Counting cancer: On making cancer a notifiable disease in India
Making cancer a notifiable disease at the national level is the way forward
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Context
This editorial argues for making cancer a notifiable disease at the national level in India. Currently, the Union Health Ministry only requires the notification of communicable diseases, relying on limited registries for cancer data, while 17 states, most recently Telangana, have independently mandated cancer notification.
UPSC Perspectives
Governance
The current approach to tracking cancer in India highlights a gap in cooperative federalism, where states are leading a crucial public health initiative while the Centre lags. The reliance on Population-Based Cancer Registries (PBCRs) and Hospital-Based Cancer Registries (HBCRs), which only cover 10-16% of the population and are skewed towards urban, government facilities, demonstrates inadequate data governance. This fragmented data collection hinders the development of a comprehensive, evidence-based national cancer control program. The editorial emphasizes that robust data is essential for effective public health administration and resource allocation. UPSC often tests understanding of how data deficits impact policy formulation; recognizing cancer as a notifiable disease nationally, as recommended by , would address this critical shortfall.
Social
The projected 74% increase in cancer cases by 2045, driven by demographic shifts (ageing population) and lifestyle changes, represents an impending crisis for India's healthcare infrastructure. A significant portion of cancer care in India is provided by the private sector, and without mandatory notification, this vast dataset remains uncaptured, leading to an incomplete picture of the disease burden. The lack of comprehensive national data impedes effective Information, Education, and Communication (IEC) strategies necessary for early detection and prevention. The transition from communicable to non-communicable diseases (NCDs) is a major theme in GS Paper 2; this editorial illustrates the urgent need to adapt national health policies, moving beyond the historical focus on infectious diseases to address the growing burden of NCDs like cancer.
Polity
The debate over notifying cancer touches upon the constitutional distribution of powers. Public health and sanitation, hospitals, and dispensaries fall under the State List (Entry 6) of the of the . However, the prevention of the extension from one State to another of infectious or contagious diseases falls under the Concurrent List (Entry 29). The Union government’s historical stance of only notifying communicable diseases aligns with this framework, focusing on preventing inter-state transmission. Yet, managing a nationwide epidemic of a non-communicable disease requires coordinated national action and funding, which the Centre can facilitate through schemes under its purview. The push for a national notification mandate challenges the traditional interpretation of these constitutional boundaries in the face of modern health crises.