According to a recent research published in The Lancet Regional Health Southeast Asia journal, India recorded around 1.2 million new cancer cases and 9,30,000 deaths in 2019, ranking as Asia’s second-highest contributor to the disease burden that year.
According to the report, India, China, and Japan are the three key Asian nations experiencing a significant impact of cancer on public health, with a total of 9.4 million new cases and 5.6 million fatalities in 2019.
While China contributed the most, with 48 lakh new cases and 27 lakh deaths, Japan reported roughly 9 lakh new cases and 4.4 lakh deaths, according to an international team of researchers led by the National Institute of Technology Kurukshetra and the All India Institute of Medical Sciences (AIIMS), Jodhpur and Bathinda, said.
“We examined the temporal patterns of 29 cancers in 49 Asian countries between 1990 and 2019 using estimates from the Global Burden of Disease, Injuries and Risk Factors 2019 Study (GBD 2019),” they wrote in their study.
They discovered that the most common cancer in Asia was tracheal, bronchus, and lung (TBL), with an estimated 13 lakh cases and 12 lakh deaths. It was also discovered to be most common in men and third most common in women.
Specifically among women, cervical cancer is ranked second or among the top-5 cancers in several Asian countries. The human papillomavirus (HPV) vaccine, introduced in 2006, has proved to be effective in preventing the disease and reducing HPV-related deaths, the researchers said.
TBL, breast, colon and rectum cancer (CRC), stomach, and non-melanoma skin cancer were among the top five most common cancers on the continent and individual countries in 2019, according to the survey, with leukemia, prostate, liver, and pancreatic cancers appearing in a few countries.
Furthermore, they stated that of the 34 cancer risk variables, smoking, alcohol intake, and ambient particulate matter (PM) pollution remained dominating. “The rising cancer burden due to increasing ambient air pollution is concerning in Asia,” they said in the paper.
According to the State of Global Air Report, which is produced annually in collaboration with the Institute for Health Metrics and Evaluation’s (IHME’s) GBD project, five of the top ten countries in terms of population-weighted annual average of PM2.5 in 2019 are in Asia: India, Nepal, Qatar, Bangladesh, and Pakistan.
The researchers said that the primary reasons for increasing air pollution in Asia were industry-led economic growth along with urbanisation, rural-to-urban migration and increasing usage of motor vehicles.
They also said that a high prevalence of smokeless tobacco (SMT) such as khaini, gutkha, betel quid and paan masala is a public health concern in South Asian countries such as India, Bangladesh, and Nepal, with India alone accounting for 32.9 per cent of global deaths and 28.1 per cent of new cases of lip and oral cavity cancer in 2019.
“More than 50 per cent of the oral cancer burden has been attributed to smokeless tobacco, whose prevalence has grown in recent times in South Asia, including India,” the team wrote.
According to the researchers, SMT not only increases the risk of oral cancer but also of esophageal and pancreatic cancer. They argued that improving water and sanitation can help reduce Helicobacter pylori (H. pylori) transmission and, as a result, potentially cut the incidence of stomach cancer.
According to the researchers, as nations developed, they identified a general pattern of decreasing cancer burden in younger age groups and increasing cancer burden associated with increased life expectancy. Between 1990 and 2019, they discovered a lower burden of malignancies such as leukemia among children under the age of five.
Over the same time period, they discovered an increased burden of cancers associated with longer lifespans, such as prostate, pancreatic, and breast cancer.
“Mere availability of screening might not improve the survival rates if cancer treatments are either unavailable or unaffordable,” the team wrote. In the low- and medium-income countries (LMICs) of Asia, oncologic infrastructure is either scarce or unaffordable, particularly in rural areas. Combined with a weak referral system, patients end up getting delayed diagnosis and treatment, leading to lower survival rates, the researchers said.
Therefore, along with timely availability of cancer screening and treatment, its cost-effectiveness or coverage of treatment expenses must also be a policy priority, they said.
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