ICMR urges govt to make cancer a notifiable disease

India recorded 9.8 lakh new cases of cancer last year, an increase of about 80,000 new cases as compared to 2009. Top cancer scientists from across the country along with Union health ministry officials and experts from the Indian Council of Medical Research (ICMR) met at the annual review meeting of the National Cancer Registry Programme in Guwahati to discuss the worrying trend over the last two days. This figure was reached at after tabulating the results from over 27 cancer registries. However, the ministry is yet to make these findings public. The ICMR has recommended to the health ministry to make cancer a "notifiable disease". Now, highly infectious diseases like plague, polio, H5N1 ( bird flu), H1N1 ( swine flu) figure in the list. Cancer may become the first non-communicable disease (NCD) to be bracketed under the same category. Sources in the ministry told TOI that Union health minister Ghulam Nabi Azad is seriously considering the proposal. "If cancer is made notifiable, like many other Western countries, every case will have to be reported and no cases can be left uncared for. Now, doctors sometimes don't look at a patient citing existing patient burden. That can't happen if it is made notifiable. We will also know exactly how many new cancer cases are affecting India. I think the 9.8 lakh new cases is just a fraction of the actual burden," Dr Rath added. Dr G K Rath, head of the department of oncology at the All India Institute of Medical Sciences (AIIMS), said "We have noticed some important changes in the cancer pattern. In north-eastern states, stomach, lung and esophagus are the commonest cancers. In the villages, breast cancer rates are only one-fourth of that in the city. However in all cities like Delhi, Chennai, Mumbai and Bangalore, breast cancer tops the list." He added, "If cancer is made notifiable, like many other Western countries, every case will have to be reported and no cases can be left uncared for. Now, doctors sometimes don't look at a patient citing existing patient burden. That can't happen if it is made notifiable. We will also know exactly how many new cancer cases are affecting India. I think the 9.8 lakh new cases is just a fraction of the actual burden." About 50 top scientists, who are part of the scientific advisory body of the National Centre for Disease Informatics and Research (Bangalore), including professor Rath, director of Tata Memorial Hospital Dr R A Badwe and ICMR director general Dr V M Katoch, feel cancer should be made notifiable. Dr Badwe said, "Once cancer becomes a notifiable disease, we will be able to appropriately document its actual magnitude and quality." Dr Katoch said, "All hospitals aren't bound to report cancer cases. Besides, our official data on cancer burden depends mostly on government hospitals. Once the ministry makes the announcement, it will become the duty of all hospitals - both public and private - to document and report every case of cancer." In India, four lakhs die of cancer every year. The ministry data shows 25 lakh cancer patients in the country at any point in time. Cancer is the third biggest killer in India. In developed countries, cancer is the second leading cause of death, accounting for 21% (2.5 million) of all mortality. In developing countries, cancer ranks third as a cause of death and accounts for 9.5% (3.8 million) of all mortality. Cancer is curable if detected early. The results of treatment in stage I and stage II (early stage) are about 80%. In late stage diseases (stage III and IV) the results are less than 20%. In India, about 70% patients are advanced stage diseases, and are difficult to treat. By 2015, the number of new cases in India is expected to cross 15 lakhs. Among Indian males, lung, head and neck cancer is the most common and among women, breast and cervical cancer is the most frequent. The ministry recently rolled out the national programme on cancer across 100 districts in 21 states. It hopes to diagnose cancer cases early and also provide chemotherapy free of cost. Besides, 38 additional cancer centres are being created. "We have been warned by the WHO that India is the next hub for cancer. The 38 new cancer centres will be linked to district hospitals. Auxiliary Nurse Midwife (ANM) personnel are being trained to identify warning signs of cancer, while doctors in primary health centres are undergoing training to diagnose cancer cases early," Azad told TOI.