Dr Jintu Sarma Sr.
As the world observes World Cancer Day on February 4, 2026, under the global theme “United by Unique”, the spot light intensifies on India’s Northeast Region (NER). While the global campaign emphasizes a person-centred approach to “Close the Care Gap”, for the “Eight Sisters” of India, the gap remains a chasm defined by some of the highest incidence rates in the world. The North Eastern Region (NER) of India—a vibrant tapestry of diverse ethnicities, stunning landscapes, and rich cultural heritage—is currently grappling with a silent, escalating crisis. Often referred to as the “Cancer Capital of India”, the region reports age-adjusted incidence rates (AAR) that are significantly higher than the national average. From the hills of Mizoram to the plains of Assam, the impact of cancer transcends biology; it is a profound socio-economic and systemic challenge that shapes the lives of millions. The data from the National Cancer Registry Programme (NCRP) and the Indian Council of Medical Research (ICMR) present a sobering picture. According to the NCRP, districts like Aizawl (Mizoram) and Papumpare (Arunachal Pradesh) consistently record the highest cancer incidence rates in the country. In some areas, the probability of developing cancer in a lifetime is as high as 1 in 4 for men and 1 in 6 for women—nearly double the national average. The types of cancer prevalent here are also distinct. While breast and cervical cancers are common among women nationwide, the NER sees an unusually high prevalence of oesophageal, stomach, and nasopharyngeal cancers. Lung cancer remains a leading cause of mortality across both genders. This specific distribution is deeply tied to regional lifestyles and environmental factors.
The number of new cancer cases in the NER is estimated to reach 57,131 by 2025-2026, marking a nearly 14% increase from five years ago. While India as a whole ranks third globally in cancer cases, the Age-Adjusted Incidence Rates (AAR) in the Northeast far exceed national averages. For instance, the AAR in Aizawl (Mizoram) is approximately 269.4 per 100,000 for men, compared to just 147.0 in Delhi. The cancer profile in the Northeast is unique, differing significantly from the rest of the country. It has been observed that males suffer from oesophagus (13.6%), lung (10.9%), and stomach (8.7%) while females suffer from breast (14.5%), cervix (12.2%), and gallbladder (7.1%). In Mizoram, the lifetime risk is staggering: 21.1% for males and 18.9% for females. This means nearly one in every five residents is likely to develop cancer during their lifetime. The most distinctive—and preventable—aspect of the Northeast’s cancer data is the high prevalence of tobacco-related cancers. As per the report, tobacco use is responsible for 49.3% of all cancers in men and 22.8% in women in the region. In states like Tripura, tobacco use prevalence is as high as 64.5%. Unlike other parts of India, tobacco and betel nut consumption often begins as early as ages 11–14, significantly lowering the median age of diagnosis compared to the national average.
World Cancer Day 2026’s focus on “Real-World Experiences” highlights the structural barriers faced by patients in the NER. Gloomily, 12-18% of cancer cases in the Northeast are diagnosed at a localised (curable) stage. For cancers like those of the cervix and breast, over 60% of patients present only when the disease has already metastasised. Despite recent improvements, many patients must travel vast distances for tertiary care. Data shows that 95.3% of patients in Sikkim and 58.1% in Nagaland seek treatment outside their home states, leading to massive Out-of-Pocket Expenditure (OOPE). Researchers are increasingly looking at high salt intake, fermented foods, and smoked meats—staples of the regional diet—alongside genetic predispositions to explain the high rates of stomach and oesophageal cancers. The high incidence of nasopharyngeal cancer, particularly in Nagaland and Manipur, suggests a complex interplay between genetic susceptibility and environmental triggers like wood smoke in poorly ventilated traditional kitchens. To align with the “United by Unique” theme, the response in the Northeast must be as specialised as the problem. AI-driven mobile screening units are being deployed to reach remote districts in Arunachal Pradesh and Meghalaya, where diagnostic facilities are sparse. The impact of cancer on the Northeastern family is devastating. First, the cost of treatment itself is high. Second, the “hidden costs”—travelling long distances to cities like Guwahati or even outside the region to Mumbai or Delhi, and the loss of livelihood for both the patient and the carer—often push families into a cycle of debt. In many tribal communities, there is also a significant psychological and cultural impact. Stigma remains a barrier to early diagnosis. Symptoms are sometimes attributed to supernatural causes, leading patients to seek traditional healers first. By the time they reach a modern oncology center, the disease is often advanced; many cases are diagnosed at Stage III or IV, where the chances of survival are significantly low.
Despite the grim statistics, there is a burgeoning movement toward change. The Government of India, along with organizations like the Tata Trusts, has initiated a “distributed model of cancer care.”. This involves setting up a network of tiered hospitals—ranging from diagnostic centres at the district level to high-end treatment facilities in state capitals—to bring care closer to the patient’s home. Prevention and awareness are the strongest weapons. Initiatives to curb tobacco use, promote early screenings (especially for breast and oral cancers), and integrate palliative care into primary health centers are essential. By 2026, the goal is not just to treat the disease but to dismantle the cultural and systemic barriers that allow it to flourish.
Cancer in Northeast India is more than a medical diagnosis; it is a lens through which we see the region’s vulnerabilities and its resilience. To change the narrative from “Cancer Capital” to a model of successful intervention, a multi-pronged approach—combining policy, infrastructure, and community education—is vital. The people of the Northeast deserve a future where the beauty of their land is matched by the health and longevity of its inhabitants.