New Delhi: Senior oncologists in Delhi have called for cancer to be declared a notifiable disease, citing concerns over the limited scope of existing cancer registries across the country.
They pointed out that the current population-based and hospital-based registries cover only 10 percent of India’s population, leading to inadequate data for effective monitoring and policy-making.
Ailments that are required to be reported to public health authorities are known as notifiable diseases, a mechanism evolved for prompt investigation, risk assessment, and an effective response to cases of infectious diseases or contamination.
“The actual cancer burden in India is two to three times higher than government estimates,” said Dr. (Prof) S.V.S Deo, senior oncologist at Apollo cancer centre and head of Delhi cancer registry. “Without accurate data, we cannot effectively plan policies, allocate budgets, expand cancer care facilities, or determine the types of treatments that need scaling up.”
According to the Global Cancer Observatory (GLOBOCAN), India ranked third worldwide for new cancer cases in 2020, after China and the United States while projecting a sharp 57.5 percent rise in cancer cases by 2040, with the total expected to reach 2.08 million.
On World Cancer Day (which falls on 4 February), Apollo Cancer Centre, in collaboration with the Oncology Forum of Delhi, Cancer Centre AIIMS and Delhi Cancer Registry, launched a nationwide campaign—‘Unify to Notify’—to make cancer a notifiable disease.
Through this initiative, medical experts are urging the government to act on the parliamentary standing committee’s report that had recommended designating cancer as a notifiable disease during the ongoing budget session.
On 13 September 2022, the Parliamentary Standing Committee on Health and Family Welfare submitted a report, ‘Cancer Care Plan and Management: Prevention, Diagnosis, Research & Affordability of Cancer Treatment’, to the Rajya Sabha recommending cancer be classified as a notifiable disease.
Currently, India lists 11 notifiable diseases, including tuberculosis, cholera, and AIDS. Since cancer is not among them, doctors and hospitals are not legally obligated to report every cancer case to health authorities. However, as of August 2022, 15 states have made cancer a notifiable disease, but the experts worry about its implementation.
Medical experts shared that they are reaching out to authorities through “official channels,” with the campaign serving as an additional effort to strengthen their appeal.
Dr. Bipin Puri, Director of Medical Services at Indraprastha Apollo Hospital, highlighted that the state requires a strong infrastructure, workforce, and legal framework to implement it on ground. “Just like COVID, which was mandatory to report for public health, the process must be enforced with penalties for non-compliance to ensure effective notification,” he said.
One of the reasons, he said, the government hasn’t implemented this is the lack of a channelised system.
He pointed out that the scale of the cancer issue is massive, and addressing it will require a significant portion of the health budget. “If cancer is made notifiable, a substantial part of the health budget will be allocated to cancer care, given its importance.”
Dr. Sushma Bhatnagar, head of B R A –IRCH, Cancer Centre and President of IAPC-AIIMS, emphasised that classifying cancer as a notifiable disease would address two key issues.
“First, it would help identify the stage of cancer, (and thereby) enabling better resource allocation—whether at tertiary care centers, district hospitals, or primary healthcare facilities. This would streamline care and reduce disparities,” she explained.
“Second, it would allow us to estimate the true cost of cancer care and plan budgets accordingly. Without accurate data and accountability, it’s impossible to make informed decisions.”
The experts also highlighted the urban bias in the data registry. Currently, the National Cancer Registry Programme includes two population-based cancer registries for rural populations (PBCRs)—Barshi and Nagpur rural. Additionally, 24 PBCRs cover both rural and urban populations, while 12 PBCRs focus exclusively on urban areas.
“There is a three-fold difference between rural and urban cancer rates. In rural India, lifestyle-related cancers are still very low—three times less than in urban areas,” said Dr. Puri, emphasising the significant disparity in cancer rates.
He further explained that rural data is crucial since the majority of the population lives there, but the lack of data is hindering the reach of the programme.
(Edited by Tony Rai)
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