Guwahati: Northeast India continues to face significant gaps in cancer care access, with financial hardship, low awareness, weak healthcare infrastructure and cultural stigma delaying diagnosis and treatment, a new study has found.
The scoping review, published in the Indian Journal of Medical Research and authored by Redolen Rose Dhar and Reshmi Bhageerathy of the Manipal College of Health Professions, along with Ramesh Holla of Kasturba Medical College, Mangalore, highlights that the region carries one of the highest cancer burdens in the country, yet remains underserved in screening, diagnosis and treatment facilities.
The study notes that cancer incidence in parts of the Northeast is significantly higher than the national average. Population-based registries show that Aizawl district in Mizoram recorded the highest age-adjusted incidence rate (AAR) among males at 269.4 per 100,000, while Papum Pare in Arunachal Pradesh reported the highest among females at 219.8 per 100,000—far exceeding figures in cities such as Delhi and Bengaluru.
The region also has a distinct cancer profile, with cancers of the upper digestive tract more prevalent, largely linked to lifestyle and socio-cultural practices such as tobacco and areca nut use, consumption of smoked meat, alcohol intake and spicy diets.
Low awareness and late detection
Despite the high burden, screening rates remain alarmingly low and awareness of early symptoms is limited.
Across Assam, Meghalaya and Nagaland, only about 21% of people surveyed had heard of cervical cancer, while just 43% knew the recommended screening age.
In Sikkim, over 80% of women were unaware of breast cancer risk factors and fewer than half practised breast self-examination. This lack of awareness often leads to late-stage diagnosis and poorer outcomes.
Financial constraints remain a major barrier. In Assam, nearly 69% of patients cited treatment costs as a key challenge, with many forced to borrow money or sell assets. Government schemes such as Ayushman Bharat provide only partial relief, often excluding expenses related to diagnostics, travel and accommodation.
Geographical challenges further worsen access, as difficult terrain, poor road connectivity and long travel distances make timely care difficult, particularly for rural and tribal populations. Many patients are compelled to travel outside their states for treatment, adding to delays and costs.
The study also highlights shortages of oncology specialists, diagnostic facilities and hospital infrastructure across the region.
Stigma, beliefs and the way forward
Cultural factors continue to influence care-seeking behaviour. Fear, stigma and reliance on traditional medicine often delay medical intervention. In some communities, cancer is still associated with myths such as karma or spiritual causes, discouraging early screening and disclosure.
Despite these challenges, the study identifies several pathways to improve cancer care in the region. Strengthening community awareness and health education, expanding the role of community health workers, and decentralising cancer services to reach rural areas are seen as critical steps.
It also highlights the need to provide financial incentives and support for screening to improve uptake.
Family support and trust in local health workers were found to significantly improve participation in screening and treatment. The findings underline the urgent need to decentralise oncology services and strengthen community-based screening programmes.
Experts also call for improved referral systems, culturally sensitive communication and expanded insurance coverage to include diagnostics, travel and accommodation. Developing district-level oncology facilities, the study notes, could play a key role in reducing treatment delays and preventing patient dropouts.
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