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Cancer, once considered an uncommon and fatal disease, has become an increasingly prevalent health issue globally and in India. Alarming trends show India as one of the countries with rapidly rising cancer rates, and it is often known as the "cancer capital of the world."

Shifts in lifestyle, environmental factors, and dietary habits have all contributed to this rising epidemic, affecting not only older adults but also a growing number of young people. However, apart from all of these factors, one factor that has played a major role in increasing cancer cases in India is pollution.

The World Health Organization (WHO) has classified air pollution, particularly fine particulate matter (PM2.5), as a Group 1 carcinogen, meaning it is known to cause cancer in humans. Research indicates that long-term exposure to polluted air can significantly increase the risk of lung cancer, as well as other types of cancers such as bladder, breast, and colon cancer.

A study published in The Lancet Oncology found that people living in areas with high levels of air pollution are at a higher risk of lung cancer, with PM2.5 particles penetrating deep into the lungs, causing cellular damage and inflammation that may lead to cancer. Another study by the American Cancer Society showed a direct correlation between high levels of air pollution and an increased incidence of cancers in non-smokers.

The carcinogenic effects of air pollution are particularly concerning for vulnerable populations, including children, the elderly, and those with pre-existing respiratory conditions.

Recent studies show an unprecedented surge in cancer cases in India. According to estimates from the Indian Council of Medical Research (ICMR), the country sees over 1.3 million new cancer cases every year, with this number projected to rise sharply over the next decade. By 2040, cancer incidence in India is expected to double, posing a significant challenge to the healthcare system. Furthermore, the mortality rate from cancer in India is among the highest globally, largely due to late-stage diagnoses and limited access to advanced treatments in rural areas.

Data from the WHO and IARC (International Agency for Research on Cancer) place India at a critical point, highlighting that cancer has become one of the leading causes of death. India’s cancer burden is compounded by unique factors, including an exceptionally high incidence of cancers of the oral cavity, lungs, breast, cervix, and stomach, each strongly tied to specific cultural and environmental factors.

Why Are Cancer Cases Rising in India?

Dr Arun Kumar Goel, Chairman, Surgical Oncology, Andromeda Cancer Hospital shares that air pollution levels in Indian cities are among the highest in the world, and exposure to pollutants has been linked to increased risk for cancers, particularly lung cancer. In addition to air pollution, water contamination and exposure to industrial waste in certain regions have led to a higher incidence of cancers in those areas.

Dr Goel explains that apart from pollution, cancer cases in India are influenced by several new and rapidly evolving risk factors:

1. Changing Dietary Habits and Adulterated Food: Food adulteration is a growing problem in India, where chemicals like formalin, pesticides, and artificial dyes are sometimes used to enhance the appearance and longevity of food products. The shift towards processed and packaged foods, high in unhealthy fats, sugars, and preservatives, has contributed to increased cancer risk, particularly for digestive and colorectal cancers.

2. Lifestyle Changes: Urbanization and lifestyle shifts have had a profound impact on cancer risk. Sedentary behaviour, lack of exercise, smoking, and alcohol consumption have all been strongly linked to cancer, especially in cities. India’s shift from traditional diets to fast food and sugar-rich diets also plays a significant role, with obesity on the rise—a major risk factor for multiple cancer types.

3. Rising Incidence Among Younger Patients: In a concerning trend, cancers once considered typical of older adults are now appearing more frequently among younger patients in their 20s, 30s, and 40s. Studies attribute this shift partly to lifestyle factors like smoking, alcohol use, and high stress levels, as well as increasing exposure to environmental toxins and unhealthy diets.

4. Increasing Prevalence of Obesity: Obesity is a known risk factor for cancer, associated with hormone-driven cancers like breast, endometrial, and colorectal cancer. India has witnessed a sharp rise in obesity, particularly in urban centres, where sedentary lifestyles and processed food consumption are more prevalent.

5. Genetic Factors and Familial Predisposition: Advances in genetic testing and precision oncology have shed light on familial predispositions for certain cancers, revealing that some individuals carry higher genetic risks for cancers, particularly breast, ovarian, and colorectal cancers. Genetic counselling and testing are becoming essential for families with a strong history of cancer.

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