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The Hindu
2 days ago
- Health
- The Hindu
Cancer is on the rise in India: could air pollution be a factor?
Over the past decade or so, air pollution has been increasingly spoken about in India, particularly in the context of the deterioration of air quality across large parts of the country, especially in the winter months. The air we breathe is known to be linked to respiratory illnesses and even cardiac disease, but now, experts say, there is also a strong association with a disease that is a rising burden in India: cancer. The scale of the cancer burden in India Cancer numbers are rising, and rising fast in India. The Indian Council of Medical Research-National Cancer Registry Programme has projected that the number of cancer cases in the country will spike from 14.6 lakh in 2022 to 15.7 lakh in 2025. Approximately one in nine people in India is expected to face a cancer diagnosis during their lifetime, the ICMR estimates. Cancer ranks second when it comes to non-communicable diseases that cause deaths in India. Lung cancer is the second-most common cancer among men in India, and also figures amongst the top five when it comes to women. Globally, it is the leading cause of cancer-related deaths, accounting for the highest mortality rates among both men and women. Over the past two decades, doctors say there has been a concerning pattern emerging in India: a rise in the number of non-smoking lung cancer cases. Traditionally, lung cancer has always been associated with smoking (which continues to remain the major risk factor) and its incidence has always been lower in India, compared to the West, says Kumar Prabhash, head, solid unit medical oncology, at Tata Memorial Hospital, Mumbai. 'Smoking rates have always been higher in the West and lower in India, and this was reflected in the lung cancer numbers. A large number of cases were associated with smoking, both in the West and India, in the past. Now however, and this is what we have been seeing over the past several years, there is a marked difference: a significant proportion of the lung cancer cases in India are in never smokers,' he says. Estimates vary, but several doctors agree that up to 30% of lung cancer cases that are now being seen are in those who have never smoked. At the Cancer Institute, Adyar, Chennai, two separate studies, one from 2012 and one from 2017, reflected this trend. In the first study, says Arvind Krishnamurthy, head of surgical oncology at the institute, researchers analysed patient data from 258 cases between 2003 and 2007, and found nearly 40% of the patients were non-smokers. In the second study, analysing data from 495 patients who came in during 2014-15, the non-smoking cases were over 55%,' he says. There are other factors that are also playing out in this pattern, the histology (the way cancer cells and tissues appear under a microscope) of the cancers for instance, is different: while most smokers present with squamous cell carcinoma, in non-smokers the usual presentation is adenocarcinoma, mirroring a global trend in the rise of adenocarcinoma, says Dr. Krishnamurthy. Age-wise, as with all cancers, patients in India are about a decade younger than those in the West, says Dr. Prabhash. Another concerning factor is that among women, the non-smoking lung cancers are higher than in men. The shift, doctors say, points to the urgent need to look beyond smoking and tobacco exposure for causes of lung cancer. Could air pollution be behind the rise? There is no doubt, says Krithiga Shridhar, head, Cancer Epidemiology Unit, Centre for Chronic Disease Control, New Delhi, that both outdoor (ambient) air pollution in general, and particulate matter (PM) in particular, are Group 1 carcinogens, meaning that there is sufficient evidence based on human studies that they have the potential to cause cancer. Indoor (household) air pollution, meanwhile, is classified as a group 2 carcinogen, meaning the evidence is probable. According to Swiss tech company IQAir's 2024 World Air Quality Report, India ranked as the fifth-most polluted country in the world with an annual average PM 2.5 concentration of 50.6 micrograms per cubic metre, against the World Health Organization's recommendation of 5, and higher than India's National Ambient Air Quality Standards of 40. 'The causal links are very well established between air pollution and lung cancer. The majority of evidence, however, is from settings where air pollution is low. From India, the evidence is still emerging,' Dr. Krithiga says. Doctors point out that while at present they can state that there is a strong association between air pollution and lung cancer, more definitive evidence is needed from the country to establish it as a cause. A 2022 research paper in the Indian Journal of Medical Research that described the epidemiology, and clinical profile of lung cancers in India, based on data from the National Cancer Registry Programme also notes this trend, and the potential role of indoor and outdoor air pollution. 'Compared to GATS (Global Adult Tobacco Survey) -1 (2009-2010), the prevalence of tobacco use has decreased in GATS-2 (2016-2017). Hence, there is an increasing recognition of the role of air pollution in the causation of lung cancer. According to recent findings of the National Non-Communicable Disease Monitoring Survey, almost half (48.5%) of the adults reported exposure to second-hand smoke at home, workplace or travel,' the paper states. Another contributor may be indoor (household) air pollution, particularly among women, say experts. The burning of solid fuels and biomass for cooking could be behind this. 'Even though the use of solid fuels for cooking has declined with most households switching to gas, their use in the past may be a factor, as lung cancer has a long latency period and generally presents a couple of decades after the exposure to the cause,' says Dr. Prabhash. Even in the northeast, says Ravi Kannan, director, Cachar Cancer Hospital and Research Centre, Assam, where the burden of cancer overall is the highest in India and where tobacco and alcohol use are major risk factors, the etiology (cause) of lung cancers is beginning to change, reflecting the larger Indian trend. 'Tobacco continues to remain a major cause of lung cancers here, but this is slowly shifting. The Northeast has always been one of the cleanest regions of India, but air pollution is beginning to be felt here as well. Also, in tribal communities, the fire is always kept burning, which could be a contributing factor, and while these traditional ways of life are changing now, it will take time for the impact of the change to be felt,' he says. Air pollution may not be the only factor however: a research paper published last year in The Lancet Regional Health - Southeast Asia, 'Uniqueness of lung cancer in Southeast Asia', states that occupational exposure to asbestos, chromium, cadmium, arsenic, coal-based products, as well as genetic susceptibility and pre-existing lung disease, could all be contributing, and these are all factors that need to be researched says Dr. Prabhash. The challenges of diagnosis and treatment Lung cancer has one of the highest mortality rates when it comes to cancers in India. Its diagnosis, however, is often late. Primarily, says Partha Pratim Medhi, assistant professor, radiation oncology, AIIMS Guwahati, this is because its symptoms are nonspecific – cough, chest pain and shortness of breath are seen with other conditions as well. 'Even in X-Rays, very few healthcare professionals will first suspect lung cancer,' he says. Dr. Prabhash adds that in India particularly, doctors are more prone to suspect tuberculosis first, potentially delaying the diagnosis. The 2022 research paper states that 'close to half of the patients had a distant spread of disease at the time of presentation in our analysis. Similar findings have been reported by studies from other Indian settings where most of the patients had Stage IV disease at the time of diagnosis.' Of 10 patients he sees in a month, says Dr. Medhi, there is perhaps one who has lung cancer that is in stage 1 or 2. Four are perhaps in stage 3, and the remaining five in stage 4. 'By this time the cancer has metastatised, spreading to the bones, brain, liver and other parts, which is why survival rates are low,' he says. While diagnostic facilities have improved over the years, with molecular testing now available to identify genetic changes and biomarkers to help with treatment plans, the infrastructure, for the most part, is still in tier 1 and tier 2 cities, making access an issue, says Dr. Prabhash. When it comes to treatment options too, most are available in India, but affordability remains a challenge. Immunotherapy, which has been showing promising results in lung cancer in other countries, is only partially available. 'Some of these drugs are approved in India, while others are not. But even the drugs that are approved are extremely expensive, putting them out of the reach of most people,' says Dr. Medhi. The way forward At present, the way air pollution is viewed is very narrow, says Abhishek Shankar, assistant professor, radiation oncology, AIIMS, Delhi. 'It is now emerging as a serious killer and should be viewed as such,' he points out. Currently, he says, India reports about 75,000 new cases of lung cancer each year, but this is projected to go up to 1 lakh cases, calling for urgent action. Data, say doctors, is what is needed: more research from India about the causes of lung cancer beyond smoking. 'While tobacco and smoking continue to be major risk factors, the pattern that has emerged now is well established, and we need to utilise this to find the links to the causes. Remember, air pollution is not only a risk factor for lung cancer – there is evidence for it across cancer sites including oral and urological, as well as childhood leukaemia,' says Dr Krithiga. In addition to extensive, India-based research into the links between air pollution and cancer, the country also needs measures to combat pollution, experts say. There is a window of opportunity in the Northeast now, to prevent the hazards of environmental pollution, says Dr. Kannan. 'We can intervene now, with a concentrated effort from the government, non-governmental organisations and civil society. The Northeast can learn, and equip itself to be able to prevent, and better handle cases in the future,' he says. When it comes to the rest of the country, household air pollution has been progressively declining in India. 'It has not been fully tackled, but we are making progress, especially with the provision of cleaner sources of fuel such as gas,' says Dr. Krithiga. Outdoor air pollution presents more of a challenge, she adds. 'The sources of outdoor pollution are multiple, and our handling of it needs to be multi-sectoral. We are at the stage of acknowledging and finding ways to address the problem. This is the way forward.'
The Hindu
4 days ago
- Health
- The Hindu
89% schools and 87% colleges declared tobacco-free: DPH
In Tamil Nadu, 89% of schools and 87% of colleges have been declared as tobacco-free educational institutions, according to the Directorate of Public Health and Preventive Medicine. Issuing a press release in line with the World No Tobacco Day (WNTD) observed on May 31, T.S. Selvavinayagam, Director of Public Health, said that Tamil Nadu has implemented comprehensive interventions focussed on enforcement, awareness, capacity building, cessation services and safeguarding institutions from tobacco exposure. This year, WNTD is observed on the theme 'Unmasking the appeal: Exposing industry tactics on tobacco and nicotine products' underscoring the urgent need to counter deceptive marketing strategies targeting children, adolescents and vulnerable communities, the release said. Listing out key achievements in tobacco control (up to May 2025) in the State, the directorate said on strict enforcement of the Cigarette and Other Tobacco Products Act (COTPA), a total of 4,60,486 persons were fined and a fine amount of ₹7,97,13,387 was collected. A total of 45,865 out of 51,477 schools and 2,173 out of 2,484 colleges were declared tobacco-free. To enforce Section 6 of COTPA and to protect the young, the directorate has asked district officials to ensure that all educational institutions mark the 100-yard tobacco-free zones by implementing the 'Yellow Line Campaign'. 'This year's theme reminds us that the battle against tobacco is not just about controlling consumption — it is about exposing the industries that profit by endangering lives,' he said. Dr. Selvavinagayam added that Tamil Nadu leads by example with widespread enforcement, education, and community engagement. 'Through initiatives like the Yellow Line Campaign, we are drawing a visible boundary between our children and the threat of tobacco.' In line with this year's theme, Cancer Institute (WIA) organised a series of events that included an awareness rally, sand sculpture, open mic and announcement of awareness messages in Chennai Metro Rail stations, according to a press release. The department of Psycho-Oncology, Cancer Institute (WIA) along with HCL Foundation organised the awareness rally at Elliot's Beach, Besant Nagar on May 31. Nearly 1,000 participants including school and college students took part. R. Murugan, Assistant Commissioner of Police, Greater Chennai Police, Adyar Range and T. G. Sagar, Governing Body Member and former director, Cancer Institute (WIA) were present. A social media campaign aligned with World Health Organisation's (WHO) WNTD was also held. It highlighted tobacco's harmful effects, debunked myths, and exposed industry tactics targeting youth, and promoted the health benefits of quitting tobacco to encourage informed choices. Sri Ramachandra Institute of Higher Education and Research conducted an awareness rally to mark WNTD. Students, faculty members and healthcare professionals participated in the rally. Sri Ramachandra Hospital has opened a cessation clinic as per WHO guidelines to overcome addiction of tobacco usage through counselling and supportive medication, a release said.
United News of India
27-04-2025
- Health
- United News of India
Maha: Fadnavis inaugurates modern equipment to treat cancer in Chhatrapati Sambhajinagar hospital
Chhatrapati Sambhajinagar, Apr 27 (UNI) Maharashtra Chief Minister Devendra Fadnavis along with Union Minister for Health, J P Nadda, inaugurated the True Beam Unit, a state-of-the-art machine providing highly specialised cancer treatment at the Government Cancer Hospital, and the expanded part of the Cancer Institute here on Sunday. Addressing the gathering, he said that a three-tier system in healthcare will be set up in next three to four years in coordination with the Public Health Department and the Medical Education Department. Through this, a new model will be created to provide quality healthcare to every person within three to five kilometres of his home, he informed. While expressing satisfaction that modern facilities like True Beam for cancer treatment are being made available in Chhatrapati Sambhajinagar, the Chief Minister said that with modern equipment like True Beam, it has become possible to treat the area where the infection is present with precision through radiation. For this treatment, patients had to go to Tata Memorial Hospital in the state, he recalled and said now, this service is available at Chhatrapati Sambhajinagar itself. This facility will be a boon for cancer patients in Marathwada and the neighbouring districts, he added. UNI VKB SS
Time of India
24-04-2025
- Time of India
Madhya Kailash turns choke point
Chennai: The twin traffic junctions — Madhya Kailash and Adyar Cancer Institute — which serve as critical links to Old Mahabalipuram Road (OMR), Adyar, Guindy and Saidapet, have emerged as the city's newest chicken necks, leading to vehicular pile-ups stretching upto Indira Nagar MRTS station on OMR and Anna University and beyond on Sardar Patel Road. To make matters worse, the artificial logjam caused by inadequate police presence, ineffective traffic regulation and potholed roads has become a cause for heartache not just during peak hours, but throughout the day. You Can Also Check: Chennai AQI | Weather in Chennai | Bank Holidays in Chennai | Public Holidays in Chennai "Forget new roads, even rudimentary maintenance is unheard of on this stretch. The neverending potholes and uneven gravel patches are a hazard for commuters. The condition is aggravated in the aftermath of even a short spell of rain," said Pooja R, who travels from Velachery to Taramani daily. The Cancer Institute signal gives just two minutes for vehicles coming from Guindy and Kotturpuram, while vehicles turning right from Madhya Kailash towards Kotturpuram block the entire strech of the road. "Even when the signal turns green, we are unable to move because of vehicles waiting to turn. We lose 15–20 minutes just between Madhya Kailash and the Cancer Institute almost every day," said Rajesh Kumar, a delivery agent working with an aggregator. Adding to the frustration of commuters is the traffic police's inaction. "They are often seen passively observing the commotion instead of taking the initiative to clear the bottlenecks and to manage the flow," said Muthuvel, an auto driver. Motorists complain that the situation has worsened ever since the TIDEL Park U-turn flyover opened. "Earlier, at least vehicles from Thiruvanmiyur and Thoraipakkam stopped at the signal. Now, with the flyover, they just pour into Sardar Patel Road without any check," said K Saravanan, a commuter from Thoraipakkam. Vehicles from Adyar heading towards Guindy are compelled to turn left at Madhya Kailash, travel 800 metres along OMR, and take a U-turn to rejoin Sardar Patel Road. Simultaneously, vehicles from OMR heading towards Adyar use the underpass at the Cancer Institute flyover to make another U-turn. These loops not only increase travel time but also funnel multiple U-turning streams into already saturated junctions, creating several conflict points. Traffic police say that once the L-shaped flyover construction at Madhya Kailash is completed, a better-regulated U-turn system will be introduced. They have also proposed diverting Guindy-bound traffic from Kotturpuram via the Cancer Institute signal to take a left and then a U-turn, after the pillars are completed for the L-shaped flyover, which could help ease congestion. In the long term, officials have floated the idea of demolishing the compound walls of institutions such as Anna University, IIT-Madras, the Cancer Institute, and Gandhi Mandapam to widen the road. Until then, they admit, the congestion is likely to persist.
Time of India
21-04-2025
- Health
- Time of India
Buy equipment at Jabalpur cancer institute soon: HC
Bhopal/Jabalpur: Hearing a public interest litigation (PIL) over the largely dysfunctional Cancer Institute at Netaji Subhash Chandra Bose Medical College, Jabalpur, a division bench of the MP high court found that an amount of Rs 84 crore was allocated 9 years ago for the purchase of equipment and machines for the institute, but the purchase has not been made yet. Following this, the court has summoned principal secretary, medical education, and managing director, MP Public Health Services Corporation. The court was told that the tender floated earlier had to be cancelled as only one or two bidders participated in the tender. Advocate Vikas Mahawar from Jabalpur, in his PIL, said that the Cancer Institute at Jabalpur Medical College lies largely defunct as it doesn't have the necessary equipment and machines to treat cancer patients. In the year 2016, the govt allocated Rs 84 crore for the purchase of equipment and machines, but there have not been any purchases made so far. During the hearing of the petition, the court was informed on behalf of the state govt that tenders were floated two or three times for purchase, but they were cancelled for technical reasons. The MP Public Health Service Corporation was supposed to make the purchases. The court then summoned the principal secretary, medical education, and MD, MP Public Health Service Corporation in this regard. The two officials told the court that only one or two bids were received in response to the tender; therefore, the tenders were cancelled. The tenders have been floated again and are likely to be opened on May 6. The court, while directing the officials to take a decision on the purchase of equipment and machines for the centre irrespective of the number of bids received when the tenders open on May 6, deferred the hearing of the case to May 13.
