By Deirdre Kelly, Ph.D.
At any one time, it is estimated that 2.5 million people are living with cancer in India. Over 550,000 people die here each year from cancer, with 70% in patients between the ages of 30-69. Lung, pharyngeal and oral cancer are the top cancers that contribute to male mortality rates, whereas cervical, uterine and breast cancer induce the highest death rates amongst women. Unfortunately, as early detection of cancer in India is rare, mortality rates are high and could be significantly reduced. The risk of getting cancer before the age of 75 in India is 10.4% according to GLOBOCAN, with an associated risk of death of 7.5%.
Over 5% of cancer cases are diagnosed in children each year. Between 25-40% of these cases are diagnosed as leukaemia, followed by lymphoma, Hodgkin’s disease and CNS tumors. There is also a trend of oral cancer in adolescents, due to exposure to tobacco. The incidence of liver cancer is also rising, and linked to the rise in hepatitis B and C infections.
Figure 1: Prevalence of Cancer Cases and Deaths in India, Male and Female
|Number of new cancer cases (thousands)||430.1||518.8||948.9|
|Age-standardised rate (W)||92.9||105.5||98.5|
|Risk of getting cancer before age 75 (%)||10.2||10.8||10.4|
|Number of cancer deaths (thousands)||321.4||312.1||633.5|
|Age-standardised rate (W)||71.2||65.5||68.0|
|Risk of dying from cancer before age 75 (%)||8.0||7.1||7.5|
|5-year prevalent cases, adult population (thousands)||620.2||1084.9||1705.1|
|Proportion (per 100,000)||149.4||277.1||211.4|
|5 most frequent cancers (ranking defined by total number of cases)|
|Lung||Cervix uterine||Cervix uterine|
|Lip, oral cavity||Breast||Breast|
|Other pharynx||Ovary||Lip, oral cavity|
|Oesophagus||Lip, oral cavity||Lung|
A recent article by Subhra Priyadarshini in Nature, indicates that the country has only one biobank, which is located in Tata Memorial Centre (TMC), Mumbai. This is the national comprehensive cancer centre which collects and stores oncology samples and biopsies for research and clinical purposes. The TMC is involved with numerous early detection programs and research projects including cervical cancer screening by “visual inspection with acetic acid (VIA)” test. It is also the country’s main oncology treatment centre, which means that most cancer patients must travel to Mumbai for follow-up care. The fact that this is the only national oncology biobank in a country of one billion people is astounding. With a potential patient pool of 2.5 million people, collection and analysis of oncology biopsies would provide research and clinical labs with an unprecedented resource.
Fortunately, the TMC has recently established a National Cancer Grid (NCG) which aims to connect all current and future oncology centres in India. This will potentially standardise treatment regimens and also promote research collaborations. To date 27 centres have joined the Indian National Cancer Grid. International collaborations with the TMC have also been recently announced including one with Kings College London. It is envisaged that the NGC will significantly improve oncology care throughout India in the future and reduce mortality rates through early detection programs.
For more information:
- Pharmaceutical Market India – A Comprehensive Industry Analysis, Kelly Scientific Publications
- India needs gen-next cancer biobank; Subhra Priyadarshini, Nature India, Published online 31st July 2013 http://www.nature.com/nindia/2013/130731/full/nindia.2013.103.html
- Tata Memorial Centre website: https://tmc.gov.in
- Kings College London: http://www.kcl.ac.uk/newsevents/news/newsrecords/2012/11-Nov/Kings-signs-partnership-agreement-with-Tata-Memorial-Centre.aspx