How India is scaling up mapping of the cancer burden

The initiative to declare cancer as a notifiable disease covers 19 remaining states and Union territories and is intended to improve early detection and careIndia’s cancer surveillance could be set for a significant expansion. The Supreme Court has asked the 19 states and Union territories that have not yet done so to consider declaring cancer as a notifiable disease. The other 17 states and UTs have already notified so.The move is intended to address disparities in reporting cancer cases and improving early detection and care. Notification matters because the cancer burden varies sharply across India, both geographically and by cancer type.Population-based cancer registries (PBCRs) are designed to capture all new cancers within a defined population, allowing researchers to calculate incidence and mortality and track changes over time. The National Cancer Registry Programme began in 1981, but registry coverage has historically been limited and disproportionately urban.Existing registry data already demonstrates the value of geographical surveillance. An analysis covering 708,223 cancer cases and 206,457 deaths across 43 PBCRs estimated the average lifetime risk of cancer in India at around 11 per cent. In Mizoram, the lifetime risk reached 21.1 per cent for men and 18.9 per cent for women. Aizawl recorded age-adjusted incidence rates of 256.1 cases per 100,000 men and 217.2 per 100,000 women. The geographical differences become still sharper for individual cancers. East Khasi Hills in Meghalaya has recorded oesophageal cancer incidence of 75.4 per 100,000 men and 33.6 per 100,000 women. Such concentrations allow public-health programmes to target the behaviours and exposures most relevant to a particular population rather than apply uniform interventions across the country.Punjab provides another example. Earlier epidemiological work reported cancer prevalence of 1,089 per million people in the Malwa region, compared with 881 per million in Doaba and 647 in Majha. The excess prompted investigations into possible environmental and occupational exposures, including pesticides and water contamination.A geographical cluster does not establish causation, but it can identify where detailed environmental and epidemiological investigation is required. This is where comprehensive notification could have its greatest value. If reporting identifies unusually high rates of oral cancer in one district, oesophageal cancer in another or gallbladder cancer in a third, health authorities can investigate tobacco use, diet, infections, occupational exposures, environmental contaminants and other potential risk factors. Cancer registration is therefore more than an exercise in counting cases. It establishes who is developing which cancer, where, and at what rate.Subscribe to India Today Magazine- EndsPublished By: Yashwardhan SinghPublished On: Aug 12, 2026 19:14 IST