Early-Onset Breast, Cervical, Colorectal and Stomach Cancer Across the States of India, 1990–2023: Divergent Trends and a Mismatch Between Burden Rate and Caseload
4 affiliations
- 1Department of Healthcare and Hospital Management, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
- 2Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
- 3Department of Global Public Health Policy and Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
- 4Manipal School of Commerce and Economics, Manipal Academy of Higher Education, Manipal 576104, India
Abstract
Background/Objectives: Cancer diagnosed before the age of 50 is rising across many countries, and the rise is not accounted for by population growth alone. India carries one of the world’s largest cancer burdens, and it varies greatly between its states, variation camouflaged by the national average. We characterised early-onset breast, cervical, colorectal and stomach cancer across the states of India. Methods: Secondary ecological analysis of Global Burden of Disease Study 2023 estimates, ages 15–49 years, 1990–2023; rates per 100,000 population of both sexes. Trends were summarised as the estimated annual percentage change, with autocorrelation-robust confidence intervals, and by segmented regression. Gradients across 30 states were assessed against the 2023 Socio-Demographic Index (SDI). Case growth was decomposed into population growth, within-band ageing and rate change. Results: In 2023, breast cancer had the highest early-onset incidence, 9.63 per 100,000 (19.63 per 100,000 women), and cervical cancer 8.18 (16.87). Breast incidence rose 2.72% per year and colorectal 1.11%; stomach fell 0.52%. Cervical incidence fell until 2011 and rose unevenly thereafter, with a near-zero net trend (−0.09% per year). Within-band standardisation shifted it downward (−0.39%; 95% confidence interval −0.87 to 0.09), and separating within-band ageing turned its rate-change share negative (−8.1%). Breast cases rose from 15,550 to 76,806: 59.0% of the rise was rate change, 51.8% after separating ageing. Point estimates suggested a stronger inverse SDI gradient for cervical disability-adjusted life years (ρ = −0.43) than incidence (ρ = −0.31). Neither survived multiple-testing correction, and the two were not distinguishable. No association was detected between burden rate and caseload across the states (ρ = +0.02). Conclusions: The early-onset cancer burden in India is not uniform. Breast cancer cases are growing faster than the population, with a rising recorded rate. The cervical gradient is exploratory. The states with the highest rates and the states with the most cases differ, and each answers a different planning question.
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BibTeX
@article{kamath2026earlyonset,
title = {{Early-Onset Breast, Cervical, Colorectal and Stomach Cancer Across the States of India, 1990–2023: Divergent Trends and a Mismatch Between Burden Rate and Caseload}},
author = {Rajesh Kamath and Sanjay B. Kini and Vidya Prabhu and Andria Sirur},
journal = {Cancers},
year = {2026},
month = nov,
doi = {10.3390/cancers18213580},
url = {https://www.mdpi.com/2072-6694/18/21/3580},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Early-Onset Breast, Cervical, Colorectal and Stomach Cancer Across the States of India, 1990–2023: Divergent Trends and a Mismatch Between Burden Rate and Caseload
AU - Rajesh Kamath
AU - Sanjay B. Kini
AU - Vidya Prabhu
AU - Andria Sirur
PY - 2026
DA - 2026/11/07
JO - Cancers
DO - 10.3390/cancers18213580
UR - https://www.mdpi.com/2072-6694/18/21/3580
AB - Background/Objectives: Cancer diagnosed before the age of 50 is rising across many countries, and the rise is not accounted for by population growth alone. India carries one of the world’s largest cancer burdens, and it varies greatly between its states, variation camouflaged by the national average. We characterised early-onset breast, cervical, colorectal and stomach cancer across the states of India. Methods: Secondary ecological analysis of Global Burden of Disease Study 2023 estimates, ages 15–49 years, 1990–2023; rates per 100,000 population of both sexes. Trends were summarised as the estimated annual percentage change, with autocorrelation-robust confidence intervals, and by segmented regression. Gradients across 30 states were assessed against the 2023 Socio-Demographic Index (SDI). Case growth was decomposed into population growth, within-band ageing and rate change. Results: In 2023, breast cancer had the highest early-onset incidence, 9.63 per 100,000 (19.63 per 100,000 women), and cervical cancer 8.18 (16.87). Breast incidence rose 2.72% per year and colorectal 1.11%; stomach fell 0.52%. Cervical incidence fell until 2011 and rose unevenly thereafter, with a near-zero net trend (−0.09% per year). Within-band standardisation shifted it downward (−0.39%; 95% confidence interval −0.87 to 0.09), and separating within-band ageing turned its rate-change share negative (−8.1%). Breast cases rose from 15,550 to 76,806: 59.0% of the rise was rate change, 51.8% after separating ageing. Point estimates suggested a stronger inverse SDI gradient for cervical disability-adjusted life years (ρ = −0.43) than incidence (ρ = −0.31). Neither survived multiple-testing correction, and the two were not distinguishable. No association was detected between burden rate and caseload across the states (ρ = +0.02). Conclusions: The early-onset cancer burden in India is not uniform. Breast cancer cases are growing faster than the population, with a rising recorded rate. The cervical gradient is exploratory. The states with the highest rates and the states with the most cases differ, and each answers a different planning question.
SN - 2072-6694
ER -