This pattern establishes South India, particularly its urban centers, as the epicenter of India's breast cancer epidemic.
Published Sep 05, 2025 | 7:00 AM ⚊ Updated Sep 05, 2025 | 7:00 AM
Breast cancer. (iStock)
Synopsis: Breast cancer is projected to affect 238,085 women nationally in 2024, making it the most common cancer among Indian women. The data shows breast cancer is more dominant in South Indian metros, unlike other regions where other cancers prevail, pointing to unique local risk factors driving its rise.
Hyderabad has emerged as India’s breast cancer capital with the highest age-adjusted incidence rate of 54.0 per 100,000 women, followed closely by Bengaluru at 46.7 per 100,000, according to a study by the National Cancer Registry Programme published in JAMA Open Network.
The comprehensive analysis reveals that South Indian metropolitan cities are not only facing an overall cancer crisis but are also experiencing distinct type-specific cancer epidemics that demand immediate targeted interventions.
The study, covering 43 population-based cancer registries (PBCR) across India from 2015-2019, shows that among the top six regions with highest breast cancer rates nationally, four are from South India, including Chennai recording 45.4 per 100,000 women and Kerala’s Alappuzha and Thiruvananthapuram showing rates of 42.2 and 40.7 per 100,000 respectively.
This pattern establishes South India, particularly its urban centers, as the epicenter of India’s breast cancer epidemic.
Breast cancer is projected to affect 238,085 women nationally in 2024, making it the most common cancer among Indian women.
The data shows breast cancer is more dominant in South Indian metros, unlike other regions where other cancers prevail, pointing to unique local risk factors driving its rise.
While South Indian cities lead in breast cancer, lung cancer patterns tell a more complex story of regional risk factors and gender-specific exposures. Among females, north-eastern states dominate lung cancer incidence with Aizawl recording an alarming 33.7 per 100,000 and Mizoram at 24.8 per 100,000.
However, South Indian cities too show concerning levels, with Hyderabad recording 6.8 per 100,000 and Bengaluru at 6.2 per 100,000 for females.
The male lung cancer patterns reveal Kerala’s overwhelming dominance in South India, with multiple districts showing extremely high rates.
After Srinagar’s national high of 39.5 per 100,000, Kerala districts occupy the next positions: Kannur at 35.4, Malabar at 32.5, Kasargod at 26.6, Alappuzha at 25.3, and Kollam at 24.2 per 100,000.
In contrast, other South Indian metros show more moderate rates, with Bengaluru at 13.2, Hyderabad at 12.9, and Chennai at 12.3 per 100,000.
“Lung cancer exhibited a statistically significant increase in 5 PBCRs for males and 9 PBCRs for females, including increases in Bengaluru of 3.7 percent for males and 5.5 percent for females,” the study reports, indicating that the lung cancer burden in South Indian cities is not only substantial but also rapidly increasing.
The study links this trend directly to tobacco use, with systematic reviews showing a significantly higher risk of respiratory system cancers with an odds ratio of 4.97.
Oral cancer patterns across South India reveal significant urban-rural and interstate variations, with cities showing mixed positions in national rankings. While Ahmedabad Urban leads nationally with 33.6 per 100,000 males, South Indian cities occupy important positions in the oral cancer landscape.
Among males, Hyderabad and Kerala’s Kasargod both record 21.2 per 100,000, positioning them among the top oral cancer regions nationally. Chennai follows at 18.2 per 100,000, Kerala’s Trivandrum at 14.1 per 100,000, and Bengaluru at 11.6 per 100,000. The pattern suggests that while South Indian metros have significant oral cancer burdens, they are not the national epicentre for this cancer type.
Female oral cancer rates show a different pattern, with East Khasi Hills in the northeast leading at 13.6 per 100,000. Among South Indian cities, Hyderabad records 7.9 per 100,000, Bengaluru 7.8 per 100,000, Chennai 6.2 per 100,000, and Kasargod 6.1 per 100,000.
The study notes that “oral cancer showed significant increases in 14 PBCRs among males and 4 PBCRs among females,” with this trend being “strongly linked to tobacco and alcohol use.”
Cervical cancer patterns across South India reveal stark contrasts with national trends and highlight potential healthcare access disparities.
While north-eastern states dominate cervical cancer incidence nationally, with Aizawl showing an extraordinary 27.01 per 100,000 and Mizoram at 22.6 per 100,000, South Indian cities present a more moderate but concerning picture.
Among South Indian regions, Visakhapatnam in Andhra Pradesh records 15.0 per 100,000, Bengaluru shows 13.8 per 100,000, Chennai 12.4 per 100,000, and Hyderabad 12.1 per 100,000.
Notably, Kerala’s Trivandrum shows the lowest rate at 6.4 per 100,000, suggesting either better preventive healthcare access or different risk factor profiles.
With cervical cancer projected to affect 78,499 women nationally in 2024, the moderate rates in South Indian cities compared to the northeast may indicate better healthcare infrastructure and screening programs. However, the study notes that “the increasing incidence of breast cancer and decreasing incidence of cervical cancer are more associated with generational shifts in risk factors than period effects,” suggesting changing demographic and lifestyle patterns.
The relatively lower cervical cancer rates in South Indian metros, particularly compared to their high breast cancer rates, may reflect urban healthcare advantages including better access to screening and preventive care, as well as different patterns of reproductive health and lifestyle factors.
Stomach cancer patterns across South India reveal generally lower incidence rates compared to other cancer types, with some regions showing declining trends that align with national patterns. Among females, South Indian cities show moderate stomach cancer rates, with Chennai at 5.0 per 100,000, Bengaluru at 4.9 per 100,000, Hyderabad at 4.1 per 100,000, and Tamil Nadu state at 2.9 per 100,000.
Male stomach cancer rates in South India follow similar moderate patterns, with Chennai recording 9.5 per 100,000, Bengaluru 8.6 per 100,000, Kasargod 8.2 per 100,000, and Hyderabad 6.5 per 100,000. These rates contrast sharply with northeastern hotspots like Aizawl, which shows 39.1 per 100,000 for males, and Kerala’s Kannur at 11.0 per 100,000.
“Stomach cancer incidence rates decreased in both males and females, particularly in Aizawl and Mizoram, and Chennai,” the study notes, indicating improving trends in some regions. This decline may reflect changing dietary patterns, reduced prevalence of Helicobacter pylori infections, and improved food preservation methods in urban areas.
Prostate cancer patterns among South Indian cities show moderate incidence rates compared to leading regions nationally. Kerala districts lead South India in prostate cancer, with Trivandrum recording 11.1 per 100,000 and Alappuzha at 10.8 per 100,000. Among major metros, Bengaluru shows 9.8 per 100,000, Chennai 9.5 per 100,000, and Hyderabad 7.8 per 100,000.
These rates, while significant, are lower than the national leader Srinagar at 12.7 per 100,000. With prostate cancer projected to affect 49,998 men nationally in 2024, making it the third most common cancer among Indian males, the moderate rates in South Indian cities suggest either different risk factor profiles or potentially underdiagnosis due to healthcare-seeking behaviours.
The prostate cancer distribution indicates that while South Indian cities face substantial burden from this cancer type, they are not the primary national hotspots, contrasting with their dominant position in breast cancer incidence.
“The regional disparities in cancer incidence across India and the increasing cancer burden underscore the urgent need to strengthen the ongoing efforts for cancer prevention and control measures to reduce the burden of cancer in India,” the study states.
(Edited by Sumavarsha)
