Cancer mortality trends in India with predictions for 2020

Rationale The burden of cancer in India is increasing due to population ageing and growth, changes of risk factors associated with economic transition, and improvements in cancer awareness and detection. We provided cancer mortality trends over the decade 2004-2013 and estimated cancer mortality figures for 2020. Methods We estimated the number of deaths by applying cause- and sex-specific proportions of cancer deaths observed in the Million Deaths Study for each year to the corresponding United Nations (UN) estimates of the absolute number of deaths from all causes. We then calculated age-standardised mortality rates (ASMRs) per 100,000 using the corresponding population estimates from the UN population database. The predicted rates for 2020 were based on cause- and sex-specific proportions of deaths in 2011-2013 combined. Cancer mortality figures were also reported according to region, rural/urban areas, and richest/poorest territories. Results Mortality trends for all cancers combined and for major sites showed stable or slightly decreasing patterns during 2004-2013. Over 450,000 cancer deaths were estimated for both sexes in India in 2020, corresponding to rates of 81.3/100,000 men and 83.4/100,000 women. The top three cancer deaths for men were oral (ASMR per 100,000: 24.4), lung (8.6) and stomach (8.4), and for women oral (13.6), cervical (10.4), and stomach (9.5). Differences in ASMRs were found across geographical areas, with higher rates recorded in the eastern states (148.4/100,000 men and 133.4/100,000 women), in rural areas (84.6/100,000 men and 86.2/100,000 women), and in the richest states (87.4/100,000 men and 85.6/100,000 women). Conclusion Despite the limitations of available rates, cancer is a major cause of death in India, with exceedingly high rates of oral and stomach cancers in both sexes and cervical cancer in women. Since these are largely preventable cancers, this, along with regional variations, underlies the scope of cancer research in India.