Why do women in India face higher cancer incidence but lower mortality than men

Understanding Cancer Incidence & Mortality

• Incidence: Number of new cancer cases diagnosed in a population during a specific time period.
• Mortality: Number of deaths due to cancer in the same period.
• Crude Incidence Rate (CIR): New cancer cases per 100,000 population.
• Age-Adjusted Incidence Rate (AAIR): Statistical measure adjusted for differences in age distribution across populations (older populations naturally have more cancer cases).

Relevance:

• GS II (Health – Public health, Disease burden, Cancer screening, Gendered healthcare inequality)
• GS I (Society – Gender issues, Women’s health & nutrition, Patriarchy in healthcare access)
• GS III (Science & Tech – Preventive healthcare, Vaccination, Epidemiology)
• Essay/Case Study (Ethics – Healthcare equity, Gender justice, Lifestyle diseases)

Current Trends in India (2015–2019, PBCR Data)

• Incidence:
  • Women: 51.1% of cases (≈700,000 cases).
  • Men: 48.9%.
• Mortality:
  • Men: 55% of cancer deaths.
  • Women: 45%.
• Most common cancers:
  • Women: Breast, cervical, ovarian.
  • Men: Oral, lung, prostate.
• Regional hotspot: Northeast India (Aizawl, Kamrup Urban, Papumpare, East Khasi Hills).

Why Women Face Higher Cancer Incidence

1. Biological & Reproductive Factors
   1. Hormonal exposure (estrogen, progesterone) → breast & ovarian cancer risk.
   2. Delayed childbirth, fewer pregnancies, reduced breastfeeding.
   3. Menstrual/reproductive patterns linked to higher hormone exposure.
2. Lifestyle & Environmental Changes
   1. Sedentary lifestyle, obesity, poor diet (processed foods, low fibre).
   2. Alcohol & tobacco use rising among women.
   3. Pollutants in air, chemicals in cosmetics, pesticides, processed foods → hormone-related cancers.
3. Occupational & Social Risks
   1. Entry into workforce (exposure to chemicals, night shifts).
   2. Greater susceptibility to infections (e.g., HPV for cervical cancer).
   3. Gender inequality → poor nutrition, limited screening access, lower economic parity.

Why Women Have Lower Cancer Mortality

1. Nature of Predominant Cancers
   1. Breast & cervical cancers → relatively higher survival rates if detected early.
   2. Breast cancer: 5-year survival >90% (early diagnosis, treatment).
   3. Cervical cancer: Preventable via HPV vaccination, detectable through Pap smears.
   4. In contrast, men’s cancers (oral, lung, liver) are highly aggressive with poor survival outcomes.
2. Awareness & Screening
   1. Large-scale campaigns for breast & cervical screening.
   2. HPV vaccination drives (though limited) improving survival chances.
   3. Women’s reproductive health often a focus in public health interventions.
3. Behavioral Factors
   1. Men have higher tobacco & alcohol use → aggressive cancers + late diagnosis.
   2. Men less likely to seek preventive healthcare compared to women.

Why Women’s Mortality is Rising Faster Now

• Healthcare Gaps: Late-stage diagnosis, poor rural access to oncology facilities.
• Socioeconomic Barriers: Costs of treatment, patriarchal decision-making limiting healthcare spending on women.
• Misdiagnosis & Delays: Symptoms ignored, stigma around breast/cervical exams.
• Double Burden: Women face biological susceptibility + structural neglect.
• Trend Projection: Over the next 2 decades, female cancer deaths projected to rise faster than men’s (Lancet 2025).

Key Takeaways

• Higher Incidence: Women more exposed to reproductive, hormonal, and lifestyle-linked risk factors.
• Lower Mortality (Currently): Women’s cancers more survivable with early detection, while men’s cancers (oral/lung) have poor outcomes.
• Alarming Trend: Mortality among women is rising quickly due to healthcare inequality, misdiagnosis, and changing lifestyles.
• Policy Priority:
  • Expand HPV vaccination & cervical screening.
  • Tackle environmental pollutants & unsafe cosmetics.
  • Integrate cancer detection in primary health systems.
  • Address gender bias in healthcare access & affordability.