New Delhi: All Indian states will witness an increase in cancer in coming decades with Uttar Pradesh along with other Empowered Action Group (EAG) states —Bihar, Jharkhand, Uttarakhand, Madhya Pradesh, Chhattisgarh, Orissa and Rajasthan to remain worst hit, according to a study published in Journal of Global Oncology.

Researchers cited continued epidemiological transition as a reason for the increase in cancer cases in future. Epidemiological transition is a phase of development witnessed by a sudden and stark increase in population growth rates brought by improved food security and innovations in public health and medicine, followed by a re-leveling of population growth due to subsequent declines in fertility rates.

“Most of the increase of patients with cancer in India is attributable to its epidemiologic transition and the improvement and increased use of cancer diagnostics in India," states the study.

“India’s cancer burden will continue to increase as a result of the continuing epidemiological transition. Maximum increases will occur in the most populous and least developed EAG states, where the current cancer treatment facilities are grossly inadequate," it said.

The study found that the fastest epidemiological transition happened in the southern state of Kerala, whereas the most populous EAG state of Uttar Pradesh remained in the lowest epidemiological transition level group.

“The types of cancers in India are also undergoing a transition. There has been an observed decline of cancers in India caused by infections, such as cervical, stomach, and penile cancer, and an increase in cancers associated with lifestyle and aging, such as breast, colorectal, and prostate cancers. Cancer transitions can influence the requirements for site-specialized cancer surgeons, and countries following similar trajectories should expect similar challenges," the study said.

The study was done by Mohandas K. Mallath, Department of Digestive Diseases, Tata Medical Center, West Bengal, under an undergraduate research fellowship from King’s College London.

The study highlighted that India"s epidemiological transition was triggered by large reductions in premature deaths from infections and associated diseases and increased life expectancy. Thus, all Indian states are experiencing an increase in cancer and other noncommunicable diseases.

“Cancer diagnoses are still missed in the least developed and rural parts of India as a result of the lack of adequate and easily accessible cancer care facilities," the study said.

The study also cited that in 1993, an autopsy study from India’s premier postgraduate medical institute revealed that 25.8% of cancers were incorrectly diagnosed.

“Data quality in Indian urban cancer registries is still prone to errors. Further reduction in cardiovascular disease mortality, which is presently three times higher than cancer in India, will increase the cancer burden further," the study said.

According to the study, cancer-like illness has been documented in the Indian subcontinent since antiquity. The actual diagnosis of cancer began in the 19th century, and the cancer burden started to increase in the 20th century. Several pioneers had sounded warnings on the growing burden of cancer in India throughout the past century, but their warnings were heeded late.

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