Lok Sabha Question No. 2219 (UNSTARRED), answered on 2015-12-11
Subject: Cancer Among Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KRISHNA RAJ, RAHUL KASWAN, ALOK SANJAR, PONNUSAMY VENUGOPAL, VIRENDER KASHYAP

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

## LOK SABHA UNSTARRED QUESTION NO. 2219 TO BE ANSWERED ON 11 TH DECEMBER, 2015

## CANCER AMONG WOMEN

## 2219. SHRIMATI KRISHNA RAJ:

SHRI RAHUL KASWAN:

SHRI ALOK SANJAR:

DR. P. VENUGOPAL:

SHRI VIRENDER KASHYAP:

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

- (a) whether the numbers of various types of cancer in women, mainly breast cancer among urban women and cervical cancer among rural women have increased over the past few years;
- (b) if so, the details thereof and the reasons therefor indicating the number of such cases reported during each of the last three years and the current year, State/ UTwise;
- (c)  whether  the  Government  has conducted  any  study/survey  to  ascertain the  prevalence  of various types of cancer among women in the country, if so, the details and the outcome thereof;
- (d) the measures taken/proposed to be taken by the Government for prevention, early detection and aff ordable treatment of all types of cancer including cervical and breast cancer in women and spreading awareness in this regard; and
- (e) the steps taken/proposed to be taken by the Government to develop low cost cancer diagnosis tests for women and make them available in the country?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (SHRI JAGAT PRAKASH NADDA)

(a) & (b): As reported by ICMR, as per the Report on 'Time Trends in Cancer Incidence Rate: 1982 -2010', the Age Adjusted Incidence rates (AAR) show breast cancer is increasing in both urban and rural registries whereas cervical cancer is decreasing or remains static urban and rural registries.  The estimated incidence cancer cases for all sites, breast among women in India, State / Union Territory wise for the years 2012 to 2015 are at annexure I to III .

The increase in the number of cancer cases in the country may be attributed to number  of  ageing  population,  unhealthy  life  styles,  use  of  tobacco  and  tobacco  pro unhealthy diet, better diagnostic facilities etc.

- (c): The systematic collection of data on cancer is being carried out by various Popu Based Cancer Registries (PBCR) across India under the National Cancer Registry Programme ICMR since 1982. The number of estimated prevalent cancer cases of all sites of cancer amo women in the country for the year 2014 is 1571252.

(d) & (e) Central  Government  supplements  the  efforts  of  the  State  Government  for improving healthcare including prevention, diagno sis and treatment of Cancer.  At present, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disea and  Stroke  (NPCDCS)  being  implemented  under  National  Health  Mission  (NHM)  for interventions  upto  the  district  level  inc ludes  awareness  generation  for  Cancer  prevention, screening, early detection and referral to an appropriate level institution for treatment.

Screening  guidelines  for  breast,  cervical  and  oral  Cancer  have  been  provided  to Governments for implementa tion. Breast self examination is also promoted for early detect for breast cancer.

Screening for cervical cancer is by Visual Inspection with Acetic Acid (VIA) techn ICMR  has  launched  an  indigenous  instrument  called  Magnivisulizer  which  can  be  use d  by trained health workers for screening for early detection of cervical cancer. Suspected ca be  referred  for  confirmatory  diagnosis  by  various  tests  including  histo - pathological  biopsy. Electronic and Print media is utilized for health awarenes s for canc r.

Government of India has approved 'Tertiary Care for Cancer' Scheme under NPCDCS in the year 2013 - 14. Under the said scheme, Government of India assists to establish/set up Cancer  Institutes (SCI)  and  Tertiary  Care  Cancer  Centres  (TCCC)  in  different  parts  of  t country. The maximum assistance inclusive of State share for SCI is upto Rs.120 crore a TCCC  is  upto  Rs.45  crore  subject  to  eligibility  as  per  scheme  guidelines  and  availabi of funds.

The treatment for cancer in Government Hospitals is either free or subsidized. In a to  Cancer  diagnosis  and  treatment  by  the  State  Governments  Health  Institutes,  the  Ce Government Institutions such as All India Institute of Medical Sciences, Safdurjung Hospital, Dr  Ram  Manohar  Lohia  Hospital,  PGIMER  Chandigarh,  JIPMER  Puducherry,  Chittaranjan National Cancer Institute, Kolkata, etc. provide facilities for diagnosis and treatment of

Oncology  in  its  various  aspects  has  focu s in ase of new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).   Setting up of Natio Cancer Institute at Jhajjar (Haryana) and 2nd campus of Chittranjan National Cancer Ins Kolkata has also been approv ed.

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),  2013  a contain drugs used for the treatment of Cancer.  NLEM (drug formulations) medi cines for which ceiling prices have been notified under DPCO, 2013, includes 47 anti - Cancer medicines.  No person is authorized to sell any such formulation to any consumer at a price exceeding the price  fixed  by  the  National  Pharmaceutical  Pricing Authority  (NPPA)  under  Ministry  of Chemicals & Fertilizers.

Financial  assistance  to  Below  Poverty  Line  (BPL)  patients  is  available  under Rashtriya  Arogya  Nidhi  (RAN).    Besides  this,  the  Health  Minister's  Cancer  Patient  Fund (HMCPF)  within  the  Rashtriy a  Arogya  Nidhi  has  been  set  up  in  2009  wherein  27  erstwhile Regional  Cancer  Centres  (RCCs)  are  provided  with  revolving  funds  to  provide  immedia financial assistance upto Rs.2.00 lakh to BPL Cancer patients.

| Estimated Incidence cancer cases in India by different State /UT - All Sites- (2012-2015) - Females   |   Estimated Incidence cancer cases in India by different State /UT - All Sites- (2012-2015) - Females |   Estimated Incidence cancer cases in India by different State /UT - All Sites- (2012-2015) - Females |   Estimated Incidence cancer cases in India by different State /UT - All Sites- (2012-2015) - Females |   Estimated Incidence cancer cases in India by different State /UT - All Sites- (2012-2015) - Females |
|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|
| States                                                                                                |                                                                                                  2012 |                                                                                                  2013 |                                                                                                  2014 |                                                                                                  2015 |
| Jammu &Kashmir                                                                                        |                                                                                                  5573 |                                                                                                  5772 |                                                                                                  5978 |                                                                                                  6190 |
| Himachal pradesh                                                                                      |                                                                                                  3158 |                                                                                                  3235 |                                                                                                  3314 |                                                                                                  3395 |
| Punjab                                                                                                |                                                                                                 12206 |                                                                                                 12509 |                                                                                                 12818 |                                                                                                 13132 |
| Chandigarh                                                                                            |                                                                                                   446 |                                                                                                   459 |                                                                                                   473 |                                                                                                   487 |
| Uttaranchal                                                                                           |                                                                                                  4684 |                                                                                                  4839 |                                                                                                  4999 |                                                                                                  5164 |
| Haryana                                                                                               |                                                                                                 11152 |                                                                                                 11499 |                                                                                                 11857 |                                                                                                 12226 |
| Delhi                                                                                                 |                                                                                                  7286 |                                                                                                  7485 |                                                                                                  7689 |                                                                                                  7896 |
| Rajasthan                                                                                             |                                                                                                 31040 |                                                                                                 31983 |                                                                                                 32950 |                                                                                                 33942 |
| Uttar pradesh                                                                                         |                                                                                                 89747 |                                                                                                 92787 |                                                                                                 95917 |                                                                                                 99141 |
| Bihar                                                                                                 |                                                                                                 47102 |                                                                                                 48870 |                                                                                                 50698 |                                                                                                 52588 |
| Sikkim                                                                                                |                                                                                                   224 |                                                                                                   236 |                                                                                                   248 |                                                                                                   264 |
| Arunachal pradesh                                                                                     |                                                                                                   506 |                                                                                                   517 |                                                                                                   529 |                                                                                                   540 |
| Nagaland                                                                                              |                                                                                                   711 |                                                                                                   714 |                                                                                                   717 |                                                                                                   721 |
| Manipur                                                                                               |                                                                                                   982 |                                                                                                   968 |                                                                                                   955 |                                                                                                   944 |
| Mizoram                                                                                               |                                                                                                   409 |                                                                                                   417 |                                                                                                   425 |                                                                                                   432 |
| Tripura                                                                                               |                                                                                                  1391 |                                                                                                  1442 |                                                                                                  1498 |                                                                                                  1562 |
| Meghalaya                                                                                             |                                                                                                  1120 |                                                                                                  1142 |                                                                                                  1165 |                                                                                                  1188 |
| Assam                                                                                                 |                                                                                                 11459 |                                                                                                 11598 |                                                                                                 11737 |                                                                                                 11877 |
| West bengal                                                                                           |                                                                                                 41763 |                                                                                                 43029 |                                                                                                 44338 |                                                                                                 45691 |
| Jharkhand                                                                                             |                                                                                                 15183 |                                                                                                 15723 |                                                                                                 16280 |                                                                                                 16854 |
| Orissa                                                                                                |                                                                                                 19419 |                                                                                                 19936 |                                                                                                 20465 |                                                                                                 21006 |
| Chattisgarh                                                                                           |                                                                                                 12041 |                                                                                                 12472 |                                                                                                 12917 |                                                                                                 13377 |
| Madhya pradesh                                                                                        |                                                                                                 33055 |                                                                                                 34174 |                                                                                                 35325 |                                                                                                 36510 |
| Gujarat                                                                                               |                                                                                                 27238 |                                                                                                 28111 |                                                                                                 29012 |                                                                                                 29940 |
| Daman &Diu                                                                                            |                                                                                                    92 |                                                                                                    98 |                                                                                                   105 |                                                                                                   113 |
| Dadra &Nagar Haveli                                                                                   |                                                                                                   146 |                                                                                                   155 |                                                                                                   165 |                                                                                                   176 |
| Maharashtra                                                                                           |                                                                                                 50472 |                                                                                                 51747 |                                                                                                 53046 |                                                                                                 54366 |
| Telangana                                                                                             |                                                                                                 16604 |                                                                                                 17241 |                                                                                                 17916 |                                                                                                 18631 |
| Andhra pradesh                                                                                        |                                                                                                 23406 |                                                                                                 24305 |                                                                                                 25255 |                                                                                                 26262 |
| Karnataka                                                                                             |                                                                                                 28223 |                                                                                                 29034 |                                                                                                 29866 |                                                                                                 30720 |
| Goa                                                                                                   |                                                                                                   669 |                                                                                                   685 |                                                                                                   702 |                                                                                                   719 |
| Lakshadweep                                                                                           |                                                                                                    30 |                                                                                                    32 |                                                                                                    33 |                                                                                                    35 |
| Kerala                                                                                                |                                                                                                 16381 |                                                                                                 16956 |                                                                                                 17585 |                                                                                                 18272 |
| Tamil nadu                                                                                            |                                                                                                 33161 |                                                                                                 33648 |                                                                                                 34135 |                                                                                                 34621 |
| Pondicherry                                                                                           |                                                                                                   607 |                                                                                                   634 |                                                                                                   663 |                                                                                                   692 |
| Andaman & Nicobar Islands                                                                             |                                                                                                   164 |                                                                                                   167 |                                                                                                   170 |                                                                                                   173 |
| Total                                                                                                 |                                                                                                547850 |                                                                                                564619 |                                                                                                581945 |                                                                                                599847 |

*Based on cancer incidence report (2009-2011) and the Report on Time Trends in Cancer incidence Rates (1982-2010).

| Estimated Incidence cancer cases in India by different State / UT - Cervix- (2012-2015)- Females   |   Estimated Incidence cancer cases in India by different State / UT - Cervix- (2012-2015)- Females |   Estimated Incidence cancer cases in India by different State / UT - Cervix- (2012-2015)- Females |   Estimated Incidence cancer cases in India by different State / UT - Cervix- (2012-2015)- Females |   Estimated Incidence cancer cases in India by different State / UT - Cervix- (2012-2015)- Females |
|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|
| States                                                                                             |                                                                                               2012 |                                                                                               2013 |                                                                                               2014 |                                                                                               2015 |
| Jammu &Kashmir                                                                                     |                                                                                                944 |                                                                                                959 |                                                                                                974 |                                                                                                989 |
| Himachal pradesh                                                                                   |                                                                                                535 |                                                                                                538 |                                                                                                540 |                                                                                                543 |
| Punjab                                                                                             |                                                                                               2068 |                                                                                               2078 |                                                                                               2089 |                                                                                               2099 |
| Chandigarh                                                                                         |                                                                                                 76 |                                                                                                 76 |                                                                                                 77 |                                                                                                 78 |
| Uttaranchal                                                                                        |                                                                                                794 |                                                                                                804 |                                                                                                815 |                                                                                                825 |
| Haryana                                                                                            |                                                                                               1889 |                                                                                               1911 |                                                                                               1932 |                                                                                               1954 |
| Delhi                                                                                              |                                                                                               1234 |                                                                                               1244 |                                                                                               1253 |                                                                                               1262 |
| Rajasthan                                                                                          |                                                                                               5259 |                                                                                               5314 |                                                                                               5369 |                                                                                               5424 |
| Uttar pradesh                                                                                      |                                                                                              15205 |                                                                                              15417 |                                                                                              15630 |                                                                                              15843 |
| Bihar                                                                                              |                                                                                               7980 |                                                                                               8120 |                                                                                               8261 |                                                                                               8404 |
| Sikkim                                                                                             |                                                                                                 23 |                                                                                                 24 |                                                                                                 25 |                                                                                                 27 |
| Arunachal pradesh                                                                                  |                                                                                                 52 |                                                                                                 53 |                                                                                                 54 |                                                                                                 55 |
| Nagaland                                                                                           |                                                                                                 73 |                                                                                                 73 |                                                                                                 74 |                                                                                                 74 |
| Manipur                                                                                            |                                                                                                101 |                                                                                                 99 |                                                                                                 98 |                                                                                                 97 |
| Mizoram                                                                                            |                                                                                                 42 |                                                                                                 43 |                                                                                                 44 |                                                                                                 44 |
| Tripura                                                                                            |                                                                                                143 |                                                                                                148 |                                                                                                154 |                                                                                                160 |
| Meghalaya                                                                                          |                                                                                                115 |                                                                                                117 |                                                                                                119 |                                                                                                122 |
| Assam                                                                                              |                                                                                               1175 |                                                                                               1190 |                                                                                               1204 |                                                                                               1218 |
| West bengal                                                                                        |                                                                                               7076 |                                                                                               7150 |                                                                                               7225 |                                                                                               7302 |
| Jharkhand                                                                                          |                                                                                               2572 |                                                                                               2612 |                                                                                               2653 |                                                                                               2693 |
| Orissa                                                                                             |                                                                                               3290 |                                                                                               3313 |                                                                                               3335 |                                                                                               3357 |
| Chattisgarh                                                                                        |                                                                                               2040 |                                                                                               2072 |                                                                                               2105 |                                                                                               2138 |
| Madhya pradesh                                                                                     |                                                                                               5600 |                                                                                               5678 |                                                                                               5756 |                                                                                               5835 |
| Gujarat                                                                                            |                                                                                               4615 |                                                                                               4671 |                                                                                               4728 |                                                                                               4785 |
| Daman &Diu                                                                                         |                                                                                                 16 |                                                                                                 16 |                                                                                                 17 |                                                                                                 18 |
| Dadra &Nagar Haveli                                                                                |                                                                                                 25 |                                                                                                 26 |                                                                                                 27 |                                                                                                 28 |
| Maharashtra                                                                                        |                                                                                               8551 |                                                                                               8598 |                                                                                               8644 |                                                                                               8688 |
| Telangana                                                                                          |                                                                                               2814 |                                                                                               2865 |                                                                                               2919 |                                                                                               2977 |
| Andhra pradesh                                                                                     |                                                                                               3965 |                                                                                               4038 |                                                                                               4116 |                                                                                               4196 |
| Karnataka                                                                                          |                                                                                               4782 |                                                                                               4824 |                                                                                               4867 |                                                                                               4909 |
| Goa                                                                                                |                                                                                                113 |                                                                                                114 |                                                                                                114 |                                                                                                115 |
| Lakshadweep                                                                                        |                                                                                                  5 |                                                                                                  5 |                                                                                                  5 |                                                                                                  6 |
| Kerala                                                                                             |                                                                                               2775 |                                                                                               2817 |                                                                                               2865 |                                                                                               2920 |
| Tamil nadu                                                                                         |                                                                                               5616 |                                                                                               5591 |                                                                                               5562 |                                                                                               5533 |
| Pondicherry                                                                                        |                                                                                                103 |                                                                                                105 |                                                                                                108 |                                                                                                111 |
| Andaman & Nicobar Islands                                                                          |                                                                                                 28 |                                                                                                 28 |                                                                                                 28 |                                                                                                 28 |
| Total                                                                                              |                                                                                              91694 |                                                                                              92731 |                                                                                              93786 |                                                                                              94857 |

| Estimated Incidence cancer cases (2012-2015)- Females States   |   2012 |   2013 |   2014 |   2015 |
|----------------------------------------------------------------|--------|--------|--------|--------|
| Jammu &Kashmir                                                 |    921 |    955 |    991 |   1029 |
| Himachal pradesh                                               |    522 |    535 |    550 |    564 |
| Punjab                                                         |   2017 |   2070 |   2125 |   2182 |
| Chandigarh                                                     |     74 |     76 |     78 |     81 |
| Uttaranchal                                                    |    774 |    801 |    829 |    858 |
| Haryana                                                        |   1843 |   1903 |   1966 |   2032 |
| Delhi                                                          |   1204 |   1239 |   1275 |   1312 |
| Rajasthan                                                      |   5130 |   5293 |   5463 |   5641 |
| Uttar pradesh                                                  |  14834 |  15356 |  15903 |  16476 |
| Bihar                                                          |   7785 |   8088 |   8406 |   8740 |
| Sikkim                                                         |     46 |     49 |     53 |     58 |
| Arunachal pradesh                                              |    104 |    109 |    113 |    118 |
| Nagaland                                                       |    147 |    150 |    154 |    158 |
| Manipur                                                        |    203 |    204 |    205 |    207 |
| Mizoram                                                        |     84 |     88 |     91 |     95 |
| Tripura                                                        |    287 |    303 |    321 |    342 |
| Meghalaya                                                      |    231 |    240 |    250 |    260 |
| Assam                                                          |   2365 |   2440 |   2518 |   2599 |
| West bengal                                                    |   6903 |   7121 |   7351 |   7593 |
| Jharkhand                                                      |   2510 |   2602 |   2699 |   2801 |
| Orissa                                                         |   3210 |   3299 |   3393 |   3491 |
| Chattisgarh                                                    |   1990 |   2064 |   2142 |   2223 |
| Madhya pradesh                                                 |   5464 |   5656 |   5857 |   6067 |
| Gujarat                                                        |   4502 |   4652 |   4810 |   4976 |
| Daman &Diu                                                     |     15 |     16 |     17 |     19 |
| Dadra &Nagar Haveli                                            |     24 |     26 |     27 |     29 |
| Maharashtra                                                    |   8342 |   8564 |   8795 |   9035 |
| Telangana                                                      |   2744 |   2854 |   2971 |   3096 |
| Andhra pradesh                                                 |   3869 |   4022 |   4187 |   4364 |
| Karnataka                                                      |   4665 |   4807 |   4952 |   5105 |
| Goa                                                            |    111 |    113 |    116 |    119 |
| Lakshadweep                                                    |      5 |      5 |      6 |      6 |
| Kerala                                                         |   2707 |   2806 |   2916 |   3037 |
| Tamil nadu                                                     |   5481 |   5569 |   5660 |   5754 |
| Pondicherry                                                    |    100 |    105 |    110 |    115 |
| Andaman & Nicobar Islands                                      |     27 |     28 |     28 |     29 |
| Total                                                          |  91240 |  94208 |  97328 | 100611 |