India is expected to witness a significant rise in lung cancer cases by 2030, with the North-East emerging as the most affected region and women recording the fastest growth in incidence. These findings come from a national study published in the Indian Journal of Medical Research.
North-East Reports the Highest Incidence and Mortality
Data drawn from 57 population-based cancer registries across six regions reveal that lung cancer incidence remains highest in the North-East. Notably, women in this region now show incidence rates close to those of men—an uncommon trend in India. Aizawl reported the highest burden, with age-standardised incidence rates of 35.9 per lakh among men and 33.7 per lakh among women, along with the highest mortality figures.
Beyond Tobacco: Changing Risk Factors in the Region
Although extremely high tobacco consumption—over 68 per cent among men and 54 per cent among women—continues to drive the disease burden in the North-East, clinicians are observing a shift in risk profiles. According to Dr Saurabh Mittal from the Department of Pulmonology at AIIMS, doctors are seeing a growing number of lung cancer cases among non-smoking women. These cases are increasingly linked to indoor air pollution, biomass fuel use, second-hand smoke and occupational exposures.
Tumour Patterns Shift Nationwide
This changing exposure profile is also reflected in tumour characteristics across the country. Adenocarcinoma has now overtaken smoking-related squamous-cell carcinoma as the most common lung cancer subtype nationwide. In Bengaluru, adenocarcinoma accounts for more than half of lung cancer cases among women, while Delhi has reported a marked rise in large-cell carcinoma.
Non-Tobacco Risks Emerge Across Regions
As reported by TOI, several regions with relatively low tobacco and alcohol use have reported unexpectedly high lung cancer incidence. In the south, districts such as Kannur, Kasargod and Kollam showed elevated rates among men, suggesting the influence of non-tobacco risk factors. Among women, Hyderabad and Bengaluru recorded the highest incidence in southern India. In the north, Srinagar reported higher lung cancer rates among men, while women in Srinagar and Pulwama also showed increased incidence despite low substance use.
Women Show the Fastest Growth in Lung Cancer Cases
Trend analysis indicates that lung cancer incidence is rising by as much as 6.7 per cent annually among women and 4.3 per cent among men in certain regions. Thiruvananthapuram recorded the steepest increase among women, whereas Dindigul showed the sharpest rise among men. Given that tobacco use among women remains below 10 per cent nationally, researchers point to deteriorating air quality and household exposures as key drivers of this trend.
2030 Projections Signal a Growing Public Health Challenge
Looking ahead, projections suggest that lung cancer incidence among men could exceed 33 per lakh in parts of Kerala by 2030. Among women, rates could rise beyond 8 per lakh in cities such as Bengaluru. Additionally, low mortality-to-incidence ratios observed in several regions indicate gaps in death reporting, potentially obscuring the true scale of the disease burden.
Urgent Need for Prevention and Early Detection
Taken together, the findings highlight an urgent need to strengthen air quality controls, improve household fuel practices, and expand early detection efforts—particularly among women and in high-burden regions—if India is to curb the rising lung cancer epidemic over the coming decade.