Cancer & Socioeconomic Evolution in India | Dr. Pritam Kalaskar | Cancer Specialist | Mumbai Oncocare Centre, Thane
Cancer has emerged as a major public health concern in India with the dramatic rise in number of new cancer patients, especially over last 2 decades. Urban geographies of India, especially metro cities with high degree of westernization of human lifestyle and high levels of human stress carry high incidence & prevalence of Cancer as compared to rural or semi-urbanized regions. Various estimates suggest that cancer prevalence in India is highest among elderly however, in reality, we often find increasing trend of young cancer patients walking into our clinics. According to the report on 'Economic Burden of Cancer in India', females in the reproductive age are the most vulnerable to breast & gynecological cancers. The wave of industrialization that drove economic growth and thriving levels of pollution coupled with rampant tobacco habits in India together fostered increasing cancer cases of head & neck and lungs.
For a long time, we have observed a significant socioeconomic gradient in terms of incidences of cancer by age, sex, organs involved, human habits & lifestyle and their economic status etc. The out-of-pocket expenditure by cancer patients &/or their families in India is probably the highest for any other disease or ailment. For a large section of society, these out of pocket expenses on cancer treatment were and perhaps are financed through borrowings, sale or pledging of assets, contributions from friends & relatives etc. Significant proportion of cancer patients who seek optimum care end up spending in excess of 15%-20% of their per capita household expenditure on the cancer treatment, according to government estimates. The expenditure on the cancer treatment is directly proportional and the chances of cure or significantly long-term survival are inversely proportional to the stage of the cancer at diagnosis. Early stage cancers are soft in impact on the pockets of patients and stands a good chance of cure or longer survival as compared to those diagnosed in advanced stages.
Such is the catastrophic nature of the cancer for patients and their families in India. The social order in India is such that many helping hands would come forward to their rescue however that may not be enough and it always comes with a compromise of dignity, pride and self-esteem for the cancer patients and their families. There are many charitable objects functioning in India who help cancer patients for monetary and otherwise assistance but with baggage of conditions and limitations.
Despite all of that, the ever-progressive Indian society is slowly adapting to be prepared for calamity like cancer in the following manner.
- People are increasingly becoming aware about and proactively investing in medical insurances for themselves and their families.
- They are increasingly sensitive to cancer causing habits like tobacco as well as the benefits of traditional or conventional lifestyle; nevertheless, we have a long way to go on this.
- Government and private cancer practitioners are driving large-scale cancer awareness that is slowly leading to incremental early stage cancer diagnosis where the curative treatment is possible with relatively lesser cost burden.
- Government initiatives to enforce controls on prices of cancer medicines has brought down the cost of treatment significantly.
- Introduction and improving efficiency of national health schemes like Rajiv Gandhi Jeevandayi Aarogya Yojna, Ayushman Bharat etc.
- Cancer treating facilities have developed innovative infrastructural and operational models that help reduce the cost of treatment to a large extent.
- Many pharmaceutical companies offer patient assistance programs in which they help patients with partly free medicines.
All these attempts & changes are certainly not enough however encouraging to a large extent. I am sure that things will improve for better as we move forward in time.
Dr. Pritam Kalaskar, MD, DM
Consultant Cancer Specialist
Mumbai Oncocare Centre, Thane