A DEBATE: Is Kashmir’s Cancer Surge Real—or Are We Simply Diagnosing Better?

To Reduce Advanced Cancers, Preventive Oncology Must Move from Hospitals To Communities. Dr. Fiaz Maqbool Fazili on the Numbers, the Noise, and Why Screening Must Reach Every Doorstep.

A question I am frequently asked by netizens on social media: “Is the cancer surge real, or are we simply diagnosing more because of increased awareness?” This is a fair query, and I welcome correction wherever reliable data and evidence demand it. My reflections are based on personal observations, decades of clinical experience, sustained engagement in cancer awareness and education., strong proponent for having state of art multispeciality cancer hospital (public and private partnership) in addition to sanctioned RCC s in each state under one roof.
Every few months, a headline sweeps through Kashmir’s media ecosystem claiming that cancer cases in the Valley are “surging,” “skyrocketing,” or “reaching unprecedented levels.” The latest figure—nearly 38 new cancer cases diagnosed per day—has once again triggered anxiety, debate, and speculation. For the layperson, such numbers sound shocking. For those of us who have worked in oncology for decades, these headlines raise a different question: Is the surge truly real, or are we simply detecting more cases than ever before? The answer is neither simple nor singular. I assume that the team projecting the figure has taken all necessary precautions in data collection and recognised the methodological differences and potential inaccuracies between population-based and hospital-based cancer data.”
To begin with, cancer cases have always been present in Kashmir—perhaps far more than what old records suggest. Twenty or thirty years ago, cancers often went undetected or were discovered very late. Many families kept illnesses hidden. Diagnostic facilities were sparse and specialised oncology services were limited. A patient with persistent symptoms might consult a local doctor, then a faith healer, and only eventually—often too late—reach a tertiary care centre. By then the disease was advanced and frequently unrecorded. Early-stage cancers were rarely diagnosed simply because the tools to find them did not exist.
Fast forward to today and the situation has transformed. Diagnostic infrastructure in the Valley has expanded dramatically. PET scans, MRI machines, high-resolution endoscopes, Mammography,, , ultrasound technologies, and advanced onco pathology labs with FNAc, cytology have become commonplace. Even district-level hospitals now pick up early-stage disease that would have been missed a decade ago. Meanwhile, awareness among the public has improved. A persistent cough, a breast lump, unexplained weight loss—symptoms once dismissed as routine are now taken more seriously, pushing people to seek care earlier. Cancer numbers in Kashmir cannot be understood through data alone; they sit at the intersection of biology, environment, healthcare capacity, and people’s health-seeking behaviour. The figures reflect not just disease patterns but also where patients seek care, how cases are diagnosed, and the gaps in data collection. Only by examining these mechanisms can we know whether Kashmir faces a true rise in cancer or an apparent one driven by better detection and reporting. Media narratives highlight a surge, but much of this increase comes from improved diagnostics, record-keeping, awareness, and earlier detection—real in numbers yet partly artificial in origin. Determining whether cancer is truly rising in Kashmir—or whether higher numbers simply reflect better detection—requires strong population-based studies and evidence wit clear, long-term incidence graphs. It is also vital to distinguish between something that merely has the potential to cause cancer, and something proven to cause it in humans. A potential risk only indicates early, unconfirmed signals from animal studies, lab experiments, or small observational data, not established danger in people. Claims such as “eggs have the potential to cause cancer” reflect these preliminary hints. Proven carcinogens, by contrast, have strong, consistent human evidence—tobacco, asbestos, and processed meats fall into this category. In simple terms, “potential” means suspected; “causes cancer” means confirmed. “The strongest evidence to determine whether cancer is truly increasing in Kashmir—and whether it is linked to specific foods, fertilisers, additives, pollution, microplastics, salt tea, chemical ripening agents, or adulteration—would come from multicentric, double-blind studies or high-quality meta-analyses. Until such evidence exists, any claim of a direct causal link remains speculation. At present, as per information I have,no such studies have been conducted in Valley.
Do Eggs really Cause Cancer? A recent video claims eggs with antibiotic traces cause cancer, but the science is more complex. Studies linking nitrofurans to cancer used doses far higher than any residue found in food. There is only animal studies, no evidence from human studies that eggs from regulated Indian markets are carcinogenic. The real issue is enforcing regulations, so farms avoid banned antibiotics and follow withdrawal periods. “An inquiry has been ordered by the Health Department into claims that eggs may cause cancer following complaints raised by MLA Tanvir Sadiq. The research and laboratory testing will take time, but until results are available, the public needs clear guidance. Since eggs are consumed by everyone—including infants, the elderly, and the sick—the authorities must state whether any temporary precautions or avoidance guidelines are necessary.”
PBCR(Population-Based Cancer Registries) data remain Kashmir’s most reliable cancer source. When coverage is limited, mortality records, hospital registries, and pathology databases help, though with biases. PBCR data remain the most reliable source for tracking cancer trends, but they must be interpreted with an understanding of these biases. PBCRs are the most trusted source for tracking cancer trends, but they are not entirely free from limitations. Some cases go unreported, especially when patients do not reach hospitals or seek treatment outside the region. Registries mainly capture hospital-going populations, which can skew the picture. Improved diagnostics may make cancer appear to be rising even when true incidence is stable. Conditions once misclassified are now more accurately labelled as cancer, raising numbers. Reporting delays, uneven participation of private clinics, and limited geographic coverage also create gaps. Outdated population estimates further affect incidence rates. Despite these biases, PBCRs remain the best tool for understanding long-term cancer patterns when interpreted carefully. A genuine rise can only be confirmed through long-term, high-quality, population-based registries, multi-centric studies, and consistent diagnostic systems—not isolated annual spikes. Trends in biopsies, imaging, endoscopies, and pathology confirmation reveal whether improved diagnostics inflate numbers. To confirm a true rise, age-standardised incidence must be tracked over time, supported by join-point analysis, mortality and survival trends, and stage distribution. Tools like capture–recapture and spatial mapping help assess data completeness and hotspots. Without such evidence, Kashmir risks debating perceptions instead of causes.
The apparent “surge” in cancer includes a clear detection surge, but that alone does not explain reality. Cancer is genuinely increasing, driven by socio-economic, environmental, and lifestyle shifts similar to global patterns. India’s rising burden—from 14% to 24%—offers context: Kashmir is not unique, and part of its rise reflects better detection rather than an explosion of disease. Changing diets—processed foods, dyes, pesticides, preservatives, sugary drinks—along with declining physical activity, widespread smoking, worsening air quality, and excessive CT scan use without justification all contribute to real risk.
Yet the widely quoted “38 cases per day” does not capture the full picture. Kashmir’s registry is incomplete and inconsistently fed. A significant factor is medical migration—many patients leave the Valley immediately after diagnosis for treatment in major Indian cities, so their data never return. Private labs often do not report cases, and diagnostic displacement—testing done outside Kashmir—creates further blind spots. Actual incidence is almost certainly higher than recorded.
Numbers should not incite panic reactions but drive awareness, early detection, and timely reporting—not panic. Kashmir’s vulnerabilities—environmental exposures, genetics, food violations—require serious attention. What is needed is balance: acknowledging the rise without fear and recognising better detection without downplaying the problem. A stronger, integrated cancer registry across public hospitals, private labs, and digital platforms is essential. Public health campaigns must prioritise prevention and screening, and trust must be rebuilt so patients believe quality cancer care exists at home.
National policy supports a regional cancer centre at SKIMS, a centre at Shireen Bagh, and district oncology units. But the bigger shift is from reactive oncology to preventive oncology—making screening accessible, affordable, and routine. Mobile mammography units, community endoscopy camps, VIA/HPV cervical screening, and structured outreach can save far more lives than late-stage treatment.
I recently shared these concerns during the GCC, Group of Concerned Citizens meeting with the Hon’ble Chief Minister Omar Abdullah, who supported the importance of preventive oncology. A proposal has been submitted outlining practical steps to expand cancer screening across Jammu & Kashmir. The message is simple: to reduce advanced cancers tomorrow, screening must reach people today. Treatment subsidies and PMJAY-like universal coverage are equally crucial. Ultimately, Kashmir needs a mindset shift—from alarm to strategy. Cancer reflects lifestyle, environment, and healthcare systems. The “38 cases a day” headline should be a call to action, not despair. As data quality improves and preventive oncology strengthens, numbers may rise—but the impact can fall through awareness, prevention, early detection, and better treatment pathways. The surge is both real and apparent, shaped by biology and statistics. The real question is whether we are ready to respond with honesty, intelligence, and urgency.
_{( STRAIGHT TALK COMMUNICATIONS EXCLUSIVE. The author is a Healthcare policy analyst, Surgeon dealing with Cancer awareness, preventive oncology , member of international tumour board can be reached at drfiazfazili@gmail.com)}