Lung cancer is India’s biggest cancer killer, yet national screening covers only breast, oral and cervical

The news

New Delhi. Lung cancer was India’s leading cancer killer in 2024: 98,687 deaths, 10.9% of cancer deaths, up from 75,031 in 2022, per Global Cancer Observatory data in The Indian Express. New cases rose from 81,748 (5.8%) in 2022 to about 1.12 lakh (7.2%) in 2024, now third by incidence. Screening at primary health centres covers only breast, oral and cervical cancer, which need a simple examination. Dr Abhishek Shankar says 93% of lung cancers are found at an advanced stage; a registry study puts it at nearly 45%. Five-year survival is 7% to 18% when found late, up to 80% in stage one. Low-dose CT (LDCT), a scan using less radiation to spot small lung nodules, is costly and CT machines are absent at primary centres. An ICMR study found it costliest but with the highest net monetary benefit.

Static syllabus linkage

1. Cancer screening sits under the National Programme for Prevention and Control of NCDs. The NP-NCD covers cancer, diabetes, heart disease and stroke. Screening for oral, breast and cervical cancer is offered through Ayushman Arogya Mandirs, using a clinical breast exam, an oral visual exam and visual inspection with acetic acid for the cervix.
2. LDCT screening suits a defined high-risk group. Guidelines advise it for people aged 50 to 80 who have smoked about a pack a day for 20 years. Indian researchers said in 2024 that beedi smokers and people exposed to second-hand smoke, biomass fuel and fumes should be added.

Why UPSC loves this

1. GS2: “issues relating to development and management of Social Sector/Services relating to Health”. A question can ask whether screening follows disease burden or convenience; lung cancer shows cost and capacity deciding what is screened.

Analysis

1. Lens — Growth and equity: the programme screens what a poor patient’s health centre can check. Screening follows what a primary centre does cheaply, so lung cancer is left out. Those hurt most are people who cannot reach a CT centre and breathe beedi smoke, cooking fuel and polluted air without being cigarette smokers. A fair policy would start with high-risk groups where exposure is greatest.
2. Pilots can answer the cost and tuberculosis worries while building Indian evidence. The fear that tuberculosis would cause false alarms was met by a 2021 Mumbai pilot and a 2025 AIIMS study, the report says; the Indian Lung Screening Trial and AIRCARE (Air Pollution and Cancer Research Ecosystem) add local evidence. The counter-view is that LDCT radiation can itself raise other cancer risks, which is why it is advised only for high-risk groups; a pilot would test that trade-off in Indian conditions before any national roll-out.
3. Screening without follow-up care only adds anxiety. A scan that finds a nodule is useful only if biopsy and treatment are near, and most districts have few oncologists. A young non-smoker’s late diagnosis, told on the companion page, shows how doctors dismiss symptoms that do not fit the usual profile. Referral capacity must grow with screening, or early detection stays on paper.

Administrator's brainstorm