By Ebi Kesiena
A new study of India’s cancer registry has highlighted a striking paradox: women are more likely to develop cancer, yet men are more likely to die from it.
Globally, men generally face higher cancer rates, but India stands apart. In 2022, women accounted for just over half of new cases, yet male deaths outnumbered female ones.
Among women, breast, cervical and ovarian cancers dominate, with breast and cervical alone making up 40 per cent. Lifestyle changes such as later pregnancies, reduced breastfeeding, obesity and inactivity have fuelled rising cases.
For men, tobacco is the biggest culprit, driving oral and lung cancers, which account for a large share of deaths. These cancers are aggressive, often detected late, and less responsive to treatment.
Experts suggest women’s cancers are spotted earlier thanks to awareness campaigns and screening, giving them better survival chances. Men, meanwhile, suffer poorer outcomes due to tobacco-linked disease and limited early detection.
Men in India are less likely to attend preventive screenings or seek medical advice early, a factor that contributes to their higher mortality despite recording fewer cases than women.
“Women’s health has become a bigger focus in public health campaigns, and that’s a double-edged sword. Greater awareness and screening mean more cancers are detected early. For men, the conversation rarely goes beyond tobacco and oral cancer,” said Ravi Mehrotra, cancer specialist and head of the Centre for Health Innovation and Policy (CHIP) Foundation.
According to Dr Mehrotra, reproductive health checks mean women are more likely to consult doctors during their lifetime, whereas many men may never see one.
Data from 43 cancer registries indicate that 11 in every 100 Indians face a lifetime risk of developing cancer, with 1.56 million cases and 874,000 deaths projected in 2024. The distribution, however, is highly uneven. The north-eastern states remain the country’s cancer epicentre, with Aizawl in Mizoram recording lifetime risks double the national average.
“For most cancers in the north-eastern state, I’m convinced lifestyle is the key factor. Tobacco use is rampant here – much higher than elsewhere,” explained R Ravi Kannan, head of Cachar Cancer Hospital and Research Centre in Assam. He noted stark contrasts even within the region: in Barak Valley chewing tobacco predominates, while just kilometres away in Mizoram, smoking is the main driver. Alcohol, areca nuts, and traditional food preparation methods further add to the risk.
Outside the northeast, other hotspots emerge. Srinagar has the country’s highest rates of lung cancer among men, while Hyderabad leads for breast cancer cases. Men in Delhi record higher overall cancer diagnoses than their counterparts elsewhere, even after adjusting for age. Oral cancer, meanwhile, is on the rise nationwide, with increases recorded in 14 male and four female registries.
These variations form part of a wider reality: cancer is both universal and unequal. Differences in geography, income, and healthcare access shape outcomes in India much as they do globally.
In richer nations, one in 12 women is diagnosed with breast cancer in her lifetime, but only one in 71 dies from it, according to the World Health Organisation. In poorer countries, fewer women are diagnosed, yet many more die due to late detection and inadequate treatment.
“Women in lower Human Development Index (HDI) countries are 50% less likely to be diagnosed with breast cancer than women in high HDI countries, yet they are at a much higher risk of dying of the disease due to late diagnosis and inadequate access to quality treatment,” said Isabelle Soerjomataram of the International Agency for Research on Cancer (IARC).
Disparities are evident elsewhere too. In the United States, Native Americans face the highest cancer mortality, while black Americans record double the death rates of whites for certain cancers, including prostate and uterine.
India’s own picture shows a society in transition. As longevity increases and lifestyles change, the country’s cancer profile is becoming more complex. Experts warn that targeted prevention, early detection, and healthier habits are urgently needed to curb rising deaths.
