Cancer cases as well as mortality are increasing rapidly among Indian women, primarily because of low awareness and late detection. India accounts for the third highest number of cancer cases among women after China and the US, growing annually at 4.5-5%.
According to a report ‘Call for Action: Expanding cancer care for women in India, 2017’, cancer among women in India is estimated at 0.7 million. However, the real incidence is much more between 1 and 1.4 million per year as many cases go undiagnosed or unreported.
India also ranks among the top two countries globally on mortality for key women-specific cancers. Data shows that cervical and breast cancer mortality rates in India are 1.6 to 1.7 times higher than the maternal mortality, highlighting the significantly adverse mortality rates for women-specific cancers in the country. India topped the list for mortality for breast and cervical cancers and reported the second highest incidence for ovarian cancer globally.
According to the report, released by E&Y in association with Ficci Flo, in 2015, cancers of the breast (19%), cervix uteri (14%) and ovary (7%) contributed to 40% of all cancer incidence among women with states such as Kerala, Tamil Nadu and Delhi having the highest incidence for these cancers.
It is alarming that awareness level of women-related cancers is low among the general population and even medical professionals. Despite the established benefits of screening, coverage in India is low for women. India-based studies have confirmed that screening improves early detection of cancers by 1.5-2.5 times. For instance, cancers such as breast and cervical can be cured if detected early and treated adequately.
According to the report, of the 2,000 new women diagnosed with cancer every day, 1,200 are detected in late stages. This reduces five-year survival rate by 3 to 17 times for breast and cervical cancer. Late detection also adds to the cost of treatment. Estimates show treatment cost for late-stage cancers is 1.5 to 2 times higher than the cost for early-stage cancers.
In fact, the mortality to incidence ratio, which is a key indicator for measuring effectiveness of national cancer control programmes, is the worst in India for key women-specific cancers when compared to global peers.
The report estimates the economic burden of cancer care treatment to be the highest compared to all other diseases, with the cost of a single hospitalisation exceeding the average annual per capita expenditure of more than 60% of the population.
It also projects cancer incidence among women in India to increase from 110 per 1 lakh population to 190-260 per 1 lakh population by 2025, which will mirror incidence rates of China and other upper middle income countries such as Brazil and Thailand.
In the wake of this, the E&Y report recommends that skilling and capacity building are needed. Promotion of investment in building cancer care centres in 10 focus states supported by appropriate funding through Centre and state allocation of budgets is vital.