Lok Sabha Question No. 1436 (UNSTARRED), answered on 2023-02-10
Subject: Rising Cases of Cancer
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ravneet Singh

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

## LOK SABHA UNSTARRED QUESTION NO. 1436 TO BE ANSWERED ON 10 th  FEBRUARY, 2023

## RISING CASES OF CANCER

## 1436.   SHRI RAVNEET SINGH BITTU:

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

- (a) whether there is an increase in breast cancer related cases, especially in the urban areas of the country and if so, the details thereof, State/UT-wise particularly in the State of Punjab;
- (b) whether there has also been an increase in the overall cancer cases in the country and if so, the  details  thereof  during  the  last  three  years,  type-wise,  year-wise  and  State/UT-wise particularly in the State of Punjab;
- (c) whether views have been expressed by some medical experts that India is likely to face a tsunami of chronic diseases like Cancer and if so, the details thereof along with the reasons for this rise;
- (d) whether the Government has done any study on this alarming rise in cancer cases in the country and if so, the details thereof; and
- (e) the steps taken or proposed to be taken by the Government to check the rising cancer cases in the country?

## ANSWER

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

(a)  to  (d):  As  per  the  Indian  Council  of  Medical  Research's  National  Cancer  Registry Programme Report, 2020, the estimated number of incidences of cancer cases of breast cancer by States / UTs wise including State of Punjab are enclosed in Annexure 1.

As per the Indian Council of Medical Research - National Cancer Registry Programme (ICMRNCRP), the estimated number of incidence of cancer cases by States / UTs wise during 2020 to 2022 for last three years are enclosed in Annexure 2.

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.

(e): The Department of Health & Family Welfare, Government of India, 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. Three most common types of cancers (oral cancer, breast cancer and cervical 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  (NCDs),  including Cancer.

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& World Cancer Day and use of print, electronic and social media for continued community awareness. Furthermore, healthy eating is also promoted through Food Safety  and  Standards  Authority  of  India  (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 taken by the States/UTs as per their Programme Implementation Plans (PIPs).

The Central Government implements Strengthening of Tertiary Cancer Care Centres Facilities Scheme in order to enhance the facilities for tertiary care of cancer. 19 State Cancer Institutes

(SCIs)  and  20  Tertiary  Cancer  Care  Centres  (TCCCs)  have  been  approved  under  the  said scheme. Seven facilities are completed so far.

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-à-vis the Maximum Retail Price.

*****

| Table 1: Estimated Incidence of cancer cases in India by State / UTs wise - Breast (2020)*- Females   | Table 1: Estimated Incidence of cancer cases in India by State / UTs wise - Breast (2020)*- Females   |
|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|
| States/UTs                                                                                            | 2020                                                                                                  |
| Jammu &Kashmir                                                                                        | 1812                                                                                                  |
| Ladakh UT                                                                                             | 37                                                                                                    |
| Himachal Pradesh                                                                                      | 1342                                                                                                  |
| Punjab                                                                                                | 6192                                                                                                  |
| Chandigarh                                                                                            | 168                                                                                                   |
| Uttaranchal                                                                                           | 1723                                                                                                  |
| Haryana                                                                                               | 4356                                                                                                  |
| Delhi                                                                                                 | 3491                                                                                                  |
| Rajasthan                                                                                             | 10597                                                                                                 |
| Uttar Pradesh                                                                                         | 28573                                                                                                 |
| Bihar                                                                                                 | 14388                                                                                                 |
| Sikkim                                                                                                | 33                                                                                                    |
| Arunachal Pradesh                                                                                     | 71                                                                                                    |
| Nagaland                                                                                              | 87                                                                                                    |
| Manipur                                                                                               | 170                                                                                                   |
| Mizoram                                                                                               | 122                                                                                                   |
| Tripura                                                                                               | 167                                                                                                   |
| Meghalaya                                                                                             | 89                                                                                                    |
| Assam                                                                                                 | 2880                                                                                                  |
| West Bengal                                                                                           | 16155                                                                                                 |
| Jharkhand                                                                                             | 5016                                                                                                  |
| Orissa                                                                                                | 7508                                                                                                  |
| Chhattisgarh                                                                                          | 4274                                                                                                  |
| Madhya Pradesh                                                                                        | 11501                                                                                                 |
| Gujarat                                                                                               | 10631                                                                                                 |
| Daman                                                                                                 | 32                                                                                                    |
| Dadra &Nagar Haveli                                                                                   | 44                                                                                                    |
| Maharashtra                                                                                           | 18174                                                                                                 |
| Telangana                                                                                             | 7491                                                                                                  |
| Andhra Pradesh                                                                                        | 11174                                                                                                 |
| Karnataka                                                                                             | 13427                                                                                                 |
| Goa                                                                                                   | 277                                                                                                   |
| Lakshadweep                                                                                           | 14                                                                                                    |
| Kerala                                                                                                | 8382                                                                                                  |
| Tamil Nadu                                                                                            | 14659                                                                                                 |
| Pondicherry                                                                                           | 297                                                                                                   |
| Andaman &Nicobar Islands                                                                              | 70                                                                                                    |
| Total                                                                                                 | 2,05,424                                                                                              |

| Table 2: Estimated incidence of cancer cases in India by States/UTs wise - All sites (ICD10: C00-C97) - (2020-2022) - both sexes   | Table 2: Estimated incidence of cancer cases in India by States/UTs wise - All sites (ICD10: C00-C97) - (2020-2022) - both sexes   | Table 2: Estimated incidence of cancer cases in India by States/UTs wise - All sites (ICD10: C00-C97) - (2020-2022) - both sexes   | Table 2: Estimated incidence of cancer cases in India by States/UTs wise - All sites (ICD10: C00-C97) - (2020-2022) - both sexes   |
|------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------|
| State                                                                                                                              | 2020                                                                                                                               | 2021                                                                                                                               | 2022                                                                                                                               |
| Jammu &Kashmir                                                                                                                     | 12726                                                                                                                              | 13060                                                                                                                              | 13395                                                                                                                              |
| Ladakh                                                                                                                             | 286                                                                                                                                | 294                                                                                                                                | 302                                                                                                                                |
| Himachal Pradesh                                                                                                                   | 8799                                                                                                                               | 8978                                                                                                                               | 9164                                                                                                                               |
| Punjab                                                                                                                             | 38636                                                                                                                              | 39521                                                                                                                              | 40435                                                                                                                              |
| Chandigarh                                                                                                                         | 1024                                                                                                                               | 1053                                                                                                                               | 1088                                                                                                                               |
| Uttaranchal                                                                                                                        | 11482                                                                                                                              | 11779                                                                                                                              | 12065                                                                                                                              |
| Haryana                                                                                                                            | 29219                                                                                                                              | 30015                                                                                                                              | 30851                                                                                                                              |
| Delhi                                                                                                                              | 25178                                                                                                                              | 25969                                                                                                                              | 26735                                                                                                                              |
| Rajasthan                                                                                                                          | 70987                                                                                                                              | 72825                                                                                                                              | 74725                                                                                                                              |
| Uttar Pradesh                                                                                                                      | 201319                                                                                                                             | 206088                                                                                                                             | 210958                                                                                                                             |
| Bihar                                                                                                                              | 103711                                                                                                                             | 106435                                                                                                                             | 109274                                                                                                                             |
| Sikkim                                                                                                                             | 445                                                                                                                                | 465                                                                                                                                | 496                                                                                                                                |
| Arunachal Pradesh                                                                                                                  | 1035                                                                                                                               | 1064                                                                                                                               | 1087                                                                                                                               |
| Nagaland                                                                                                                           | 1768                                                                                                                               | 1805                                                                                                                               | 1854                                                                                                                               |
| Manipur                                                                                                                            | 1899                                                                                                                               | 2022                                                                                                                               | 2097                                                                                                                               |
| Mizoram                                                                                                                            | 1837                                                                                                                               | 1919                                                                                                                               | 1985                                                                                                                               |
| Tripura                                                                                                                            | 2574                                                                                                                               | 2623                                                                                                                               | 2715                                                                                                                               |
| Meghalaya                                                                                                                          | 2879                                                                                                                               | 2943                                                                                                                               | 3025                                                                                                                               |
| Assam                                                                                                                              | 37880                                                                                                                              | 38834                                                                                                                              | 39787                                                                                                                              |
| West Bengal                                                                                                                        | 108394                                                                                                                             | 110972                                                                                                                             | 113581                                                                                                                             |
| Jharkhand                                                                                                                          | 33961                                                                                                                              | 34910                                                                                                                              | 35860                                                                                                                              |
| Orissa                                                                                                                             | 50692                                                                                                                              | 51829                                                                                                                              | 52960                                                                                                                              |
| Chhattisgarh                                                                                                                       | 27828                                                                                                                              | 28529                                                                                                                              | 29253                                                                                                                              |
| Madhya Pradesh                                                                                                                     | 77888                                                                                                                              | 79871                                                                                                                              | 81901                                                                                                                              |
| Gujarat                                                                                                                            | 69660                                                                                                                              | 71507                                                                                                                              | 73382                                                                                                                              |
| Daman                                                                                                                              | 124                                                                                                                                | 135                                                                                                                                | 150                                                                                                                                |
| Dadra &Nagar Haveli                                                                                                                | 206                                                                                                                                | 219                                                                                                                                | 238                                                                                                                                |
| Maharashtra                                                                                                                        | 116121                                                                                                                             | 118906                                                                                                                             | 121717                                                                                                                             |
| Telangana                                                                                                                          | 47620                                                                                                                              | 48775                                                                                                                              | 49983                                                                                                                              |
| Andhra Pradesh                                                                                                                     | 70424                                                                                                                              | 71970                                                                                                                              | 73536                                                                                                                              |
| Karnataka                                                                                                                          | 85968                                                                                                                              | 88126                                                                                                                              | 90349                                                                                                                              |
| Goa                                                                                                                                | 1618                                                                                                                               | 1652                                                                                                                               | 1700                                                                                                                               |
| Lakshadweep                                                                                                                        | 27                                                                                                                                 | 28                                                                                                                                 | 28                                                                                                                                 |
| Kerala                                                                                                                             | 57155                                                                                                                              | 58139                                                                                                                              | 59143                                                                                                                              |
| Tamil Nadu                                                                                                                         | 88866                                                                                                                              | 91184                                                                                                                              | 93536                                                                                                                              |
| Pondicherry                                                                                                                        | 1577                                                                                                                               | 1623                                                                                                                               | 1679                                                                                                                               |
| Andaman &Nicobar Islands                                                                                                           | 366                                                                                                                                | 380                                                                                                                                | 393                                                                                                                                |
| Total                                                                                                                              | 13,92,179                                                                                                                          | 14,26,447                                                                                                                          | 14,61,427                                                                                                                          |