Cancer deaths rose to 10.4 million and new cases jumped to 18.5 million globally in 2023, an increase of 74 per cent and 105 per cent since 1990, according to a new analysis published in The Lancet. While this spiral seems alarming, four out of 10 cancer deaths were linked to established risk factors like smoking, poor diet and high blood sugar, all of which can be controlled to prevent the disease.
In India, the number of cancer cases rose sharply to an estimated 5.43 million in 2023. In 1990, the rate of new cancer cases in the Indian population, adjusted to account for differences in age (age-standardised cancer incidence rate) was 84.8 per lakh population. This rate increased by 26.4 per cent, reaching 107.2 per lakh population by 2023. The age-standardised mortality rate in India in 1990 was 71.7 per lakh population, which increased by 21.2 per cent, reaching 86.9 per lakh in 2023.
As per the analysis conducted by the Global Burden of Disease Cancer Collaborators, at least 30.5 million people worldwide are forecast to receive a new cancer diagnosis in 2050 while the annual global death toll has been predicted to increase by 75 per cent to 18.6 million.
What are the top cancers responsible for mortality in India?
“The top cancers responsible for mortality and morbidity in India include breast, lung, oesophagus, oral, cervical, stomach and colon cancers,” says Rakhi Dandona, professor, Public Health Foundation of India (PHFI), who is one of the collaborators on the analysis. However, she feels that the findings have to be interpreted in the context of ongoing cancer data being collected in cancer registries. Dr C S Pramesh, director, Tata Memorial Hospital, Mumbai and convenor, National Cancer Grid, says India has 38 population-based cancer registries which roughly cover 12 per cent of the population. In 2022, the total estimated incidence was 1.4 million cases and 910,000 deaths. “The common cancers among Indian women are breast, cervical and ovarian while in men, it is the oral, lung and the oesophagus,” he says.
What are risk factors?
At least 42 per cent (4.3 million) of the estimated 10.4 million cancer deaths globally in 2023 were attributable to 44 potentially modifiable risk factors, including tobacco use, an unhealthy diet and high blood sugar. “As far as India is concerned, major risk factors are diet, alcohol use, air pollution and obesity,” says Prof Dandona.
This means an aggressive reworking of our lifestyle protocols at the community level as a cancer-preventive measure. “We have to strengthen prevention efforts by reducing tobacco consumption, promoting healthy lifestyles, improving awareness and early detection among both public and primary care physicians. We should also enhance high quality, evidence-based, affordable treatment close to patients’ homes,” Dr Pramesh adds.
A greater proportion of global cancer deaths in men (46 per cent) in 2023 was linked to potentially modifiable risk factors (mostly tobacco, unhealthy diet, high alcohol use, occupational risks, and air pollution) than in women (36 per cent) for whom the leading risk factors were tobacco, unsafe sex, unhealthy diet, obesity and high blood sugar.
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What about the risks of ageing?
The analysis concludes that most of the incidence and deaths are mostly driven by population growth and increasingly ageing populations, with the majority of people affected living in low- and middle-income countries. “Most of the increases in cases and deaths will be due to population growth and the rise of ageing populations…. Improvement, however, is still far away from the ambitious UN Sustainable Development Goal (SDG) to reduce premature mortality due to non-communicable diseases, which include cancer, by a third by 2030,” lead author Dr Lisa Force from the Institute for Health Metrics and Evaluation (IHME), University of Washington, US, has said in the report.
Despite advances in cancer treatment and efforts to tackle cancer risk factors, the analysis indicates that if urgent action and targeted funding are not taken up, then worldwide cancer cases could rise to 61 per cent in 2050.
What’s the most diagnosed cancer?
In 2023, breast cancer was the most diagnosed cancer worldwide for both sexes, combined with tracheal, bronchus and lung (TBL) cancer being the leading cause of cancer deaths. “Our analysis also highlights the need for more data from sources such as cancer and vital registries, particularly in lower resource settings. Supporting cancer surveillance systems is crucial to informing both a local and global understanding of the cancer burden,” say study authors.
