The Burden of Breast Cancer in Punjab: A Rising Concern

Introduction

Breast cancer is a significant public health issue globally and is the most commonly diagnosed cancer among women (World Cancer Research Fund International, 2023). In India, the northern state of Punjab has seen a worrying increase in breast cancer incidence and mortality, making it the second highest in the country for breast cancer deaths. This rise is compounded by specific environmental factors unique to the region, particularly its agricultural practices. Punjab’s intensive use of pesticides and fertilizers has long been suspected to contribute to the rising cancer rates. Additionally, the state has witnessed a staggering 26% increase in breast and cervical cancer deaths over the past decade, alongside an 11% increase in breast cancer deaths alone (Times of India, 2023). Understanding these interconnected factors is crucial to addressing the public health crisis in the state and formulating effective cancer control strategies.

Discussion

The increase in breast cancer cases in Punjab follows a broader trend in northern India, with states like Haryana, Himachal Pradesh, and Chandigarh reporting similar spikes in both incidence and mortality (Times of India, 2023). However, Punjab’s cancer rates standout due to the region’s agricultural practices. Known as the “Granary of India,” Punjab is heavily reliant on agriculture, and the state’s farmers are some of the highest users of chemical fertilizers and pesticides in the country. Punjab is the leading consumer of fertilizers and ranks third in the use of chemical pesticides, which significantly impact both the environment and health (New Indian Express, 2024).

Several studies and reports suggest a strong link between the excessive use of these chemicals and the rising cancer rates in Punjab. Persistent exposure to carcinogenic pesticides, such as organophosphates and synthetic pyrethroids, have been shown to elevate cancer risk among those living in rural agricultural areas (Sharma et al., 2019). Over the years, the rampant use of these toxic chemicals has contaminated the soil, water, and food supply, contributing to a range of health issues, including cancer. The “cancer train” from Punjab to Rajasthan, transporting patients for treatment, has become a symbol of the region’s cancer epidemic, with many attributing the alarming spike in cases to the state’s agricultural practices.

In rural areas where agriculture dominates, late-stage diagnosis is common due to a lack of awareness and limited access to healthcare services. Coupled with environmental exposures, the risk factors for breast cancer and other cancers increase dramatically. The alarming increase in breast cancer deaths, including the 11% rise in recent years, highlights how pervasive the issue has become (Times of India, 2023). The socio-economic burden on families, particularly those in rural areas, is immense as they often must travel long distances for diagnosis and subsequent treatment.

Although efforts are being made to address these issues through programs like the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS), the healthcare system in Punjab struggles to keep up with the rising rates of cancer among the population (Press Information Bureau, 2019). In addition to enhancing cancer detection and treatment infrastructure, a more targeted approach is needed to reduce environmental exposure to carcinogens by promoting safer agricultural practices and educating the public to ensure early detection and diagnosis.

Conclusion

The rising incidence and mortality of breast cancer in Punjab are deeply concerning, particularly when viewed alongside the environmental risks posed by the state’s agricultural practices. The high consumption of chemical pesticides and fertilizers is contributing to an environment that fosters cancer development, underscoring the need for urgent reforms in both healthcare and agriculture. The 26% increase in breast and cervical cancer deaths, alongside an 11% increase in breast cancer deaths, is a stark reminder of the growing health crisis that disproportionately targets those working in the agricultural sector. Public health initiatives should focus not only on improving cancer detection and treatment services but also on raising awareness about the health risks associated with pesticide exposure. Addressing these challenges will be crucial to mitigating the impact of breast cancer and reducing the overall cancer burden in Punjab.

References

GLOBOCAN (2023) ‘Breast cancer statistics.’ Global Health Journal, 7(2), pp. 235-242. DOI: 10.1016/j.glohj.2023.02.006.

New Indian Express (2024) ‘Punjab is the highest consumer of fertilizers in the country, third highest consumer of chemical pesticides.’ The New Indian Express, 27 July. Available at: https://www.newindianexpress.com/nation/2024/Jul/27/punjab-is-the-highest-consumer-of-fertilizers-in-the-country-third-highestconsumer-of-chemical-pesticides (Accessed: 18 October 2024).

Press Information Bureau (2019) ‘Incidence of cancer in India: state-wise estimates.’ Government of India Press Information Bureau. Available at: https://www.pib.gov.in/PressRelease (Accessed: 18 October 2024).

Sharma, N., Singh, G. and Kaur, B. (2019) ‘Impact of pesticide use on cancer prevalence in rural Punjab: A case-control study.’ Indian Journal of Public Health, 63(4), pp. 326-332.

Times of India (2023) ‘Punjab witnesses a 26% increase in breast and cervical cancer deaths over a decade.’ The Times of India. Available at: https://timesofindia.indiatimes.com/city/chandigarh (Accessed: 18 October 2024).

World Cancer Research Fund International (2023) ‘Breast cancer statistics.’ World Cancer Research Fund. Available at: https://www.wcrf.org/breast-cancer-statistics (Accessed: 18 October 2024).