Why India Lacks a Screening Programme for Lung Cancer

India's three-tier health system channels most cancer screening through primary health centres under the Ayushman Bharat – Health and Wellness Centres initiative, which currently screens for three cancers only: oral, breast and cervical. These rely on low-cost clinical and visual tools, a clinical breast exam, a visual inspection of the oral cavity, and Visual Inspection with Acetic Acid (VIA) for cervical cancer, all of which frontline health workers can perform without expensive machinery. India's National Health Policy also set non-communicable disease goals, including reducing premature mortality from cancer, diabetes, cardiovascular disease and chronic respiratory disease by 25%, and cutting tobacco use prevalence by 30%, reflecting a policy push to treat cancer as a manageable NCD burden rather than a disease caught only at advanced stages.

Despite this architecture, India's cancer burden keeps shifting. Data from the Global Cancer Observatory, maintained by the WHO's International Agency for Research on Cancer, show lung cancer cases rising from about 5.8% to 7.2% of all cancer cases between 2022 and 2024, moving it from the fourth to the third most common cancer by incidence, while its share of cancer deaths rose from 8.2% to 10.9% in the same period. Unlike oral, breast and cervical cancer, lung cancer has no low-cost visual or clinical screening equivalent; it can only be reliably caught early through low-dose computed tomography (LDCT), a resource-intensive imaging test that most PHCs cannot provide.