When conversations around cancer begin, most people immediately think of tobacco, poor diet, genetics or lifestyle choices. Rarely does air pollution enter that list. Yet, in cities like Delhi, where smog has become a seasonal reality, the air itself may be shaping long-term health risks in ways many women do not realise.
Air pollution, both indoors and outdoors, is no longer just a respiratory issue. It is increasingly being recognised as a silent driver of non-communicable diseases, including heart disease, stroke and various cancers. According to Dr Geeta Kadayaprath, Lead Oncology and Oncoplastic Surgeon at Apollo Athenaa Women’s Cancer Centres, the risk is no longer hypothetical.
“While the common belief is that cancer is often caused by tobacco, diet, genetics and lifestyle, one cannot ignore glaring factors like air pollution, both indoors and outdoors, which has emerged as a silent yet powerful driver of non-communicable diseases, including various cancers,” she explains.
Global health bodies such as the World Health Organization (WHO) have placed air pollution firmly on their radar, as mounting evidence links it to a growing cancer burden worldwide.
The hidden risk inside homes
When discussing pollution, images of traffic congestion and factory smoke often dominate the conversation. But for millions of women, exposure begins much closer to home, in kitchens and poorly ventilated spaces. Across India, particularly in villages and small towns, solid fuels such as wood, crop residue, charcoal, coal, dung and kerosene are still used for cooking. These fuels are typically burned in open fires or inefficient stoves, releasing high concentrations of harmful pollutants.
Globally, nearly 2.1 billion people still rely on such fuels. While only 14 per cent of urban populations worldwide use polluting fuels, nearly 49 per cent of rural populations continue to depend on them.
Burning solid fuels produces fine particulate matter that penetrates deep into the lungs and can enter the bloodstream. In poorly ventilated homes, indoor smoke can reach particle concentrations more than 100 times above acceptable safety limits.
Women, children and elderly family members are particularly vulnerable because they spend longer hours indoors. Global estimates suggest that approximately 11 per cent of lung cancer deaths are linked to household air pollution.
“This is a largely preventable risk,” Dr Kadayaprath notes. “But awareness remains low, especially when symptoms develop years after exposure.”
Delhi’s outdoor air: A growing carcinogenic concern
Beyond the home, urban women face another layer of exposure, the city air itself. Outdoor air pollution stems largely from fossil fuel combustion in vehicles, industrial operations, coal-based power plants, agriculture and waste burning. Key pollutants include particulate matter (PM2.5 and PM10), nitrogen oxides, sulphur oxides, carbon monoxide and volatile organic compounds (VOCs).
Among these, PM2.5 is particularly concerning. Because these particles are extremely small, they bypass natural defence mechanisms and lodge deep within lung tissue.
Why women may face greater exposure
In terms of exposure, there are differences between the exposure of men and women to cancer risk factors. Women, for example, may spend more time in a confined environment, or they may travel daily through a busy thoroughfare. In terms of biological differences, there are variations in the hormonal system of men and women, and this may affect the way in which toxins interact in the body, thereby affecting cancer risk patterns. “Air pollution may be invisible, but its impact on health is measurable and profound. Not only is addressing it an environmental imperative, but it is a public health priority for cancer prevention itself.”
What can be done?
Tackling the problem of pollution requires a concerted effort at the policy, community, and individual levels. Increasing access to cleaner fuels like LPG, electricity, solar, and biogas is essential to combat household air pollution. Using better biomass stoves that meet WHO emission levels can also help, although this might not be feasible at all levels.
Improving ventilation at home, using air purifiers, and staying updated on air quality indexes might help at the individual level. But the larger solution lies beyond personal behaviour. Pollution control policies, cleaner energy transitions and stricter industrial emission standards remain central to reducing long-term cancer risks at the population level.
The air crisis affecting urban women is subtle. It does not create immediate alarms. It does not always produce early symptoms. But over the years, cumulative exposure can shape health outcomes in ways that are difficult to reverse. Cancer prevention conversations must therefore expand beyond lifestyle habits to include environmental exposures.
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