Preventable Cancers in India

Why in news ?

• A WHO–IARC linked study estimates ~40% of cancers in India are preventable, highlighting large scope for primary prevention through lifestyle change, vaccination, pollution control, and infection management.
• Study analysed 30 preventable cancers using Indian exposure data on tobacco, alcohol, obesity, infections, diet, and pollution, quantifying attributable fractions for evidence-based cancer control policies.

Basics and background

• Cancer involves uncontrolled cell growth driven by genetic mutations; risk arises from interaction of lifestyle, environmental exposures, infections, and ageing, making many cancers theoretically preventable through risk reduction.
• Primary prevention targets risk-factor reduction before disease onset, unlike secondary prevention which relies on screening and early detection after disease processes have begun.

Key findings and data

• 37% of new cancer cases in 2022 (~14 lakh cases) were attributable to known preventable risk factors, showing significant avoidable burden within India’s overall cancer incidence.
• Men (50.6%) show higher preventable burden than women (30.3%), reflecting higher tobacco and alcohol consumption patterns among males in India.
• Tobacco alone accounts for 13.4% of cancers, making it the single largest preventable contributor to India’s cancer burden.
• Infections contribute 13.4%, including HPV, hepatitis B/C, and H. pylori, indicating strong role of vaccination and sanitation in cancer prevention.
• Alcohol contributes 6.4%, obesity 5.7%, air pollution 3.9%, showing rising lifestyle and environmental cancer risks alongside traditional factors.

Public health and governance dimension

• India’s cancer burden rising due to epidemiological transition, ageing population, and urban lifestyles, increasing pressure on already resource-constrained oncology infrastructure.
• Prevention aligns with National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) focusing on screening, awareness, and lifestyle modification.
• Population-level interventions offer higher cost-effectiveness compared to tertiary cancer treatment, which is expensive and infrastructure-intensive.

Social and behavioural dimension

• High-risk behaviours like smoking, smokeless tobacco, unhealthy diets, and sedentary lifestyles are shaped by socio-economic and cultural factors, requiring behavioural-change communication.
• Lower awareness and late diagnosis among poorer groups worsen outcomes, making prevention and early education crucial for equity in cancer control.

Environmental dimension

• Air pollution contributes nearly 4% of cancers, especially lung cancer, linking environmental regulation directly with non-communicable disease control.
• Industrial emissions, vehicular pollution, and biomass burning increase carcinogenic particulate exposure in Indian cities.

Global and comparative perspective

• WHO estimates 30–50% of global cancers are preventable, placing India within global pattern but with higher tobacco and infection-related burden than many developed countries.
• Countries with strong tobacco control and HPV vaccination show significant cancer incidence decline, demonstrating policy effectiveness.

Challenges and gaps

• Weak enforcement of tobacco and alcohol regulations reduces impact of prevention policies.
• Limited HPV and Hepatitis B vaccination coverage constrains infection-related cancer prevention.
• Urban pollution control remains inconsistent despite regulatory frameworks.
• Behavioural change is slow due to addiction and social norms.

Way forward

• Strengthen tobacco taxation, plain packaging, and cessation services to reduce largest risk factor.
• Expand HPV and Hepatitis B vaccination under Universal Immunisation Programme.
• Integrate cancer prevention into Ayushman Bharat–Health and Wellness Centres for grassroots awareness.
• Enforce air-quality standards and promote healthy urban planning.
• Invest in mass awareness campaigns on diet, exercise, and alcohol risks.

---