India’s cancer paradox: more women diagnosed but men account for most deaths

More women than men in India are being diagnosed with cancer, yet men account for the majority of cancer deaths, according to an analysis of the country's cancer registry data and expert commentary.

Women make up just over half of new cancer cases in India, while men represent a larger share of fatalities. The country’s cancer registries project about 1.56 million new cases and 874,000 deaths for 2024, reflecting a growing and uneven burden of disease across regions and cancer types.

The pattern contrasts with global averages. In 2022 the World Cancer Research Fund estimated 197 new cancer diagnoses per 100,000 people worldwide, with men faring worse (212 per 100,000) than women (186 per 100,000). In many high-income countries, widespread screening and earlier detection have narrowed differences in lifetime risk between sexes; in India the picture is more complex.

Breast, cervical and ovarian cancers account for the largest share of female cases, with breast and cervical cancers making up about 40% of cancers in women. Cervical cancer is largely linked to infections such as human papillomavirus (HPV), while breast and ovarian cancers are influenced by hormonal factors. Rising breast and ovarian cancers in India have been tied to lifestyle and demographic shifts including later pregnancies, less breastfeeding, increasing obesity and more sedentary behaviour.

For men, oral, lung and prostate cancers dominate. Tobacco use is a principal driver: about 40% of preventable cancers in India are linked to tobacco, particularly oral and lung cancers. Experts say the mix of risk factors, differences in health-seeking behaviour and access to early diagnosis help explain why men die at higher rates despite lower overall incidence.

"Women's health has become a bigger focus in public health campaigns, and that's a double-edged sword. Greater awareness and screening mean more cancers are detected early. For men, the conversation rarely goes beyond tobacco and oral cancer," said Ravi Mehrotra, a cancer specialist and head of the non-profit Centre for Health Innovation and Policy Foundation. "Women, through reproductive health checks, are more likely to see a doctor at some stage. Many men, by contrast, may go their whole lives without ever seeing one."

Cancer risk and outcomes vary sharply across India. Data from 43 population registries show that about 11 in 100 people in India will develop cancer at some point in their lives. The northeast is a hotspot: Aizawl district in Mizoram records lifetime risks roughly twice the national average. Doctors in the region point to high rates of tobacco use and other lifestyle factors rather than genetic differences.

"For most cancers in the north-eastern state, I'm convinced lifestyle is the key factor. Tobacco use is rampant here — much higher than elsewhere," said R. Ravi Kannan, head of Cachar Cancer Hospital and Research Centre in Assam. He described local variation in tobacco habits: chewing is common in Barak Valley while smoking predominates in nearby Mizoram. Alcohol, areca nut consumption and food preparation practices also contribute to regional risk patterns, he said.

The regional patchwork extends beyond the northeast. Srinagar records high lung cancer rates in men, while Hyderabad has some of the highest recorded breast cancer rates. Men in Delhi are diagnosed with all cancers combined at higher rates than men in many other regions, even after adjusting for age. Oral cancer incidence is rising in multiple registries: 14 report increases among men and four among women.

Global comparisons underline the consequences of disparities in detection and care. The World Health Organization and the International Agency for Research on Cancer note that in high Human Development Index countries more women are diagnosed with breast cancer but far fewer die, owing to screening and better access to treatment. In lower HDI countries, fewer diagnoses paradoxically coincide with higher mortality because cancers are detected late and treatment is often inadequate.

"Women in lower Human Development Index countries are 50% less likely to be diagnosed with breast cancer than women in high HDI countries, yet they are at a much higher risk of dying of the disease due to late diagnosis and inadequate access to quality treatment," said Isabelle Soerjomataram, deputy head of the Cancer Surveillance Branch at the International Agency for Research on Cancer.

India's registry data reflect a country in transition: changing lifestyles, greater longevity and uneven access to services are reshaping the cancer landscape. Public health experts and clinicians say the priorities are clearer than the causes: targeted prevention, expanded screening, reductions in tobacco and alcohol use, vaccination against HPV, and improved access to timely, quality treatment.

The data underscore the need for interventions tailored to regional and gender-specific risks. While awareness campaigns and screening have begun to shift detection patterns for women, experts say addressing men's higher mortality will require greater outreach, earlier diagnosis and broader efforts to curb tobacco and alcohol use. Policymakers and health programmes face the challenge of narrowing gaps in prevention, detection and care to reduce both incidence and deaths across the population.