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Prostate cancer, often considered a disease primarily affecting Western nations, is increasingly becoming a significant health concern in India. While its incidence rates are currently much lesser when compared to developed countries like the United States of America or Australia, a mix of demographic shifts, changes in lifestyle, and limited awareness has led to rises in the cases of prostate cancer. This changing scenario makes it essential for Indians to start taking prostate cancer more seriously.

One of India's most pressing reasons for increased vigilance is the changing demographic landscape. India's population is ageing, with a growing proportion of men entering the age bracket where prostate cancer risk escalates. As life expectancy increases and the number of older adults rises, the potential for a surge in prostate cancer cases becomes a real possibility. Projections estimate a continued rise in cases in the coming years, highlighting the need for proactive measures.

Furthermore, evolving lifestyles are contributing to the heightened risk. Urbanisation, dietary shifts towards processed foods and red meat, decreased physical activity, and increased smoking and alcohol consumption – all characteristic of modern Indian life – have been linked to an increased risk of prostate cancer. 2 These trends necessitate more significant public health initiatives promoting healthier lifestyles and educating men about modifiable risk factors.

Another crucial factor is low awareness and a lack of screening programs. An added disadvantage is the lack of any noticeable early symptoms, which makes diagnosis of prostate cancer especially challenging. Many cases are diagnosed at advanced stages without routine screening when treatment options are limited and less effective. The absence of a national screening program, coupled with cultural hesitations about discussing men's health issues, contributes to late diagnoses and poorer outcomes.

Moreover, disparities in access to quality healthcare exacerbate the problem. While urban centres may have advanced diagnostic and treatment facilities, rural areas often lack the necessary infrastructure and trained medical professionals. This disparity leads to delayed diagnoses and inadequate treatment for a major portion of the population. Bridging this gap in healthcare access is essential to ensure equitable care for all Indian men.

Prostate cancer incidence varies across different regions in India. Urban registries such as Delhi, Mumbai, and Chennai report higher age-adjusted incidence rates than rural areas. 1,6. For instance, the age-adjusted incidence rate in Delhi is notably high at 11.8 per 100,000. At the same time, it is much lower in rural areas like Manipur. This regional disparity highlights the need for targeted interventions to improve early detection and treatment in underserved areas.

Indian men are diagnosed with prostate cancer at a higher serum PSA level and often present with more aggressive disease characteristics compared to their Western counterparts1. This again highlights the importance of early detection and aggressive management strategies tailored to the Indian context.

While the challenges are significant, there is hope. Increased awareness campaigns and improved access to affordable screening and treatment can make a substantial difference. Encouraging men to discuss their health concerns with their doctors and oncologists, promoting prostate-specific antigen (PSA) testing for those at higher risk, and investing in research to understand the specific risk factors for Indian men are all crucial steps.

By addressing these challenges head-on, we can mitigate the growing threat of prostate cancer and improve the health and well-being of Indian men. It's time to prioritise prostate cancer awareness and action in India.

Dr. Prakash Devde
MD DM
Sr. Cancer Physician
M|O|C Chh. Sambhajinagar