Debate on Making Cancer a Notifiable Disease

• 19 Mar 2025

For Prelims: Cancer, World Health Organization, National Cancer Registry Program, Cervical cancer 

For Mains: Public Health Policies in India, Disease Notification in India, Cancer Prevention 

Source:TH 

Why in News?

There are growing calls to make cancer a notifiable disease in India, but the Union government resists, citing its non-communicable nature. 

• The inclusion of snakebites as a notifiable disease (2024) and global precedents like the US listing lead poisoning (1995) as notifiable disease challenges this reasoning, prompting a re-evaluation of India’s stance on cancer notification. 

What is Notifiable Disease in India? 

• About: A notifiable disease is one that must be legally reported to government authorities by healthcare providers for real-time epidemiological tracking, resource allocation, and early intervention. 
  • The Epidemic Diseases Act, 1897 governs the notification and regulation of epidemic disease (rapid spread of disease to a large number) reporting. 
  • The World Health Organization (WHO) mandates notification for certain diseases to aid in global disease surveillance and control. 
• Examples: Infectious diseases like tuberculosis, malaria, and Covid-19 are typically notifiable due to their potential to spread. 
  • However, the Ministry of Health and Family Welfare (MoHFW) classified snakebite as a notifiable disease, despite it being non-communicable. 

What is the Debate on Classifying Cancer as a Notifiable Disease? 

Arguments in Favor 

• Better Data Collection: The National Cancer Registry Program (NCRP), covering only 16% of India’s population, lacks comprehensive data, drawing criticism from a parliamentary committee, highlighting the need for improved tracking. 
  • With enhanced data nearly 50% of cancer deaths are preventable by controlling risk factors like smoking, air pollution, and asbestos exposure. 
  • Some cancers, like cervical cancer, are linked to human papillomavirus (spreads through contact), prompting experts to propose classifying cancer as a “documentable disease” for mandatory data collection. 
  • Making cancer notifiable would ensure real-time data on incidence, prevalence, and mortality rates can be prevented by controlling risk factors like tobacco, air pollution, and carcinogenic chemicals. 
• Indian States Approach: 17 states have made cancer notifiable through administrative orders, highlighting the need for a national-level mandate. 
  • States with high cancer incidence, like Kerala and Mizoram, could benefit from mandatory notification for better intervention. 
• Global Precedents: Countries like Australia have made cancer notifiable, while the United Kingdom mandates cancer registration, in contrast, India’s NCRP registration remains voluntary. 

Arguments Against

• Non-Communicable Nature: Unlike infectious diseases, cancer is not contagious or an immediate public health threat, making mandatory notification unnecessary. 
• Privacy Concerns: Notifiable diseases prioritize public health over individual privacy, which may deter people from seeking diagnosis. 
  • Cancer carries social stigma, and legal obligations to report cases could reduce patient willingness to seek timely treatment. 
• Burden on Healthcare Providers: Physicians may face unnecessary legal burdens if notification is made mandatory. 
  • Cancer requires personalized long term treatment, and notifiability is typically used for emergency containment, not long-term diseases. 

India’s Existing Cancer Surveillance Mechanism 

• The NCRP under Indian Council of Medical Research (ICMR), tracks cancer demographics, diagnosis, treatment, and survival through Hospital-Based (HBRs) and Population-Based Registries (PBRs).  
  • As of 2022, India has 269 HBRs and 38 PBRs, but coverage remains inadequate.  
  • In 2023, over 14 lakh cancer cases were reported, with 100 per 1 lakh people diagnosed. 

What Should India Do to Strengthen Cancer Surveillance? 

• Phased Notification Approach: Classify high-risk cancers like cervical and lung cancer as “documentable diseases” for mandatory data collection. 
• Integrate Digital Health Technologies: Link cancer data collection with the Ayushman Bharat Digital Mission (ABDM) to create a centralized cancer registry. 
  • Integrate cancer screening records with CoWIN-like platforms to ensure targeted follow-ups and treatment adherence. 
• Cancer Reporting: Increase the number of PBRs to expand cancer testing and related facilities nationwide, and implement universal screening for high-risk cancers. 
  • Empower local health workers (like Accredited Social Health Activists) to actively report cancer cases and conduct door-to-door awareness campaigns. 
  • Expand cancer coverage under Pradhan Mantri Jan Arogya Yojana and increase insurance support, as treatment is long-term and costly.  
    • This will enable free screening for low-income families, ensuring financial barriers do not delay diagnosis and treatment. 
• Reduce Stigma: Partner with spiritual leaders, influencers, and media icons to destigmatize cancer reporting and normalize screenings. 
  • Promote cancer survivors as “ambassadors”, sharing their stories to inspire early detection and eliminate fear surrounding the disease. 

Drishti Mains Question: 

Discuss the merits and challenges of making cancer a notifiable disease in India. Should India adopt a national-level mandatory cancer reporting system?. 

UPSC Civil Services Examination, Previous Year Questions (PYQs) 

Prelims

Q. With reference to the treatment of cancerous tumours, a tool called cyberknife has been making the news. In this context, which one of the following statements is not correct? (2010)

(a) It is a robotic image guided system    

(b) It delivers an extremely precise dose of radiation    

(c) It has the capability of achieving sub-millimetre accuracy    

(d) It can map the spread of tumour in the body    

Ans: (d)  

Q. ‘RNA interference (RNAi)’ technology has gained popularity in the last few years. Why? (2019)

1. It is used in developing gene-silencing therapies.    
2. It can be used in developing therapies for the treatment of cancer.    
3. It can be used to develop hormone replacement therapies.    
4. It can be used to produce crop plants that are resistant to viral pathogens.    

Select the correct answer using the code given below.    

(a) 1, 2 and 4    

(b) 2 and 3    

(c) 1 and 3    

(d) 1 and 4 only    

Ans: (a) 

Mains

Q. “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (2021)

Q. Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain. (2018)