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Four out of 10 cancer deaths linked to smoking, poor diet and high blood sugar: Lancet study shows why mortality could rise by 75% in 2050

Major risk factors in India are diet, alcohol use, air pollution and obesity. Controlling them can arrest disease spiral, says public health expert

4 min readUpdated: Sep 25, 2025 09:25 AM IST

Four of 10 cancer deaths were linked to established risk factors like smoking, poor diet and high blood sugar. (File Photo)

Cancer deaths rose to 10.4 million and new cases jumped to 18.5 million globally in 2023, an increase of 74 per cent and 105 per cent since 1990, according to a new analysis published in The Lancet. While this spiral seems alarming, four out of 10 cancer deaths were linked to established risk factors like smoking, poor diet and high blood sugar, all of which can be controlled to prevent the disease.

In India, the number of cancer cases rose sharply to an estimated 5.43 million in 2023. In 1990, the rate of new cancer cases in the Indian population, adjusted to account for differences in age (age-standardised cancer incidence rate) was 84.8 per lakh population. This rate increased by 26.4 per cent, reaching 107.2 per lakh population by 2023. The age-standardised mortality rate in India in 1990 was 71.7 per lakh population, which increased by 21.2 per cent, reaching 86.9 per lakh in 2023.

As per the analysis conducted by the Global Burden of Disease Cancer Collaborators, at least 30.5 million people worldwide are forecast to receive a new cancer diagnosis in 2050 while the annual global death toll has been predicted to increase by 75 per cent to 18.6 million.

What are the top cancers responsible for mortality in India?

“The top cancers responsible for mortality and morbidity in India include breast, lung, oesophagus, oral, cervical, stomach and colon cancers,” says Rakhi Dandona, professor, Public Health Foundation of India (PHFI), who is one of the collaborators on the analysis. However, she feels that the findings have to be interpreted in the context of ongoing cancer data being collected in cancer registries. Dr C S Pramesh, director, Tata Memorial Hospital, Mumbai and convenor, National Cancer Grid, says India has 38 population-based cancer registries which roughly cover 12 per cent of the population. In 2022, the total estimated incidence was 1.4 million cases and 910,000 deaths. “The common cancers among Indian women are breast, cervical and ovarian while in men, it is the oral, lung and the oesophagus,” he says.

What are risk factors?

At least 42 per cent (4.3 million) of the estimated 10.4 million cancer deaths globally in 2023 were attributable to 44 potentially modifiable risk factors, including tobacco use, an unhealthy diet and high blood sugar. “As far as India is concerned, major risk factors are diet, alcohol use, air pollution and obesity,” says Prof Dandona.

This means an aggressive reworking of our lifestyle protocols at the community level as a cancer-preventive measure. “We have to strengthen prevention efforts by reducing tobacco consumption, promoting healthy lifestyles, improving awareness and early detection among both public and primary care physicians. We should also enhance high quality, evidence-based, affordable treatment close to patients’ homes,” Dr Pramesh adds.

A greater proportion of global cancer deaths in men (46 per cent) in 2023 was linked to potentially modifiable risk factors (mostly tobacco, unhealthy diet, high alcohol use, occupational risks, and air pollution) than in women (36 per cent) for whom the leading risk factors were tobacco, unsafe sex, unhealthy diet, obesity and high blood sugar.

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What about the risks of ageing?

The analysis concludes that most of the incidence and deaths are mostly driven by population growth and increasingly ageing populations, with the majority of people affected living in low- and middle-income countries. “Most of the increases in cases and deaths will be due to population growth and the rise of ageing populations…. Improvement, however, is still far away from the ambitious UN Sustainable Development Goal (SDG) to reduce premature mortality due to non-communicable diseases, which include cancer, by a third by 2030,” lead author Dr Lisa Force from the Institute for Health Metrics and Evaluation (IHME), University of Washington, US, has said in the report.

Despite advances in cancer treatment and efforts to tackle cancer risk factors, the analysis indicates that if urgent action and targeted funding are not taken up, then worldwide cancer cases could rise to 61 per cent in 2050.

What’s the most diagnosed cancer?

In 2023, breast cancer was the most diagnosed cancer worldwide for both sexes, combined with tracheal, bronchus and lung (TBL) cancer being the leading cause of cancer deaths. “Our analysis also highlights the need for more data from sources such as cancer and vital registries, particularly in lower resource settings. Supporting cancer surveillance systems is crucial to informing both a local and global understanding of the cancer burden,” say study authors.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

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