Why early detection matters
Cancers often grow quietly, without obvious symptoms. When caught early, they are usually easier to treat, require less aggressive therapies, and offer substantially higher chances of cure. Public health programs that promote regular screening and risk-based prevention can turn cancer from a life-changing diagnosis into a manageable condition or even prevent it altogether.
Breast cancer screening in India
For average-risk women in India, current guidelines recommend starting annual mammography screening at age 40 and continuing until age 70, alongside monthly self-breast exams and yearly clinical examinations by a clinician. Women with a family history or other risk factors may be offered BRCA gene testing to identify inherited risk and tailor a plan that may include more vigilant surveillance, preventive medications, or preventive surgeries. Genetic counselling and cascade testing in family members are essential to managing inherited cancer risk.
The story of Meera, a 42-year-old schoolteacher, illustrates the impact of proactive screening. Her routine mammogram revealed a tiny lesion she could not feel, a biopsy confirmed as early-stage breast cancer, and surgery plus radiation led to an excellent outcome. “One simple test saved my life,” she said, underscoring how screening can catch disease before it becomes life-threatening.
Cervical cancer screening and self-sampling
Cervical cancer screening has evolved to include self-sampling for high-risk HPV testing, a method endorsed by the World Health Organization. Self-collection is as accurate as clinician-collected samples in many studies and helps overcome barriers like discomfort, cost, or travel. When a sample tests positive for high-risk HPV, women can be referred for further evaluation and treatment if needed. In India, self-sampling and HPV-based screening are expanding access, contributing to the global effort to eradicate cervical cancer through early detection.
Sharada, a 54-year-old daily wage worker, benefited from a home-based self-sampling kit that she used with instructions in her local language. The result ruled out high-risk HPV, giving her reassurance for the next decade and demonstrating how convenient screening can be when barriers are removed.
Lung cancer screening
Low-dose CT (LDCT) scans can detect lung cancer at a stage when it is most treatable. In India, there is no formal nationwide screening program yet, but guidelines advocate annual LDCT for adults aged 50–74 with a heavy smoking history (20 pack-years or more). Rajan, a 60-year-old office worker who quit smoking, followed his doctor’s advice and underwent LDCT, which found a small early-stage nodule that was surgically removed. He credits timely screening with saving his life, reflecting that ignoring medical advice could have had a very different outcome.
As evidence grows, experts emphasize that LDCT is a proven life-saving intervention for long-term smokers and ex-smokers when applied accessibly and consistently.
Oral cancer screening and prevention
Oral cancer remains a significant concern in India, largely linked to tobacco use. The ICMR and the National Cancer Grid recommend oral-visual examination every three years in high-risk adults over 30. A simple inspection of the lips, cheeks, gums, tongue, and palate, paired with neck palpation, can identify early cancers and precancerous lesions. Suresh Kumar, a 48-year-old shopkeeper with pan, powder, and tobacco use, presented with a rough white patch that was biopsied and diagnosed as a precancerous condition. Early removal prevented progression to cancer and underscored the value of routine oral examinations.
Advances in precision oncology
Cancers often present without clear symptoms, making early detection crucial. Beyond traditional screening tests such as mammography, PAP/HPV testing, colonoscopy, and LDCT, researchers are exploring AI to improve accuracy and reduce false positives. The past decade has seen breakthroughs in genomics and precision oncology, including next-generation sequencing to identify risk biomarkers. A breakthrough area is multi-cancer early detection (MCED) tests that analyze cell-free circulating tumor DNA in blood to flag multiple cancers before symptoms arise. While promising, MCED and related tests require more validation across diverse populations and integration with existing screening programs. Saliva-based biomarkers and other noninvasive methods are being explored to monitor disease progression and support early diagnosis.
Looking ahead
Progress in cancer early detection depends on accessibility, affordability, and thoughtful integration into public health systems. Collaboration among researchers, clinicians, policymakers, and communities is essential to ensure that life-saving screening reaches all populations, including those in rural areas. By embracing preventive tests, risk-based strategies, and precision oncology, we can help people detect cancer earlier, reduce its progression, and save countless lives.
