According to the American Cancer Society, cancer deaths have decreased by 33% since 1991, resulting in 8 million fewer deaths in the United States. This success is primarily due to earlier detection, lower smoking rates, and advancements in cancer treatment. Even with advancements in treatment, this trend has yet to be reflected in India, where cancer incidence and mortality continue to rise.

 

What is Cancer?

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Cancer can start almost anywhere in the human body, which is made up of trillions of cells.

 

Why are some cancers on the decline and others continue to rise?

  • In India, the incidence of cervical cancer has decreased from 45 to 10 per 100,000 people in the last 50 years, while the prevalence of breast cancer is rising, particularly in urban areas, for example, 45 per 100,000 in Hyderabad.
      • Late marriages, fewer children, improved hygiene and human papillomavirus vaccine are all contributing to the decline of cervical cancer.
      • Late marriages, having the first child at a later age, not breastfeeding, and a high protein diet resulted in the rise of breast cancer.
      • Breast cancer, unlike cervical cancer, has no specific intervention other than screening because the exact cause is unknown.
  • Tobacco-related – oral, esophageal – cancer rates are also decreasing, owing largely to tobacco laws that have reduced smoking in public places.
  • Lung cancer, which is caused by pollution as well as smoking, continues to be a source of concern. In Arunachal Pradesh, for example, lung cancer rates are high because people light fires indoors during the winter. Lung cancer has a low survival rate and is typically diagnosed in its late stages.

 

Have there been improvements in cancer treatments?

  • This can be elucidated by the cure rate for various cancers. For example,
      • In the last 50 years, the cure rate for pancreatic cancer has doubled from 3% to 6%.
      • It has risen from 60% to 100% for prostate.
      • Breast cancer survival rates have increased from 50% to 90% thanks to newer treatments.
  • However, India’s infrastructure for the seven pillars of cancer care – prevention, surgery, chemotherapy, radiotherapy, imaging, laboratory diagnostics, and palliation, is deficient.
  • In developing countries, for example, as per WHO there should be one radiotherapy machine for every million people. So, for 1.4 billion people in India, 1,400 machines are needed, but we only have 700.

 

What should be done?

  • Screening must be the first intervention. This has already begun with the government’s upgraded health and wellness centres for the three most common types of cancer – breast, cervical, and oral (34% of cancers in India).
  • Screening should lead to hospital treatment, which should be accessible and affordable.
  • The current one cancer care facility for every 5-crore people in India must be increased.
  • The need is to ensure that people are diagnosed early and treated promptly.
  • There is a need to coordinate existing efforts because the government has several programs that operate independently and in silos.

 

SourceThe Indian Express

 

QUESTION – Mortality rate due to cancer in the U.S. has declined by more than 30 percent since 1991. What are the particular reasons behind this feat? What India needs to learn from the U.S. in this case?