ANUPMA KHANNA | Dehradun
In a disturbing trend in Uttarakhand’s Garhwal region, eight out of 10 cancer patients are being diagnosed at advanced stages—either stage III or IV—severely reducing their chances of survival. A recent study published in the Indian Journal of Surgical Oncology revealed that 21 per cent of patients were diagnosed in stage III and a staggering 62 per cent in stage IV—the most advanced stage.
Among women, breast cancer was the most commonly reported, followed by cancers of the gallbladder, lungs, ovaries and cervix. In men, lung, urinary bladder, oral cavity, stomach, and colorectal cancers were the most prevalent. Doctors attribute this rise to lifestyle factors such as smoking, tobacco chewing, alcohol use and poor dietary habits.
In another concerning finding, nearly 90 per cent of patients had not received any form of treatment before arriving at the hospital. About two out of 10 patients were in such critical condition that they could only be referred for palliative care.
Talking to The Pioneer, Dr Pankaj Garg, lead author of the study, called the findings deeply troubling. “Over 80 per cent of patients came to us with late-stage cancer. This clearly shows the massive gap in early diagnosis and awareness. One particularly worrying observation was the unusually high number of urinary bladder cancer cases in men—something rarely seen in other regions of India. This could be linked to local factors like water quality, tobacco use, or occupational exposure. It definitely requires further investigation.”
Other oncologists in Dehradun echoed his concerns, confirming that late-stage diagnoses dominate the cases they see, significantly worsening outcomes for patients.
The hospital-based study analysed data from 3,600 cancer patients between May 2021 and June 2024. Of these, 55 per cent were men and 45 percent women. Surprisingly, the overall literacy rate among patients was high—92 per cent—but this did not translate to timely detection or treatment. Garhwal, comprising seven districts, faces unique healthcare challenges due to its remote terrain, scattered population and limited access to specialised medical care. According to Garg, lack of awareness, stigma and reliance on traditional remedies are key reasons why people don’t seek help in time. “Cancer often goes undiagnosed because people don’t know what symptoms to look for. Many patients first try home remedies. By the time they reach a cancer centre, it’s often too late. Financial worries—even with Ayushman Bharat—and the stigma around the word ‘cancer’ delay action further.”
To combat this crisis, the study suggests making cancer a notifiable disease to improve tracking and response. State-wide awareness campaigns are essential to educate people on early symptoms and the importance of screening. The report recommends involving local influencers, religious leaders to drive community awareness. Cancer survivors should be made ambassadors to show that the disease can be fought successfully with timely diagnosis and treatment. It also calls for training community nurses to recognise early signs, deploying mobile screening vans and leveraging telemedicine to reach remote areas. Public messaging should emphasise that treatment is nearly free under Ayushman Bharat, and various NGOs offer support. The study further stresses the need to boost HPV vaccination coverage across Uttarakhand, aligning with India’s goal to eliminate cervical cancer by 2030.
