Lok Sabha Question No. 5041 (UNSTARRED), answered on 2022-04-01
Subject: Prevalence of Various Types of Cancer
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Jyotirmay Singh Mahato, Prathap Simha, Navneet Ravi Rana, Umesh G. Jadhav, L.S. Tejasvi Surya, Bache Gowda B.N., Annasaheb Shankar Jolle, B. Y. Raghavendra, Sanganna Amarappa Karadi, S. Muniswamy

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

## LOK SABHA UNSTARRED QUESTION NO. 5041

## TO BE ANSWERED ON 1 st  April, 2022

## PREVALENCE OF VARIOUS TYPES OF CANCER

## 5041. SHRI JYOTIRMAY SINGH MAHATO:

SHRI PRATHAP SIMHA:

SHRIMATI NAVNEET RAVI RANA:

DR. UMESH G. JADHAV:

SHRI L.S. TEJASVI SURYA:

SHRI B.N.BACHE GOWDA:

SHRI ANNASAHEB SHANKAR JOLLE:

SHRI B.Y. RAGHAVENDRA:

SHRI SANGANNA AMARAPPA:

SHRI S. MUNISWAMY

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

- (a) whether the Government has taken note of prevalence of various types of cancer in certain/specific areas of the country and if so, the details thereof, State/ UT-wise;
- (b) whether there have been rapid increase in cancer cases in the country, if so, the details thereof and number of such cases reported, State/UT-wise;
- (c)  whether  the  Government  has  conducted  any  study  to  ascertain  the  reasons  for  the  increasing number of cancer patients in these specific areas and also in other parts of the country and if so, the details and the outcome thereof, State/UT-wise;
- (d) whether the Government hospitals/health centres across the country are adequately equipped/facilitated to detect various types of cancer including breast cancer at the preliminary/initial stage; and
- (e)  if  so,  the  details  thereof  and  if  not,  the  steps  taken/proposed  to  be  taken  by  the  Government  to diagnose various types of cancer at the preliminary/ initial stage and provide treatment at affordable cost and create awareness in this regard throughout the country and curb cancer cases?

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

## (DR. BHARATI PRAVIN PAWAR)

(a) to (c): As per the Indian Council of Medical Research's Cancer Registry Data Report on 'National Cancer Registry Programme Report, 2020', the estimated number of incidences of cancer cases in the country during 2018 to 2020 by State/UT wise is enclosed in Annexure 1. The Age Adjusted Incidence Rates (AAR) cancer across Population Based Cancer Registries (PBCRs) in various specific areas in states are enclosed in Annexure 2. As per National Non-Communicable Diseases Monitoring Survey

(NNMS),  the  prevalence  of  risk  factors  associated  with  Non-Communicable  Diseases  (NCDs) including  cancer  amongst  adults  (18-69  years)  are  such  as  32.8%  in  current  tobacco  use,  15.9%  in current  alcohol  use,  98.4%  in  inadequate  intake  of  fruits  and/or  vegetables  intake  and  41.3%  in insufficient physical activity.

(d)  and  (e):  Health  is  a  state  subject.  The  Department  of  Health  &  Family  Welfare,  Government of India,  however,  provides  technical  and  financial  support  to  the  States/UTs  under  the  National Programme  for  Prevention  and  Control  of  Cancer,  Diabetes,  Cardiovascular  Diseases  and  Stroke (NPCDCS), as  part  of  National  Health  Mission  (NHM),  based  on  the  proposals  received  from  the States/UTs  and  subject  to  the  resource  envelope.  Cancer  is  an  integral  part  of  NPCDCS.  The programme focusses on strengthening infrastructure, human resource development, health promotion &  awareness  generation  for  Cancer  prevention,  early  diagnosis,  management  and  referral  to  an appropriate level of healthcare facility for treatment of the NCDs, including Cancer. Under NPCDCS, 682 District NCD Clinics, 191 District Cardiac Care Units, and 5408 Community Health Center NCD Clinics has been set up.

A population-based initiative for prevention, control and screening for common NCDs i.e. diabetes, hypertension and common cancers has been rolled out in the country under NHM and also as a part of Comprehensive  Primary  Health  Care.  Under  the  initiative,  persons  more  than  30  years  of  age  are targeted for their screening for the three common cancers i.e oral, breast and cervical. Screening of these  common cancers is an integral part of service delivery under Ayushman Bharat  - Health and Wellness Centres.

Preventive  aspect  of  Cancer  is  strengthened  under  Comprehensive  Primary  Health  Care  through Ayushman Bharat Health Wellness Centre scheme, by promotion of wellness activities and targeted communication at the community level. Other initiatives for increasing public awareness about Cancer and for promotion of healthy lifestyle includes observation of National Cancer Awareness Day and use of  print,  electronic  and  social  media  for  community  awareness.  Furthermore,  healthy  eating  is  also promoted  through  FSSAI.  Fit  India  movement  is  implemented  by  Ministry  of  Youth  Affairs  and Sports,  and  various  Yoga  related  activities  are  carried  out  by  Ministry  of  AYUSH.  In  addition, NPCDCS gives financial support under NHM for awareness generation (IEC) activities for Cancer to be undertaken by the States/UTs as per their Programme Implementation Plans (PIPs).

The Central Government is also implementing Strengthening of Tertiary Care of Cancer Scheme in order  to  enhance  the  facilities  for  tertiary  care  of  cancer.  19  State  Cancer  Institutes  (SCIs)  and  20 Tertiary  Care  Cancer  Centres  (TCCCs)  have  been  approved  under  the  said  scheme.  The  details  are attached in Annexure 3.

There  is  also  focus  on  Oncology  in  its  various  aspects  in  case  of  new  AIIMS  and  many  upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY). Setting up of National Cancer Institute at Jhajjar (Haryana) and second campus of Chittaranjan National Cancer Institute, Kolkata are also steps in this direction. All these enhance the capacity for treatment of cancer in the country.

Cancer  is  diagnosed  and  treated  at  various  levels  in  the  health  care  facilities.  The  treatment  in Government Hospitals is either free or highly subsidized for the poor and needy. Treatment of Cancers is  also  available  under  Ayushman  Bharat  -  Pradhan  Mantri  Jan  Arogya  Yojana  (PMJAY). Besides, quality generic medicines are made available at affordable prices to all, under Pradhan Mantri Bhartiya

Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for  Treatment  (AMRIT)  Pharmacy  stores  have  been  set  up  in  some hospitals/institutions, with an objective to make available Cancer drugs at a substantial discount vis-àvis the Maximum Retail Price. Under the umbrella scheme of Rashtrya Arogya Nidhi (RAN), financial assistance  is  provided  to  families  living  below  threshold  poverty  line  for  their  treatment,  including treatment of Cancer in Government hospitals.

Table 2: Estimated Incidence of cancer cases in India by different State/UT - All sites (2018-2020)* - Both sexes

| State                    | 2018     | 2019     | 2020     |
|--------------------------|----------|----------|----------|
| Jammu &Kashmir           | 12,071   | 12,396   | 12,726   |
| Ladakh                   | 273      | 279      | 286      |
| Himachal Pradesh         | 8,412    | 8,589    | 8,799    |
| Punjab                   | 36,888   | 37,744   | 38,636   |
| Chandigarh               | 966      | 994      | 1,024    |
| Uttaranchal              | 10,932   | 11,216   | 11,482   |
| Haryana                  | 27,665   | 28,453   | 29,219   |
| Delhi                    | 23,678   | 24,436   | 25,178   |
| Rajasthan                | 67,380   | 69,156   | 70,987   |
| Uttar Pradesh            | 1,92,019 | 1,96,652 | 2,01,319 |
| Bihar                    | 98,383   | 1,01,014 | 1,03,711 |
| Sikkim                   | 437      | 443      | 445      |
| Arunachal Pradesh        | 991      | 1,015    | 1,035    |
| Nagaland                 | 1,684    | 1,719    | 1,768    |
| Manipur                  | 1,803    | 1,844    | 1,899    |
| Mizoram                  | 1,742    | 1,783    | 1,837    |
| Tripura                  | 2,454    | 2,507    | 2,574    |
| Meghalaya                | 2,741    | 2,808    | 2,879    |
| Assam                    | 36,029   | 36,948   | 37,880   |
| West Bengal              | 1,03,309 | 1,05,814 | 1,08,394 |
| Jharkhand                | 32,150   | 33,045   | 33,961   |
| Orissa                   | 48,491   | 49,604   | 50,692   |
| Chhattisgarh             | 26,443   | 27,113   | 27,828   |
| Madhya Pradesh           | 73,957   | 75,911   | 77,888   |
| Gujarat                  | 66,069   | 67,841   | 69,660   |
| Daman                    | 107      | 118      | 124      |
| Dadra &Nagar Haveli      | 173      | 186      | 206      |
| Maharashtra              | 1,10,696 | 1,13,374 | 1,16,121 |
| Telangana                | 45,335   | 46,464   | 47,620   |
| Andhra Pradesh           | 67,370   | 68,883   | 70,424   |
| Karnataka                | 81,729   | 83,824   | 85,968   |
| Goa                      | 1,543    | 1,591    | 1,618    |
| Lakshadweep              | 27       | 27       | 27       |
| Kerala                   | 55,145   | 56,148   | 57,155   |
| Tamil Nādu               | 84,320   | 86,596   | 88,866   |
| Pondicherry              | 1,469    | 1,523    | 1,577    |
| Andaman &Nicobar Islands | 351      | 357      | 366      |

## Ref: National Cancer Registry Programme report, 2020

* Projected cancer cases for India were computed using Age specific incidence Rate of 28 PBCRs of 2012-2016 and the projected population (person-years)

Table 1: Age Adjusted Incidence Rate (AAR) per 100,000 population for All Sites of Cancer in PBCRs under NCRP

| Registry, State                       |   Males |   Females |
|---------------------------------------|---------|-----------|
| Aizawl district , Mizoram             |   269.4 |     214.1 |
| East Khasi Hills district , Meghalaya |   227.9 |     118.6 |
| Kamrup urban, Assam                   |   213   |     169.6 |
| Mizoram state                         |   207   |     172.3 |
| Papumpare district , Meghalaya        |   201.2 |     219.8 |
| Meghalaya, Meghalaya                  |   176.8 |      96.5 |
| Delhi, Delhi NCT                      |   147   |     141   |
| Thiruvananthapuram district, Kerala   |   137.8 |     127.3 |
| Cachar district, Assam                |   129   |     104.8 |
| Kollam district, Kerala               |   127.7 |     107.1 |
| Nagaland, Nagaland                    |   124.5 |      88.2 |
| Bangalore, Karnataka                  |   122.1 |     146.8 |
| Pasighat, Arunachal Pradesh           |   120.4 |     116.2 |
| Chennai, Tamil Nadu                   |   119.9 |     132.8 |
| Mumbai, Maharashtra                   |   108.4 |     116.2 |
| Patiala district, Punjab              |   108.2 |     124.6 |
| Hyderabad district, Telangana         |   101.6 |     136   |
| West Arunachal, Arunachal Pradesh     |   101.1 |      96.3 |
| Bhopal, Madhya Pradesh                |   101   |     106.9 |
| Ahmedabad urban, Gujarat              |    98.3 |      76.7 |
| Imphal West district , Manipur        |    95.3 |     110.9 |
| Dibrugarh district, Assam             |    91.9 |      76.8 |
| Kolkata, West Bengal                  |    91.2 |      89.2 |
| Nagpur, Maharashtra                   |    91.1 |      89.8 |
| Sikkim state                          |    88.7 |      97   |
| Pune, Maharashtra                     |    83   |      94   |
| Tripura state                         |    80.9 |      58.3 |
| Aurangabad, Maharashtra               |    70.9 |      75.1 |
| Wardha district, Maharashtra          |    64.5 |      69.9 |
| Manipur state                         |    62.8 |      71.1 |
| Barshi rural, Maharashtra             |    50.6 |      61   |
| Osmanabad &Beed, Maharashtra          |    39.5 |      49.4 |

## Table of SCIs/TCCCs:

|   S No | State            | Name of the Institute                                                 | SCI / TCCC   |
|--------|------------------|-----------------------------------------------------------------------|--------------|
|      1 | Andhra Pradesh   | Kurnool Medical College, Kurnool                                      | SCI          |
|      2 | Assam            | Gauhati Medical College &Hospital, Guwahati                           | SCI          |
|      3 | Bihar            | Indira Gandhi Institute of Medical Sciences, Patna                    | SCI          |
|      4 | Chhattisgarh     | Chhattisgarh Institute of Medical Sciences, Bilaspur                  | SCI          |
|      5 | Delhi            | Lok Nayak Hospital                                                    | TCCC         |
|      6 | Gujarat          | Gujarat Cancer Research Institute, Ahmedabad                          | SCI          |
|      7 | Goa              | Goa Medical College, Panaji                                           | TCCC         |
|      8 | Haryana          | Civil Hospital, Ambala Cantt                                          | TCCC         |
|      9 | Himachal Pradesh | Indira Gandhi Medical College, Shimla                                 | TCCC         |
|     10 | Himachal Pradesh | Shri Lal Bahadur Shastri Medical College, Mandi                       | TCCC         |
|     11 | Jammu&           | Sher-i-Kashmir Institute of Medical Sciences, Srinagar                | SCI          |
|     12 | Kashmir          | Government Medical College, Jammu                                     | SCI          |
|     13 | Jharkhand        | Rajendra Institute of Medical Sciences, Ranchi                        | SCI          |
|     14 | Karnataka        | Kidwai Memorial Institute of Oncology (RCC), Bangaluru                | SCI          |
|     15 |                  | Mandya Institute of Medical Sciences, Mandya                          | TCCC         |
|     16 | Kerala           | Regional Cancer Centre, Tjiruvananthapuram                            | SCI          |
|     17 |                  | Government Medical College, Kozhikode                                 | TCCC         |
|     18 | Madhya Pradesh   | G.R. Medical College, Gwalior                                         | TCCC         |
|     19 |                  | Netaji Subhas Chandra Bose Medical College, Jabalpur                  | SCI          |
|     20 | Maharashtra      | Rashtrasant Tukdoji Regional Cancer Hospital& Research Centre, Nagpur | TCCC         |
|     21 |                  | Government Medical College, Aurangabad                                | SCI          |
|     22 |                  | Vivekanand Foundation &Research Centre, Latur                         | TCCC         |
|     23 | Mizoram          | Mizoram State Cancer Institute, Aizawl                                | TCCC         |
|     24 | Nagaland         | District Hospital, Kohima                                             | TCCC         |
|     25 | Odisha           | Acharya Harihar Regional Cancer Centre, Cuttack                       | SCI          |
|     26 | Punjab           | Government Medical College, Amritsar                                  | SCI          |
|     27 |                  | Civil Hospital, Fazilka                                               | TCCC         |
|     28 | Rajasthan        | S P Medical College, Bikaner                                          | TCCC         |
|     29 |                  | SMS Medical College, Jaipur                                           | SCI          |
|     30 |                  | Jhalawar Medical College &Hospital, Jhalawar                          | TCCC         |
|     31 | Sikkim           | Multispecialty Hospital at Sochygang (Sichey), near Gangtok, Sikkim   | TCCC         |
|     32 | Tamil Nadu       | Cancer Institute (RCC), Adyar, Chennai                                | SCI          |
|     33 | Telangana        | MNJ Institute of Oncology &RCC, Hyderabad                             | SCI          |
|     34 | Tripura          | Cancer Hospital (RCC), Agartala                                       | SCI          |
|     35 | Uttar Pradesh    | Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow     | TCCC         |
|     36 | Uttarakhand      | Government Medical College, Haldwani                                  | SCI          |
|     37 | West Bengal      | Government Medical College, Burdwan                                   | TCCC         |
|     38 |                  | Murshidabad Medical College &Hospital, Berhampore, Murshidabad        | TCCC         |
|     39 |                  | Sagore Dutta Memorial Medical College and Hospital, Kolkata           | TCCC         |