A major cross-sectional analysis from the National Cancer Registry Programme (NCRP) Investigator Group has revealed striking variations in cancer incidence and mortality across India, underscoring the urgent need for strengthened prevention and control strategies.
Published in JAMA Network Open (20 August 2025), the study drew on data from 43 population-based cancer registries between 2015 and 2019, covering more than 700,000 cases and 200,000 deaths. Projections suggest that by 2024, India will record 1.56 million new cases of cancer and 874,000 deaths.
Lifetime Risk and Regional Hotspots
The analysis found that the overall lifetime risk of developing cancer in India is 11.0%, though this figure masks stark regional differences.
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Mizoram, in the country’s northeast, reported the nation’s highest risks: 21.1% for men and 18.9% for women.
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Within Mizoram, Aizawl district recorded the highest age-adjusted incidence rates (AAIR): 256.1 per 100,000 in men and 217.2 per 100,000 in women.
Among metropolitan centres (urban agglomerations >1 million people), Delhi had the highest overall cancer incidence in men (AAIR 146.7), while Srinagar showed the highest incidence of lung cancer (AAIR 39.5).
Common Cancers
Patterns of disease burden varied by sex:
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Men: oral, lung, and prostate cancers dominated.
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Women: breast, cervical, and ovarian cancers were most prevalent.
Concerning Trends
Time-trend analyses revealed significant increases in oral cancer in 14 registries for men and 4 registries for women.
In Ahmedabad Urban, oral cancer incidence rose by 4.7% annually in men and 6.9% in women.
The average annual percent change (AAPC) in overall cancer incidence showed significant rises in Kamrup Urban (men, +3.3%) and Thiruvananthapuram Taluk (women, +3.4%).
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Implications for Practice
The NCRP authors highlight that cancer incidence is rising faster in certain regions, with oral cancer emerging as a particularly pressing challenge. They stress the importance of enhanced cancer surveillance, targeted prevention efforts, and greater resource allocation to high-burden states and districts.
The authors noted, “The significant variation in area-wise cancer incidence rates and cancer types in India highlights the need for tailored strategies to enhance cancer prevention and control efforts.
These insights may guide future studies on environmental and lifestyle risk factors in Indian populations. This heterogeneity underscores the importance of strengthening infrastructure and human resources both nationally and at the state level.”
The findings reinforce India’s position as a country facing one of the world’s heaviest cancer burdens, ranking second in Asia and third globally in incidence. For clinicians, the study provides a crucial epidemiological context for understanding patient populations in India and the South Asian diaspora.
Paper: National Cancer Registry Programme Investigator Group. Cancer Incidence and Mortality Across 43 Cancer Registries in India. JAMA Netw Open. 2025;8(8):e2527805. doi:10.1001/jamanetworkopen.2025.27805. Access online here.
