Telangana government has declared cancer a notifiable disease, making it mandatory for every healthcare facility in the state to report diagnosed cancer cases to a centralised portal within one month of diagnosis.
A government order has been issued to this effect. The notification covers all cancers, including in situ and invasive types, and applies to government and private hospitals, clinics, AYUSH facilities, pathology and radiology laboratories.
There is no reliable, real-time national data on the incidence of cancer in the country, though the dreaded disease is one of the major causes of the public health crisis.
The existing system relies on Population-based Cancer Registries (PBCRs) under the National Cancer Registry Programme (NCRP), run by the Indian Council of Medical Research (ICMR) since 1981. But these cover only 16.4 per cent of India’s total population, across 38 registries in 22 states and union territories.
What policymakers are left with amounts to little more than a “shot in the dark.”
“The burden of non-communicable diseases is increasing steadily and has become a major public health concern. Cancer has emerged as a significant cause of morbidity and mortality, underscoring the need for a systematic and institutional mechanism to capture reliable and timely information on the disease burden in the state,” the government order said.
The objective, it says, is to build a surveillance system that estimates cancer incidence, prevalence and mortality; strengthens preventive screening and early detection; assists in planning diagnostic and treatment facilities; and supports evidence-based policy formulation, monitoring and research.
“A uniform cancer registry for the state will serve as a centralised platform for estimation of cancer incidence and prevalence,” the order noted.
The state has also outlined how it expects cancer cases to move through the system, from suspicion to diagnosis to treatment.
S. Sangeetha Satyanarayana, Commissioner of Health and Family Welfare, explained that probable cases would emerge through multiple pathways before ever reaching a hospital.
Once referred to government general hospitals, diagnoses would be confirmed. From there, the plan follows a hub-and-spoke model.
“We are planning a system where the first round of chemotherapy or initial medical management will take place at the hub institutions, such as MNJ or NIMS. Subsequently, if travel becomes difficult for patients and they prefer treatment closer to home, chemotherapy sessions can be continued at district cancer care centres,” Satyanarayana said.
The approach, she added, is designed not just for treatment but for building a living database of cancer in Telangana.
“This will help create a comprehensive database, mapping different types of cancers as well as patient distribution across districts. It will enable us to identify patterns, understand which cancers are more prevalent in specific regions, and support research. Ultimately, this will also make treatment planning and management more efficient,” she said.
At the district level, the District Medical and Health Officer (DMHO) is responsible for ensuring all hospitals, laboratories and other facilities under their jurisdiction comply with the reporting requirement.
Each facility must maintain a designated cancer register in a prescribed format, recording both existing and new cases from the date of the notification.
Also read: Cancer cases on rise in Telangana
The Mehdi Nawaz Jung Institute of Oncology and Regional Cancer Centre (MNJIORCC), Hyderabad, has been designated as the Centre of Excellence for cancer care in the state. It will be responsible for periodically scrutinising and validating all reported data before submitting it to the ICMR’s National Cancer Registry.
The Director of Public Health and Family Welfare will monitor the quality and timeliness of all submissions.
All data collected is to be treated as strictly confidential, used solely for public health purposes, and stored and transmitted securely. Personally identifiable information will not be disclosed.
Telangana’s move comes against the backdrop of a long-standing gap in national health policy.
A notifiable disease, by definition, is one that must be reported to authorities by law due to its frequency, severity or threat to public health. Cancer clearly meets that threshold, yet India has not made it notifiable at the central level.
The ICMR first recommended doing so in 2008. A parliamentary panel reiterated the recommendation in its 139th report submitted to the Rajya Sabha in September 2022, titled ‘Cancer Care Plan and Management: Prevention, Diagnosis, Research and Affordability of Cancer Treatment.’ The Ministry of Health and Family Welfare has not acted on either.
As of December 2024, only 16 Indian states had made cancer notification mandatory. Internationally, mandatory cancer notification is well established, particularly in developed countries.
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