Researchers find that India, China and Japan were the 3 leading countries in Asia in terms of number of new cases and deaths in 2019.
India registered about 12 lakh new cancer cases and 9.3 lakh deaths in 2019, becoming the second highest contributor to the disease burden in Asia for that year, according to a new study published in The Lancet Regional Health Southeast Asia journal.
Researchers found that India,
China and Japan were the three leading countries in Asia in terms of number of
new cases and deaths, where they say cancer has become a more significant
public health threat with 94 lakh new cases and 56 lakh deaths in 2019.
Of these, while China contributed the most with 48
lakh new cases and 27 lakh deaths, Japan recorded about 9 lakh new cases and
4.4 lakh deaths, the international team of researchers including those from the
National Institute of Technology Kurukshetra and 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 found that in Asia, the leading cancer was that
of tracheal, bronchus, and lung (TBL), resulting in an estimated 13 lakh cases
and 12 lakh deaths. It was also found to be most frequent in men and third most
frequent in women.
Specifically among women,
cervical cancer is ranked second or among top five 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.
Overall, in the continent and
individual countries, TBL, breast, colon and rectum cancer (CRC), stomach and
non-melanoma skin cancer were among the top five most frequent cancers in 2019
with a few countries having leukemia, prostate, liver and pancreatic cancers in
the list, they said in their study.
Further, smoking, alcohol consumption and ambient
particulate matter (PM) pollution remained dominant among the 34 risk factors
for cancer, they said.
"The rising cancer burden
due to increasing ambient air pollution is concerning in Asia," they
wrote.
Five of the top 10 countries
with regard to population-weighted annual average of PM2.5 in 2019 are present
in Asia - India, Nepal, Qatar, Bangladesh and Pakistan, they said quoting the
State of Global Air Report, produced annually in collaboration with the
Institute for Health Metrics and Evaluation's (IHME's) GBD project.
The researchers said 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 said 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.
SMT not only increases the risk of oral cancers but
also enhances the risk of esophageal and pancreatic cancer, they said.
They wrote that improved water
and sanitation can help reduce the transmission of Helicobacter pylori (H.
pylori) and, in turn, potentially lower the risk of stomach cancer.
The researchers wrote that as
countries underwent development, they observed a common pattern of reducing
cancer burden in younger age groups and increasing cancer burden associated
with increasing life expectancy.
They found a reduced burden of
cancers such as leukemia among those under five years of age between 1990 and
2019.
Simultaneously, they found a
raised burden of cancers associated with longer lifespan such as prostate,
pancreatic and breast cancer over the same time period.
"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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