Why India doesn’t screen for its deadliest cancer, Pg13

Key Highlights:

• Lung cancer became India's deadliest cancer in 2024, causing 10.9% of all cancer deaths, totaling 98,687 fatalities.
• Most lung cancer cases in India are diagnosed in advanced stages, leading to significantly lower survival rates.
• India's national cancer screening programs currently do not include lung cancer, focusing instead on breast, oral, and cervical cancers.
• Low-Dose Computed Tomography (LDCT) is identified as an effective screening method that can reduce mortality through early detection.
• Challenges to implementing widespread lung cancer screening include the high cost of LDCT, limited availability of equipment, and the need to define a broader at-risk population beyond traditional smokers.

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Detailed Insights:

• New lung cancer cases increased from 81,748 in 2022 to 1.12 lakh in 2024, moving it from fourth to third in incidence.
• Data from the Global Cancer Observatory, maintained by the International Agency for Research on Cancer (IARC), highlights this rising mortality.
• Early detection can boost the five-year survival rate for lung cancer from 7-18% (late stage) to 80% (early stage).
• An Indian Council of Medical Research (ICMR) study suggested that despite higher initial costs, LDCT offers the highest net monetary benefit for screening high-risk populations.
• Unlike Western populations, a significant proportion of lung cancer in India occurs among non-smokers, including beedi smokers and those exposed to biomass fuel and air pollution.
• Pilot studies from Mumbai and by AIIMS doctors indicate that India's high prevalence of Tuberculosis (TB) does not pose a problem for LDCT screening.
• The Indian Lung Screening Trial is generating local evidence for LDCT screening, while AIRCARE (Air Pollution and Cancer Research Ecosystem) studies environmental contributions to lung cancer risk.

Key Concepts Involved:

• Low-Dose Computed Tomography (LDCT): A specialized CT scan using minimal radiation to detect lung abnormalities, crucial for early cancer screening.
• Global Cancer Observatory: An online platform by the World Health Organization (WHO) providing global cancer statistics and estimates.
• International Agency for Research on Cancer (IARC): The specialized cancer agency of the WHO, conducting and coordinating research on cancer causes and prevention.
• Indian Council of Medical Research (ICMR): India's apex body for the formulation, coordination, and promotion of biomedical research.