Every toast you make, Every breath you take…

Now that bread has joined an environment body’s list of suspicious objects that can cause cancer, we need to be careful what we eat.

On 24 May, Delhi’s newspapers created a stir when they carried a report thatCentre for Science and Environment (CSE) had analysed bread samples and found they contained ‘possible’ cancer-causing chemicals. The chemicals found were potassium bromate and potassium iodate, which are banned in many countries, but not in India. The bread industry promptly denied it uses these chemicals.

CSE will not have the last word on the subject – the Food Safety and Standards Authority of India (FSSAI) will now step in to examine its findings. But there can be no doubt that people will panic if they find that their daily bread can cause cancer. While bread used to be a breakfast good only for the Anglicised elite a few years back, its use has percolated down to all sections of society.

The incidence of cancer is increasing day by day in India. The number of cases is estimated to grow at a rate of 25 percent by 2020, according to the cancer registry released by the Indian Council of Medical research (ICMR). If 14 lakh cases were reported in 2016, the number is expected to jump to 17.3 lakh by 2020. Death due to cancer is estimated to go up from 7.36 lakh to over 8.8 lakh in the next four years.

According to Dr Dinesh Singh, Radiation Oncologist at Balaji Action Cancer Hospital, “Increase in intake of tobacco, alcohol, pesticides, insecticides, besides viral infections and sedentary lifestyle are the main causes of the increasing incidence of cancer.”

Take Meera. Her life was interrupted by the shadow of cancer when she was 45. But she has been lucky. After a year of intensive treatment, she is enjoying life again. “It was a tough time for me but I was confident about surviving,” she says.

Prashant, 28, was addicted to chewingtobacco from school time. At this young age, he is suffering from throat cancer. He is the only earning member of the family and has responsibility for a one-year-old son. “When Prashant came to us he was very critical. We gave him chemotherapy and radiotherapy and slowly, somehow, he recovered,” says Dr Dinesh Singh.

Data with the Indian Council of Medical Research (ICMR) shows an increase in cancer of the breast, lung and cervix.

ICMR conducted a country-wide study during the period 2012-14 drawing on various population-based and hospital-based cancer registries. ICMR has also demanded that the government make cancer a notifiable disease.

Over 1.5 lakh new breast cancer cases were estimated during 2016, which is over 10 percent of total cases. Lung cancer is second, with an estimated 1.14 lakh new cases (83,000 in males and 31,000 in females) during 2016.

The incidence of breast cancer is projected to go up to 1.9 lakh by 2020, whereas new lung cancer cases are likely to increase to 1.4 lakh cases in the next four years.

Data also revealed that only 12.5 percent of patients come for treatment in their early stages.

While there is a huge regional disparity, the Northeast reported the highest number of cases in both male and female. A district of Arunachal Pradesh reported the highest rate of the disease among women. A district in Mizoram recorded the largest number of cancer cases among males.

Top cancer doctors say in Delhi near about 20 percent of lung cancer patients are those who are non-smokers and the culprit is an alarming rise of air pollution. No wonder, the disease is rising even in women day by day.

Delhi’s Cancer Registry data shows the highest rise in cancer from 14 cases per 1,00,000 population in 2008 to 15.5 per 100,000 population in 2010.

“If we talk about a few years ago, lung cancer patients were less than 10 percent of the total, but now maybe due to continuously rising pollution and smoking, this percentage has increased to 20 percent,” says Dr PK Julka, Professor of Oncology at AIIMS.

While the data is based on cases in Delhi, doctors said it represents a wider trend because a significant number of cancer patients being treated in city hospitals are from outside.

The specialised cancer agency of the World Health Organisation (WHO) has also classified outdoor air pollution as carcinogenic to humans. Exposure can cause lung and bladder cancer. The study conducted by IARC in 2010 indicates that in recent years, exposure levels have increased significantly in some parts of the world, which is increasing lung cancer cases.