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National Cancer Awareness: Can India close the care gap?

National Cancer Awareness: Can India close the care gap?

National Cancer Awareness: Can India close the care gap?
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By Ch Unnikrishnan  Nov 10, 2022 12:11:20 AM IST (Updated)

Cancer burden in India, which is currently ranked among the top three in the world in terms of number of new cases every year after the US and China, is actually worse than those two countries. The country’s reported new cases annually is more than 20 lakh, but the real incidences are at least three times higher. While the country has put in place its comparatively better resources and care, unequal distribution of resources, wide rural-urban divide, wrong selection of technologies and poor discussion among the industry and service stakeholders create a wide gap.

Cancer is undoubtedly one of the top causes of death and the fastest growing disease in India. But unfortunately, it is also one of the least addressed health issues, considering the priority that it actually deserves.

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The cancer burden in India, which is ranked among the top three in the world in terms of the number of new cases yearly after the US and China, is actually worse than that of these two countries.
Official data shows the new cancer cases reported in India every year are about 2 million on an average. However, the real incidences are at least three times higher. The other biggest concerns are the fastest growing cases of infant and child cancers, and the world's highest number of organ specific cancers such as head and neck, breast, cervix and ovary cancers.
The rate of growth in head & neck and breast cancer segments in India is much higher compared to the other top cancer affected countries like China, the US and the UK.
An October report by global consultancy firm EY and local industry body Federation of Indian Chambers of Commerce and Industry (Ficci) suggests  that India is currently faced with a sizeable cancer incidence burden, which continues to grow exponentially. 
This report also showed that the head & neck cancer are rising at 23 percent annually and other organ cancers such as prostate, ovarian and breast are increasing at the rate of 19 percent, 11 percent and 8 percent respectively every year. This is alarmingly faster than the overall disease growth.
States like Assam, Mizoram, Punjab, Kerala, Tamil Nadu and Karnataka, which together represent about 20 percent of India’s population unfortunately reported a disease prevalance rate of at least 130 cases per 1,00,000 people, which is more than 24 percent of the total patient population.
While India has initiated several cancer control programmes, involving central and state health budgets, patient awareness campaigns, screening and treatment both in the public and private settings. These have been running for decades.  However, the results have been suboptimal. It is obviously points out to the need of a rethink in the care model and its entire strategies.
For instance, the lacunas in providing healthy living conditions, inadequate  population screening, impediments in early detection and poor access to  modern diagnostics and precise treatments and lack of a result oriented approach create wide gaps in the overall care.
The country has allotted comparatively higher budgets for cancer care,  it also has access to modern technologies, both indigenous and imported, for cutting edge screening, diagnostics and treatments. However, unequal distribution of resources, wide rural-urban divide, wrong selection of technologies and absence of open discussion with all stakeholders, including healthcare institutions, industry, academia and patient groups widen these gaps.     
The EY-Ficci report says; “...cancer burden in India is typically characterised by poor and late stage detection. Especially, early detection-critical segments like    breast, lung and cervical cancers are typically diagnosed in stages 1 and 2, respectively.”
The late-stage detection coupled with poor access to quality treatment impacts the care outcomes negatively. While the cutting-edge treatments  are still not accessible to patients from the weak socioeconomic background.
A recent WHO report highlights that care for cancer mostly reflects inequalities in the world and there is a clear distinction between high- and low-income countries, with comprehensive treatment reportedly available in more than 90 percent of high-income countries but less than 15 percent of low-income countries.
Considering the data from India specifically, the world health report suggest that the survival of children diagnosed with cancer in countries like India is less than 30 percent while it is more than 80 percent in high-income countries. Similarly, survival of breast cancer patients five years after diagnosis now exceeds 80 percent in most high-income countries, while it is it is less than 66 percent in India.
Hence, it is time for India to act towards closing these gaps in care to bring this disease, which has once again emerged as the emperor of maladies in the country, in the much desired control.
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