Closing cancer gaps: Availability of genomic data can improve outcomes

Marking the World Cancer Day earlier this month, the Indian Institute of Technology (Madras) launched the Bharat Cancer Genome Atlas (BCGA), a public database of Indian cancer genomes, and the Bharat Cancer Genome Grid (BCG2) to help doctors use this data in treatment. This addresses a major gap: The Indian Council of Medical Research’s National Cancer Registry Programme data shows that one in nine Indians may develop cancer, and reports that 2.5 million people are living with the disease and the incidence rising by 12.8 per cent every year since 2022. Despite the high incidence, Indian patients have been poorly represented in global cancer-genome studies. Most international genomic research reflects Western populations, leaving clinicians without vital insights into the genetic variants of cancers affecting Indians. By systematically mapping these across multiple cancers, the atlas aims to deepen the understanding of India-specific disease patterns and support earlier diagnosis. It also targets monitoring disease progression better and more informed treatment decisions, and, most importantly, assists in drug development.

 

India’s disease burden is undergoing a structural shift. According to the recent data, non-communicable diseases account for more than 57 per cent of all deaths in India. Yet, access to advanced diagnostics remains deeply uneven. Genomic testing was long considered prohibitively expensive and niche, but that is beginning to change. As reported by this newspaper, prices of routine genomic tests have fallen by 30-40 per cent in recent years. Advanced procedures like whole exome sequencing have also become more affordable, reflecting technological advances, higher volumes, and the entry of domestic players.

 

However, falling prices alone do not guarantee access. Genomic care remains constrained by a shortage of trained genetic counsellors, molecular pathologists, and bioinformaticians — professionals critical for interpreting complex test results and integrating them into clinical decision-making. Limited insurance coverage for genomic tests further restricts uptake, particularly among lower-income patients, which leaves out a large section of population. Advanced treatment and diagnostic facilities are concentrated in a small number of tertiary hospitals, mostly in large cities, forcing patients from smaller towns and rural areas to travel long distances and bear high out-of-pocket costs.

 

The Union Budget 2026-27 sought to address parts of this challenge by raising health allocation by nearly 10 per cent, pushing domestic biopharmaceutical manufacturing, and exempting Customs duties on 17 cancer drugs. These measures can help reduce treatment costs, for which advanced therapies can range from ₹2 lakh to ₹10 lakh per month. However, the larger objective must be to prevent patients from reaching advanced stages where expensive medicines become the only option. This will require wider insurance coverage, greater availability of diagnostics, and trained clinicians beyond major cities. Sustained investment in genomic research, workforce training, and screening programmes in rural areas are, therefore, essential. Early detection and prevention must take centre stage alongside treatment expansion if precision cancer care is to become affordable, India-specific, and widely accessible.