Risk factors Archives - InnoHEALTH magazine

Cancer in India: Prevention, Early Detection, and the Human Side of Oncology

Khushi Khandelwal — Wed, 01 Apr 2026 06:30:00 +0000

Brig. (Dr.) Arvind Kumar Tyagi is a senior surgical oncologist and Director of Surgical Oncology & Robotic Surgery at Yashoda superspeciality hospital & cancer institutes. He was interviewed by Dr. Soumya Singh, Creative Editor at InnoHEALTH m agazine on the importance of prevention, early diagnosis, and compassionate, patient-centric care in improving cancer outcomes across the country.

Cancer is increasingly recognized as a major public health challenge. How significant is its impact today?

Cancer has emerged as one of the leading causes of death worldwide and in India. In a country with a population exceeding 1.4 billion, the absolute number of cancer cases is substantial. What makes this burden particularly concerning is that many cancers are preventable or treatable if detected early. Late presentation, lack of awareness, and lifestyle-related risk factors continue to drive high mortality, making cancer not only a medical issue but a public health priority.

Your professional journey is unique, combining military service with medicine. How has that experience shaped your approach to cancer care?

Training and serving as a paratrooper instills discipline, resilience, and the ability to perform under extreme physical and mental pressure. Military medicine demands precision, teamwork, and rapid decision-making—qualities that translate directly into surgical oncology. Exposure to high-risk environments and leadership roles strengthens accountability and calmness, which are essential when dealing with complex cancer surgeries and emotionally challenging patient care. The soldier’s mindset reinforces the commitment to duty, perseverance, and service to humanity.

What exactly is cancer, and why can it develop in almost any part of the body?

Cancer originates from the body’s own cells when they lose normal regulatory control and begin to divide uncontrollably. These abnormal cells can invade nearby tissues or spread to distant organs. Since every organ in the body is composed of cells, cancer can arise virtually anywhere. This is why cancer is not a single disease but a diverse group of diseases, each with distinct behavior, prognosis, and treatment strategies.

What are the most common risk factors for cancer, especially in the Indian population?

Cancer is multifactorial. In India, tobacco use—both smoking and chewing—is one of the most significant contributors, particularly to oral, throat, and lung cancers. Alcohol consumption, air pollution, obesity, physical inactivity, and poor dietary habits also increase risk. Certain infections, such as Hepatitis B and C or Human Papillomavirus, are known causes of liver and cervical cancers respectively. Genetic predisposition plays a role in some cancers, but lifestyle and environmental factors remain dominant contributors.

Can lifestyle changes genuinely reduce the risk of developing cancer?

Yes, lifestyle modification can significantly reduce cancer risk. Avoiding tobacco and excessive alcohol, maintaining a healthy body weight, engaging in regular physical activity, eating a balanced diet, and ensuring adequate sleep all strengthen immunity and reduce cancer incidence. While genetic factors are beyond control, lifestyle choices are powerful tools for prevention and long-term health.

What early warning signs or symptoms should people be vigilant about?

Any unexplained bleeding—from the mouth, nose, urine, or stools—should never be ignored. Persistent lumps or swellings in the breast, neck, armpit, or groin require prompt evaluation. Sudden weight loss, loss of appetite, prolonged fatigue, or unexplained pain are also warning signs. Awareness of one’s own body and early medical consultation can lead to timely diagnosis and improved outcomes.

How important is early detection, and what screening tests are advisable?

Early detection dramatically improves survival rates. Cancers identified at early stages are often curable. Screening tests such as Pap smears for cervical cancer and mammography for breast cancer are particularly valuable. Ultrasound examinations can help detect certain abdominal cancers. Advanced imaging techniques like PET scans are primarily used for staging rather than routine screening due to cost and limited applicability.

There are many myths surrounding cancer. Which misconceptions need to be corrected?

A common myth is that sugar causes or “feeds” cancer. In reality, all cells—healthy and cancerous—require sugar for energy; sugar itself does not cause cancer. Another misconception is that only smokers develop cancer, whereas non-smokers can also develop cancer due to genetic, infectious, or environmental factors. Such myths can delay diagnosis and distract from genuine preventive measures.

How has cancer treatment evolved, particularly in surgical oncology and technology?

Advances in surgical techniques, including minimally invasive and robotic surgery, have improved precision and recovery in selected cases. However, these technologies are not suitable for all cancers, especially large or advanced tumors where open surgery remains essential. Artificial intelligence and advanced imaging assist in diagnosis and planning, but the surgeon’s expertise, judgment, and hands-on skill remain irreplaceable.

Can cancer be cured, and what is the most important message for the public?

Many cancers are curable when detected early. Early-stage cancers respond well to treatment, while advanced-stage cancers are often managed to prolong life and improve quality of life rather than cure. The most important message is prevention and awareness: avoid tobacco, limit alcohol, exercise regularly, maintain a healthy weight, eat a balanced diet, sleep adequately, and seek medical evaluation early. A disciplined lifestyle—much like military training—can be the strongest defense against cancer.

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Lifestyle diseases: A threat to backward states

InnoHEALTH Magazine — Wed, 02 May 2018 08:13:02 +0000

Lifestyle diseases like chronic respiratory and heart diseases are killing more people in India than communicable ailments like Tuberculosis (TB) or Diarrhea in every states, including most backward belts, says the India State-Level Disease Burden Initiative’s Report.

Among the leading non-communicable diseases, the largest disease burden or Disability-Adjusted Life Year (DALY) rate increase from the period of 1990 to 2016 was observed for diabetes at 80 per cent, and ischaemic heart disease at 34 per cent.

In 2016, three of the five leading individual causes of disease burden in India were non-communicable, with ischaemic heart disease and chronic obstructive pulmonary disease as the top two causes and stroke as the fifth leading cause. The range of disease burden or DALY rate among the states in 2016 was nine-fold for ischaemic heart disease, four-fold for chronic obstructive pulmonary disease, and six-fold for stroke, and fourfold for diabetes across the country.

The key metric used in the study is DALYs, which is the sum of the number of years of life lost due to premature death and a weighted measure of the years lived with disability due to a disease or injury. The use of DALYs to track disease burden is recommended by India’s National Health Policy of 2017.

While ischaemic heart disease and diabetes generally had higher DALY rates in states that are at a more advanced epidemiological transition stage toward non-communicable diseases, the DALY rates of chronic obstructive pulmonary disease were generally higher in the Empowered Action Group (EAG) states that are at a relatively less advanced epidemiological transition stage.

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The report shows that communicable diseases constitute almost two-thirds of the disease burden in India from a little over a third in 1990. Despite the transition, which is associated with development, malnutrition remains the single top risk for health loss.

All states have thus made what’s called the ‘epidemiological transition’ there remain wide variations in their disease profiles with some having made that transition as early as 1986, and others as recently as 2010.

The first group to make the transition in 1986 included Kerala, Tamil Nadu, Goa, Himachal Pradesh and Punjab. The last group to do so, accounting for the highest number of people (588 million), made the transition almost a quarter of a century later, in 2010. This group included Bihar, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Rajasthan and Odisha. India as a country made the transition in 2003.

The Report’s executive summary says with almost one-fifth of the world’s population living in India, the health status and the drivers of health loss are expected to vary between different parts of the country and between the states.

Accordingly, effective efforts to improve population health in each state require systematic knowledge of the local health status and trends. While state-level trends for some important health indicators have been available in India, a comprehensive assessment of the diseases causing the most premature deaths and disability in each state, the risk factors responsible for this burden, and their time trends have not been available in a single standardised framework.

The Report finds that the Health status improving, but major inequalities between states Life expectancy at birth improved in India from 59.7 years in 1990 to 70.3 years in 2016 for females, and from 58.3 years to 66.9 years for males.

There were, however, continuing inequalities between states, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala for females, and from 63.6 years in Assam to 73.8 years in Kerala for males in 2016.

The per person disease burden measured as DALYs rate dropped by 36% from 1990 to 2016 in India, after adjusting for the changes in the population age structure during this period. But there was an almost two-fold difference in this disease burden rate between the states in 2016, with Assam, Uttar Pradesh, and Chhattisgarh having the highest rates, and Kerala and Goa the lowest rates.

While the disease burden rate in India has improved since 1990, it was 72% higher per person than in Sri Lanka or China in 2016. The under-5 mortality rate has reduced substantially from 1990 in all states, but there was a four-fold difference in this rate between the highest in Assam and Uttar Pradesh as compared with the lowest in Kerala in 2016, highlighting the vast health inequalities between the states.

Large differences between states in the changing disease profile of the total disease burden in India measured as DALYs, 61% was due to communicable, maternal, neonatal, and nutritional diseases (termed infectious and associated diseases in this summary for simplicity) in 1990, which dropped to 33% in 2016. There was a corresponding increase in the contribution of non-communicable diseases from 30% of the total disease burden in 1990 to 55% in 2016, and of injuries 18 %.

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