Every day, oncology clinics across India confront the same heartbreaking reality. More than 70% of patients present with advanced-stage cancer, when treatment is more complex, more expensive, and far less likely to achieve a cure. Over the past two decades, India has invested substantially in building world-class tertiary cancer centres and has expanded access to sophisticated surgery, radiation therapy, and systemic treatments. Yet these advances cannot deliver their full potential because most patients arrive too late.

The solution to this challenge lies upstream.

Cancer in India is still diagnosed predominantly after symptoms become severe enough to disrupt daily life. By then, opportunities for curative treatment have often been lost. The consequences extend far beyond health. More than three-quarters of cancer-affected households experience catastrophic healthcare expenditure. Late diagnosis is therefore not only a medical problem — it also drives poverty.

Moreover, five-year survival for lung cancer in India is only about 4%, compared with nearly 33% in Japan. Similar gaps exist across several common cancers, reflecting differences not merely in treatment quality but in the stage at which patients enter the healthcare system. A delayed diagnosis is thus a poor outcome on all fronts.

Need for fundamental change

The scale of the challenge continues to grow. India recorded an estimated 1.56 million new cancer cases and over 8,74,000 cancer deaths in 2024. The lifetime risk of developing cancer has now reached approximately 11% nationally and exceeds 20% in some northeastern States. As the population ages and lifestyles change, this burden will continue to rise unless our national strategy changes fundamentally.

The first step is to redefine prevention as a lifelong public health priority rather than as an occasional awareness campaign. Nearly half of all cancers are preventable. However, efforts to spread awareness among adults give poor results as lifestyle wiring happens at an early age. Once habits are coded, it is extremely difficult to course correct them through awareness campaigns. Health education must therefore begin in schools, where “life skills” should receive the same importance as other mainstream subjects such as mathematics or social sciences. These life skills would not only help in cancer prevention but also other major health issues such as cardiac, neurological, vascular, and bowel diseases. Such education would comprehensively cover all aspects related to physical, mental and social health, addictions, diet, vaccinations, financial literacy, and responsibilities towards the family, society, and nation.

The second step is the need to receive earlier diagnoses. Public awareness about the fact that persistent symptoms lasting more than three weeks deserve medical evaluation can substantially reduce diagnostic delays. However, symptom awareness alone is insufficient. Screening remains our most powerful tool for identifying cancer before symptoms appear. Until recently, organised screening was largely confined to cancers such as cervical, breast, and prostate cancer. Scientific advances are now expanding these possibilities. Blood-based Multi-Cancer Early Detection (MCED) tests have the potential to detect biological signals from multiple malignancies — including colorectal, lung, liver, pancreatic, ovarian, gastric, oesophageal, breast, prostate, and bladder cancers — through a single blood sample.

While these technologies still require careful evaluation for population-wide implementation, they represent one of the most promising frontiers in cancer research and deserve focused Indian validation.

Future plan for India

India must also develop solutions suited to its own healthcare realities. A single centralised screening programme cannot effectively serve a country of 1.4 billion people with enormous geographical and socioeconomic diversity. Instead, we need a layered model combining community health workers, digital risk assessment, AI, mobile diagnostic services, and strong referral pathways linking primary care with cancer centres.

Encouragingly, important foundations are already being laid. NITI Aayog is supporting the development of a large imaging biobank comprising more than 20,000 cancer patient profiles. Such datasets can accelerate the development of AI tools capable of assisting frontline healthcare workers in identifying suspicious lesions and prioritising patients who require specialist evaluation.

The Draft National Health Research Policy 2026 provides an opportunity to accelerate this transformation. By prioritising diseases that contribute the most to India’s health burden and encouraging research with measurable impact, the policy signals a welcome shift from publication-driven research towards implementation science. This approach should encourage innovation in affordable screening technologies, risk prediction models, digital health platforms, and implementation research that improves cancer detection across India’s diverse healthcare settings.

India should not measure progress in cancer care solely by the sophistication of treatments delivered during advanced stages. The true measure of success is how many cancers never reach an advanced stage. And that success will require coordinated partnerships between government agencies, medical colleges, technology companies, and community healthcare providers.

Dr. Harit K. Chaturvedi is CEO & Clinical Head, Apollo Oncology Network

Published - August 06, 2026 01:01 am IST