 30—69 years because these 
deaths are more likely to be avoidable than are those at older ages," they said.

The study revealed that 37 per cent of all female cancer deaths were from 
infection-related cervical, stomach, and liver cancers and 18·3 per cent were from 
tobacco-related cancers.

The results of the study are the first to provide direct nationally representative 
estimates and rates of cancer deaths in men and women in India. Cervical cancer is the 
leading cause of cancer death in women in both rural and urban areas. The cervical cancer 
death rate of 16 per 100000 suggests that a 30-year old Indian woman has about 0·7 per 
cent risk of dying from cervical cancer before 70 years of age in the absence of other 
diseases. By contrast, the risk of dying during pregnancy for Indian women aged 15—49 
years is about 0·6 per cent.

Cervical cancer risks were much lower in Muslim women and in states where the proportion 
of Muslims was larger, as noted internationally. Circumcision among Muslim men, which 
reduces the sexual transmission of human papillomavirus,is a likely explanation although 
other factors might also account for this difference. Strategies to reduce cervical 
cancer deaths include vaccination against human papilloma virus before marriage and for 
married women a once-only testing or screening followed by visual inspection with acetic 
acid and further referral for treatment.