The Emergence of the Northeast as India's Cancer Capital

Khasi tribal man smoking a handmade pipe in front of his home at Cherrapunji [Meghalaya, India].

(Photo: iStock/Tanvir Parves Ahmed)

In the midst of Northeast India's breath-taking landscapes and rich cultural diversity lies a silent epidemic that looms over the region's well-being - an escalating surge in cancer cases.

The ICMR-NCDIR report titled "Profile of Cancer and Health Indicators in Northeast India" revealed that new cancer cases in the Northeast Region (NER) are projected to rise to 57,131 by 2025, up from 50,317 in 2020.

This crisis is an intricate web of lifestyle choices and profound deficiencies in our healthcare infrastructure, demanding urgent attention and unwavering action.

A Disturbing Trend

In 2018, a report by the Cancer Registry of India echoed like an alarm bell, labelling the Northeast as the "Cancer Capital" of India. By the year 2023, nothing has changed; on the contrary, things have gotten worse. The National Cancer Registry Programme data reveals that the national average for cancer diagnoses is 2.45 percent, while Manipur has seen a startling 6.48 percent surge in incidence.

This increase, which comes after a 3.71 percent rise in 2021, emphasizes how serious the problem is. Though to varying degrees of escalation, the same terrible realities exist in Sikkim, Tripura, Mizoram, Meghalaya, Nagaland, Assam, and Arunachal Pradesh. These numbers are more than simply statistics; they represent the suffering of our fellow citizens.

A prominent villain in this healthcare tragedy is the widespread use of tobacco, both smoked and smokeless, in the northeastern region. According to a study conducted by the Indian Journal of Medical Research, surprisingly, smoking is responsible for 57 percent of all malignancies in men and 28% in women in this area. These figures ought to stun the entire country and call for broad and immediate cigarette control measures.

The grim outlook is further compounded by the fact that the survival and prognosis rates for cancer in the northeastern states are much lower than the national average. This is partially due to a lack of healthcare institutions that offer cancer services. That those who require care are being let down by the system that is there to assist them is heartbreaking.

The age-adjusted incidence rates for all cancers are higher in the North East than in the Rest of India for both males and females. The highest rates for males are found in Aizawl district, Mizoram (269.4 per 100,000 population), and for females in Papumpare district, Arunachal Pradesh (219.8 per 100,000 population).

The state governments in the Northeast have taken some steps to address the healthcare crisis, including the construction of a 200-bed super-specialty cancer hospital and the introduction of advanced diagnostic technology like the PET-CT scan machine. However, it is evident that these efforts alone may not be sufficient to adequately address the healthcare challenges in the region.

Moreover, data from the Lok Sabha parliamentary question reveals that though various government schemes provide financial assistance to cancer patients, the fluctuating number of beneficiaries under the Health Minister’s Cancer Patient Fund (HMCPF) from 1773 patients in 2018-19 to just 63 patients in 2022-23 raises questions about the consistency and effectiveness of these support mechanisms.

Nevertheless, one crucial question lingers—where is the central government in all of this? It is high time for the Central Government to acknowledge the gravity of the situation and take concrete steps to address this burgeoning crisis.

Urgent Steps for the Central Government

The central government should set aside a considerable sum of money to improve the northeastern states' healthcare system. The absence of a State/UT-wise allocation of funds under the Umbrella Scheme of Rashtriya Arogya Nidhi (RAN) is a critical issue.

Without a regional allocation, there's a risk that patients from this region may not receive equitable access to financial assistance, despite the increasing cancer cases in the area. Also necessary is the strict implementation of a comprehensive National Tobacco Control Program, with a particular emphasis on the northeastern part of the country. We cannot afford to ignore the detrimental impact of cigarette usage on the occurrence of cancer.

The central government should also support the education and placement of more medical specialists in the northeastern states with an emphasis on early cancer identification and basic care. A significant step toward achieving this goal is the creation of cancer OPD units in every hospital.

It should also collaborate with the northeastern states to educate the people about cancer prevention, early detection, and the value of leading a healthy lifestyle.

Conclusion

The northeastern states deserve better, specifically a healthcare system that is capable of properly addressing the growing cancer issue. The absence of centralized data on the number of patients and the amounts disbursed in each State/UT raises questions about transparency and accountability. In the context of Northeast India, where healthcare infrastructure is often underdeveloped, it is crucial to have clear data on the impact of the HMCPF in the region to assess whether it adequately addresses the rising cancer cases.

While the government has initiated the 'Strengthening of Tertiary Care Cancer Facilities Scheme' to establish State Cancer Institutes (SCIs) and Tertiary Care Cancer Centres (TCCCs) with the aim of enhancing cancer care, the data underscores the need for a more robust and region-specific approach in a geographically diverse nation like India.

The absence of specific data for the Northeastern states hinders targeted interventions, while the lack of region-specific strategies overlooks the region's remote and underserved areas. 

The time for action is now, and it is a collective duty that we cannot avoid. Addressing the rising cancer issues in North East India requires a multifaceted approach.

This involves increased research, improving healthcare infrastructure, raising public awareness, promoting community-based initiatives, providing financial assistance to patients, training more medical professionals, developing state-specific cancer control plans, and international collaboration to share resources and knowledge. These efforts collectively aim to reduce the burden of cancer and save lives in the region.

(The author is a sitting Member of Parliament in the Lok Sabha and a three-time Cabinet Minister from Assam. Shabbir Ahmed is a research intern and a current undergraduate student at Faculty of Law, Jamia Millia Islamia, Delhi. This is an opinion piece. The views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)