Rising Cases of Endometrial and Lung Cancer Among Indian Women: Causes and Challenges
Amid changing lifestyles and environmental risks in the country, uterine and lung cancers are rising rapidly among women; what do science and medical statistics warn?
Traditionally in India, breast cancer and cervical cancer have been the most prevalent cancers among women, but over the past few years, a major shift in epidemiological trends has been observed. In particular, endometrial cancer of the inner wall of the uterus and lung cancer are increasing at an alarming rate among women. In developed countries, endometrial cancer has long been the most common cancer of the female reproductive system, but now in India too, with changing lifestyles, a continuous surge in the number of patients is being witnessed. On the other hand, the figures for lung cancer are rising rapidly even among non-smoking women, raising new concerns in the public health sector.
As the month of November is celebrated worldwide as Lung Cancer Awareness Month, recent statistics point towards an extremely serious situation. According to a report by 'The Hindu' newspaper, data from the Kidwai Memorial Institute of Oncology (KMIO), a well-known government cancer care institution in Karnataka, shows that the rate of lung cancer is increasing three times faster in women compared to men. During the year 2025, approximately 5,503 new cases of lung cancer were registered in the state, which accounts for about 6.1% of all cancers in the state. Similarly, according to official information that emerged in Gujarat on the occasion of 'National Cancer Awareness Day', an average of 206 cancer cases are registered and 55 patients lose their lives daily in the state.
What is endometrial cancer and how does it develop?
The softest and blood-vessel-rich lining inside the uterus is called the endometrium. Under normal circumstances, this lining breaks down and sheds every month during menstruation, and a new one is formed. However, when a defect arises in the genetic makeup of the cells of this lining, the old or damaged cells begin to divide uncontrollably instead of dying. This abnormal mass of cells takes the form of a tumor. According to Wikipedia's medical research data, more than 80% of endometrial cancer cases are of the endometrioid carcinoma type, which originates from the glands of this lining.
The balance of female hormones plays the most critical role behind this cancer. Under normal conditions, the hormone estrogen thickens the uterine wall, and the hormone progesterone keeps its growth in regulation. When only the level of estrogen increases in the body without the protection of progesterone—which is medically termed unopposed estrogen—the risk of cancer increases by 2 to 10 times. Excess body fat, that is, adipose tissue, converts a component called androstenedione into estrogen, due to which the level of estrogen in the blood remains constantly high and the cells of the uterus continually receive signals for abnormal growth.
- Accumulation of fatExcess body fat (adipose tissue) converts androstenedione into the estrogen hormone.
- Hormonal imbalanceConsistently high levels of estrogen without progesterone continuously stimulate the lining of the uterus.
- Uncontrolled cell divisionOld cells of the uterine wall begin to grow at an abnormal rate instead of dying.
- Tumor formationAn abnormal mass of cells takes the form of an endometrial cancer tumor.
Obesity, Diabetes, and Modern Risk Factors
Approximately 40% of endometrial cancer cases are directly linked to obesity. According to medical research, the risk of developing this cancer in obese women is about 300% to 400% higher than in women with normal weight. In countries like India, a sedentary lifestyle, processed foods, and a lack of exercise are fueling this disease. The habit of sitting for long periods is directly linked to an increased mortality rate. Women with type 2 diabetes, insulin resistance, and high blood pressure also face a significantly higher risk of this disease.
In addition to this, genetic factors are also important. 2% to 10% of endometrial cancer cases are hereditary. In women with a genetic defect called Lynch syndrome, the risk of developing this cancer reaches 40% to 60%, which is generally caused by mutations in DNA repair genes such as MLH1, MSH2, and MSH6. Similarly, the use of tamoxifen, a drug used in the treatment of breast cancer, for 1 to 2 years doubles this risk, and its use for five years can quadruple it, although its benefit against breast cancer is much greater.
Symptoms and Diagnostic Process
The primary and earliest visible symptom of endometrial cancer is vaginal bleeding after menopause, that is, the cessation of menstruation. More than 90% of women with this cancer experience irregular bleeding or spotting. Abnormally prolonged or heavy menstrual flow in the pre-menopausal stage can also be an indication of it. Other less common symptoms include a thin white discharge, pain during urination, or a persistent throbbing in the pelvic region.
A standard pap smear is not sufficient for detecting this cancer because it only examines cells from the cervix. For an accurate diagnosis, a tissue sample is taken from inside the uterus using an endometrial biopsy or a dilation and curettage (D&C) procedure and examined under a microscope. If diagnosed in the early stages, the patient can be completely cured by surgically removing the uterus and ovaries (hysterectomy), with a five-year survival rate recorded at over 80%.
The Unsolved Mystery of Lung Cancer in Women
On the other hand, statistics on lung cancer among women in India are becoming a major challenge for scientists. In the year 2020, 2.2 million cases of lung cancer and 1.8 million deaths were recorded worldwide, making it the world's deadliest cancer. While smoking is considered the primary cause of this cancer in men, the situation in women is quite different. Data from Bengaluru's Kidwai Memorial Institute of Oncology shows that the average annual age-adjusted rate (AAR) of lung cancer in women has increased at a rate of 4.8%, whereas this growth in men has been only 1.6%.
This figure shows that the rate of cancer spread in women is three times higher than in men. Most Indian women do not smoke cigarettes, yet tumors are being found in their lungs. Secondhand smoke, hazardous levels of air pollution in cities, and smoke emanating from biomass fuel (wood or dung stoves) in rural areas are believed to be responsible for this. In addition to this, sudden genetic mutations in lung cells and exposure to toxic particles like asbestos are also making women prey to it.
About 85% of lung cancer cases are non-small cell lung cancer (NSCLC) and 15% are small cell lung cancer (SCLC). The greatest tragedy of lung cancer is that it has no clear symptoms in its initial stages. When coughing, shortness of breath, or chest pain occurs, the disease has mostly already progressed. Worldwide, the five-year survival rate after diagnosis is only about 20%, highlighting the urgent need for early diagnosis.
Protective Factors and Precautionary Measures
Science shows that the risk of cancer can be significantly reduced through proper awareness and lifestyle changes. In the case of endometrial cancer, combined oral contraceptive pills have proven to be protective as they provide both estrogen and progesterone. According to research, using them for 4 years reduces the risk by 56%, at 8 years by 67%, and after 12 years of use by up to 72%, and this protection lasts for up to 15 years even after discontinuing the medication.
In addition, having at least one child reduces the risk of cancer by 35%, and breastfeeding for more than 18 months results in a 23% reduction in risk. Regular physical exercise and staying physically active can lower the risk of endometrial cancer by 38% to 46%. To prevent lung cancer, it is essential to stay away from smoke-filled environments, use clean cooking fuel indoors, and seek medical examination without delay for any lung-related issues.
