India witnessed sharp 26.4% surge in cancer incidence rates over the past 3 decades

Without urgent action and targeted funding, 18.6 million are expected to die from cancer in 2050

India has witnessed a sharp 26.4% surge in cancer incidence rates over the past three decades, climbing from 84.8 cases per 100,000 people in 1990 to 107.2 in 2023, a landmark study published in The Lancet revealed on Wednesday.

Representative photograph. (Freepik)(Freepik)

The country’s cancer mortality rates have simultaneously risen 21.2%, increasing from 71.7 deaths per 100,000 in 1990 to 86.9 in 2023, mirroring global trends that show accelerating cancer burden despite medical advances.

In relative terms, India ranks 168th out of 204 nations for cancer death rates, suggesting that while absolute numbers are rising due to population growth and ageing demographics, India’s age-adjusted rates remain lower than most countries worldwide.

Dr PK Julka, former head of radiation oncology department, AIIMS-Delhi, said, “Aging is one of the causes of various types of cancers that one can get due to overexposure to various pollutants including atmospheric, and food. The age-adjusted rates may seem low currently because India is a relatively young country, but it is just a matter of time before the numbers go through the roof. It has already started.”

The comprehensive analysis, titled ‘The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050’, examined 47 cancer types across 204 countries and territories, providing the most detailed picture yet of the global evolving cancer landscape. It found that globally, the number of new cancer cases has more than doubled since 1990 to 18.5 million in 2023; while the number of cancer deaths increased 74% to 10.4 million.

Without urgent action and targeted funding, 30.5 million people are forecast to receive a new cancer diagnosis and 18.6 million are expected to die from cancer in 2050—with over half of new cases and two-thirds of deaths occurring in low- and middle-income countries (LMICs), it added.

“Cancer remains an important contributor to disease burden globally and our study highlights how it is anticipated to grow substantially over the coming decades, with disproportionate growth in countries with limited resources,” said lead author Dr Lisa Force from the Institute for Health Metrics and Evaluation (IHME), University of Washington, USA. “Despite the clear need for action, cancer control policies and implementation remain underprioritised in global health, and there is insufficient funding to address this challenge in many settings.”

In India, breast cancer has emerged as India’s deadliest malignancy, claiming 8.5 lives per 100,000 people annually—a shift that reflects changing demographics and lifestyle patterns. Lung cancer follows closely at 8.4 deaths per 100,000, whilst oesophageal cancer ranks third at 8.2 deaths per 100,000.

Stomach cancer (6.9 deaths per 100,000) and oral cavity cancer (6.5 deaths per 100,000) round out the top five—patterns linked to the country’s unique cultural and dietary practices.

The study identifies several India-specific risk factors that distinguish the country’s cancer profile from global patterns. Betel nut and pan consumption directly correlate with high oral cancer rates, while traditional practices such as consuming very hot beverages may contribute to elevated oesophageal cancer incidence.

“Tobacco use is tremendous in India— both smoking and smokeless— and it leads to not just head and neck cancer but there is emerging evidence showing it can cause bladder and kidney cancer as well. The problem is that the awareness among masses still remains low,” added Dr Julka.

Tobacco use in multiple forms—smoking, chewing, and bidis—continues to fuel lung and oral cancers, whilst traditional food preservation methods involving pickled and preserved foods are linked to stomach cancer rates.

The research found that 42% of global cancer deaths result from modifiable risk factors, presenting significant prevention opportunities. For India, this translates to potentially preventable cases through targeted interventions addressing tobacco use, dietary modifications, infection prevention, and lifestyle changes.

“Ensuring equitable cancer outcomes globally will require greater efforts to reduce disparities in health service delivery, including access to accurate diagnosis and quality treatment,” Force emphasised.

The study’s forecasts suggest that with India’s massive population of 1.4 billion, even relatively modest rate increases translate into millions of additional cases, making prevention strategies critical for managing future healthcare demands.