Adopt a national framework for early cancer detection

A screening policy could overcome behavioural barriers, lower costs and save Indian lives

- YUGANK GOYAL & JAHNAVI SANT

India recently announced a budgetary allocation of ₹3,200 crore to set up 200 Day Care Cancer Centres in all district hospitals over the next three years. This is welcome. It signals that cancer has reached the policy table. India has a high mortality rate (around 64%, age-standardized) and the prevalence of the disease has risen by more than 50% in three decades. With an estimated 1.5–2 million cancer patients in India (some reports claim this may be as high as 6 million), it is a significant public health challenge now.

A cost-effective way of enhancing survival among patients is early detection. For example, the estimated survival rate for breast cancer patients is 99% if detected early, compared to 31% for late detection cases. For lung cancer, the survival rates for stages I, II, III, and IV show a dramatic survival gradient of 65%, 40%, 15%, and 5%, respectively (not adjusting for lead-time bias).

A plausible reason for low survival rates in India could stem from the fact that most cancers (over 60%) are detected at stage III. In the US, most are detected at Stage I or II. India's breast cancer survival rate is only 68%, while rich countries have 90%+ rates; for lung cancer, India's rate is merely 17%, far below the 60%+ rates in countries like Japan.