Kolkata, Feb 4: Despite major advances in diagnostics, treatment, and technology, lung and cervical cancers in India continue to be diagnosed at advanced stages, largely due to gaps in awareness, screening, and access, oncologists from leading hospitals in Kolkata said on World Cancer Day.
Late diagnosis is not limited to cervical cancer, with lung cancer also often detected at advanced stages, even among non-smokers, women, and younger Indians, they said.
World Cancer Day, observed on February 4, is a global awareness initiative led by the Union for International Cancer Control to promote cancer prevention, early detection and treatment.
Dr Arunava Roy, Head of the Department and Senior Consultant of Gynaecologic Oncology at Manipal Hospital, told PTI that cervical cancer is still detected late due to low awareness, stigma, lack of routine screening, and delayed referrals at the primary care level.
He emphasised the importance of integrating screening into routine care.
On the persistence of high cervical cancer mortality despite preventability, Roy pointed to vaccination and social barriers.
“The key gaps are low HPV vaccination coverage, poor screening participation, and persistent social stigma. Myths, fear, and poor follow-up further delay care,” he said, adding that solutions include “school-based HPV vaccination, community-level screening programs, and sustained, culturally sensitive awareness initiatives.” The HPV vaccine is a series of injections that protects against the human papillomavirus (HPV), a common virus causing more than 90 per cent of cervical and several other cancers.
Doctors said delays often begin at the first signs of illness.
Senior Consultant, Medical Oncology, Apollo Cancer Centre, Kolkata, Dr Sandip Ganguly, said late presentation is largely driven by misinterpretation of symptoms rather than limitations in treatment.
“So it’s a lack of awareness that makes lung cancer patients present at an advanced stage. People often think this is tuberculosis or just a normal infection, and as many patients have COPD, they believe these are COPD symptoms,” he said, adding that cervical cancer, particularly in low socioeconomic groups, is similarly overlooked.
“There is also a lack of awareness about symptoms such as excessive discharge or vaginal bleeding. People consider these normal and ignore them,” he added.
Ganguly also flagged environmental factors, noting that “the most important cause of lung cancer as per WHO is environmental tobacco smoke or environmental pollution,” including indoor exposures such as incense sticks.
Pulmonologist Dr Shyam Krishnan of CK Birla Hospitals, CMRI, said lung and cervical cancers often go undetected in early stages because symptoms are vague or ignored.
“Despite significant advances in diagnostics and treatment, lung and cervical cancers in India continue to present at advanced stages primarily due to gaps in awareness, screening and primary care integration,” he said.
“In lung cancer, persistent cough or breathlessness is often attributed to pollution, smoking, or infections,” he added.
Dr Krishnan further highlighted the rising incidence among non-smokers, women, and younger patients.
“The rising incidence of lung cancer among non-smokers, women, and younger individuals reflects changing environmental and biological risk factors,” he said, adding that public messaging must move away from the outdated notion that lung cancer is only a smoker’s disease.
Gynaecologist Dr Parnamita Bhattacharya of CK Birla Hospitals, CMRI, said preventable cervical cancer deaths persist due to low vaccination coverage, limited screening uptake, and social stigma.
“High cervical cancer mortality in India is driven by low HPV vaccination coverage, limited screening uptake and persistent social stigma,” she told PTI.
Bhattacharya added that community initiatives have made an impact. “Under an initiative led by Arpit Jain, Vice President, CK Birla Hospitals, free HPV vaccination has been provided to over 5,000 girls across Kolkata and Jaipur.” The oncologists further highlighted that rural patients face compounded challenges due to limited infrastructure and specialist access.
Dr S K Bala, a specialist in Surgical Oncology and Robotic Surgery at CK Birla Hospitals, CMRI, said, “The outcome gap between urban and rural cancer patients remains substantial, with rural patients more likely to be diagnosed at advanced stages and experience treatment delays.” He added that models like “tele-oncology for specialist consultations, mobile screening units for early detection, decentralised diagnostics, and task-shifting to trained nurses and primary care providers” are showing results.
Consultant Physician at Neotia Mediplus, Kolkata, Dr Amit Gupta, told PTI, “Low awareness, stigma, weak screening, and missed opportunities in primary care lead to delays.” He also emphasised cost barriers.
“Cost remains a major barrier despite schemes like Ayushman Bharat. Expanding coverage limits, faster inclusion of newer therapies, and public-private partnerships are essential.” Dr Sreya Mullik, Senior Consultant, Medical Oncology at Desun Hospital, said embedding screening into routine care is critical.
“Lung and cervical cancers still present late because early symptoms are ignored or mistaken for common illnesses, and screening is not routine,” she said, adding that clear communication is key to combating misinformation.
Oncologists agreed that early detection remains the most effective way to reduce mortality and financial burden.
Solutions highlighted include school- and community-based HPV vaccination, mobile screening units, tele-oncology consultations, and training frontline health workers. Several also emphasised the importance of addressing social stigma and building trust at the community level to encourage timely care-seeking.
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