Early cancer detection begins with getting the first step right

About Author: Shunsuke Honda, Business Advisor, Medical Systems Division, FUJIFILM India. Shunsuke has been instrumental in shaping FUJIFILM India’s Medical Division since joining the organisation in 2013. With extensive global experience across Japan, the UK, and India, he leads the Medical Systems Division as Business Advisor. Prior to his current role at FUJIFILM India, he served as Business Acceleration Manager and Assistant Managing Director at FUJIFILM UK Medical Systems, and contributed to global marketing in the Modality System Division in Tokyo.

Cancer care conversations in India often begin too late. Not because people do not seek care, but because the earliest signals, those small, often ambiguous changes in the body, fail to trigger timely action. By the time a diagnosis is confirmed, the disease has frequently progressed beyond its most treatable stages.

This is the defining challenge in India’s cancer landscape today. Incidence is rising steadily, with more than 1.46 million new cases recorded in 2022 and projections pointing to a significant increase over the next decade. India ranks third globally in cancer incidence, after China and the United States, with GLOBOCAN estimating cases will rise to 2.08 million by 2040, a 57.5% increase from 2020. Yet the real concern lies not only in how many people are developing cancer, but in when they are being diagnosed. More than two-thirds of cancers in India are still detected at advanced stages, limiting treatment options and reducing survival outcomes.

Early detection, therefore, is not a technological problem alone. It is a question of systems, behaviours, access, and trust, and of getting the very first step right.

Why Early Detection Breaks Down

The reasons early cancers are missed in India are layered and deeply interconnected. At an individual level, awareness remains uneven. Early symptoms, such as a small breast lump, abnormal bleeding, a non-healing oral lesion, or persistent cough, are often dismissed or normalised, particularly when they are painless. For many, the absence of discomfort is wrongly equated with the absence of risk. Studies show that nearly 84% of rural women remain unaware of breast or cervical cancer symptoms, contributing directly to delayed presentation.

Community-level factors add another layer. Social hesitation around physical examinations, fear of diagnosis, loss of income from time away from work, and dependence on family approval, especially for women, delay health-seeking behaviour. Women from lower socioeconomic strata, Scheduled Tribes, and low-education groups account for a disproportionate share of missed screening opportunities, with over 70% of cases in these populations diagnosed at late stages. In rural and tribal regions, these challenges are compounded by distance, transport limitations, and limited availability of diagnostic facilities.

Systemically, India’s reliance on opportunistic screening means access varies widely by geography. While government programmes have created a strong foundation, uptake remains inconsistent, data is fragmented, and follow-up pathways are not always seamless. NFHS-5 data indicates that national screening uptake remains below 2%, with cervical screening coverage below 10% in many regions. Urban–rural gaps reach up to 7% in states such as Madhya Pradesh and Puducherry, with rural women showing 0.6% lower uptake overall. As a result, early detection remains more likely in higher-income, urban populations, precisely where disease burden is often lower.

The outcome is predictable: cancers that are clinically detectable at earlier stages continue to surface only when symptoms become unavoidable.

The First Step for Treating Cancer

Early detection does not begin with a scan or a blood test. It begins earlier, with recognition, reassurance, and readiness to act.

For a population of India’s scale, the first step must be simple enough to be accessible, reliable enough to inspire confidence, and close enough to people’s daily lives to be practical. This is why primary-level screening, community engagement, and frontline health workers remain central to any sustainable solution.

Government-led efforts to integrate cancer screening into primary care have laid an important foundation, but a more pathway-driven model can further strengthen early detection. In this approach, individuals first complete simple Health Risk Assessment (HRA) questions to surface risk factors and early symptoms, followed by structured self-examination training that builds awareness and self-care capability. Only those with positive HRA signals are then guided to appropriate screening for breast, cervical, or oral cancers, ensuring that screening is targeted rather than blanket. This sequencing improves precision, focuses limited resources where they are most needed, and brings meaningful early detection closer to where people live. What determines their impact, however, is how effectively they are supported.

Using the Right Technology, in the Right Way

Technology is rapidly reshaping cancer detection, but its true contribution lies not in sophistication alone, but in appropriateness. Advances such as AI-assisted imaging, and biopsies, are expanding the boundaries of what early detection can achieve, particularly for cancers that are difficult to detect through conventional methods. 

In India, these tools are increasingly being developed and adapted for population-specific needs. Ethnic variability, disease presentation patterns, and infrastructure constraints are informing innovation in ways that make early detection less invasive, more scalable, and easier to deploy beyond tertiary hospitals.

When integrated thoughtfully, technology strengthens, not replaces, existing systems. AI can support clinicians to get better results with AI supported in their workflow which reduces human errors in placing breasts for a Mammography. Importantly, early detection rates nationally remain low, around 29%, underscoring that technology alone cannot compensate for weak screening pathways.

Crucially, these tools work best when they complement human judgment, community trust, and public health frameworks. Early detection succeeds when innovation is embedded within systems people already rely on.

Solving for Scale Without Losing Sensitivity

One of the most difficult balances in cancer screening is scale versus precision. Expanding coverage is essential, but it must be done responsibly. Risk-based approaches, guided by age, family history, lifestyle, and emerging data, offer a way forward, allowing resources to be deployed where they are most likely to make a difference. This is where the Health Risk Assessment system developed by Apollo Foundation helps us where they have a set of questions which helps us to categorize the patients.

By standardising and optimising breast positioning at the point of image acquisition, AI-enabled guidance helps ensure consistently high-quality mammograms, reducing repeat scans and inappropriate downstream referrals. This not only improves diagnostic confidence for clinicians but also protects patients and the healthcare system from avoidable delays, costs, and procedural burden. Current estimates suggest that early detection rates could rise from ~25% today to nearly 50% by 2030 if risk stratification, task-shifting, and follow-up systems are effectively aligned.

The long-term impact of this balance is significant. Earlier detection reduces treatment intensity, lowers overall costs, and allows individuals to return to productive lives sooner. Over time, this strengthens not just health outcomes, but social and economic resilience.

A Future Built on Earlier Decisions

India’s cancer burden will continue to grow. The incidence of cancer is projected to increase by 12.8% in 2025 compared to 2020, with one in nine Indians likely to develop cancer in their lifetime. Lung and breast cancers remain the leading sites among men and women respectively, while lymphoid leukaemia dominates childhood cancers. That reality is unlikely to change in the near term. What can change is how early the disease is identified, how equitably services are delivered, and how confidently individuals engage with the health system.

The pieces of the puzzle already exist, public health intent, frontline workforce, emerging technology, and a growing culture of collaboration. Task-shifting to ASHA workers, mobile screening camps at PHCs and Anganwadis, and PPP-led outreach in aspirational districts and North-Eastern states are already demonstrating improved uptake, despite financing and follow-up challenges. The task ahead is alignment.

When awareness meets access, when innovation is guided by real-world needs, and when systems are designed around people rather than places, early detection stops being an aspiration and starts becoming routine.

Getting the first step right does not guarantee outcomes, but it dramatically improves the odds. And in cancer care, that shift, from late reaction to early action, makes all the difference.

*Views expressed by the author are his own.

References:

¹ https://pmc.ncbi.nlm.nih.gov/articles/PMC10231735/ 

² https://pmc.ncbi.nlm.nih.gov/articles/PMC10089064/ 

³ https://pmc.ncbi.nlm.nih.gov/articles/PMC12593890/ 

⁴ https://pmc.ncbi.nlm.nih.gov/articles/PMC11724505/ 

⁵ https://pmc.ncbi.nlm.nih.gov/articles/PMC11368269/ 

⁶ https://pmc.ncbi.nlm.nih.gov/articles/PMC10231735/