Is Cancer Too Gender-Biased in India?

Most Rural Women Remain Unaware of their Breast Cancer Incidence

​Indian women outnumber men in cancer ailments and this is an element of surprise for researchers who find more men affected by cancer than women, globally. Secondly, we are one of the most-populated countries and reporting more than 1.5 million cancer cases annually, India’s cancer rate remains far lower than the number of cancer cases reported in the economically-developed US. If 300 people per 1,00,000 people are affected in US, it is only 100 people in India. The logic is quite simple here-our major population comprises of younger people and as these people get old, the chances of getting cancer increases. But sadly, survival rates in our country are on the downside-only a third of the patients live beyond 5 years after being diagnosed with the disease.

Men Vs Women
Estrogen, the female sex hormone, strangely increases the risk of cancer as well as the chances of survival from the same. While men show 25% increase in cancer rates than women globally, India stands out proving more women diagnosed with cancer compared to men. But surprisingly, more men die of cancer than women in our country.

Generally, women seek more medical attention due to different problems during their different stages of life, right from antenatal checkups and menopause problems to menstrual disorder. They are screened for cancer during all these times, by default, and prevalence of the disease is noticed at an earlier stage compared to men and hence, the mortality rates too remain low. Firstly, most cancers such as breast, cervical, ovarian and uterine cancer (these account for 70% cancers found in women in our country) that hit women assure greater chances of survival after treatment. Also, national policies for screening too include more cancer types that hit women such as breast cancer and cervical cancer that are non-invasive. Breast cancer alone accounts for 27% of all cancer cases in women which comes to around 1,44,937 cases yearly. Cervical cancer is the second commonly found cancer in women accounting for 1,22,844 cases annually. Also, the peak age of onset for both breast and cervical cancer in India appear to be a decade younger (45-50 years) than the peak onset age in high-income countries (above 60 years). Researchers bet on genetic and environmental factors to play a huge role in this difference and to prove this, Lancet suggests parallel studies of women cancer patients in the Punjab region in India and the Punjab diaspora in the UK. Researchers feel that this study might prove to be the ideal setup to get a clear understanding of the genetic and environmental influences of cancer development in genetically related populations that exist in different environmental conditions.

Oral Cancer Survival Rates in Men are Bad

​Lifestyle risk factors such as tobacco use, substance abuse and alcohol consumption cause oral or lung cancer-two of the most popular cancer forms in men whose survival rates are also badly low. Lung and oral cancer are detected at a late stage and hence, lead to increased mortality rates. Almost 95% of lung and oral cancer cases can be attributed to tobacco consumption while 40% of all cancers in India are due to tobacco abuse. World Cancer Report estimated 1,589,925 lung cancer deaths worldwide in 2012 of which 30.90% were of women and 69.10% were men. Also, the third-most prevalent cancer form, lip and oral cavity cancer, affect around 53,842 men.
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Genome-related Risk
Cancer sometimes seems to be genome-related. The existence of the BRCA1 and BRCA2 gene usually increases the risk of breast cancer in a woman 4 to 8 times and this is an important reason for members of the same family to be diagnosed with breast or ovarian cancer simultaneously. Studies show that father can pass the gene for ovarian cancer to daughter or even multiple daughters (if present). Read more about this unwanted gift from a dad to his daughter (ovarian cancer) at www.firsteatright.com.
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Frankly, less than 10% of breast cancer cases in India are inherited and genomic screening would not be of great help in these times. While 80% of the breast cancer cases in the US are diagnosed at the first or second stages, most cases in India are diagnosed only in the third or fourth stages. This might be because many women feel reluctant to visit a doctor or might remain unaware of the symptoms. There are chances that these cancers might be region-specific too! For instance, Delhi shows the highest rates of breast cancer incidence indicating that urbanization might also contribute to more number of breast cancer cases (high-fat diet, obesity, late marriage, fewer children and decreased breastfeeding rates are known risk factors). As a washout to all these negative statistics, the only good numbers here are the 60% survival rates beyond five years in women with breast cancer in India. But, the exact reason for such increased breast cancer rates in India has not been pin-pointed.

Although cervical cancer is prevalent in 23% of women affected by cancer in India, it can be tackled easily with the HPV vaccine that fights against the human papilloma virus (cervical cancer-causing agent). Remaining as one of the most preventable forms of cancer, it is unacceptable that cervical cancer is the second-most common cancer prevalent in women accounting for a quarter of deaths in India. HPV vaccines that can be issued to girls between the ages of 11 and 13 to curb cervical cancer but is not found widespread in our country and remains an area to be explored further by the government.

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