Opinion Express view on mapping cancer: First step towards making data on disease more robust

According to Global Cancer Care Observatory Data, India has the third-highest number of cases of the disease. The country’s ratio of cancer mortalities to malignancy incidences was 64.47 per cent in 2022, the highest among the top 10 countries in terms of the burden of the dreaded disease. Cancer has been a part of the country’s national healthcare programmes for at least five decades. The Indian Council of Medical Research’s Cancer Registry programme began in the early 1980s. Yet, cancer care in India remains a complex and evolving landscape. Targeted interventions have often been hobbled by the lack of a comprehensive cancer map. An analysis of 43 cancer registries across the country by national investigators — they comprise researchers from premier medical institutions — could plug some of the gap. It provides crucial data on the types of cancer in the country and the vulnerabilities of different sections of people, gender-wise and regionally.

Women accounted for a higher proportion of the cases (51 per cent) in the registries. This goes against the global trend. The discrepancy should alert policymakers to a challenge long underlined by cancer specialists. Breast and cervical cancers, which together account for more than 40 per cent of cases among women, are easier to detect and have better treatment outcomes — that’s why cancer cases among women are likely to be reported more, and they have a lower proportion of deaths due to the disease. In contrast, oral, lung, and gastric cancer are detected at a relatively later stage in the country. Oncologists believe that a significant number of such cases still fall off the radar. The study of cancer registries has important clues for the country’s cancer screening programmes. For instance, it flags the high burden of the disease, especially oral cancer, in several parts of the country’s Northeast. The highest lifetime risk of cancer was found to be in Mizoram — 21 per cent for men and nearly 19 per cent for women, far higher than the national rate of 11 per cent. Such disaggregated data could help policymakers frame region-specific awareness initiatives and detection programmes — targeting oral cancer in parts of the Northeast and Ahmedabad and Bhopal, for instance.

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The ICMR registries capture less than 20 per cent of the country’s population. Unlike in the case of infectious diseases — tuberculosis, for example — healthcare providers are not legally mandated to provide cancer-related data to the government. Seventeen states do have rules that require hospitals and doctors to provide such information. But some of the more populous states, including Uttar Pradesh, Maharashtra and Bihar, do not make such demands of their healthcare sector. The latest cancer registry study should spur the Centre and state governments to make data more robust. This could, in turn, foster better understanding of common preventable causes, improve the utilisation of resources and make government programmes more effective, ultimately improving the cancer survival rate in the country.