Cancer mortality trends 2004–2013 in India at ages 30–69 years with predictions for 2020: estimates from the Million Death Study

The cancer burden in India is rising due to population aging, growth, changing risk factors, and improved awareness and diagnostics. Using data from the nationally representative Million Death Study, we assessed cancer mortality trends over 2004-2013 and estimated figures for 2020. Cause-, age-, and sex-specific proportions of cancer deaths were applied to the corresponding United Nations estimates of total deaths for each year. Age-standardized mortality rates (ASMRs) per 100 000 were calculated, and 2020 mortality was projected using proportions from 2011 to 2013. Mortality from all cancers combined and major cancer sites remained stable or slightly declined over 2004-2013. In 2020, over 450 000 cancer deaths were estimated for both sexes at ages 30-69 years, corresponding to ASMRs of 76.5 males and 79.4 females. Leading male causes of cancer death were oral (ASMR: 22.9), colorectal (8.6), and lung (8.0) cancer; among females, oral (12.8), uterine - mainly cervical - (9.9), and colorectal (9.8) cancer were predominant. ASMRs varied markedly by region, with the highest rates observed in eastern states, rural areas, and wealthier states. Cancer remains a major cause of death in India, with notably high rates of oral, stomach, and cervical cancers. These largely preventable cancers, together with marked regional disparities, highlight substantial opportunities for cancer prevention. Reliable, nationally representative mortality data, as provided by this study, are critical for guiding cancer control policies in India. By quantifying the burden of largely preventable cancers and regional inequalities, these findings support targeted prevention, early detection, and resource allocation at both national and state levels.