India is witnessing a sharp escalation in cancer incidence and mortality, with breast and lung cancers emerging as the leading causes of cancer-related deaths, according to a comprehensive analysis published in The Lancet by the Global Burden of Disease (GBD) Cancer Collaborators.
The findings, which paint a concerning picture of rising cancer trends across low- and middle-income countries, suggest that India could carry one of the world’s heaviest cancer burdens by 2050.
In 2023, India reported an estimated 5.43 million cancer cases, a significant jump from 1990 when the age-standardised cancer incidence rate was 84.8 per 1 lakh population. That figure rose by 26.4% to 107.2 per lakh in 2023. The mortality rate followed a similar trajectory, increasing from 71.7 to 86.9 per lakh during the same period — a 21.2% increase.
Globally, the scale of the crisis is equally stark. In 2023, 18.5 million new cancer cases and 10.4 million deaths were recorded — an increase of 105% and 74%, respectively, since 1990. These figures are projected to rise to 30.5 million cases and 18.6 million deaths annually by 2050, with the steepest increases expected in resource-constrained nations, including India.
Yet, amid this bleak scenario, the report highlights a critical area for intervention: nearly 40% of cancer deaths are linked to modifiable risk factors — such as tobacco use, poor diets, elevated blood sugar levels, and air pollution — offering a path for prevention and early action.
Unlike high-income countries where lung and colorectal cancers dominate mortality charts, India's cancer profile reflects distinct regional and behavioural risk factors.
In 2023, breast cancer emerged as the deadliest, accounting for 8.5 deaths per 100,000 population, closely followed by lung (tracheal-bronchial) cancers at 8.4, oesophageal cancer at 8.2, stomach cancer at 6.9, and oral cavity and lip cancers — largely linked to tobacco and betel quid use — at 6.5 deaths per 100,000.
These trends reflect the growing burden of lifestyle-related and environment-linked cancers, particularly in urban and peri-urban areas. Experts attribute the rise to tobacco use, poor air quality, nutritional shifts, and late-stage diagnoses.
“India has only 38 population-based cancer registries, covering just 12% of the population,” said Prof. Rakhi Dandona, Public Health Foundation of India, and a key contributor to the GBD study. The limited surveillance capacity, she said, poses a major challenge to evidence-based planning and timely interventions.
In 2022 alone, India reported 1.4 million cancer cases and 910,000 cancer-related deaths — numbers that are likely underestimated due to underreporting and diagnostic gaps.
“Most of the increases in cases and deaths will be due to population growth and the rise of ageing populations… Improvement, however, is still far away from the ambitious UN Sustainable Development Goal (SDG) to reduce premature mortality due to non-communicable diseases, which include cancer, by a third by 2030,” said Dr. Lisa Force, lead author of the report and researcher at the Institute for Health Metrics and Evaluation (IHME), University of Washington.
The GBD analysis underscores that over 40% of global cancer deaths are attributable to preventable risk factors. In India, oral and lung cancers have long been linked to smoking and smokeless tobacco, while breast and stomach cancers are increasingly associated with changing diets and sedentary lifestyles.
“While the age-standardised death rates have declined marginally, the reduction is not sufficient to meet the UN Sustainable Development Goal (SDG) of reducing premature non-communicable disease deaths by one-third by 2030,” the report noted.
Health experts argue that India's cancer control efforts must go beyond treatment-centric approaches and instead focus on early detection, health promotion, tobacco control, HPV vaccination, and environmental safeguards. Strengthening primary care infrastructure, expanding screening programmes, and increasing public awareness are essential.
The World Health Organization’s latest global report on cancer presents a sobering forecast — particularly for countries like India, where the steepest rises in cancer incidence are expected in the coming decades.
“I see a major driver of this crisis everyday — obesity and unhealthy diets. Excess body weight, junk food, processed sugars, and sedentary lifestyles are not just causing diabetes and heart disease; they are directly linked to higher risks of gastrointestinal, breast, liver, and even pancreatic cancers. Unfortunately, many patients realize this connection only when it is too late,” said Dr. Pankaj Sharma, Director of General, Laparoscopic, Bariatric & Robotic Surgery at Fortis Hospital, Shalimar Bagh, and Founder of Shalya Clinic, Delhi.
“What concerns me most is that the steepest rise in cancer will be in countries like India, where awareness about these risk factors is still low, and access to early detection is uneven. We need to understand that surgery and advanced technologies can save lives, but prevention will always save more,” said Dr. Sharma.
While the Lancet report points to a rapidly escalating public health crisis, it also offers policymakers a window of opportunity. Investments in cancer surveillance, risk-reduction strategies, and universal access to affordable care will be crucial to mitigating the long-term impact of the disease on India’s population and economy, said the report.
