The Indian subcontinent occupies 2.4% of the world land mass and is home to 16.5% of the world population. At present, it is roughly estimated that ~1 million new cancer cases per annum will be recorded and at any given time there will be 3 million cancer patients in India. Nevertheless, cancer is not a frequent disease for the Indian population. Cancer statistics demonstrate that cancers frequently observed in India are lifestyle dependent, with offending factors such as tobacco usage, low socio-economic status, multiple pregnancies and poor sexual hygiene. These factors are closely related to the population living in rural surroundings and they are targets for cancer prevention. Low socio-economic status and low literacy rates ensure that most patients are diagnosed at an advanced stage of the disease. It is very difficult for these patients to achieve a cure and they are always treated by palliative care with much cost and morbidity. Therefore, it is reasonable to postulate that the strategy for cancer control in India should be focused on health education for the rural population and the creation of an infrastructure for cancer management. These systems with appropriate low-cost technology might be able to be duplicated as a model for developing countries with low capital inputs.

The main need in the coming decades is education: education about prudence in lifestyles and diets; education about symptomatology of early cancer; education about availability of screening programmes for the high-risk population; and education about the fact that early diagnosis and appropriate treatment are compatible with long-term cancer-free survival with minimum morbidity. In essence, no cancer control effort can be mounted without education at all levels – public and professional.

The need of the coming decades is not huge, comprehensive cancer centres, but small community cancer centres, which are cost effective and can manage most cancer patients in their own environment. Currently, 50% of cancers are curable if detected early, 25% can be effectively palliated by treatment even in an advanced stage and for the remaining 25% good palliative care and pain relief can be achieved. If appropriate steps are taken to address the problem in a pragmatic manner, by 2025, two-thirds of cancers could be cured and only 5% of patients will need terminal care. These figures are based on demographic estimates, which have proved that cancer death rates are steadily declining in countries where appropriate strategies have been implemented.