Four in 10 cancer cases among Indian men and women are preventable, says study

In India, nearly 4 in 10 (37.1%) cancers are preventable or for both women and men which amounts to approximately 520,000 cases. The top modifiable contributors to cancer are infections, accounting for 13.4% of the total cancer burden, tobacco smoking accounting for 10.5% of the total cancer burden and smokeless tobacco and areca nut consumption accounting for 5% of the total cancer burden.

The burden of potentially preventable cancer is higher among men with over 4 in 10 cancers being due to modifiable risk factors (44.7%; more than 305,000 cases) in India. Among women, around 3 in 10 cancers are potentially preventable (30.5%; approximately 218,000 cases).

Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study at a virtual media conference said that by examining patterns across countries and population groups, they can provide governments and individuals with more specific information to help prevent many cancer cases before they start. According to Dr Isabelle Soerjomataram, Deputy Head of the IARC Cancer Surveillance Unit, this landmark study is a comprehensive assessment of preventable cancer worldwide, incorporating for the first time infectious causes of cancer alongside behavioural, environmental, and occupational risks.

Oral, lung and stomach cancers among top ones that are preventable among men

As per the analysis, the top modifiable contributors to cancer among men in the country include tobacco smoking. This accounts for 18.5 % of all new cancer cases, smokeless tobacco and areca nut consumption accounting for 7.7% of all new cancer cases and infections accounting for 7.6 % of new cancer cases. Among men the top cancers which are potentially preventable include lip, oral cavity (more than 85,000 cases can be prevented mainly due to smokeless tobacco, areca nut consumption and tobacco smoking). This is followed by lung cancer where more than 45,000 cases are potentially preventable mainly due to tobacco smoking) and stomach cancers where over 31,000 cases are potentially preventable mainly due to infectious agents.

Cervical, breast and oral cancers among top ones that are preventable among women

The top modifiable contributors to cancer among women are: (1) infections accounting for 20.2% of all new cancer cases among women, (2) insufficient physical activity accounting for 2.7% of all new cancer cases, and (3) smokeless tobacco and areca nut consumption accounting for 2.4% of all new cancer cases. The top cancers which are potentially preventable among women are: (1) cervical (more than 127,000 cases are potentially preventable mainly due to high-risk human papillomavirus (HPV)), (2) breast (more than 25,000 cases are potentially preventable mainly due to insufficient physical activity as well as excess body weight), and (3) lip, oral cavity (more than 20,000 cases are potentially preventable mainly due to smokeless tobacco and areca nut consumption).

Why it is important to review impact of National Programme for Prevention and Control of NCD

Dr Partha Basu,Head, Early Detection, Prevention and Infections Branch of IARC (WHO) (not attached with the study) told The Indian Express that it was important to review the progress and impact of the National Programme for Prevention and Control of Nob-Communicable Diseases (NPNCD).

“Unfortunately the programme lacks SMART (specific, measurable, achievable, realistic and time bound) objectives for cancer/NCD prevention as recommended by the WHO. This makes it quite difficult even to monitor the progress,” Dr Basu said.

According to Dr Basu, the two most important infection preventable cancers in India are cervical and gastric cancers. “Every year we are delaying the introduction of HPV vaccine, we are pushing thousands of young girls to a lifetime risk of developing cervical cancer and these young girls unfortunately belong to the lowest socio-economic strata of the society. There is very little awareness about gastric cancer and its link to chronic infection from H Pylori – a waterborne bacteria. Availability of potable drinking water and healthy storage of food have drastically reduced gastric cancer across the globe. Unfortunately, there are pockets of high gastric cancer in India and the incidence is rising in some parts. This is quite concerning. We need to closely look into this,” Dr Basu said.

While stating that the government had taken a commendable step by raising taxes to reduce tobacco consumption, Dr Basu also flagged that low tax in the unorganised sector of tobacco production/consumption (e.g. bidi) and increasing availability of unregulated tobacco products (imported cigarettes, Shisha) are major concerns.