A silent assasin is stalking us more virulently than ever, especially our young, but to quote from Aleksandr Solzhenitsyn’s Cancer Ward, “you can have eyes and still not see”. It’s cancer, the second leading cause of death after cardiovascular diseases in India. Going by an estimate deduced from registered incidences since 2004, cancer cases in all age groups in the county is expected to reach 819,354 by the yearend. But the scarier bit, a cause of concern, is that cancer among adolescents and young adults—those between 15 and 29 years generally, and bundled under the abbreviation AYA—has risen over the years. An exact number isn’t available as data is still being collected. The volume could be significant because in a country of nearly 1.3 billion people, about 55 per cent of the population is below 35, and around 30-40 per cent of them are in the adolescent bracket.
Cancer in the AYA group is unique in the distribution of types as well as what it does to patients psychologically. As per Globocan 2018, International Agency for Research on Cancer, World Health Organization (WHO), the commonest cancers in this group are leukaemia (blood), germ cell tumour of the ovary, thyroid, oral, Hodgkin’s lymphoma, testicular, female genital tract malignancies, and bone sarcomas. A study from 2011 to 2014 on cancer patterns among 1,077 AYA cases at a tertiary care in northern India and published in South Asian Journal of Cancer in 2017 found that the most common was head and neck (32 per cent), followed by breast (14.2 per cent). “Cancer has the greatest impact on individuals from this group because it occurs when they are most productive. They suffer from adverse psychosocial effects because most of their potential years are spent battling cancer. This also puts a large economic burden on society,” says Ravi Mehrotra, chief executive officer, India Cancer Research Consortium.