Cancer as Notifiable Disease: Need & Challenges

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On World Cancer Day (February 4, 2024), the ICMR, Indian Cancer Society, Apollo Cancer Centres, and Family Physician Associations launched the “Unify to Notify” campaign. It urges the government to classify cancer as a notifiable disease to improve early detection, treatment, and research.
Doctors believe this move will enable real-time data collection, standardised treatment protocols, and better cancer control in India.

Cancer in India: Key Statistics

Cancer Prevalence: 100 out of every 1 lakh people in India are diagnosed with cancer.
Rising Incidence: Over 14 lakh cancer cases were reported in India in 2023. (ICMR)
Cervical Cancer Impact: India accounts for 23% of global cervical cancer deaths. (Lancet Health-23)
Future Projections: Cancer cases in India are expected to increase by 57.5%, reaching 2.08 million by 2040. (GLOBOCAN)
Disease Burden: The National Cancer Registry Program (NCRP) estimates that cancer will cause 29.8 million DALYs (Disability-Adjusted Life Years) by 2025.
Existing Notifiable Diseases in India: Tuberculosis, HIV/AIDS, Malaria, Dengue, and COVID-19.
State-Level Notification: Haryana, Karnataka, & West Bengal have already classified cancer as a notifiable disease.

Read in detail about the cancer.

A notifiable disease is a disease that, by law, must be reported to government authorities when diagnosed. The objective is to enable timely surveillance, control, and public health interventions to prevent its spread and mitigate its impact.

Accurate Data Collection: Ensures real-time reporting of cancer cases, improving epidemiological tracking and healthcare planning.
Enhanced Resource Allocation: Helps identify high-risk areas and directs healthcare resources efficiently for better diagnosis and treatment.
Improved Cancer Prevention Strategies: Enables targeted policies to control major risk factors like tobacco use, air pollution, and unhealthy diets.
Better Treatment & Survival Rates: Facilitates early detection, timely intervention, and standardised treatment protocols.
Bridging Gaps in Cancer Surveillance: The NCRP covers only 16% of India’s population, and national-level notification would ensure comprehensive coverage.

Privacy Concerns and Social Stigma: Fear of discrimination may discourage patients from seeking timely diagnosis and treatment.
Administrative and Legal Burden: Increased reporting requirements may strain healthcare providers and slow down service delivery.
Weak Healthcare Infrastructure: Limited oncology facilities and trained personnel in rural areas hinder effective implementation.
Underreporting and Data Inaccuracy: Private hospitals and smaller clinics may resist mandatory reporting, leading to gaps in data collection.
Resource Allocation Constraints: Diverting funds to mandatory notification may strain existing cancer treatment and prevention programs.

Phased Notification Approach: Classify high-risk cancers like cervical and lung cancer as documentable diseases for mandatory data collection.
Integration of Digital Health Technologies: Link cancer data with Ayushman Bharat Digital Mission (ABDM) and use CoWIN-like platforms for follow-ups and treatment adherence.
Enhanced Cancer Reporting: Expand Population-Based Registries (PBRs), implement universal screening, and empower ASHAs for community-based reporting and awareness.
Financial Support for Patients: Extend cancer coverage under PMJAY and provide free screenings to ensure affordability for low-income families.
Reducing Stigma & Promoting Awareness: Collaborate with influencers, media, and cancer survivors to normalize screenings and encourage early detection.

National Program for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases, & Stroke: Focuses on early detection, treatment, and palliative care under the National Health Mission.
Strengthening of Tertiary Care for Cancer Scheme: Establishes State Cancer Institutes (SCIs) and Tertiary Care Cancer Centres (TCCCs) to decentralize and enhance cancer treatment infrastructure.
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY): Provides ₹5 lakh financial coverage per family for cancer treatment, including chemotherapy, radiotherapy, and surgeries.
Health Minister’s Cancer Patient Fund (HMCPF): Offers financial assistance up to ₹5 lakh to BPL cancer patients under the Rashtriya Arogya Nidhi (RAN) scheme.
National Cancer Grid (NCG): A network of 250+ cancer centers ensuring standardised and high-quality cancer care across India.
National Cancer Registry Programme (NCRP) Under ICMR: Under ICMR, collects & analyses cancer incidence, mortality, and trends to enable data-driven policymaking and resource allocation for effective cancer control.
Quad Cancer Moonshot Initiative: Aim to eliminate cervical cancer in the Indo-Pacific region through HPV vaccination, screening, and advanced research.

Making cancer a notifiable disease balances public health benefits with individual rights. While it improves early detection and resource allocation, concerns over privacy and stigma must be addressed.
A patient-centric approach with informed consent, data protection, and equitable access is essential. As Mahatma Gandhi said, “The true measure of any society is how it treats its most vulnerable.” India must ensure scientific progress aligns with compassionate care.

Reference: The Hindu | PMFIAS: Cancer Disease

Introduction: Begin by stating the significance of cancer notification in public health while highlighting ethical concerns.
Body: Discuss ethical conflicts such as privacy vs. transparency & public good vs. individual autonomy.
Conclusion: Write a way forward & end with a balanced statement that aligns public health needs with ethical governance.