Cancer kills 9.3 lakhs in India, smokeless tobacco a major worry

India, China and Japan were the three leading countries in Asia in terms of new cancer cases and deaths, researchers say.

Major worry

Cancer has become a more significant public health threat in the region with 94 lakh new cases and 56 lakh deaths in 2019.

China contributed the most in Asia with 48 lakh new cases and 27 lakh deaths while Japan recorded about 9 lakh new cases and 4.4 lakh deaths.

The researchers include those from the National Institute of Technology Kurukshetra and the All India Institute of Medical Sciences, Jodhpur and Bathinda.

Asian crisis

"We examined the temporal patterns of 29 cancers in 49 Asian countries between 1990 and 2019 using estimates from the Global Burden of Disease, Injuries and Risk Factors 2019 Study (GBD 2019)," they wrote in their study.

They found that in Asia, the leading cancer was that of tracheal, bronchus and lung (TBL), resulting in 13 lakh cases and 12 lakh deaths.

Men, women

It was found to be most frequent in men and third most frequent in women.

Among women, cervical cancer was ranked second or among top five cancers in several Asian countries.

At the same time, the human papillomavirus (HPV) vaccine, introduced in 2006, has proved to be effective in preventing the disease and reducing HPV-related deaths, the researchers said.

Forms of cancer

Overall, in the continent and individual countries, TBL, breast, colon and rectum cancer (CRC), stomach and non-melanoma skin cancer were among the top five most frequent cancers in 2019.

Some countries also reported leukemia, prostate, liver and pancreatic cancers.

Smoking, alcohol consumption and ambient particulate matter (PM) pollution remained dominant among the 34 risk factors for cancer, the researchers said.

Pollution worries

Five of the top 10 countries with regards to population-weighted annual average of PM2.5 in 2019 are in Asia: India, Nepal, Qatar, Bangladesh and Pakistan.

The researchers said that the primary reasons for increasing air pollution in Asia were industry-led economic growth along with urbanisation, rural-to-urban migration and increasing usage of motor vehicles.

They also said that a high prevalence of smokeless tobacco such as khaini, gutkha, betel quid and paan masala was a public health concern in South Asian countries.

Indian toll

India alone accounted for 32.9 per cent of global deaths and 28.1 per cent of new cases of lip and oral cavity cancer in 2019.

"More than 50 per cent of the oral cancer burden has been attributed to smokeless tobacco,” the team wrote.

The researchers wrote that improved water and sanitation can help reduce the transmission of Helicobacter pylori (H. pylori) and potentially lower the risk of stomach cancer.

Healthcare facilities

"Mere availability of screening might not improve the survival rates if cancer treatments are either unavailable or unaffordable," the team wrote.

In the low- and medium-income countries (LMICs) of Asia, oncologic infrastructure is either scarce or unaffordable, particularly in rural areas.

Therefore, along with timely availability of cancer screening and treatment, its cost-effectiveness or coverage of treatment expenses must be a policy priority, they said.