Increase in cancer mortality among Indian women, declining trend seen in men, reveals study by Amrita Hospital, Kochi

Kochi: The cancer mortality trend in India has decreased by 0.19% annually among men but increased by 0.25% among women, which translates to an increase of 0.02% among the combined sexes, an analysis of mortality trends of 23 major cancers in the Indian population, which killed 12.85 million Indians between 2000 and 2019, has found.

The study, published in JCO Global Oncology, a journal affiliated with the American Society of Clinical Oncology, was conducted by Ajil Shaji, Dr. Pavithran K, and Dr. Vijaykumar DK from the Amrita Hospital, Kochi, in collaboration with Dr. Catherine Sauvaget from the International Agency for Research on Cancer, a division of WHO.

According to the study, increasing mortality trends were seen among cancers of the lung, breast, colorectum, lymphoma, multiple myeloma, gallbladder, pancreas, kidney, and mesothelioma between 2000 and 2019. The highest annual increase in mortality was observed in pancreatic cancer among both sexes at 2.7% (2.1% among men and 3.7% in women). However, the stomach, esophagus, leukemia, larynx, and melanoma cancers showed a declining cancer mortality trend irrespective of sex.

The cancer mortality was high among men than women for all common cancers except thyroid (0.6) and gallbladder (0.6) cancers. Larynx cancer had almost a 6-fold high mortality among men than women, followed by lung (2.9), melanoma (2.5), urinary bladder (2.3), mouth and oropharynx (2.2), and liver (1.9), while stomach and colorectal cancer mortality was relatively similar among both sexes, the study has found.

Ajil Shaji, Head of Cancer Registry at Amrita Hospital, Kochi, said: “Cancer mortality trends have not been documented across the population of India. We, therefore, analyzed the overall and individual cancer mortality trends for 23 major cancers between 2000 and 2019 on basis of Global Health Observatory (GHO) database. This estimation-based study might be a substitute for constructing precise and efficient health care infrastructure to acquire better cancer control programs in India in the absence of a national cancer registry or countrywide cancer mortality data.”

Talking about the findings of the study, Dr. Vijaykumar DK, Head of Dept. Breast & Gynec Oncology, Amrita Hospital, Kochi, said: “We wanted to investigate how the number of cancer-related fatalities has changed in India over the past two decades. The study has shown that cancer mortality trend among men in India have shown a slight yet statistically significant decrease over time.

In contrast, the increase in cancer mortality among women and both sexes combined has been minor and not statistically significant. Among all common malignancies, women had higher rate of gallbladder and thyroid cancer mortality than men; meanwhile, a yearly significant increase of pancreatic cancer mortality was seen among both sexes, with higher increase in women.”

Added Dr. Pavithran K, Head of Dept. Medical Oncology, Amrita Hospital, Kochi, said: ‘The study highlights the need for a multi-pronged approach to address the rising cancer mortality rates in India, including awareness on cancer symptoms, cancer prevention policies, improved health infrastructure, and specifically dedicated human resources. A multi-faceted strategy is required to tackle India’s rising cancer mortality rates.

Lack of knowledge about cancer symptoms delays treatment for preventable cancers. We need better infrastructure, dedicated human resources, and expanded cancer screening programs. The best long-term strategy could be implementing awareness of cancer symptoms among the population and cancer prevention policies with improved health infrastructure and specifically dedicated resources.”

Globally, cancer is the second most lethal noncommunicable disease after cardiovascular disease, accounting for about 9.9 million deaths in 2020. Around 9% of all cancer deaths occurred in the Indian population. The country has a 63.1 per 100,000 age-standardized mortality rate (ASMR) for cancer, with men and women accounting for 65.4 and 61.0, respectively.

Between 2000 and 2019, 12.85 million deaths occurred in India from 23 major cancers. The most common lethal cancers were mouth and oropharyngeal (15.6%), stomach (10.6%), lung (9.6%), breast (9%),and colorectal (8%) cancers.