India’s lung cancer cases are projected to rise sharply by 2030, with the North-Eastern region emerging as the most affected and women showing the fastest increase, according to a new study published in the Indian Journal of Medical Research.
Analysis of data from 57 populations across six regions shows the North-East leading in both lung cancer incidence and deaths. Notably, women in this region are experiencing rates nearly equal to men—a rare pattern in India. Aizawl tops the list, reporting an age-standardised incidence of 35.9 per lakh in men and 33.7 per lakh in women, alongside the highest mortality.
High tobacco consumption in the North-East—over 68% in men and 54% in women—remains a major driver of lung cancer. However, clinicians are increasingly observing cases in non-smoking women, linked to indoor air pollution, biomass fuel use, second-hand smoke, and occupational exposures, particularly in urban and peri-urban areas.
The study highlights a nationwide change in lung cancer patterns. Adenocarcinoma, which is less linked to smoking, has overtaken squamous-cell carcinoma as the predominant subtype in many regions. In Bengaluru, over half of lung cancer cases in women are adenocarcinoma, while Delhi has seen a sharp rise in large-cell carcinoma, suggesting evolving environmental and lifestyle risk factors.
Certain southern districts, including Kannur, Kasaragod, and Kollam, show high incidence among men despite lower tobacco and alcohol use, pointing to environmental exposures such as air pollution. Among women, Hyderabad and Bengaluru have the highest incidence in the south, while in the north, Srinagar and Pulwama report elevated rates in women and men alike, even with low substance use.
Trend analysis reveals lung cancer incidence rising by up to 6.7% per year in women and 4.3% in men in select regions. Thiruvananthapuram shows the fastest increase among women, while Dindigul leads among men. Researchers attribute these trends to worsening air quality and household exposures, as female smoking remains below 10% nationally. By 2030, incidence in men could surpass 33 per lakh in parts of Kerala, while in women it may exceed 8 per lakh in cities like Bengaluru. Low mortality-to-incidence ratios in several regions also suggest under-reporting of lung cancer deaths.
The study underscores an urgent need for targeted prevention strategies, stricter air quality controls, and awareness campaigns addressing both tobacco and non-tobacco risk factors, particularly among women in high-risk regions.
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