Much of what the world knows about cancer – how it begins, how it progresses, and how it should be treated, are often insights derived from research conducted in a small cluster of High-income countries (HICs).
While these insights are valuable, they are not an accurate representation. They reflect the realities of societies that account for a fraction of the global population. Their lifestyles, environment, health systems, and demographic structures differ from the rest of the world. As a result, cancer care for the global south continues to be shaped disproportionately by evidence that does not fully represent where the majority of patients actually live.
India accounts for nearly one-fifth of the world’s population and with other low- and middle-income countries nearly one-third of the cancer burden, yet their contribution to global evidence in prevention, early detection, and real-world outcomes remains modest.
Cancer in India
In India, cancer often presents earlier in life but is diagnosed late, unfolding amid rapid urbanisation, dietary changes, environmental exposures, and constrained healthcare access. Without locally generated insights, we risk applying solutions designed for very different contexts. This is where preventive oncology must take center stage. Prevention is India’s most scalable and affordable strategy, yet is often misunderstood as a soft, lifestyle-centric idea. In reality, it is one of the most evidence-backed, cost-effective, and humane approaches. India’s cancer profile tells a revealing story. We continue to see disproportionately high rates of tobacco-related cancers, especially of the aerodigestive tract, with tobacco use contributing to nearly 27–33% of all oral cancer cases. Alcohol, now recognized as a Group 1 carcinogen, is emerging as another significant contributor to a variety of cancers. Alongside this, urban India is witnessing a steady rise in cancers traditionally associated with HICs- colorectal, pancreatic, and breast cancers. These are usually driven by sedentary lifestyles, dietary shifts, obesity, and metabolic diseases. These patterns are not accidental. They reflect how we live.
Cancer Prevention
Cancer prevention is rooted in moderation – regular physical activity, healthy weight, avoiding tobacco, limiting alcohol, and supporting mental well-being. Small, consistent choices made over decades shape population-level outcomes.
Early detection is equally important. Screening is a powerful tool, but blanket approaches can overwhelm India’s already stretched health system. Targeted, risk-based and region-specific screening — supported by community awareness and integrated into routine primary care — offers a pragmatic pathway to detecting cancers earlier.
For such strategies to succeed, data is indispensable. India has made progress through cancer registries and digital platforms, but coverage remains uneven. Initiatives such as the National Non-Communicable Diseases (NCD) Portal, developed by the Tata Trusts and Dell Technologies, in partnership with the Ministry of Health and Family Welfare, demonstrate what is possible when population-level screening, documentation, and follow-up are systematically captured within routine care.
By enabling on-ground comprehensive data recording mechanisms, referral tracking, and continuity of care, such solutions lay the foundation for evidence-driven prevention and early detection strategies. Countries that lead in public health outcomes do so not only because of technology or clinical expertise, but because they measure consistently, learn systematically, and course-correct early.
Strengthening these data ecosystems is essential to move preventive oncology from aspiration to impact. Preventive oncology also requires balanced communication. While newer technologies deserve attention, overselling poorly contextualized innovation can create unrealistic expectations and financial distress. A balanced narrative- that celebrates scientific progress while emphasising appropriate evidence-based care is essential.
Where do we stand today?
Encouragingly, India is not starting from scratch. Over the past decade, investments in cancer infrastructure, insurance coverage, and decentralised care have increased access significantly. This progress is reflected in the steady growth of cutting-edge medical institutions across the country, like the Sri Venkateswara Institute of Cancer Care & Advanced Research in Tirupati and Ranchi Cancer Hospital and Research Centre to others in remote geographies of Assam and Maharashtra. These institutions are bringing cancer care closer to communities that previously had little or no access. The next leap forward lies in complementing this treatment capacity with equal seriousness towards prevention.
Where will Cancer Prevention take us?
The dividends of cancer prevention are long-term — delayed onset, reduced severity, lower financial distress, and healthier ageing. This requires sustained commitment, as public health success is often invisible in the short term but transformative over a generation
Cancer will remain a formidable challenge in the coming decade, but it need not be an unmanageable one. By aligning individual behaviour, community awareness, and system-level planning around prevention, India can not only reduce its cancer burden but demonstrate how a developing country can respond intelligently and compassionately to one of the defining public health challenges of our time.
The most powerful cancer intervention may not lie in the next breakthrough drug or technique, but in the collective choices we make today, even before a diagnosis is ever made.
The article is written by By Dr Shailesh Shrikhande, Chief Executive, Tata Cancer Care Foundation, supported by Tata Trusts
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