GS Paper 2
Syllabus: Issues Relating to Development and Management of Social Sector/Services relating to Health
Direction: The article tries to find out the reasons behind high cancer incidence and mortality in India despite the progress in cancer treatment.
- Even with improvements in treatment, both the incidence of cancer and mortality continue to rise in India.
- Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.
- According to a report by the American Cancer Society, deaths due to cancer have declined by 33% (translating into 3.8 million fewer deaths) in the United States since 1991.
- This success is mainly due to early detection, lower rates of smoking, and improvements in cancer treatment.
- However, this trend is yet to be reflected in India.
What is the incidence of cancer and mortality in India?
- According to an ICMR study, one in nine Indians will develop cancer during their lifetime. One in 68 men will develop lung cancer and one in 29 women will develop breast cancer.
Why are some cancers declining while others continue to rise?
- The incidence of cervical cancer has dropped in India over the last 50 years from 45 to 10 per 100,000 population.
- The decline is because of late marriages, fewer children, better hygiene, and vaccination (human papillomavirus vaccine (HPV)).
- At the same time, there is an increase in rates of breast cancer, especially in urban centres (45 per 100,000 in Hyderabad).
- This is because of the same reasons (which resulted in cervical cancer decline) – late marriages, having the first child at a later age, not breastfeeding, and a high protein diet.
- Unlike cervical cancer, there is no specific intervention for breast cancer other than screening because what causes it is unknown.
- The rates of tobacco-related cancers (oral, oesophageal) are also coming down, largely due to tobacco laws that have brought down smoking in public places.
- Lung cancers, however, remain a cause for concern. It is caused not only by smoking but also by pollution. For example, lung cancer rates are high in Arunachal Pradesh because they light fires indoors in winter.
- The survival rate for lung cancer is not very high and it is mostly diagnosed in the late stages.
Has there been progress in cancer treatment?
Yes, as the cure rate for various cancers is rising. For example,
- The cure rate for pancreatic cancer has doubled from 3% to 6% in the last 50 years.
- Prostate cancer has gone up from 60% to 100%.
- Breast cancer has improved from 50% to 90% with newer treatments.
- The infrastructure for the seven pillars of cancer care – prevention, surgery, chemotherapy, radiotherapy, imaging, laboratory diagnostics, and palliation – is inadequate in India.
- For example, there should be 1 radiotherapy machine per million population in developing countries (as per WHO standards). So, for 1.4 billion people in India, 1,400 machines are required, and we have only 700.
- In order to reduce mortality, the need is to ensure that people get diagnosed early and receive timely treatment.
- The first intervention has to be screening. For the three most common types of cancer (34% of cancers in India – breast, cervical and oral), this has already started through the government’s upgraded health and wellness centres.
- Screening should lead to treatment (in hospitals), which has to be accessible and affordable.
- The number of cancer care facilities must be increased (currently, one for every 5-crore population in India).
Conclusion: There are several programmes of the government that are working independently and in silos. In order to reduce incidence and mortality, there is a need to coordinate existing efforts.
In order to enhance the prospects of social development, sound and adequate healthcare policies are needed particularly in the fields of geriatric and maternal healthcare. Discuss. (UPSC 2020)