Why are Indian women diagnosed more with cancer but have lower mortality than men

More Indian women than men are diagnosed with cancer, yet women face lower mortality, mainly due to early detection and diagnosis.

According to estimates from the Indian Council of Medical Research (ICMR), of every 100 cancer cases in India, 51.1 per cent occur in women and 48.9 per cent in men. However, women contribute to only 45 per cent of overall cancer deaths, whereas men account for 55 percent.  

This disparity is explained by the kinds of cancers common to each gender. Breast, cervical, and ovarian cancers make up almost 40 per cent of cancers among women, with breast and cervical cancers being the two most prevalent. These cancers, while concerning, are also among the most curable if detected early. For example, early-stage breast cancer has a five-year survival rate of over 90 per cent. Cervical cancer, which affects around 120,000 Indian women annually, is preventable in most cases through the human papillomavirus (HPV) vaccine and regular pap smear testing.  

Dr Kunal Jobanputra, Oncologist at M|O|C Cancer Care, Mumbai, says the relatively favourable prognosis for breast and cervical cancers helps explain why women, despite having a marginally higher incidence of cancer, have a lower mortality rate in India. In contrast, men more commonly develop lung, oral, and esophageal cancers, conditions with far poorer outcomes.

ICMR survival data show that the five-year survival for advanced lung cancer falls below 20 per cent, highlighting the aggressive and late-diagnosed nature of these diseases.  

Measures to be taken:

Access to early detection plays a critical role in protecting women. Awareness campaigns, mammography camps, and cervical cancer screening in both urban and semi-urban India have helped more women identify cancers at treatable stages. This relative advantage has not been mirrored for men’s cancers, where screening remains less effective. Oral and lung cancers, strongly tied to tobacco and alcohol consumption, rarely offer the window for early diagnosis that breast and cervical cancers do.  

Jobanputra noted that as screenings become more accessible across India’s varied geographies, the chances of catching cancers early and improving survival rates will increase.  

Technological advances have also contributed to early detection, with breast exams now being possible with simple handheld devices on which front-line health workers can be trained.

Cervical cancer remains the second most common cancer in women and a major contributor to global cancer mortality. In India, it accounts for more than 77,000 deaths annually according to the World Health Organization. 

With the introduction of Cervavac, India’s first indigenous HPV vaccine, things will change. More affordable and easier to deploy, Cervavac holds the potential to drastically reduce future cervical cancer cases. Public health experts are pushing for nationwide vaccination programs that could prevent thousands of new cases each year.  

Challenges:

While prevention strategies are improving outcomes for cervical cancer, breast cancer is posing a growing challenge. Data from the International Agency for Research on Cancer (Globocan 2020) indicates an age-adjusted incidence rate of 25.8 per 100,000 women and a mortality rate of 12.7 per 100,000 women in India. Each day, approximately 350 women are newly diagnosed, and one life is lost every 13 minutes to breast cancer.  

Dr Minish Jain, Director of Medical Oncology at Ruby Hall Clinic, Pune, said that nearly 60 per cent of women in India are diagnosed at stages 3 or 4 of breast cancer, when survival rates plummet. He attributes this late detection to factors such as low screening uptake, social stigma, financial barriers, and preference for alternative therapies. Indian women’s survival rate across five years is about 66 per cent, compared with almost 90 per cent in the United States.  

Breast cancer risks are heightened by genetic and lifestyle variables. Early menarche, late menopause, first pregnancies after age 30, absence of breastfeeding, obesity, sedentary living, smoking, alcohol, and high-fat diets all add to the risk. Genetic predispositions such as BRCA1/2 mutations, along with the higher prevalence of aggressive forms like triple-negative breast cancers in India, complicate treatment further.  

The poor survival rates among Indian men are largely a result of cancer type and delayed diagnosis. Lung cancer alone accounts for 10.6 per cent of all male cancers in India, while oral cancer accounts for about 8 per cent. Both are strongly linked to tobacco use, which contributes to nearly half of all male cancer cases. These cancers frequently present at advanced stages, leaving limited options for cure or long-term survival.  

India is expected to see a steep rise in its cancer burden, reaching over 1.5 million new cases annually by 2030. The gender gap in cancer outcomes underscores the urgent need for dual strategies: maintaining and expanding prevention and screening for women, while extending similar early detection efforts to men’s cancers.  

Experts emphasise that the solution lies in prevention, vaccination, lifestyle modification, and access to affordable cancer treatment.