Cancer Notification Debate in India
The Department of Medical Oncology at Nizam’s Institute of Medical Sciences (NIMS), Hyderabad, organized an awareness walk on World Cancer Day, February 4, 2025, to promote cancer prevention.
Designation of Cancer as a Notifiable Disease
- There is an ongoing debate in India regarding making cancer a notifiable disease.
- The Union government traditionally mandates notification only for infectious diseases.
- Recent shifts in notification policies raise questions about this stance, notably when snakebites were made notifiable in 2024.
- The U.S. set a precedent in 1995 by making lead poisoning a notifiable disease.
Purpose and Challenges of Disease Notification
- The primary goal of disease notification is to control contagious diseases through legal mandates.
- Cancer differs as it is not infectious and requires long-term management rather than emergency interventions.
- Notification of cancer could place undue legal burdens on physicians without necessarily improving patient care.
India’s National Cancer Registry Programme (NCRP)
Since 1982, the NCRP has collected crucial data on cancer demographics, identification, treatment, and outcomes.
- There are currently 269 hospital-based and 38 population-based registries, considered insufficient for comprehensive surveillance.
- Expanding hospital-based registries to every cancer-treating hospital and establishing population-based registries in every district is recommended.
Privacy Concerns and Stigma
- Making cancer notifiable raises privacy concerns, as notifiability often overlooks individual confidentiality for public health.
- Cancer stigma could deter patients from diagnosis and treatment if included in notifiable disease frameworks.
World Health Organization (WHO) Recommendations
- The WHO advocates for cancer registries rather than mandatory notification.
- Expanding the NCRP and improving screening initiatives are emphasized for early detection.
Conclusion
- Mandatory notification suits outbreak-prone diseases, not cancer.
- A robust registry system, with wider hospital participation and better follow-up, can enhance cancer surveillance in India.