Lok Sabha Question No. 932 (UNSTARRED), answered on 2020-02-07
Subject: Rise in Cancer Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Mimi Chakraborty, Chinta Anuradha, Abdul Khaleque, Francisco Cosme Sardinha, E. T. Mohammed Basheer, Nusrat Jahan Ruhi, Dharambir Singh, Arun Sao

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 932 TO BE ANSWERED ON 07 TH FEBRUARY, 20 20

## RISE IN CANCER CASES

## 932. MS. MIMI CHAKRABORTY:

SHRIMATI CHINTA ANURADHA:

SHRI ABDUL KHALEQUE:

SHRI COSME FRANCISCO CAITANO SARDINHA:

SHRI E.T. MOHAMMED BASHEER:

SHRIMATI NUSRAT JAHAN RUHI:

SHRI DHARAMBIR SINGH:

SHRI ARUN SAO:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government is aware of the rise in various kinds of cancer cases, if so, thereof and the number of such cases reported along with the funds provided for prevent cancer to States/UTs during the last ten years;
- (b) whether Government has assessed the factors responsible for its increase including exce use of chemical manure used in growing of foodgrains as one of the factors, if so, the thereof and the steps taken by the Government to check such adulteration an d spread of cancer;
- (c) the number of specialised cancer hospitals both in Government and private sectors run country,  along  with  the  number  of  cancer  hospitals  required  keeping  in  view  the  incr number of cancer patients and the action being taken in this regard, State/UT - wise;
- (d)  whether  the  Government  has  implemented/  proposes  schemes  to  facilitate  spreading awareness on cancer, providing cost effective treatment, financial assistance/free treatm hospitals including private hospitals and introduce early detection centres in the Primary Hea Centres (PHCs) for such patients particularly belonging to the Economically Weaker Secti so, the details thereof and the eligibility criteria for such persons; and
- (e) whether Go vernment has received proposals from States/UTs to setup State Cancer Instit Specialised Cancer hospital/cancer treatment hubs on the lines of Tata Memorial Hospital in Goa, if so, the details thereof and the action taken thereon, State/ UT - wise including Bilaspur district in Chhattisgarh and Bongaigaon district in Assam?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

- (a) and (b): As per National Cancer Registry Programme (NCRP) of Indian Co uncil of Medical Research (ICMR), the estimated number of incidence of cancer cases during 2014 - 2018 in the country, State/UT wise is at Annexure - I .

Cancer  is  a  multifactorial  disease,  the  risk  factor  of  which  interalia,  include population,  sedentary  life  styles,  use  of  tobacco  products  &  alcohol,  unhealthy  diet pollution. Indian Council of Agriculture Research (ICAR) has informed that it has not con any study to assess the spread of cancer like diseases from soils o f agricultural fields due to excessive use of fertilizers.

(c) to (e): Cancer is being diagnosed and treated at various levels in the Government health system. While doctors with D. M. (Medical Oncology), M.Ch (Surgical Oncology) and M.D. (Radiatio n Oncology) treat Cancer patients in higher level tertiary care hospitals, Cancer being  treated  in  hospitals  by  other  Doctors  such  as  General  Surgeons,  Gynecologists, Surgeons etc., depending on the type and site of Cancer.

Health is a State s ubject. The Central Government, however, supplements the efforts of the State Governments to prevent and control cancer and to provide affordable and acce care.  The  Government  is  implementing National  Programme  for  Prevention  and  Control  of Cancer, D iabetes, Cardiovascular Diseases and Stroke (NPCDCS), with focus on strengthenin infrastructure, human resource development, health promotion & awareness generation, e diagnosis, management and referral to an appropriate level institution for treatmen .

To tackle the challenge of Non Communicable Diseases (NCD), including cancer, 616 NCD Clinics at District level and 3,827NCD Clinics at Community Health Centre level have been set up under NPCDCS.  Population level initiative for prevention, control and screening for common  NCDs  (diabetes,  hypertension  and  common  cancers  viz.  oral,  breast  and  cervica cancer) has also been rolled out under the National Health Mission (NHM) in over 215 districts. Screening of common NCDs including three common cancers i.e. oral, breast and cervical is also an integral part of service delivery under Ayushman Bharat -Health and Wellness Centres. Awareness campaigns on common risk factors for NCDs, including cancer, and promotion o healthy lifestyle are also carried out through electronic and social media. Camps for awareness generation and screening for common NCDs are also organized at Pragati Maidan, New Delh during  the  India  International  Trade  Fair. ICMR - National  Institute  of  Cancer  Prevention  and Research (NICPR), Noida, has launched www.cancerindia.org with  the  theme  'India  Against Cancer', a portal that provides information on the leading cancers in India with a major focus on awareness,  prevention  and  treatment  of  these canc rs. Several  measures  have  been  taken  to discourage the use of tobacco products, which is one of the key risk factors of Cancer, initiative  to  promote  healthy  lifestyles  through  healthy  eating  and  regular  physical Under  NHM  support  i s  provided  to  States/UTs  to  provide  free  essential  medicines  an diagnostic services for primary and secondary health care needs.

To  enhance  the  facilities  for  tertiary  care  of  cancer,  the  Central  Governme implementing Strengthening of Tertiary Care for Cancer Scheme, under which setting up of 1 9 State Cancer Institutes and 20 Tertiary Care Cancer Centres have been approved. The list of such  approved  SCIs/TCCCs  in  the  country  including  in  the  States  of  Goa,  Chhattisgarh Assam alongwith funds rele ased year - wise is at Annexure - II .Further, Oncology is also one of the focus areas in case of new AIIMS and many upgraded institutions under Pradhan Man Swasthya  Suraksha  Yojana  (PMSSY).  Setting  up  of  National  Cancer  Institute  at  Jhajjar in Haryana and strengthening of Chittaranjan National Cancer Institute, Kolkata, are also s the same direction.

Cancer  is  diagnosed  and  treated  at  various  levels  in  the  health  care  syste Government hospitals, treatment is either free or highly subsidized. Treatment of cancers available under Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana (PMJAY). Be sid s this, Affordable  Medicines  and  Reliable  Implants  for  Treatment  (AMRIT)  Deendayal  outlets  hav been  opened  at  195  Institutions/Hospitals  with  an  objective  to  make  available  Cancer Cardiovascular  Diseases  drugs  and  implants  at  discounted  prices  to the  patients.  Under  the umbrella scheme of Rashtriya Arogya Nidhi, financial assistance is provided to families below threshold poverty line for their treatment, including treatment of cancer, in Gov hospitals.

## Statement referre d to in reply to part (c) to (e) of the Lok Sabha Unstarred Question No. 932 due for reply on 07.02.2020.

Estimated Incidence of cancer cases in India - State/UT - All sites - Both sexes (2014-2018)*

| States                    |    2014 |    2015 |    2016 |    2017 |    2018 |
|---------------------------|---------|---------|---------|---------|---------|
| Jammu &Kashmir            |   14115 |   14864 |   15652 |   16480 |   17351 |
| Himachal Pradesh          |    7425 |    7722 |    8029 |    8348 |    8679 |
| Punjab                    |   30002 |   31214 |   32474 |   33781 |   35137 |
| Chandigarh                |    1162 |    1217 |    1274 |    1335 |    1398 |
| Uttaranchal               |   11240 |   11796 |   12381 |   12995 |   13640 |
| Haryana                   |   27933 |   29240 |   30611 |   32049 |   33558 |
| Delhi                     |   18356 |   19168 |   20015 |   20899 |   21821 |
| Rajasthan                 |   75642 |   79160 |   82836 |   86675 |   90686 |
| Uttar Pradesh             |  222615 |  233659 |  245231 |  257353 |  270053 |
| Bihar                     |  117603 |  123949 |  130628 |  137656 |  145051 |
| Sikkim                    |     467 |     473 |     479 |     485 |     490 |
| Arunachal Pradesh         |    1231 |    1252 |    1272 |    1292 |    1313 |
| Nagaland                  |    1288 |    1294 |    1300 |    1309 |    1318 |
| Manipur                   |    2836 |    2916 |    2998 |    3082 |    3168 |
| Mizoram                   |    1585 |    1618 |    1652 |    1687 |    1723 |
| Tripura                   |    2139 |    2169 |    2199 |    2229 |    2260 |
| Meghalaya                 |    3184 |    3246 |    3311 |    3376 |    3442 |
| Assam                     |   31124 |   31474 |   31825 |   32177 |   32530 |
| West Bengal               |   99339 |  103532 |  107906 |  112466 |  117220 |
| Jharkhand                 |   37031 |   38947 |   40959 |   43071 |   45289 |
| Orissa                    |   45736 |   47666 |   49674 |   51763 |   53936 |
| Chhattisgarh              |   28738 |   30239 |   31817 |   33477 |   35223 |
| Madhya Pradesh            |   81034 |   85078 |   89315 |   93754 |   98403 |
| Gujarat                   |   66952 |   70171 |   73551 |   77097 |   80820 |
| Daman &Diu                |     339 |     385 |     440 |     504 |     579 |
| Dadra &Nagar Haveli       |     421 |     457 |     497 |     542 |     591 |
| Maharashtra               |  122256 |  127390 |  132726 |  138271 |  144032 |
| Telangana                 |   38492 |   40177 |   41939 |   43784 |   45713 |
| Andhra Pradesh            |   53572 |   55776 |   58072 |   60475 |   62978 |
| Karnataka                 |   67237 |   70302 |   73511 |   76867 |   80381 |
| Goa                       |    1587 |    1655 |    1726 |    1801 |    1881 |
| Lakshadweep               |      77 |      82 |      89 |      96 |     104 |
| Kerala                    |   37550 |   39672 |   42004 |   44566 |   47382 |
| Tamil Nadu                |   76091 |   78512 |   80999 |   83554 |   86180 |
| Pondicherry               |    1428 |    1510 |    1596 |    1687 |    1783 |
| Andaman & Nicobar Islands |     402 |     415 |     429 |     443 |     458 |
| Total                     | 1328229 | 1388397 | 1451417 | 1517426 | 1586571 |

## Statement referred to in reply to part (c) to (e) of the Lok Sabha Unstarred Question No. 932 due for reply on 07.02.2020.

State/UT - wise list of approved State Cancer Institutes (SCI) and Tertiary Care Cancer Centres (TCCCs) alongwith funds released year -wise

(Rs. in Crore)

| S   | State            | Name of the Institute                                                  | SCI/ TCCC     | Approve d Cost   | Amount Released (Year wise)   | Amount Released (Year wise)   | Amount Released (Year wise)   | Amount Released (Year wise)   | Amount Released (Year wise)   |         | Total   |
|-----|------------------|------------------------------------------------------------------------|---------------|------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|---------|---------|
| No  | State            | Name of the Institute                                                  | SCI/ TCCC     | Approve d Cost   | 2014- 15                      | 2015- 16                      | 2016-17                       | 2017-18                       | 2018-19                       | 2019-20 | Total   |
| 1   | Andhra Pradesh   | Kurnool Medical College, Kurnool                                       | SCI           | 120.00           | -                             | -                             | -                             | 54.00                         | -                             | -       | 54.00   |
| 2   | Assam            | Gauhati Medical College & Hospital, Guwahati                           | SCI           | 119.90           | -                             | -                             | 08.43                         | 30.00                         | 42.5025                       | -       | 80.9325 |
| 3   | Bihar            | Indira Gandhi Institute of Medical Sciences, Patna                     | SCI           | 120.00           | -                             | 33.06                         | -                             | -                             | -                             | -       | 33.06   |
| 4   | Delhi            | Lok Nayak Hospital                                                     | TCCC          | 39.82            | -                             | -                             | 25.40                         | 4.47                          | -                             | -       | 29.87   |
| 5   | Gujarat          | Gujarat Cancer Research Institute, Ahmedabad                           | SCI           | 120.00           | 67.50                         | -                             | -                             | -                             | -                             | -       | 67.50   |
| 6   | Goa              | Goa Medical College, Panaji                                            | TCCC          | 45.00            | -                             | -                             | -                             | 8.3519                        | 11.8981                       | -       | 20.25   |
| 7   | Haryana          | Civil Hospital, Ambala Cantt                                           | TCCC          | 45.00            | -                             | -                             | 9.2253                        | 2.925                         | 8.0997                        | -       | 20.25   |
| 8   | Himachal Pradesh | Indira Gandhi Medical College,                                         | Shimla TCCC   | 45.00            | -                             | 14.87                         | -                             | -                             | -                             | -       | 14.87   |
| 9   | Himachal Pradesh | Shri Lal Bahadur Shastri Medical College, Mandi                        | TCCC          | 45.00            | -                             | -                             | -                             | 12.1932                       | 17.443                        | -       | 29.6362 |
| 10  | Jammu & Kashmir  | Sher- i -Kashmir Institute of Medical Sciences, Srinagar               | SCI           | 120.00           | 47.25                         | -                             | -                             | -                             | -                             | -       | 47.25   |
| 11  |                  | Government Medical College, Jammu                                      | SCI           | 104.00           | -                             | -                             | -                             | -                             | -                             | 70.2028 | 70.2028 |
| 12  | Jharkhand        | Rajendra Institute of Medical Ranchi                                   | Sciences, SCI | 51.00            | -                             | -                             | -                             | 22.95                         | -                             | -       | 22.95   |
| 13  | Karnataka        | Kidwai Memorial Institute of Oncology (RCC), Bangaluru                 | SCI           | 120.00           | 67.50                         | -                             | -                             | -                             | -                             | -       | 67.50   |
| 14  |                  | Mandya Institute of Medical Sciences, Mandya                           | TCCC          | 45.00            | -                             | 17.257                        | -                             | -                             | -                             | -       | 17.257  |
| 15  | Kerala           | Regional Cancer Centre, Tjiruvananthapuram                             | SCI           | 102.35           | -                             | -                             | 46.957                        | -                             | -                             | -       | 46.957  |
| 16  |                  | Government Medical College, Kozhikode                                  | TCCC          | 44.50            | 25.03                         | -                             | -                             | -                             | -                             | -       | 25.03   |
| 17  | Madhya Pradesh   | G.R. Medical College, Gwalior                                          | TCCC          | 42.00            | -                             | -                             | -                             | 18.90                         | -                             | -       | 18.90   |
| 18  |                  | Netaji Subhas Chandra Bose Medical College, Jabalpur                   | SCI           | 120.00           | -                             | -                             | -                             | -                             | -                             | 31.931  | 31.931  |
| 19  | Maharashtra      | Rashtrasant Tukdoji Regional Cancer Hospital & Research Centre, Nagpur | TCCC          | 44.991           | -                             | -                             | 15.3196                       | 4.8564                        | -                             | -       | 20.176  |
| 20  |                  | Government Medical College, Aurangabad                                 | SCI           | 96.70            | -                             | -                             | -                             | 43.515                        | -                             | -       | 43.515  |
| 21  |                  | Vivekanand Foundation & Research                                       | TCCC          | 45.00            | -                             | -                             | -                             | 20.25                         | -                             | -       | 20.25   |

## Annexure - II

|       |               | Centre, Latur                                                       |             |         |        |        |          |          |         |         |           |
|-------|---------------|---------------------------------------------------------------------|-------------|---------|--------|--------|----------|----------|---------|---------|-----------|
| 22    | Mizoram       | Mizoram State Cancer Institute,                                     | Aizawl TCCC |   44.27 | -      | 14.64  | -        | -        | -       | -       |   14.64   |
| 23    | Nagaland      | District Hospital, Kohima                                           | TCCC        |   43.5  | -      | -      | 13.23    | -        | -       | -       |   13.23   |
| 24    | Odisha        | Acharya Harihar Regional Cancer Centre, Cuttack                     | SCI         |   79.62 | -      | -      | 35.829   | -        | -       |         |   35.829  |
| 25    | Punjab        | Government Medical College, Amritsar                                | SCI         |  114.61 | -      | -      | 51.58    | -        | -       | -       |   51.58   |
| 26    | Punjab        | Civil Hospital, Fazilka                                             | TCCC        |   44.71 | -      | -      | 20.119   | -        | -       | -       |   20.119  |
| 27    | Rajasthan     | S P Medical College, Bikaner                                        | TCCC        |   38.05 | -      | 17.123 | -        | -        | -       | -       |   17.123  |
| 28    | Rajasthan     | SMS Medical College, Jaipur                                         | SCI         |  119.25 | -      | -      | 40.6683  | 4.1394   | -       | -       |   44.8077 |
| 29    | Rajasthan     | Jhalawar Medical College & Hospital, Jhalawar                       | TCCC        |   43.9  | -      | -      | -        | 19.755   | -       | -       |   19.755  |
| 30    | Sikkim        | Multispecialty Hospital at Sochygang (Sichey), near Gangtok, Sikkim | TCCC        |   42.99 | -      | -      | -        | 23.01    | 6.01    | -       |   29.02   |
| 31    | Tamil Nadu    | Cancer Institute (RCC), Adyar, Chennai                              | SCI         |  120    | 67.38  | -      | -        | -        | -       | -       |   67.38   |
| 32    | Telangana     | MNJ Institute of Oncology & RCC, Hyderabad                          | SCI         |  112.7  | -      | 18.12  | -        | -        | -       | -       |   18.12   |
| 33    | Tripura       | Cancer Hospital (RCC), Agartala                                     | SCI         |   81.5  | 55.00  | -      | -        | -        | -       | -       |   55      |
| 34    | Uttar Pradesh | Sanjay Gandhi Postgraduate Institute Medical Sciences, Lucknow      | of TCCC     |   41.5  | -      | 11.43  | -        | -        | -       | -       |   11.43   |
| 35    | Uttarakhand   | Government Medical College, Haldwani                                | SCI         |  103.66 | -      | -      | -        | -        | -       | 30.027  |   30.027  |
| 36    | West Bengal   | Government Medical College, Burdwan                                 | TCCC        |   39.54 | 22.24  | -      | -        | -        | -       | -       |   22.24   |
| 37    | West Bengal   | Murshidabad Medical College & Hospital, Berhampore, Murshidabad     | TCCC        |   32.15 | -      | -      | 10.9793  | 0.005    | -       | -       |   10.9843 |
| 38    | West Bengal   | Sagore Dutta Memorial Medical College and Hospital, Kolkata         | TCCC        |   45    | -      | -      | -        | 20.25    | -       |         |   20.25   |
| 39    | Chhattisgarh  | Chhattisgarh Institute of Medical Scineces, Bilaspur                | SCI         |  115.2  | -      | -      | -        | -        | -       | 10.23   |   10.23   |
| Total | Total         | Total                                                               | Total       | 2683.11 | 351.90 | 126.50 | 277.7375 | 289.5709 | 85.9533 | 97.7318 | 1274.05   |