Lok Sabha Question No. 1136 (UNSTARRED), answered on 2021-12-03
Subject: Cause of Cancer
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Jyotirmay Singh Mahato, Riti Pathak, Dileshwar Kamait

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

## LOK SABHA UNSTARRED QUESTION NO. 1136 TO BE ANSWERED ON 3 rd  DECEMBER, 2021

## CAUSE OF CANCER

## 1136. SHRI JYOTIRMAY SINGH MAHATO: SHRIMATI RITI PATHAK: SHRI DILESHWAR KAMAIT:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state: (a) the number of cases of cancer reported, State/ UT-wise including West Bengal during the last three years; (b) the number of deaths reported out of the above cancer cases State/UT-wise during the said period; (c) whether faulty diet, lifestyle and other intoxicants including alcohol are the main reasons for the spread of cancer disease, if so, the details thereof; (d) whether the Government has made any concrete action plan to get rid of this fatal disease; and

- (e) if so, the details thereof and the steps taken thereon?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)  and  (b):  As  per  Indian  Council  Medical  Research's  (ICMR)  cancer  registry  data  on "National Cancer Registry Programme Report, 2020", the estimated number of incidence and mortality cancer cases in the country including West Bengal during 2018 to 2020 by State/UT wise is enclosed in Annexure (Table 1 & Table 2).

- (c): Cancer is a multi-factorial disease, the risk factors of which, include ageing population, sedentary lifestyle, use of tobacco products, unhealthy diet and air pollution. Published various studies have indicated that alcohol consumption is causally associated with the  cancers  of  the  oral  cavity,  pharynx,  larynx,  oesophagus,  colorectum,  liver  and  female

breast. Harmful use of alcohol is a major cause of morbidity and mortality and is associated with many illnesses including cancer.

(d) and (e): Health is a state subject. The Department of Health & Family Welfare, 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 Non-Communicable Diseases, including Cancer.

A  population-based  initiative  for  prevention,  control  and  screening  for  common  NonCommunicable Diseases (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 continued 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 so far under the said scheme.

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 being 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-à-vis 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 1: Estimated Incidence of cancer cases in India by different State/UT - All sites (ICD10: C00-C97) - (2018-2020)* - Both sexes

| State                    |    2018 |    2019 |    2020 |
|--------------------------|---------|---------|---------|
| Jammu &Kashmir           |   12344 |   12675 |   13012 |
| Himachal pradesh         |    8412 |    8589 |    8799 |
| Punjab                   |   36888 |   37744 |   38636 |
| Chandigarh               |     966 |     994 |    1024 |
| Uttaranchal              |   10932 |   11216 |   11482 |
| Haryana                  |   27665 |   28453 |   29219 |
| Delhi                    |   23678 |   24436 |   25178 |
| Rajasthan                |   67380 |   69156 |   70987 |
| Uttar pradesh            |  192019 |  196652 |  201319 |
| Bihar                    |   98383 |  101014 |  103711 |
| Sikkim                   |     437 |     443 |     445 |
| Arunachal pradesh        |     991 |    1015 |    1035 |
| Nagaland                 |    1684 |    1719 |    1768 |
| Manipur                  |    1803 |    1844 |    1899 |
| Mizoram                  |    1742 |    1783 |    1837 |
| Tripura                  |    2454 |    2507 |    2574 |
| Meghalaya                |    2741 |    2808 |    2879 |
| Assam                    |   36029 |   36948 |   37880 |
| West bengal              |  103309 |  105814 |  108394 |
| Jharkhand                |   32150 |   33045 |   33961 |
| Orissa                   |   48491 |   49604 |   50692 |
| Chattisgarh              |   26443 |   27113 |   27828 |
| Madhya pradesh           |   73957 |   75911 |   77888 |
| Gujarat                  |   66069 |   67841 |   69660 |
| Daman                    |     107 |     118 |     124 |
| Dadra &Nagar Haveli      |     173 |     186 |     206 |
| Maharashtra              |  110696 |  113374 |  116121 |
| Telangana                |   45335 |   46464 |   47620 |
| Andhra pradesh           |   67370 |   68883 |   70424 |
| Karnataka                |   81729 |   83824 |   85968 |
| Goa                      |    1543 |    1591 |    1618 |
| Lakshadweep              |      27 |      27 |      27 |
| Kerala                   |   55145 |   56148 |   57155 |
| Tamil nadu               |   84320 |   86596 |   88866 |
| Pondicherry              |    1469 |    1523 |    1577 |
| Andaman &Nicobar Islands |     351 |     357 |     366 |
| Total                    | 1325232 | 1358415 | 1392179 |

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 2: Estimated Mortality of cancer cases in India by different State/UT - All sites (ICD10: C00-C97) - (2018-2020)** - Both sexes

| State                    |   2018 |   2019 |   2020 |
|--------------------------|--------|--------|--------|
| Jammu &Kashmir           |   6824 |   7003 |   7189 |
| Himachal pradesh         |   4642 |   4744 |   4856 |
| Punjab                   |  21278 |  21763 |  22276 |
| Chandigarh               |    532 |    548 |    564 |
| Uttaranchal              |   6028 |   6184 |   6337 |
| Haryana                  |  15255 |  15684 |  16109 |
| Delhi                    |  13218 |  13644 |  14057 |
| Rajasthan                |  37123 |  38100 |  39111 |
| Uttar pradesh            | 106350 | 108911 | 111491 |
| Bihar                    |  54566 |  56028 |  57531 |
| Sikkim                   |    270 |    275 |    276 |
| Arunachal pradesh        |    612 |    622 |    635 |
| Nagaland                 |    961 |    982 |   1008 |
| Manipur                  |   1047 |   1070 |   1105 |
| Mizoram                  |   1119 |   1149 |   1183 |
| Tripura                  |   1496 |   1526 |   1571 |
| Meghalaya                |   1791 |   1837 |   1887 |
| Assam                    |  21715 |  22261 |  22824 |
| West bengal              |  56988 |  58368 |  59786 |
| Jharkhand                |  17710 |  18215 |  18716 |
| Orissa                   |  26810 |  27427 |  28024 |
| Chattisgarh              |  14522 |  14891 |  15279 |
| Madhya pradesh           |  40798 |  41876 |  42966 |
| Gujarat                  |  36325 |  37300 |  38306 |
| Daman                    |     55 |     63 |     66 |
| Dadra &Nagar Haveli      |     92 |    102 |    109 |
| Maharashtra              |  60814 |  62291 |  63797 |
| Telangana                |  24788 |  25408 |  26038 |
| Andhra pradesh           |  36884 |  37724 |  38582 |
| Karnataka                |  44775 |  45926 |  47113 |
| Goa                      |    848 |    877 |    893 |
| Lakshadweep              |     13 |     13 |     13 |
| Kerala                   |  30057 |  30615 |  31166 |
| Tamil nadu               |  45846 |  47075 |  48314 |
| Pondicherry              |    794 |    820 |    852 |
| Andaman &Nicobar Islands |    193 |    195 |    200 |
| Total                    | 733139 | 751517 | 770230 |

Ref: National Cancer Registry Programme report, 2020

**Projected mortality cases for India were computed by applying Mumbai Mortality/Incidence (MI) ratio to the projected incidence cancer cases.