For decades, lung cancer in India carried a familiar profile: a disease largely confined to men, concentrated among communities with heavy tobacco consumption. That narrative is now breaking down at an alarming pace. A national study projects a sharp rise in lung cancer cases by 2030, with one disturbing shift standing out – women, particularly non-smokers and homemakers, are emerging as the fastest-growing group of victims. The data are stark. While the Northeast continues to bear the highest burden-driven by exceptionally high tobacco use-metro cities and several non-traditional regions are rapidly joining the cancer map. Even more striking is the near parity between men and women in some Northeastern states, an unusual pattern for India. Premier institutes like AIIMS confirm what clinicians are seeing on the ground: lung cancer is no longer only a smoker’s disease.
Among women, tobacco use nationally remains below 10 percent, yet incidence rates are climbing by as much as 6-7 percent annually in certain regions. This paradox points decisively towards environmental and household risk factors. Indoor air pollution from biomass fuel, exposure to second-hand smoke, occupational hazards, and, above all, worsening ambient air quality are now central drivers. Metro cities are leading this grim charge after the Northeast. Bengaluru, Hyderabad, Delhi and several cities in Kerala show rising incidence despite lower traditional risk factors. With each passing year, new urban and semi-urban centres are added to the list. India today hosts a pack of cities regularly designated among the world’s most polluted. Researchers estimate that pollution alone may reduce life expectancy by nearly eight years in the Delhi NCR region-a statistic that should ring alarm bells across policy corridors.
What makes this trend especially tragic is that many of the new victims are women who have never smoked – homemakers spending long hours indoors, unknowingly inhaling toxic air. The cancer charts, once dominated by excessive smokers, are now increasingly led by those with the least personal culpability. Unless the Government intervenes on a war footing, this trajectory will spiral out of control. Pollution control cannot remain a matter of incremental tweaks or seasonal measures. Clean fuel transitions, stricter industrial and vehicular emission norms, urban planning reforms, and credible air quality enforcement are no longer optional – they are lifesaving imperatives. Equally, civil society must recognise that pollution is a collective problem demanding collective action.
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