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Rising cases of Cancer in India: How early screening can help in handling cancer burden?

India has one of the biggest populations in the world. Our country's mixed demographics are remarkable, yet they present obstacles for cancer care. Because of the varied culture and lifestyle, various malignancies are prevalent in certain communities. Each geographical area should be planned independently.

Rising cases of Cancer in India: How early screening can help in handling cancer burden? RBA
First Published Apr 15, 2024, 7:00 AM IST

India has one of the biggest populations of any nation. Mixed demography is unique to our country, however it challenges cancer care. Because of the mixed culture and habits different cancers present in large among specific populations. Every geographic area should be planned separately.

According to the Global Cancer Observatory (GLOBOCAN), India ranks third after China and the USA in cancer incidence. Globocan also predicts an increase of almost 60 % in cancer incidence in India from 2020 to 2040. The Indian Council of Medical Research has seen about a 5 % increase in cases year on year and estimates an increase of 5 to 10 percent every 2 to 3 years, which is quite prohibitive. 

Globally, about half of the cancer burden is in the age group of 65+. In India, it is only 1/3rd. We are a young population, and as our population ages, we expect the trend to be similar. Cancer incidence burden is increasing in India. Among Females, Breast is the most common cancer, followed by female reproductive organs - The cervix, ovary and Uterus. Among Men, Lung and Oral Malignancy are common. Both are related to tobacco consumption. 

Cigarettes and Other Tobacco Products Act 2003, or the COTPA 2003, is a watershed moment in India's cancer prevention. It has been improved timely with amendments. It's been almost two decades, and it's almost time we start seeing results. Vaccination against cancer-causing viruses, such as Hepatitis B and HPV, is a very strong preventive strategy. This strategy can prevent a significant number of Liver and Cervical cancers. 

In India a large portion of the patients are detected in advanced stage lll and lV hence decreasing the survival with cancer. Screening is a practice to detect cancer in its very early or preclinical stage. Cancer detection in its early stage of l and ll improves the outcome. Such treatment would be cost-effective, less morbid and cosmetically appealing. It will also give the patient a good quality of life. Screening in simple terms is early detection and screening. 

Rising number of breast cancer cases with younger affected ladies in their 30's and 40's is a concern in India. Breast cancer is screen-detectable. Basic pillar of any screening is awareness. A “Breast aware” patient can be counseled for screening. 35 to 70 years old should undergo counseling for screening. The patient for screening is decided based on the age and risk. Younger age patients will benefit from sonomammograms; the older ones will need a Mammogram once a year or biannually.

Carcinoma cervix is another screen detectable cancer. It is advisable for a woman in reproductive age group or sexually active individuals to request for a pap smear from their gynecologist. They should also discuss about the relevance and timing of the screening. 

Oral Cancer and Lung Cancer screening applies to high risk individuals who use tobacco. Oral hygiene has to be noted and any type of ulceration should raise suspicion of cancer. 

Socioeconomic heterogeneity is a challenge in India with growing cancer cases. India is seeing a younger population affected and in delayed stages posing further challenges. Awareness and screening can bridge the deficiency. Picking up patients in early stages can promise better outcome and reduce financial burden to the society. 

-    Dr. Karthik K S, Consultant Surgical Oncology, KMC Hospital, Mangalore

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