Debate on Making Cancer a Notifiable Disease | 19 Mar 2025

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. 

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.