A major national study has sounded the alarm on a looming public health crisis, projecting a sharp increase in India's lung cancer burden by the year 2030. Published in the Indian Journal of Medical Research, the findings pinpoint the North-Eastern region as the future epicentre of the disease and reveal that women are experiencing the fastest rise in cases across the country.
The North-East Emerges as the Lung Cancer Hotspot
Data gathered from 57 populations across six regions paints a concerning picture for North-East India. This region has the highest lung cancer incidence in the nation, with a particularly unusual pattern: the rates for women are now alarmingly close to those for men. The city of Aizawl in Mizoram recorded the most severe burden, with an age-standardised incidence rate of 35.9 per 100,000 among men and 33.7 per 100,000 among women. It also reported the highest mortality rates.
While extremely high tobacco consumption—over 68% in men and 54% in women—remains a primary driver, doctors note a significant shift in the disease profile. Dr. Saurabh Mittal from the pulmonology department at AIIMS highlighted a worrying trend: "We are seeing more lung cancer cases among non-smoking women, linked to indoor air pollution, biomass fuel use, second-hand smoke and occupational exposure."
Changing Tumor Patterns and National Trends
This shift in risk factors is reflected in the changing patterns of lung cancer tumors nationwide. Adenocarcinoma, a subtype less directly tied to smoking, has now replaced smoking-linked squamous-cell carcinoma as the dominant form of the disease. In Bengaluru, adenocarcinoma accounts for over half of all lung cancer cases in women. Delhi has witnessed a sharp rise in another subtype, large-cell carcinoma.
The study uncovered other surprising hotspots. In southern districts like Kannur, Kasargod, and Kollam, high incidence rates among men were recorded despite relatively low tobacco and alcohol use, strongly pointing to the role of non-tobacco risk factors. Among women in the south, Hyderabad and Bengaluru reported the highest incidence. In the north, Srinagar showed elevated rates for men, while women in Srinagar and Pulwama also reported higher incidence despite low substance use.
Projections Point to a Steep Climb, Especially for Women
Trend analysis from the study is particularly stark for women. In some regions, lung cancer incidence is climbing by up to 6.7% annually among women, compared to 4.3% among men. Thiruvananthapuram recorded the sharpest rise among women, while Dindigul saw the steepest increase among men.
With tobacco use among women still below 10% nationally, researchers identify worsening ambient air quality and household exposures as the key drivers behind this disproportionate rise. Projections for 2030 are sobering: lung cancer incidence among men could exceed 33 per 100,000 in parts of Kerala, while among women it could rise to over 8 per 100,000 in cities like Bengaluru.
The study also flagged a critical data gap: low mortality-to-incidence ratios in several regions suggest significant under-reporting of deaths, potentially masking the true and devastating toll of the disease in India.
