India (2019 @ Cancer): 12 lakh new cases & 9.3 lakh deaths & Possible Dietary Solution

Researchers found that India, along with China and Japan, are the three leading countries in Asia in terms of number of new cases and deaths.

CANCER - GLOBAL STATISTICS

• The highest cancer rate for men and women combined was in Denmark at 334.9 people per 100,000.
• The estimated number of incident cases of cancer in India for the year 2022 was found to be 14,61,427 (crude rate: 100.4 per 100,000). In India, one in nine people are likely to develop cancer in his/her lifetime.

January 03, 2024 03:16 pm | Updated January 07, 2024 11:21 am IST - New Delhi

India registered about 12 lakh new cancer cases and 9.3 lakh deaths in 2019, becoming the second highest contributor to the disease burden in Asia for that year, according to a new study published in The Lancet Regional Health Southeast Asia journal.

Researchers found that India, along with China and Japan, were the three leading countries in Asia in terms of number of new cases and deaths, where they say cancer has become a more significant public health threat with 94 lakh new cases and 56 lakh deaths in 2019.

Of these, while China contributed the most with 48 lakh new cases and 27 lakh deaths, Japan recorded about nine lakh new cases and 4.4 lakh deaths, the international team of researchers including those from the National Institute of Technology Kurukshetra and All India Institute of Medical Sciences (AIIMS), Jodhpur and Bathinda, said.

"We examined the temporal patterns of 29 cancers in 49 Asian countries between 1990 and 2019 using estimates from the Global Burden of Disease, Injuries and Risk Factors 2019 Study (GBD 2019)," they wrote in their study.

They found that in Asia, the leading cancer was that of tracheal, bronchus, and lung (TBL), resulting in an estimated 13 lakh cases and 12 lakh deaths. It was also found to be most frequent in men and third most frequent in women.

Overall, in the continent and individual countries, TBL, breast, colon and rectum cancer (CRC), stomach and non-melanoma skin cancer were among the top five most frequent cancers in 2019 with few countries having leukemia, prostate, liver and pancreatic cancers in the list.

Smoking, alcohol consumption and ambient particulate matter (PM) pollution remained dominant among the 34 risk factors for cancer.

The rising cancer burden due to increasing ambient air pollution is concerning in Asia.

Five of the top 10 countries with regards to population-weighted annual average of PM2.5 in 2019 are present in Asia — India, Nepal, Qatar, Bangladesh and Pakistan, they said quoting the State of Global Air Report, produced annually in collaboration with the Institute for Health Metrics and Evaluation's (IHME's) GBD project.

Primary reasons for increasing air pollution in Asia were

• industry-led economic growth along with urbanisation,
• rural-to-urban migration
• increasing usage of motor vehicles.

High prevalence of smokeless tobacco (SMT) such as khaini, gutkha, betel quid and paan masala is a public health concern in South Asian countries such as India, Bangladesh, and Nepal.

India alone accounting for 32.9% of global deaths and 28.1% of new cases of lip and oral cavity cancer in 2019.

More than 50% of the oral cancer burden has been attributed to smokeless tobacco, whose prevalence has grown in recent times in South Asia, including India.

SMT not only increases the risk of oral cancers but also enhances the risk of esophageal and pancreatic cancer.

Improved water and sanitation can help reduce the transmission of Helicobacter pylori (H. pylori) and, in turn, potentially lower the risk of stomach cancer.

Countries underwent development, they observed a common pattern of reducing cancer burden in younger age groups and increasing cancer burden associated with increasing life expectancy.

Reduced burden of cancers such as leukemia were seen among those under five years of age between 1990 and 2019.

Raised burden of cancers associated with longer lifespan such as prostate, pancreatic and breast cancer over the same time period.

Mere availability of screening might not improve the survival rates if cancer treatments are either unavailable or unaffordable.

In the low- and medium-income countries (LMICs) of Asia, oncologic infrastructure is either scarce or unaffordable, particularly in rural areas. Combined with a weak referral system, patients end up getting delayed diagnosis and treatment, leading to lower survival rates.

Therefore, along with timely availability of cancer screening and treatment, its cost-effectiveness or coverage of treatment expenses must also be a policy priority.

• Mechanisms of signaling from short-chain fatty acid derived from bacteria in gut immune cells. Short-chain fatty acids (propionate, butyrate, and acetate) involve in a complexed host-microbiome interaction to intestinal immune reactions (for example development of Regulatory T cells (Tregs), the activity of Dendritic cell (DC) and macrophage, and the anti-inflammatory cytokines production, proliferation of plasma B cell, as well as production of antibody) by inhibition of histone deacetylase (HDAC) and activation of GPR109A and GPR43, finally exerting anti-inflammatory impacts and conferring tolerance toward microbial pathogens.

Role of microbiota-derived short-chain fatty acids (SCFA) in cancer development and prevention

• It has been indicated that microbiota can alter the host immune responses, inflammation, and metabolic pathways, thereby playing a central role in cancer occurrence and progression.
• Similarly, the SCFAs generated by gut microbiota have crucial roles in cancer occurrence and progression.
• The alternations in gut structure change SCFA levels, thereby affecting histone deacetylases (HDAC), cell adhesion, cytokine production, chemotaxis, immune cell recruitment, and apoptosis.
• Therefore, studies in this field can help us combat cancer.
• Although many studies have been conducted on SCFAs and their association with cancer, most studies have focused on colorectal cancer (CRC).
• Functional foods like prebiotics and probiotics have beneficial influences in controlling and preventing cancer in preclinical and animal models.
• As a result, these agents have attracted attention for playing a role in preventing cancer development.
• In this regard, it has been found the immunomodulatory influences of SCFAs generated by probiotics, but the processes of their activities still need much investigation.
• The administration of probiotic bacteria to treat and prevent intestinal dysbiosis that can cause SCFAs formation seems to be crucial for further study.
• Microbiota-derived SCFAs seem to act synergistically on antitumor approaches, such as drugs to control immune reactions to cancer cells by dampening stimulation of inflammatory cytokines and activation of Regulatory T cells (Tregs) that have a crucial activity in controlling the tumor cells.

References:

• The Hindu Newspaper
• Indian Journal Medical Research
• World Cancer Research Fund International
• Journal of Biomedicine & Pharmacotherapy