Lung cancer is fast emerging as one of India’s most pressing but least discussed public health crises. Once largely associated with elderly smokers, the disease is increasingly being diagnosed among younger adults, women and people who have never touched tobacco,
Recent data from the National Cancer Registry Programme and the Indian Council of Medical Research (ICMR) indicates that lung cancer incidence in India is projected to rise to over 81,000 cases in 2025 with a significant and growing—proportion of these patients being non-smokers, women and young adults in their 30s and 40s.
In urban hotspots like Delhi and Mumbai, environmental factors such as toxic air pollution (PM2.5) and indoor biomass smoke are increasingly identified as primary drivers, often eclipsing traditional tobacco use. This evolving demographic faces unique challenges from delayed diagnosis due to “low-risk” profiles to the struggle of balancing aggressive treatments with active professional lives. As the disease profile changes so too must the strategy shifting away from a one-size-fits-all approach toward precision oncology and patient-centric delivery models.
Firstpost talked to Dr Sajjan Rajpurohit, Senior Director at Medanta (Noida & Defence Colony) to understand how innovation in diagnostics and treatment is paving the way for better survival rates and a higher quality of life for patients across the country.
Excerpts:
Why lung cancer is emerging as a major concern in India?
Dr Rajpurohit: Lung cancer has become one of the most urgent public health priorities in India because of its high mortality and rising incidence, particularly in urban and polluted regions. Recent registry data suggests tens of thousands of new cases annually and lung cancer remains a leading cause of cancer-related deaths in the country. Many patients present at advanced stages due to low awareness and late detection, making treatment more complex and outcomes poorer.
According to the Indian Journal of Medical Research, lung cancer cases in India are projected to rise sharply by 2030. The disease profile in India is evolving with a substantial proportion of lung cancer occurring in non-smokers, particularly women, and in relatively younger adults compared to Western countries. These trends mean we cannot rely solely on traditional risk assumptions linked to smoking.
This evolving burden demands investment in modern diagnostics, accessible care pathways and innovative therapies that not only extend survival but also improve quality of life, especially in settings where conventional intravenous oncology treatments can be burdensome for patients.
Key challenges in lung cancer diagnosis and treatment?
Dr Rajpurohit: In India, lung cancer care is hindered by several interlinked challenges:
Late diagnosis: A very high proportion of patients are diagnosed at advanced stages when curative options are limited. This is driven by low public awareness of early symptoms and the absence of large-scale screening programmes.
Diagnostic barriers: Access to high-quality imaging and molecular testing remains uneven, particularly outside major metros.
Treatment access and tolerance: Traditional systemic therapies often require lengthy hospital visits and can be poorly tolerated, especially in patients with compromised functional status. Minimally invasive and patient-friendly treatment formats, such as subcutaneous administration options, have the potential to reduce hospital time and improve patient experience, a real need in our health ecosystem.
Resource limitations: There is variability in oncology infrastructure across regions, with many centres lacking multidisciplinary care teams and advanced treatment modalities. Addressing these challenges requires strengthening early detection pathways, decentralizing care access, and embracing innovations that make treatment more convenient and less disruptive for patients and caregivers. Lung cancer incidence is rising in India, including among non-smokers and younger patients.
Why lung cancer is no longer just a smoker’s disease in India
Dr Rajpurohit: Lung cancer in India is no longer limited to older smokers. Increasingly, we are seeing cases among non-smokers, women, and younger patients. This points to external factors such as air pollution, occupational exposure, indoor smoke, and genetic susceptibility. These trends indicate that lung cancer is not solely a smoker’s disease, with studies from India showing that 40–50% of cases occur in non-smokers. Many of these patients are diagnosed while actively working and managing family responsibilities, when treatment can have a greater impact on daily routines.
How early detection, awareness improve lung cancer survival rates
Dr Rajpurohit: Early detection plays an important role because lung cancer is often diagnosed late, when symptoms are more advanced and treatment becomes more complex. Greater awareness of early signs such as a persistent cough, breathlessness, unexplained weight loss, or fatigue is critical, particularly as we are seeing more cases among non-smokers. Earlier diagnosis allows treatment to begin sooner, before patients become physically weakened by the disease as it could make treatment journeys more manageable and less disruptive. Importantly, as outcomes improve, attention is increasingly shifting to how patients experience treatment day to day, including the time spent travelling, waiting, and receiving care, and how well treatment fits into their everyday lives.
How will precision medicine and minimally invasive therapies improve lung cancer patients’ quality of life?
Dr Rajpurohit: Lung cancer care is evolving in ways that increasingly reflect patients’ quality of life. Precision and personalized therapies, such as immunotherapy are shaping the future of cancer care by working with the patient’s immune system and individual disease characteristics to deliver more precise treatment. Increasing attention is also being given to subcutaneous modes of administration. Simpler and shorter subcutaneous treatment administration can reduce the time patients spend in hospitals over repeated visits. These innovations also support decentralisation of care, making it possible to deliver treatment closer to home, easing travel and disruption and improving quality of life for patients and their families.
End of Article