When we think about cancer, the first reasons that come to most people’s mind are smoking, exposure to too much radiation, or someone in the family having cancer. But recently, a senior cancer specialist, Dr. Rajeev Vijayakumar, made such a claim in a podcast. Which created a lot of controversy.
He said that Kerala has the highest number of cancer cases in India and the main reason for this is that the people there eat too much red meat (especially beef). He specifically mentioned beef curry and parotta. Dr. Rajiv cited the World Health Organization (WHO) and IARC (International Agency for Cancer Research) to strengthen his point. According to WHO:
- Processed meat (such as sausages, bacon, ham, etc. that are prepared by salt, smoke or other methods) is placed in Group 1, meaning it is considered a definite carcinogen to humans.
- Unprocessed red meat (e.g. fresh beef, sheep, goat meat) is in Group 2A, meaning it can potentially cause cancer, especially colorectal cancer.
Is the claim true?
This classification was made after reviewing more than 800 studies. The video of this claim quickly went viral on social media, and a new debate broke out among people regarding food habits. But this claim was refuted by a hepatologist (liver specialist) and medical teacher in a long post on the ax handle. He said that Dr. Rajeev’s claim is based on a wrong understanding of epidemiology. He connected it to Simpson’s Paradox.
What is Simpson’s Paradox?
This is such a statistical paradox. In which a trend is visible in different groups. But when we look at all the groups together, the trend is reversed. Simple example: Some hospitals appear to have higher mortality rates. But this is because they have better ICUs and handle only the most serious patients. At the same time, minor patients come to hospitals with less facilities, hence the death rate appears to be low. But in reality, better hospitals are saving more lives. Similarly in Kerala cancer statistics:
- Kerala seems to be recording the highest number of cancer cases, but this does not mean that cancer is spreading the most there.
- Reason: Kerala has one of the oldest and best cancer registries (population-based cancer registers) in India. These have been running for decades and accurately track many cancer cases.
- In other states, registries are weak and screening and diagnosis facilities are limited, so many cases go undetected or unreported.
- The result: There are fewer reported cases, but the actual burden may be higher.
- A very important point: How can something that is not detected be reported?
Also in Kerala:
- Life expectancy (average age) is highest – about 75-77 years, which is the same as in many developed countries.
- Cancer mostly occurs with increasing age. As people live longer, the risk of cancer increases.
- In other states, people die at an early age due to reasons like infection, malnutrition or maternal death, so they do not reach the age where cancer is common.
The hepatologist further said, ‘There is no strong evidence to directly believe that unprocessed red meat is a cause of cancer. Even in WHO/IARC data, the main threat is from processed or ultra-processed meat. The biggest and proven reasons for increasing cancer are tobacco, alcohol, and obesity.
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