How the next major breakthrough in cancer could come from India

According to a World Health Organization (WHO) report, nearly 20 million new cancer cases were recorded in 2022, with the figure projected to surpass 35 million annually by 2050. The surge in India is just as stark. While the Indian Council of Medical Research has estimated the incidence of cancer in 2024 at 1.5 million, WHO projections indicate the country will have nearly 2.5 million cases by 2045. Unlike epidemics, cancer incidence has been rising steadily for five decades worldwide, fuelled by ageing populations, urban lifestyles and environmental exposures. And at these levels, cancer has become a structural health challenge. But there’s also opportunity within that challenge — perhaps a new frontier in cancer detection, classification and management. And that opportunity might lie in India.

What we can learn

History provides context: India’s polio immunisation drive led to us becoming polio-free in 2014. It also led to enhanced eradication efforts globally, including in Africa. Around the same time, Indian pharmaceutical firms extended access to HIV/AIDS treatment through mass production of affordable antiretroviral generics, which greatly expanded coverage across Africa and other low- and middle-income nations. The lesson is not that these diseases mirrored cancer; it’s that scale and adaptive policy can create global effects. A scale like that needs to be demanded for cancer now.

Modern cancer research is closely linked to the study of genes, with a particular focus on variants. Each tumour type is associated with specific variant, and scientists examine these in detail to identify patterns across multiple patients. With big pools of genetic information analysed in concert, researchers can figure out which genes are repeated, how they influence the cancer, and which treatments are more likely to succeed. The more diverse and larger the dataset, the higher the accuracy of such deductions. India is home to one of the most genetically diverse populations in the world. Its National Cancer Registry Programme started in 1982, with some shortcomings, gathers information from a large number of population- and hospital-based registries across the country. Simultaneously, lower next-generation sequencing (NGS) costs lead to more cost-effective genetic sampling than in most Western systems.

And, again, the global context matters. Within the U.S. and some European regions, the biomedical research landscape is struggling with shrinking grant cycles and growing operational costs. China, by contrast, has increased domestic cancer research in the past decade. But its internal and now geopolitical scepticism has added a layer of complexity to any global collaboration. This makes room for India to be a trusted collaborator in the same way that it has been a collaborator for the pharma space, especially for low- and middle-income countries (LMICs) who have often been overlooked in genomic studies.

Policy shifts

However, potential alone does not generate breakthroughs. Our overall policy has started to treat cancer as a public health priority, a step in the right direction. Budget 2025–26 expanded funding for cancer care centres, lowered customs duties on cancer drugs and invested in digital health systems. Programmes such as Ayushman Bharat are increasing access to cancer treatments. India’s medical tourism industry is expected to surpass USD 12 billion by 2026, and oncology is one of the fastest-growing fields. Hundreds of thousands of foreign patients arrive in India annually for sophisticated cancer treatment at prices significantly lower than in a number of Western countries. This, in the long run, has resulted in Indian cancer centres having extensive experiences in a diverse range of genetic backgrounds and disease presentations. With robust ethical frameworks these gathered insights can enhance our knowledge of genomic variations and global relevance for research out of India.

Regulation must evolve, too. The Central Drugs Standard Control Organisation’s January 2026 oncology device classification identifies 75+ cancer-related devices categorised primarily into radiation systems, surgical instruments, and therapeutic equipment. This is relevant. However, the other key consideration which is gaining prominence to informed treatment decisions for cancer in a global context, is comprehensive genomic profiling. To keep this in perspective, the U.S. Food and Drug Administration has approved a range of NGS–based cancer diagnostics that point patients toward targeted therapies. If India is to be an avenue leader in data-driven oncology, then regulatory regimes need to formalise a setting in which the frameworks can accommodate platforms beyond therapeutics.

The next leap in oncology

Cancer is the second-leading cause of death worldwide, and the cancer burden is increasing in all countries. The next big breakthroughs might not be a new miracle drug or gene therapy; it might be better detection tools, clearer methods for predicting risk and broader genetic insights. A country that learns fast from its data will form the future of oncology. When India considers this innovation, it can start to help shape the evidence that drives global cancer care. We have the scale. Now we need to design systems to match it.

(Vikas Pawar is part of Hyderabad-based Exsegen Genomics, a company focused on cancer diagnostics. vikaspawar@exsegen.com)