Lok Sabha Question No. 3425 (UNSTARRED), answered on 2016-08-05
Subject: Cancer Patients and Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SANJAY SHAMRAO DHOTRE, RAHUL RAMESH SHEWALE, BHARTRUHARI MAHTAB

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

## LOK SABHA UNSTARRED  QUESTION NO. 3425 TO BE ANSWERED ON 5 TH AUGUST, 2016

## CANCER PATIENTS AND DEATHS

## 3425. SHRI SANJAY DHOTRE: SHRI RAHUL SHEWALE: SHRI BHARTRUHARI MAHTAB:

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

(a)  whether  the  National  Programme  for Prevention  and  Control  of  Cancer,  Diabetes, Cardiovascular  Diseases  and  Stroke (NPCDCS)  has  achieved  its  objectives, especially with regard to Cancer and if so, the details thereof and if not, the reasons the for;

(b) whether  a sharp increase has been recorded  in  cancer  patients  and  deaths reported in the country and if so, the details thereof during the last three years and the current year, State/UT wise and the reasons therefor;

(c)  whether  the  cancer  patients  living Below  Poverty  Line  (BPL)  are  being  denied cancer treatment by private sector hospitals in the country, if so, the number of such cases reported during the said period, State/ UT - wise; and

(d) the new initiatives/steps taken by the Government to control the spread of cancer diseases in the country and to ensure adequate and timely treatment to cancer patients particularly of BPL?

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

(SMT. ANUPRIYA PATEL

## )

(a) to (d): While, Public Health is a State subject, the Central Government is implement the  National  Programme  for  Prevention  and  Control  of  Cancer,  Diabetes,  Car diovascular Diseases and Stroke (NPCDCS), under National Health Mission (NHM) for interventions upt the district level, to support the State Governments. The objectives of the programme awareness  generation  for  Cancer  prevention,  screening,  early detection  and  referral  to  an appropriate  level  institution  for  treatment.  For  Cancer  the  focus  is  on three  types  of  Cancer namely  breast,  cervical  and  oral  Cancer. As  informed  by  the  State  Governments,  1880  NCD Clinics at Community Health, 298 District NCD Cells, 88 CCU and 64 Day Care Centres have been  set  up  under  the  programme.  Operational  guidelines  have  been  released  for  preven control and screening of Diabetes, Hypertension and common Cancers (Cervix, Breast and Or to the States for implement ation.

As per Indian Council of Medical Research's National Cancer Registry data, there has been an increase in the estimated incidence and mortality due to cancer in the countr estimates of incidence and mortality of cancer patients in India durin g the last three years and current year, State/UT wise are at Annexure I & II.

Cancer  is  a  multi  factorial  disease,  the  risk  factors  of  which  inter  alia  inclu population,  unhealthy  life  styles,  use  of  tobacco  and  tobacco  products,  unhealthy  die t  &  air pollution.

Public Health is a State subject and the information regarding instances, if any, o patients  living  Below  Poverty  Line  (BPL)  being  denied  cancer  treatment  by  private  s hospitals in the country is not maintained centrally.

The treatment of Cancer in many of State and Centre Government institutions is free fo patients and subsidized for others. The Central Government supplements the efforts of th Governments to prevent and control cancer. Some of the steps taken by Central Government are as follows:

- I. Implementation  of  NPCDCS  upto  district  hospital  level.  Further,  the  guidelines population  level  screening  of  common  cancer  viz.  Cervix,  Breast  and  Oral  have  be released to the State Government for implementation .
- II. To  enhance  the  facilities  for  tertiary  care  of  cancer,  the  Central  Governme implementing  a  Tertiary  Care  for  Cancer  Scheme  to  support  the  setting  up  of  St Cancer Institutes (SCI) and Tertiary Care Cancer Centres (TCCC) in different parts country. The proposals for 9 SCIs and 8 TCCCs have been approved and funds have bee released.
- III. Supporting Cancer care under new AIIMS and State Government Medical Colleges being upgraded under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).
- IV. Setting up o f 2nd campus of Chittaranjan National Cancer Institute, Kolkata and Nation Cancer  Institute  (NCI)  as  part  of  second  campus  of  AIIMS,  New  Delhi  has  been approved.
- V. The Government is providing financial assistance to patients living below poverty li life  threatening  diseases  under  the  schemes    such  as  Rashtriya  Arogya  Nidhi  (RA Health Minister's Cancer Patient Fund (HMCPF), State Illness Assistance Fund (SIAF) and Health Minister's Discretionary Grant (HMDG).
- VI. Seven Affordable Medicines and Reliabl e Implants for Treatment (AMRIT) outlets have been  opened  at  Central  Government  institutions  with  an  objective  to  make  availa Cancer  and  Cardiovascular  Diseases  drugs  and  implants  at  discounted  prices  to patients. Opening of such outlets at eight ot her Central Government Institutions has been approved.
- VII. The  list  of  medicines  specified  in  the  National  List  of  Essential  Medicines  (N which are included in the First Schedule of Drug Pricing Control Order (DPCO), 20 also contain drugs used for the t eatment of Cancer for which ceiling prices have been fixed.

| Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes   |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Incidence of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |
|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|
| States                                                                                                          |                                                                                                            2013 |                                                                                                            2014 |                                                                                                            2015 |                                                                                                            2016 |
| Jammu &Kashmir                                                                                                  |                                                                                                           13404 |                                                                                                           14115 |                                                                                                           14864 |                                                                                                           15652 |
| Himachal Pradesh                                                                                                |                                                                                                            7140 |                                                                                                            7425 |                                                                                                            7722 |                                                                                                            8029 |
| Punjab                                                                                                          |                                                                                                           28835 |                                                                                                           30002 |                                                                                                           31214 |                                                                                                           32474 |
| Chandigarh                                                                                                      |                                                                                                            1110 |                                                                                                            1162 |                                                                                                            1217 |                                                                                                            1274 |
| Uttaranchal                                                                                                     |                                                                                                           10709 |                                                                                                           11240 |                                                                                                           11796 |                                                                                                           12381 |
| Haryana                                                                                                         |                                                                                                           26688 |                                                                                                           27933 |                                                                                                           29240 |                                                                                                           30611 |
| Delhi                                                                                                           |                                                                                                           17578 |                                                                                                           18356 |                                                                                                           19168 |                                                                                                           20015 |
| Rajasthan                                                                                                       |                                                                                                           72275 |                                                                                                           75642 |                                                                                                           79160 |                                                                                                           82836 |
| Uttar Pradesh                                                                                                   |                                                                                                          212075 |                                                                                                          222615 |                                                                                                          233659 |                                                                                                          245231 |
| Bihar                                                                                                           |                                                                                                          111572 |                                                                                                          117603 |                                                                                                          123949 |                                                                                                          130628 |
| Sikkim                                                                                                          |                                                                                                             462 |                                                                                                             467 |                                                                                                             473 |                                                                                                             479 |
| Arunachal Pradesh                                                                                               |                                                                                                            1212 |                                                                                                            1231 |                                                                                                            1252 |                                                                                                            1272 |
| Nagaland                                                                                                        |                                                                                                            1284 |                                                                                                            1288 |                                                                                                            1294 |                                                                                                            1300 |
| Manipur                                                                                                         |                                                                                                            2759 |                                                                                                            2836 |                                                                                                            2916 |                                                                                                            2998 |
| Mizoram                                                                                                         |                                                                                                            1552 |                                                                                                            1585 |                                                                                                            1618 |                                                                                                            1652 |
| Tripura                                                                                                         |                                                                                                            2110 |                                                                                                            2139 |                                                                                                            2169 |                                                                                                            2199 |
| Meghalaya                                                                                                       |                                                                                                            3121 |                                                                                                            3184 |                                                                                                            3246 |                                                                                                            3311 |
| Assam                                                                                                           |                                                                                                           30775 |                                                                                                           31124 |                                                                                                           31474 |                                                                                                           31825 |
| West Bengal                                                                                                     |                                                                                                           95316 |                                                                                                           99339 |                                                                                                          103532 |                                                                                                          107906 |
| Jharkhand                                                                                                       |                                                                                                           35206 |                                                                                                           37031 |                                                                                                           38947 |                                                                                                           40959 |
| Orissa                                                                                                          |                                                                                                           43882 |                                                                                                           45736 |                                                                                                           47666 |                                                                                                           49674 |
| Chhattisgarh                                                                                                    |                                                                                                           27310 |                                                                                                           28738 |                                                                                                           30239 |                                                                                                           31817 |
| Madhya Pradesh                                                                                                  |                                                                                                           77175 |                                                                                                           81034 |                                                                                                           85078 |                                                                                                           89315 |
| Gujarat                                                                                                         |                                                                                                           63884 |                                                                                                           66952 |                                                                                                           70171 |                                                                                                           73551 |
| Daman &Diu                                                                                                      |                                                                                                             299 |                                                                                                             339 |                                                                                                             385 |                                                                                                             440 |
| Dadra &Nagar Haveli                                                                                             |                                                                                                             389 |                                                                                                             421 |                                                                                                             457 |                                                                                                             497 |
| Maharashtra                                                                                                     |                                                                                                          117317 |                                                                                                          122256 |                                                                                                          127390 |                                                                                                          132726 |
| Telangana                                                                                                       |                                                                                                           36885 |                                                                                                           38494 |                                                                                                           40177 |                                                                                                           41939 |
| Andhra Pradesh                                                                                                  |                                                                                                           51462 |                                                                                                           53570 |                                                                                                           55776 |                                                                                                           58072 |
| Karnataka                                                                                                       |                                                                                                           64306 |                                                                                                           67237 |                                                                                                           70302 |                                                                                                           73511 |
| Goa                                                                                                             |                                                                                                            1522 |                                                                                                            1587 |                                                                                                            1655 |                                                                                                            1726 |
| Lakshadweep                                                                                                     |                                                                                                              71 |                                                                                                              77 |                                                                                                              82 |                                                                                                              89 |
| Kerala                                                                                                          |                                                                                                           35620 |                                                                                                           37550 |                                                                                                           39672 |                                                                                                           42004 |
| Tamil Nadu                                                                                                      |                                                                                                           73736 |                                                                                                           76091 |                                                                                                           78512 |                                                                                                           80999 |
| Pondicherry                                                                                                     |                                                                                                            1351 |                                                                                                            1428 |                                                                                                            1510 |                                                                                                            1596 |
| Andaman & Nicobar Islands                                                                                       |                                                                                                             389 |                                                                                                             402 |                                                                                                             415 |                                                                                                             429 |
| Total                                                                                                           |                                                                                                         1270781 |                                                                                                         1328229 |                                                                                                         1388397 |                                                                                                         1451417 |

Ref: Three-year Report of the PBCRs: 2012-2014, Bengaluru, 2016 *Projected cancer cases for India were computed using a projected incidence

rates and the population (person-years)

| Estimated Mortality of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes   |   Estimated Mortality of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Mortality of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Mortality of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |   Estimated Mortality of cancer cases in India by different State/UT - All sites - (2013 to 2016)* - Both sexes |
|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------|
| States                                                                                                          |                                                                                                            2013 |                                                                                                            2014 |                                                                                                            2015 |                                                                                                            2016 |
| Jammu &Kashmir                                                                                                  |                                                                                                            6782 |                                                                                                            7144 |                                                                                                            7525 |                                                                                                            7925 |
| Himachal Pradesh                                                                                                |                                                                                                            3598 |                                                                                                            3742 |                                                                                                            3893 |                                                                                                            4048 |
| Punjab                                                                                                          |                                                                                                           14580 |                                                                                                           15171 |                                                                                                           15784 |                                                                                                           16423 |
| Chandigarh                                                                                                      |                                                                                                             563 |                                                                                                             590 |                                                                                                             618 |                                                                                                             646 |
| Uttaranchal                                                                                                     |                                                                                                            5399 |                                                                                                            5667 |                                                                                                            5949 |                                                                                                            6245 |
| Haryana                                                                                                         |                                                                                                           13505 |                                                                                                           14135 |                                                                                                           14797 |                                                                                                           15491 |
| Delhi                                                                                                           |                                                                                                            8897 |                                                                                                            9290 |                                                                                                            9699 |                                                                                                           10127 |
| Rajasthan                                                                                                       |                                                                                                           36495 |                                                                                                           38202 |                                                                                                           39985 |                                                                                                           41848 |
| Uttar Pradesh                                                                                                   |                                                                                                          107170 |                                                                                                          112514 |                                                                                                          118115 |                                                                                                          123985 |
| Bihar                                                                                                           |                                                                                                           56372 |                                                                                                           59431 |                                                                                                           62651 |                                                                                                           66040 |
| Sikkim                                                                                                          |                                                                                                             234 |                                                                                                             236 |                                                                                                             240 |                                                                                                             242 |
| Arunachal Pradesh                                                                                               |                                                                                                             619 |                                                                                                             628 |                                                                                                             638 |                                                                                                             649 |
| Nagaland                                                                                                        |                                                                                                             659 |                                                                                                             662 |                                                                                                             665 |                                                                                                             667 |
| Manipur                                                                                                         |                                                                                                            1381 |                                                                                                            1419 |                                                                                                            1460 |                                                                                                            1500 |
| Mizoram                                                                                                         |                                                                                                             791 |                                                                                                             808 |                                                                                                             824 |                                                                                                             841 |
| Tripura                                                                                                         |                                                                                                            1079 |                                                                                                            1094 |                                                                                                            1109 |                                                                                                            1125 |
| Meghalaya                                                                                                       |                                                                                                            1612 |                                                                                                            1644 |                                                                                                            1676 |                                                                                                            1710 |
| Assam                                                                                                           |                                                                                                           15677 |                                                                                                           15853 |                                                                                                           16029 |                                                                                                           16206 |
| West Bengal                                                                                                     |                                                                                                           48075 |                                                                                                           50110 |                                                                                                           52231 |                                                                                                           54443 |
| Jharkhand                                                                                                       |                                                                                                           17760 |                                                                                                           18683 |                                                                                                           19653 |                                                                                                           20671 |
| Orissa                                                                                                          |                                                                                                           22105 |                                                                                                           23043 |                                                                                                           24019 |                                                                                                           25035 |
| Chhattisgarh                                                                                                    |                                                                                                           13751 |                                                                                                           14472 |                                                                                                           15231 |                                                                                                           16030 |
| Madhya Pradesh                                                                                                  |                                                                                                           38962 |                                                                                                           40917 |                                                                                                           42964 |                                                                                                           45110 |
| Gujarat                                                                                                         |                                                                                                           32275 |                                                                                                           33832 |                                                                                                           35466 |                                                                                                           37182 |
| Daman &Diu                                                                                                      |                                                                                                             154 |                                                                                                             176 |                                                                                                             200 |                                                                                                             229 |
| Dadra &Nagar Haveli                                                                                             |                                                                                                             198 |                                                                                                             215 |                                                                                                             233 |                                                                                                             254 |
| Maharashtra                                                                                                     |                                                                                                           59231 |                                                                                                           61732 |                                                                                                           64332 |                                                                                                           67035 |
| Telangana                                                                                                       |                                                                                                           18573 |                                                                                                           19385 |                                                                                                           20235 |                                                                                                           21126 |
| Andhra Pradesh                                                                                                  |                                                                                                           25904 |                                                                                                           26970 |                                                                                                           28082 |                                                                                                           29244 |
| Karnataka                                                                                                       |                                                                                                           32401 |                                                                                                           33881 |                                                                                                           35430 |                                                                                                           37052 |
| Goa                                                                                                             |                                                                                                             767 |                                                                                                             799 |                                                                                                             834 |                                                                                                             870 |
| Lakshadweep                                                                                                     |                                                                                                              36 |                                                                                                              39 |                                                                                                              42 |                                                                                                              45 |
| Kerala                                                                                                          |                                                                                                           17858 |                                                                                                           18827 |                                                                                                           19892 |                                                                                                           21062 |
| Tamil Nadu                                                                                                      |                                                                                                           37118 |                                                                                                           38310 |                                                                                                           39537 |                                                                                                           40796 |
| Pondicherry                                                                                                     |                                                                                                             678 |                                                                                                             717 |                                                                                                             759 |                                                                                                             802 |
| Andaman & Nicobar Islands                                                                                       |                                                                                                             196 |                                                                                                             203 |                                                                                                             210 |                                                                                                             217 |
| Total                                                                                                           |                                                                                                          641455 |                                                                                                          670541 |                                                                                                          701007 |                                                                                                          732921 |

Ref: Three-year Report of the PBCRs: 2012-2014, Bengaluru, 2016

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