Lok Sabha Question No. 145 (STARRED), answered on 2022-02-11
Subject: Cancer Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Jamyang Tsering Namgyal

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

## LOK SABHA STARRED QUESTION NO.145 TO BE ANSWERED ON THE 11 TH  FEBRUARY, 2022 CANCER CASES

## *145. SHRI JAMYANG TSERING NAMGYAL:

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

- (a)  the number of cases of cancer reported during the last three years, State/UTwise including Ladakh;
- (b)  the  number  of  cancer  deaths  reported,  State/UTwise  especially  in  Leh  and Kargil districts in UT of Ladkah during the said period;
- (c)  whether  faulty  diet,  lifestyle  and  other  intoxicants  including  alcohol  are  the main reasons for the spread of cancer disease and if so, the details thereof;
- (d) whether facilities for treatment of cancer patients is available in the hospitals at Leh and Kargil districts and if so, the details thereof and if not, the reasons therefor including the alternative treatment and funding plan being made available to these patients; and
- (e)  whether the Government has devised any concrete action plan to control this fatal disease in the country more particularly in the UT of Ladakh and if so, the details thereof and the steps taken in this regard?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (DR MANSUKH MANDAVIYA)

(a) to (e) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 145* FOR 11 TH  FEBRUARY, 2022

(a) and (b): As per the Indian Council of Medical Research's Cancer Registry Data Report  on  'National  Cancer  Registry  Programme  Report,  2020',  the  estimated number of incidence and mortality of cancer cases in the country including Ladakh UT  (Leh  and  Kargil)  during  2018  to  2020  by  State/UT  wise  is  enclosed  in Annexure 1 (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, alcohol, unhealthy diet and air pollution.

(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  including  Ladakh  UT  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.

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.  The  facility  for  treatment  of  cancer  patients  is  available  in  the hospitals  at  Leh  District  &  Kargil  District  and  patients  are  being  provided chemotherapy. Under NPCDCS, 2 District NCD Clinics, 2 Cardiac Care Units, 2 District Day Care Centres and 5 CHC NCD Clinics have been set up in Ladakh UT.

A  population-based  initiative for prevention,  control and  screening  for common  Non-Communicable  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.  As  on 31 st January  2022,  110  HWCs  have  been  operationalized  in  Ladakh  UT.  The number of persons screened so far through Health and Wellness Centres includes 18,680 for oral cancer, 9,569 for breast cancer and 6,938 for cervical cancers.

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).

There is focus on Oncology in its various aspects in case of 22 new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).  Treatment  of  Cancers  is  also  available  under  Ayushman  Bharat  Pradhan Mantri Jan Arogya Yojana (PMJAY). Financial assistance is provided to poor patients belonging to families living below poverty line, suffering from major life-threatening  diseases  including  Cancer  under  Umbrella  scheme  of  Rashtriya Arogya  Nidhi  and  Health  Minister's  Discretionary  Grant  (HMDG).  Financial assistance upto a maximum of Rs. 1,25,000/- is provided under HMDG to defray a part of the treatment cost and the maximum financial assistance provided under the Umbrella Scheme of RAN is Rs. 15 lakhs.

Quality generic medicines are made available at affordable prices to all, under Pradhan  Mantri  Bhartiya  Janaushadhi  Pariyojana  (PMBJP)  in  collaboration  with the State Governments. Three Jan Aushadhi Kendras have been set up in Ladakh UT under the scheme.

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           | 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       |
| Total                    | 13,25,232 | 13,58,415 | 13,92,179 |

* 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           | 6,670    | 6,845    | 7,027    |
| Ladakh                   | 154      | 158      | 162      |
| Himachal Pradesh         | 4,642    | 4,744    | 4,856    |
| Punjab                   | 21,278   | 21,763   | 22,276   |
| Chandigarh               | 532      | 548      | 564      |
| Uttaranchal              | 6,028    | 6,184    | 6,337    |
| Haryana                  | 15,255   | 15,684   | 16,109   |
| Delhi                    | 13,218   | 13,644   | 14,057   |
| Rajasthan                | 37,123   | 38,100   | 39,111   |
| Uttar Pradesh            | 1,06,350 | 1,08,911 | 1,11,491 |
| Bihar                    | 54,566   | 56,028   | 57,531   |
| Sikkim                   | 270      | 275      | 276      |
| Arunachal Pradesh        | 612      | 622      | 635      |
| Nagaland                 | 961      | 982      | 1,008    |
| Manipur                  | 1,047    | 1,070    | 1,105    |
| Mizoram                  | 1,119    | 1,149    | 1,183    |
| Tripura                  | 1,496    | 1,526    | 1,571    |
| Meghalaya                | 1,791    | 1,837    | 1,887    |
| Assam                    | 21,715   | 22,261   | 22,824   |
| West Bengal              | 56,988   | 58,368   | 59,786   |
| Jharkhand                | 17,710   | 18,215   | 18,716   |
| Orissa                   | 26,810   | 27,427   | 28,024   |
| Chhattisgarh             | 14,522   | 14,891   | 15,279   |
| Madhya Pradesh           | 40,798   | 41,876   | 42,966   |
| Gujarat                  | 36,325   | 37,300   | 38,306   |
| Daman                    | 55       | 63       | 66       |
| Dadra &Nagar Haveli      | 92       | 102      | 109      |
| Maharashtra              | 60,814   | 62,291   | 63,797   |
| Telangana                | 24,788   | 25,408   | 26,038   |
| Andhra Pradesh           | 36,884   | 37,724   | 38,582   |
| Karnataka                | 44,775   | 45,926   | 47,113   |
| Goa                      | 848      | 877      | 893      |
| Lakshadweep              | 13       | 13       | 13       |
| Kerala                   | 30,057   | 30,615   | 31,166   |
| Tamil Nādu               | 45,846   | 47,075   | 48,314   |
| Pondicherry              | 794      | 820      | 852      |
| Andaman &Nicobar Islands | 193      | 195      | 200      |
| Total                    | 7,33,139 | 7,51,517 | 7,70,230 |

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.