Breast Cancer Is the Number One Cancer in India When Both Genders Are Considered
A critical but often under-emphasised finding from GLOBOCAN 2022 is that breast cancer ranks as the most common cancer in India when men and women are taken together. It also stands among the leading causes of cancer mortality overall, not merely among women¹.
In India:
- Breast cancer contributes the largest share of total cancer incidence across all cancer sites¹.
- It ranks among the top causes of cancer-related deaths, alongside oral cavity and cervical cancers¹.
- No single cancer site contributes as many new cases nationally as breast cancer when both sexes are combined¹.
This elevates breast cancer from a “women-specific issue” to a national cancer priority of the highest order.
A Gender-Neutral Statistic with Gender-Skewed Suffering
Although breast cancer is counted across both genders, the biological, clinical, and social burden is borne almost entirely by women.
Biological Reality
- More than 99% of breast cancer cases in India occur in women¹.
- Indian women develop breast cancer at a younger age (often 30–50 years) compared with Western populations, where incidence peaks later²,³.
- Premenopausal breast cancer, often with aggressive subtypes, is relatively more common in Indian cohorts².
Breast Cancer: One of the Leading Causes of Cancer Death in India
From a mortality perspective, breast cancer is one of the most lethal cancers in India.
According to GLOBOCAN 2022:
- India reported over 82,000 breast cancer deaths in 2022, placing it among the top causes of cancer mortality nationally¹.
- Breast cancer alone accounts for a substantial proportion of all female cancer deaths, and significantly influences overall cancer mortality figures¹.
India’s mortality-to-incidence ratio (MIR) for breast cancer remains high compared to high-income countries, reflecting late diagnosis rather than lack of effective treatment¹,⁴.
Late-Stage Diagnosis: The Core Reason for High Mortality
Stage at Presentation
Evidence from ICMR registry analyses and national task force reports shows:
- Only ~25–30% of breast cancers in India are diagnosed at Stage I or II⁵.
- More than half present at Stage III or IV, when cure rates fall sharply⁵,⁶.
This contrasts starkly with high-income countries, where early-stage detection exceeds 60–70% and survival approaches 90%⁴.
Indian women are not dying because breast cancer is untreatable;
they are dying because it is detected too late.
Screening: The Single Greatest Missed Opportunity
NFHS-5 (2019–2021) Findings
The National Family Health Survey-5, India’s most authoritative population survey, reports:
- Only 0.9% of women aged 30–49 years had ever undergone breast examination for cancer screening⁷.
- Even in better-performing states, coverage remains far below what is required for population impact⁷.
This indicates that India does not suffer from poor screening quality—it suffers from near-total absence of screening.
Survival Outcomes: What the Registries Reveal
A pooled analysis from 11 Population-Based Cancer Registries (PBCRs) under ICMR reported:
- 5-year relative survival for breast cancer: ~66.4% in India⁸.
- Survival ranged widely—from ~75% in some urban registries to <45% in parts of the Northeast and rural registries⁸.
In contrast:
- Five-year survival exceeds 85–90% in North America and Western Europe⁴.
The survival gap mirrors:
- Stage at diagnosis
- Access to timely treatment
- Health system inequities
Why Breast Cancer Ranks First Overall in India
| Indicator | Breast Cancer | Other Major Cancers |
|---|---|---|
| Incidence (both sexes) | Highest¹ | Lower individually |
| Contribution to total cases | Largest single share¹ | Fragmented |
| Screening coverage | Lowest⁷ | Higher (oral, cervix) |
| Stage at diagnosis | Mostly late⁵ | Variable |
| Overall mortality impact | Among highest¹ | Comparable |
When incidence, mortality, and preventability are considered together, breast cancer clearly emerges as India’s number one cancer burden.
The Hidden Gendered Costs
Beyond mortality, breast cancer inflicts disproportionate social harm on women:
- Delayed care due to caregiving roles
- Catastrophic out-of-pocket expenditure
- Stigma related to body image and mastectomy
- Loss of livelihood and social participation
These dimensions, though not captured in cancer registries, amplify suffering and inequity⁶,⁹.
Public Health Implications
Given that breast cancer:
- Is the most common cancer overall in India
- Is one of the leading causes of cancer deaths
- Is largely curable when detected early
India urgently needs:
- Normalisation of breast health discussions/ breast awareness
- Universalisation of clinical breast examination at primary care
- Strong integration into NP-NCD
- Gender-sensitive cancer pathways
Conclusion
Breast cancer in India occupies a unique and troubling position:
- Numerically the leading cancer across both genders
- Biologically and socially devastating for women
- Largely preventable in terms of mortality
Recognising breast cancer as India’s number one cancer overall is not a semantic exercise—it is a public health imperative.
References
- International Agency for Research on Cancer. GLOBOCAN 2022: India Fact Sheet. Lyon: IARC; 2024.
- Agarwal G, Ramakant P. Breast cancer care in India: The current scenario and challenges for the future. Breast Care (Basel). 2008;3(1):21-27.
- Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol. 2017;13(4):289-295.
- Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2022. CA Cancer J Clin. 2024;74(1):17-48.
- National Academy of Medical Sciences. Task Force Report on Breast Cancer in India. New Delhi: NAMS; 2016.
- Dikshit R, Gupta PC, Ramasundarahettige C, et al. Cancer mortality in India: A nationally representative survey. Lancet. 2012;379(9828):1807-1816.
- International Institute for Population Sciences (IIPS). National Family Health Survey (NFHS-5), 2019–21: India Report. Mumbai: IIPS; 2021.
- Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of cancer survival 2000–14. Lancet.2018;391(10125):1023-1075.
- Ginsburg O, Bray F, Coleman MP, et al. The global burden of women’s cancers. Lancet. 2017;389(10071):847-860.
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