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Thursday, October 29, 2020

Explained: The cancer crisis in India

As per Indian Council of Medical Research data, India will have over 17.3 lakh cancer cases by 2020 -- a doubling of cases in 25 years. It may see over 8.8 lakh deaths due to the disease, with only 12.5 per cent of the patients receiving treatment in early stages.

, Edited by Explained Desk | New Delhi | Updated: February 24, 2019 5:18:40 pm
The dedicated Oncology Emergency on the ground floor of the hospital block. The facility has 30 beds and a dedicated Operation Theatre. (Express photo: Tashi Tobgyal)

With cancer being India’s second biggest killer after heart disease, the nation is staring at a cancer crisis, with unequipped hospitals, spiralling cost of treatment, belated diagnosis and the doctor-patient ratio gap all causing large-scale problems. However, to lessen the deficit of tertiary cancer care in the country, India’s biggest cancer hospital is coming up at Haryana’s Jhajjar, which will have over 700 beds exclusively for cancer patients.

The National Cancer Institute, being built at a cost of Rs 2,035 crore, is slated to be completed by December 2020 and most importantly, like at AIIMS, Delhi, most of the treatment and procedures would be free.

As per Indian Council of Medical Research data, India will have over 17.3 lakh cancer cases by 2020 — a doubling of cases in 25 years. It may see over 8.8 lakh deaths due to the disease, with only 12.5 per cent of the patients receiving treatment in early stages.

Compared with 1990, cancer has killed more than double the number of people in 2016. The ICMR’s quarter-century study of cancer has found that while 3.82 lakh people had died of cancer in 1990, the number jumped to 8.13 lakh in 2016, a rise of 53 per cent.

Inside India’s largest cancer hospital The OPD block, the hospital block and research block of the NCI. (Express photo: Tashi Tobgyal)

The numbers seem staggering especially at a time when the country is facing a shortage of cancer specialists, with only 2,000 oncologists to look after around 10 million patients, according to the latest government data.

Even there is a dearth of medical specialists in India, the gap in the number of oncologists, experts say, is relatively bigger and India has a challenging task on its hands if it needs to meet the optimum of one cancer specialist for every 1,00,000 population.

As per an assessment by the World Health Organisation (WHO), cancer cases in India will multiply five times over by 2025, with more women falling prey to the deadly disease than men. The National Health Profile, curated by the Union Health Ministry, predicts that the total number of male cancer patients will jump to 6,22,203 in 2020 from the current 5,22,164. The number of female cancer patients will touch 6,98,725 by 2020 from the present 5,64,619.

The trend is in sync with the shift in India’s disease profile, with non-communicable diseases now accounting for 60 per cent of all deaths every year in the country.

However, behind the numbers lie a tale of the cancer burden in India, with poorer people more likely to die from the disease before the age of 70 years than those who are more affluent, according to a 2014 study published in Lancet Oncology.

With a study claiming that out-of-pocket health expenditure in India accounts for nearly 7 per cent of household expenses, diseases like cancer are most damaging to a family’s finances. In the absence of health and social security nets, cancers, particularly the ones that offer a chance of cure, can be financially debilitating for a family.

The most common kinds of cancer cases found in India are stomach cancer (9 per cent), breast cancer (8.2 per cent), lung cancer (7.5 per cent), lip and oral cavity cancer (7.2 per cent), pharynx cancer other than nasopharynx (6.8 per cent), colon and rectum cancer (5.8 per cent), leukaemia (5.2 per cent), and cervical cancer (5.2 per cent).

As per the National Institute of Cancer Prevention and Research, a woman dies of cervical cancer every eight minutes in India. Among the most common cancers in India, breast cancer kills one of every two women it afflicts in the country.

Interestingly, an analysis by the Institute of Health Metrics and Evaluation, Washington University, has found that the incidence rate of cancer in India is among the lowest in the world. At 106.6 new cancer cases in 2016 per 100,000 people, India ranked tenth among the countries with the lowest cancer incidence.

Despite the low rate of incidence, the actual figures of cancer cases remain a cause for concern. Data from the National Cancer Registry shows that an estimated 39 lakh cancer cases were registered in India in 2016. The top three countries in terms of incidence rates were Australia (743.8), New Zealand (542.8) and the United States (532.9).

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