TELANGANA DECLARES CANCER A NOTIFIABLE DISEASE

Why in News?

• Telangana has declared cancer a notifiable disease, making it mandatory for all public and private healthcare facilities to report every diagnosed cancer case to a State Cancer Registry Portal within one month.
• The initiative aims to:
  • Accurately assess the state's cancer burden.
  • Improve disease surveillance.
  • Facilitate evidence-based public health planning.
  • Strengthen India's cancer data ecosystem by integrating with the National Cancer Registry Programme (NCRP) under the Indian Council of Medical Research (ICMR).

WHAT IS THIS NEW POLICY?

Key Provisions Under the new policy:

• Every public and private hospital, clinic, laboratory, and diagnostic centre must report all confirmed cancer cases.
• Reporting must be completed within one month of diagnosis.
• Data will be uploaded to a State Cancer Registry Portal.
• The information will be validated by the Centre of Excellence (MNJ Cancer Hospital) before being transmitted to the National Cancer Registry Programme (NCRP).

OBJECTIVES & SIGNIFICANCE The initiative seeks to:

• Accurately estimate the cancer burden.
• Track cancer incidence and mortality.
• Identify geographical disease patterns.
• Improve healthcare planning.
• Enable targeted screening and prevention programmes.
• Strengthen evidence-based policymaking.

Significance of the Initiative The policy will help:

• Generate comprehensive cancer statistics.
• Improve allocation of healthcare resources.
• Support early diagnosis and treatment planning.
• Enhance cancer surveillance across the state.
• Standardize cancer reporting with national databases.

WHAT IS A NOTIFIABLE DISEASE? A notifiable disease is a disease that must be reported by law to designated government authorities whenever it is diagnosed. The objective is to enable:

• Disease surveillance.
• Early detection of outbreaks.
• Timely public health interventions.
• Better health planning and resource allocation.

LEGAL FRAMEWORK IN INDIA

Epidemic Diseases Act, 1897 The Epidemic Diseases Act, 1897 provides the legal framework for disease notification in India. However:

• The State Governments decide which diseases are notified within their jurisdictions.
• The Union Government generally mandates notification for nationally significant communicable diseases.

COMMON NOTIFIABLE DISEASES IN INDIA Several diseases have already been notified by various states, including:

• Tuberculosis (TB)
• Dengue
• Malaria
• Cholera
• Hepatitis
• Measles
• Polio

During the COVID-19 pandemic:

• COVID-19 was declared a notifiable disease across the country.

CANCER NOTIFICATION INDIA: CURRENT SCENARIO

National Position

• At present:
  • Cancer is not a nationally notifiable disease.
• The Ministry of Health and Family Welfare has traditionally restricted mandatory notification mainly to communicable diseases because of their epidemic potential.

State-Level Initiatives In the absence of a national mandate:

• 17 Indian States have independently declared cancer a notifiable disease.
• Telangana is the latest state to adopt this policy.

This reflects growing recognition of the need for comprehensive cancer surveillance.

DATA DEFICIT IN INDIA’S CANCER CARE

Existing Cancer Surveillance System India currently relies on two major cancer surveillance mechanisms: 1. Population-Based Cancer Registries (PBCRs)

• These registries collect data on cancer cases occurring within a defined population.

2. Hospital-Based Cancer Registries (HBCRs)

• These registries collect information from hospitals regarding cancer diagnosis, treatment, and outcomes.

LIMITATIONS OF EXISTING REGISTRIES The current surveillance system faces several challenges:

• Limited Population Coverage
  • PBCRs and HBCRs together cover only 10–16% of India's population.
• Urban Bias
  • Most registries are concentrated in:
  • Urban areas
  • Major cities
  • leading to underrepresentation of rural populations.
• Public Sector Bias
  • Many cancer cases diagnosed in:
  • Private hospitals
  • Small clinics
  • remain outside the existing registry network.

Incomplete National Data As a result:

• Actual cancer incidence remains underestimated.
• Regional disparities are poorly captured.
• Policy decisions may not reflect ground realities.

GROWING CANCER BURDEN IN INDIA

Projected Increase

• Approximately 74% increase between 2022 and 2045.

REASONS FOR RISING CANCER CASES The increase is attributed to:

• Ageing population.
• Increased life expectancy.
• Lifestyle changes.
• Tobacco and alcohol consumption.
• Environmental pollution.
• Changing dietary habits.

INSTITUTIONAL RECOMMENDATIONS The following institutions have long advocated mandatory cancer notification:

• Indian Council of Medical Research (ICMR)
• National Centre for Disease Informatics and Research (NCDIR)

They recommend making cancer a notifiable disease to:

• Capture missing data.
• Improve surveillance.
• Include private healthcare providers.
• Develop comprehensive national cancer statistics.

POLICY IMPLICATIONS Making cancer a notifiable disease would have several important policy implications. 1. Improved Disease Surveillance Mandatory reporting would provide:

• Reliable incidence data.
• Mortality statistics.
• Regional disease mapping.

2. Better Healthcare Planning Accurate data would support:

• Establishment of cancer treatment centres.
• Expansion of oncology services.
• Human resource planning.
• Better allocation of healthcare funds.

3. Strengthening Health Insurance Reliable epidemiological data can help:

• Expand insurance coverage.
• Estimate financial requirements.
• Improve reimbursement planning.

4. Targeted Public Health Interventions Disease mapping enables:

• Focused screening programmes.
• High-risk district identification.
• Awareness campaigns.
• Early diagnosis initiatives.

5. Enhanced Research Comprehensive databases support:

• Cancer epidemiology research.
• Clinical studies.
• Health policy analysis.
• Identification of emerging cancer trends.

CHALLENGES Despite its benefits, mandatory cancer notification may face several challenges:

• Increased reporting burden on healthcare providers.
• Need for digital reporting infrastructure.
• Ensuring data accuracy and standardisation.
• Integrating private healthcare institutions.
• Protecting patient confidentiality and data privacy.
• Requirement for trained personnel and continuous monitoring.

WAY FORWARD To strengthen cancer surveillance across the country, the following measures are needed: National-Level Notification

• Consider declaring cancer a nationally notifiable disease to ensure uniform reporting across all states.

Strengthen Cancer Registries

• Expand the coverage of Population-Based Cancer Registries (PBCRs).
• Improve Hospital-Based Cancer Registries (HBCRs).
• Increase rural and private-sector participation.

Digital Integration

• Develop a unified national digital reporting platform.
• Integrate state registries with the National Cancer Registry Programme (NCRP).

Public–Private Collaboration

• Mandate reporting by private hospitals, laboratories, and diagnostic centres.
• Standardise reporting formats and timelines.

Capacity Building

• Train healthcare professionals in cancer reporting.
• Improve digital infrastructure and data management systems.

Strengthen Prevention and Early Detection Use surveillance data to:

• Expand screening programmes.
• Promote early diagnosis.
• Improve Information, Education, and Communication (IEC) campaigns.
• Enhance tobacco control and lifestyle interventions.