Cancer should be declared notifiable disease nationwide: Parl panel

The panel noted that over five Indians die every hour due to oral cancer, with cases rising among those under 40, much earlier than in Western populations

New Delhi: A parliamentary committee has recommended that cancer should be declared a notifiable disease across all states and Union Territories.

Headed by Narain Dass Gupta, the Committee on Petitions, Rajya Sabha, in its 163rd report presented on Wednesday, said reliable data is vital for assessing public health issues, particularly cancer, where comprehensive information is essential to track trends, design policies and plan infrastructure.

At present, cancer data is primarily drawn from the National Cancer Registry Programme (NCRP), which covers only about 18 per cent of the population, considered to be insufficient for a national picture. Healthcare professionals have long advocated for declaring cancer a notifiable disease.

At present, the government's position is guided by WHO norms, which limit notification to communicable diseases.

"However, given the rising cancer burden in India, this stance warrants a serious reconsideration. Given India's rising cancer burden, the Committee is of the view that declaring cancer notifiable would ensure systematic reporting, generate real-time and credible data, strengthen surveillance and enable evidence-based policymaking," it said in the report.

It would support targeted interventions, rational resource allocation, region-specific strategies and development of appropriate infrastructure, the report said.

While some states have already made cancer notifiable, a national mandate would ensure uniform documentation and a clear picture of the disease burden.

The Committee also recommended imposing a high-risk cess or heavy taxes on tobacco products and said that the revenue earned may be utilised for supplementing cancer research and cancer care across the country.

It observed that the government has taken several steps to reduce the consumption of tobacco. "However, the ground reality indicates that more needs to be done," it said.

According to the National Oral Registry, it is estimated that in India, nearly 60,000 new cases of oral cancer are reported annually and over five people die every hour because of oral cancer, indicating that the disease is highly fatal.

What is even more alarming is the fact that Indians are contracting oral cancer at a much younger age (i.e. those 40 years or younger) in comparison to the patients from the western population, the Committee pointed out.

Looking at its negative impact on the population, the Committee recommended that a high-risk cess or heavy taxes may be imposed on tobacco products and the revenue earned may be utilised for supplementing cancer research and cancer care across the country.

Besides, it called for extensive awareness campaigns, especially in educational institutions, to spread awareness of its ill effects.

The Committee also observed that there has been a significant increase in the number of undergraduate and postgraduate medical seats in recent years, which has the potential to strengthen the medical workforce in the country.

Although the number of trained oncologists remains relatively limited, the ongoing expansion of medical training infrastructure and increase in college seat availability, coupled with the formal recognition of DNB faculty, is contributing meaningfully towards bridging both geographic disparities and specialist shortages in the oncology domain.

It also noted with concern that a considerable number of medical professionals are opting to work abroad. Many of these individuals have benefited either directly or indirectly from public funding through grants, scholarships or subsidised education while studying in Indian institutions.

"In light of such a high rate of exodus, the increased availability of medical seats is not resulting in a proportional increase in medical professionals serving within the country, it said.

The Committee, thus, suggested that a comprehensive study should be undertaken to assess the actual requirement of medical professionals in relation to population density, so that the expansion of medical education facilities may be undertaken in a holistic and regionally balanced manner.

Further, to ensure that medical graduates who have availed government aid contribute to national service, it recommended the introduction of compulsory service norms.

Simultaneously, the government should consider making the salary structures more attractive to encourage qualified professionals to practice domestically, it said.

A key concern that emerged during the Committee's interaction with stakeholders was the limited introduction of new drug molecules in India. The primary reason cited for this was the inadequate level of domestic research and development.

The Committee has observed that the majority of cancer drugs available in the Indian market are imported from developed nations such as the United States and countries in Europe, where substantial emphasis is placed on research and innovation.

Given the considerable scientific and clinical talent available within the country, it recommended that the government significantly enhance budgetary allocations for research and development, particularly in the field of oncology.

It also observed that beyond tobacco use, environmental pollution and carcinogens in air, water, pesticides and fertilisers significantly contribute to India's rising cancer burden.

Since these issues span over multiple ministries, the panel recommended a coordinated inter-ministerial strategy, particularly between health, environment, and agriculture, to address environmental risk factors, stressing that siloed approaches are counterproductive and synergy is essential to mitigate long-term health impacts.