Lok Sabha Question No. 396 (UNSTARRED), answered on 2023-07-21
Subject: Cases of Cancer in North Eastern Region
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Pradyut Bordoloi

## GOVERNMENT OFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 396 TO BE ANSWERED ON 21 st JULY, 2023

## CASES OF CANCER IN NORTH EASTERN REGION

## 396. SHRI PRADYUT BORDOLOI:

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

- (a) whether the Government has taken cognizance of the high burden of cancer cases in the North Eastern region, and if so, the details thereof including the region's percentage share in the total cases in the country, year-wise over the past 5 years;
- (b) the details of the number of cases, its gender distribution and types of prevalent cancers, State/UTwise;
- (c) whether the Government has conducted any study to assess the reasons for high prevalence of cancer in the North East, and if so, the measures being taken to address the localized causes;
- (d) the steps being taken/proposed to be taken by the Government towards prevention and early detection of cancer in the North East; and
- (e) whether the Government is taking any steps to make quality treatment affordable and accessible to cancer patients in the North East and if so, the details thereof?

## ANSWER THE MINISTER OFSTATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (PROF. SATYA PAL SINGH BAGHEL)

(a) & (b): As per the Indian Council of Medical Research- National Centre for Disease Informatics and Research (ICMR-NCDIR) National Cancer Registry Programme (NCRP), the estimated number of incidences of cancer cases in the North Eastern region is given below:

| Estimated Incidence of cancer cases in North East Region of India - All sites (ICD10: C00-C97) - (2019-2022)* - Both sexes   |   Estimated Incidence of cancer cases in North East Region of India - All sites (ICD10: C00-C97) - (2019-2022)* - Both sexes |   Estimated Incidence of cancer cases in North East Region of India - All sites (ICD10: C00-C97) - (2019-2022)* - Both sexes |   Estimated Incidence of cancer cases in North East Region of India - All sites (ICD10: C00-C97) - (2019-2022)* - Both sexes |   Estimated Incidence of cancer cases in North East Region of India - All sites (ICD10: C00-C97) - (2019-2022)* - Both sexes |   Estimated Incidence of cancer cases in North East Region of India - All sites (ICD10: C00-C97) - (2019-2022)* - Both sexes |
|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|
| Region                                                                                                                       |                                                                                                                         2018 |                                                                                                                         2019 |                                                                                                                         2020 |                                                                                                                         2021 |                                                                                                                         2022 |
| North East                                                                                                                   |                                                                                                                        47881 |                                                                                                                        49067 |                                                                                                                        50317 |                                                                                                                        51675 |                                                                                                                        53046 |

The North East region of India accounts for 3.6% of the total cancer incidence cases in the country during the last five years.

As per ICMR-NCDIR, National Cancer Registry Programme Report 2020, the number of cancer cases by gender and types of leading site of cancers in North Eastern Population Based Cancer Registries (PBCR) are enclosed in Annexure 1.

(c) Under the Cancer Research North East (CaRes NER) multidisciplinary programme, implemented by ICMR-NCDIR, a monitoring survey between November 2019 to April 2021 was conducted to generate key cancer and other NCD related risk factors and health system response indicators in 12 Population Based Cancer Registries in 8 states of North East India. The results are available on:https://ncdirindia.org/All\_Reports/NE\_Report\_2022/Default.aspx.

(d) and (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 NonCommunicable Diseases (NP-NCD), 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 NP-NCD. 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. Under NP-NCD, 724 District NCD Clinics, 326 District Day Care Centres and 6110 Community Health Center NCD Clinics has been set up. For activities upto District level and below, states are given financial assistance under NHM in the ratio of 60:40 (90:10 in case NE and hilly states). The infrastructure status related to NP-NCD Programme in North -Eastern Region till 31 st March 2023:

| S. No.   | State/UT          | No. of Facilities (Cumulative till March-2023)   | No. of Facilities (Cumulative till March-2023)   |
|----------|-------------------|--------------------------------------------------|--------------------------------------------------|
| S. No.   | State/UT          | District NCDClinics                              | CHCNCD Clinics                                   |
| 1        | Arunachal Pradesh | 25                                               | 53                                               |
| 2        | Assam             | 33                                               | 178                                              |
| 3        | Manipur           | 16                                               | 18                                               |
| 4        | Meghalaya         | 11                                               | 28                                               |
| 5        | Mizoram           | 8                                                | 10                                               |
| 6        | Nagaland          | 11                                               | 15                                               |
| 7        | Sikkim            | 4                                                | 2                                                |
| 8        | Tripura           | 7                                                | 22                                               |
| Total    | Total             | 115                                              | 326                                              |

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, NP-NCD 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. Seventeen facilities are functional so far. Out of which, five institutes in North -East are approved.

1. Gauhati Medical College & Hospital, Assam (SCI)
2. State Cancer Institute, Aizwal, Mizoram (TCCC)
3. District Hospital, Kohima, Nagaland (TCCC)
4. Multispecialty Hospital at Sochygang, Sikkim (TCCC)
5. Cancer Hospital, Agartala, Tripura (SCI)

There is also focus on Oncology in its various aspects in case of AIIMS in Guwahati, Assam under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).

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.

## Annexure 1

| Total number of incidence of cancer cases and leading sites of cancer cases in North East   | Total number of incidence of cancer cases and leading sites of cancer cases in North East   | Total number of incidence of cancer cases and leading sites of cancer cases in North East   | Total number of incidence of cancer cases and leading sites of cancer cases in North East   | Total number of incidence of cancer cases and leading sites of cancer cases in North East   | Total number of incidence of cancer cases and leading sites of cancer cases in North East   | Total number of incidence of cancer cases and leading sites of cancer cases in North East   |
|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|
| PBCR                                                                                        | MALE                                                                                        | MALE                                                                                        | MALE                                                                                        | FEMALE                                                                                      | FEMALE                                                                                      | FEMALE                                                                                      |
| PBCR                                                                                        | Leading Sites (Rank)                                                                        | Leading Sites (Rank)                                                                        | Leading Sites (Rank)                                                                        | Leading Sites (Rank)                                                                        | Leading Sites (Rank)                                                                        | Leading Sites (Rank)                                                                        |
| PBCR                                                                                        | 1                                                                                           | 2                                                                                           | 3                                                                                           | 1                                                                                           | 2                                                                                           | 3                                                                                           |
| Manipur State                                                                               | Lung                                                                                        | Stomach                                                                                     | Nasopharynx                                                                                 | Breast                                                                                      | Lung                                                                                        | Cervix uteri                                                                                |
| Mizoram State                                                                               | Stomach                                                                                     | Oesophagus                                                                                  | Lung                                                                                        | Cervix uteri                                                                                | Lung                                                                                        | Breast                                                                                      |
| Sikkim State                                                                                | Stomach                                                                                     | Oesophagus                                                                                  | Lung                                                                                        | Breast                                                                                      | Cervix uteri                                                                                | Stomach                                                                                     |
| Tripura State                                                                               | Lung                                                                                        | Oesophagus                                                                                  | Larynx                                                                                      | Cervix uteri                                                                                | Breast                                                                                      | Gall bladder                                                                                |
| West Arunachal, Arunachal Pradesh                                                           | Stomach                                                                                     | Liver                                                                                       | Oesophagus                                                                                  | Stomach                                                                                     | Breast                                                                                      | Cervix uteri                                                                                |
| Meghalaya                                                                                   | Oesophagus                                                                                  | Hypopharynx                                                                                 | Stomach                                                                                     | Oesophagus                                                                                  | Cervix uteri                                                                                | Mouth                                                                                       |
| Nagaland                                                                                    | Nasopharynx                                                                                 | Stomach                                                                                     | Oesophagus                                                                                  | Cervix uteri                                                                                | Breast                                                                                      | Stomach                                                                                     |
| Pasighat, Arunachal Pradesh                                                                 | Stomach                                                                                     | Lung                                                                                        | Liver                                                                                       | Cervix uteri                                                                                | Breast                                                                                      | Stomach                                                                                     |
| Cachar, Assam                                                                               | Oesophagus                                                                                  | Hypopharynx                                                                                 | Lung                                                                                        | Cervix uteri                                                                                | Breast                                                                                      | Gall bladder                                                                                |
| Dibrugarh, Assam                                                                            | Oesophagus                                                                                  | Hypopharynx                                                                                 | Stomach                                                                                     | Breast                                                                                      | Gall bladder                                                                                | Ovary                                                                                       |
| Kamrup Urban, Assam                                                                         | Oesophagus                                                                                  | Hypopharynx                                                                                 | Lung                                                                                        | Breast                                                                                      | Oesophagu s                                                                                 | Gall bladder                                                                                |