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NEW DELHI: India's lung cancer burden is projected to rise sharply by 2030, with the North-East emerging as the worst-affected region and women recording the fastest increase in cases, a national study published in Indian Journal of Medical Research has found.Data from 57 populations across six regions show lung cancer incidence to be highest in the North-East, where rates for women are now close to those for men - an unusual pattern in India. Aizawl recorded the highest burden, with age-standardised incidence at 35.9 per lakh among men and 33.7 per lakh among women, along with the highest mortality.

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Although extremely high tobacco use - over 68% among men and 54% among women - continues to drive the region's burden, doctors say the disease profile is shifting.

"We are seeing more lung cancer cases among non-smoking women, linked to indoor air pollution, biomass fuel use, second-hand smoke and occupational exposure," said Dr Saurabh Mittal of AIIMS's pulmonology department.

The shift is also reflected in tumour patterns nationwide. Adenocarcinoma has replaced smoking-linked squamous-cell carcinoma as the dominant subtype. In Bengaluru, it now accounts for over half of lung cancer cases among women, while Delhi has seen a sharp rise in large-cell carcinoma.

Southern districts such as Kannur, Kasargod and Kollam reported high incidence among men despite relatively low tobacco and alcohol use, pointing to non-tobacco risk factors. Among women, Hyderabad and Bengaluru recorded the highest incidence in the south. In the north, Srinagar showed elevated lung cancer rates among men, while women in Srinagar and Pulwama also reported higher incidence despite low substance use.Trend analysis shows lung cancer incidence climbing by up to 6.7% annually among women and 4.3% among men in some regions. Thiruvananthapuram recorded the sharpest rise among women, while Dindigul saw the steepest increase among men. With tobacco use among women still below 10% nationwide, researchers point to worsening air quality and household exposures as key drivers.Projections suggest that by 2030, lung cancer incidence among men could exceed 33 per lakh in parts of Kerala, while among women it could rise to over 8 per lakh in cities like Bengaluru. Low mortality-to-incidence ratios in several regions also point to gaps in death reporting, potentially masking the true toll.