Cancer will affect one in ten Indians in their lifetime. One in fifteen Indians will lose their lives to the disease.
These are the concerning findings of the latest edition of the World Cancer Report, published earlier this week by the World Health Organization (WHO). Among the key takeaways of the report is how unevenly dispersed the global cancer burden is, with lower- and middle-income countries (LMICs) set to account for the overwhelming majority of new cancer cases in the next two decades.
In 2018, there were 18.1 million cancer cases. By 2040, the WHO estimates there will be 29.4 million cases. The greatest increase will be seen in LMICs, where cases are predicted to jump by 81 percent. As such, by 2040, LMICs will account for two-thirds of the world’s cancer burden.
According to the WHO report, India reported almost 1.16 million cancer cases in 2018 and 784,821 deaths. Cancer mortality accounts for 19.1 percent of all premature deaths due to noncommunicable diseases (NCDs).
The WHO’s estimates as to the risk differ from the Government of India’s own, which suggest the risk for developing the disease is one in nine. “The estimates are marginally different as the IARC modelling is done using Indian Council of Medical Research-National Cancer Registry Programme (ICMR-NCRP) data, which is collected from 36 population-based registries and 236 hospital-based registries across states to calculate national estimates and state-wise trends,” explains Dr Prashant Mathur, director of the National Centre for Disease Informatics and Research under the ICMR.
The report does contain some good news for India. It ranks its population-based cancer registry as being of high quality; the country has an operational integrated plan for tackling NCDs and an operational national cancer control programme; and has delineated cancer management guidelines. However, there are many gaps in India’s response to cancer – one reflective of the problems linked to LMICs which is expected to drive the expansion of its cancer burden.
Compared to high-income countries, the treatment gap in LMICs is often more pronounced and survival rates are lower. For example, the public health systems of more than ninety percent of high-income countries provide comprehensive oncology treatment to their citizens. The same is true for fewer than fifteen percent of LMICs.
India is no stranger to gaps in its cancer infrastructure, which has dire portents for its many citizens affected by the disease. Last year, a parliamentary panel flagged the “highly inadequate” state of the country’s healthcare infrastructure in terms of tackling the disease. There are just 62 dedicated oncology care centres in the country and its number of oncologists is paltry considering its number of patients. Just 1,250 oncologists are available to service the country’s two million-plus cancer patients.
As Health Issues India reported on World Cancer Day earlier this week, “the need of the hour is for the current warnings about the inadequacies of India’s present response to its cancer burden and the gaps in its treatment infrastructure to not go unheeded, but be responded to and resolved.” The WHO report provides a clear call to action – with it being imperative for the call of WHO Director-General Dr Tedros Adhanom Ghebreyesus to be heeded.
“My hope and expectation is that this report will help countries to set priorities for investing in cancer control and universal health coverage….[but the] WHO does not work alone,” he writes in the foreword to the report. “Controlling cancer will require governments to prioritize investments and implement policies to address risk factors; countries to have trained health workers and medicines; civil society to take a lead in mobilising communities; development partners and donors to make strategic investments; individuals to make healthy choices; and industry to promote access and innovation.
“Recent decades have seen rapid innovation in cancer diagnosis and treatment. Yet the distribution and uptake of these services, medicines and technologies have been profoundly inequitable and inefficient. Being diagnosed with cancer shouldn’t be a death sentence because you do not have access to health care or the means to pay for it.”
“WHO report on cancer: setting priorities, investing wisely and providing care for all” can be accessed here.