Op-ed: Make cancer a notifiable disease so that every diagnosis is counted
India keeps cancer registries, yet cancer is not notifiable in about half its States and UTs. Why does that matter?
Published 6 October 2026. Written by Pratidin from the reports linked at the end; every fact checked by a separate review before publishing. How we work
An opinion article in The Indian Express on 6 October 2026 argues that India will fight cancer better only if every diagnosis is reported to public health authorities. It builds on a Supreme Court order of 11 August 2026 in Anurag Srivastava v. Union of India, a public interest petition. A Bench of Chief Justice Surya Kant and Justices Joymalya Bagchi and V. Mohana noted that 17 States and Union Territories had already notified cancer as a reportable disease, asked the remaining 19 to consider doing so, and required compliance affidavits. The CJI asked the Union government why it did not issue mandatory guidelines for all States and UTs, saying, "There should be uniform policy." The Parliamentary Standing Committee on Health had earlier recommended making cancer notifiable.
A notifiable disease is one that hospitals, doctors and laboratories are legally required to report. Cancer is not notifiable across most of India, so registration depends on effort. The Indian Council of Medical Research (ICMR) started the National Cancer Registry Programme in December 1981, with its coordinating centre in Bengaluru; it is now run by ICMR's National Centre for Disease Informatics and Research. Because cancer is not notifiable, registry staff routinely visit hospitals and pathology laboratories to find cases. Some States have acted on their own: Telangana's order of April 2026 requires government and private hospitals, diagnostic laboratories and clinics to report diagnosed cases within one month through a State portal, with patient details kept confidential. The Union Health Ministry used a similar route in November 2024, asking States to make snakebite cases and deaths notifiable under their public health laws.
The article argues that timely reporting, combined with cancer registries, would reveal incidence, patterns and trends, guide where hospitals, diagnostics and radiotherapy are needed, and help forecast demand for medicines. It wants the Health Ministry to frame national guidelines, a standard dataset and compliance rules, and proposes a common digital system on the lines of CoWIN, with strong data protection and cybersecurity. It cautions that reported cases will rise at first once reporting becomes complete, and that this should not be read as a rise in disease. The harder questions are federal and practical. Public health is in the State List, so the Centre can guide but States must notify; reporting adds work for small private clinics and laboratories; and cancer records are sensitive personal data, so confidentiality has to be built in from the start.
Prelims facts
- On 11 August 2026, in Anurag Srivastava v. Union of India, the Supreme Court asked the 19 States and UTs that had not notified cancer to consider doing so; 17 had already notified it.
- The National Cancer Registry Programme was started by ICMR in December 1981 with its coordinating centre in Bengaluru; it is run by ICMR-NCDIR.
- Because cancer is not notifiable in most of India, cancer registries rely on active case-finding visits to hospitals and laboratories.
- Telangana declared cancer notifiable in April 2026, requiring all facilities to report diagnosed cases within one month.
- 'Public health and sanitation; hospitals and dispensaries' is Entry 6 of the State List, so notification is mainly a State decision.
Quick recall
- What is a notifiable disease?
- A disease that hospitals, doctors and laboratories must legally report to public health authorities.
- What did the Supreme Court do on 11 August 2026 about cancer?
- In Anurag Srivastava v. Union of India it asked 19 States and UTs that had not notified cancer to consider doing so, with compliance affidavits.
- How many States and UTs had notified cancer by August 2026?
- 17 of 36.
- When did the National Cancer Registry Programme start?
- December 1981, under ICMR, with its coordinating centre in Bengaluru.
- Which institution now runs the NCRP?
- ICMR's National Centre for Disease Informatics and Research (NCDIR), Bengaluru.
- What is the difference between a PBCR and an HBCR?
- A population-based registry covers all cases in a defined area; a hospital-based registry records treatment and outcomes in one hospital.
- What did Telangana decide in April 2026?
- To make cancer notifiable: all facilities must report diagnosed cases within one month through a State portal.
- Which State List entry covers public health?
- Entry 6: public health and sanitation; hospitals and dispensaries.
Prelims practice question
With reference to the National Cancer Registry Programme (NCRP) in India, consider the following statements:
1. It functions under the Indian Council of Medical Research.
2. Population-based cancer registries record the treatment and outcomes of patients in a single hospital.
3. It began in the 1980s.
Which of the statements given above are correct?
- 1 only
- 1 and 3 only
- 2 and 3 only
- 1, 2 and 3
Show answer
Answer: (b) 1 and 3 only. Statement 1 is correct: the NCRP is an ICMR programme, now run by ICMR-NCDIR, Bengaluru. Statement 2 is wrong: that describes hospital-based registries; population-based registries collect all cancer cases in a defined geographic population. Statement 3 is correct: it started in December 1981.
Use this in UPSC Mains: previous-year questions
Recurring theme: Strengthening India's public health system through data, surveillance and State capacity
- How to use this
Argue that the State's role includes knowing the disease burden: mandatory cancer notification would pull private clinics and laboratories into public planning and guide placement of services.
- On 11 August 2026 the Supreme Court asked 19 States and UTs to consider notifying cancer; 17 of 36 already had.
- Telangana's April 2026 order makes all hospitals, laboratories and clinics, public or private, report cancer cases within one month.
- Without notification, the ICMR's National Cancer Registry Programme, running since 1981, must send staff to hospitals and laboratories to find cases.
On primary health care as a precondition for development; disease surveillance supports it, but this story is about cancer reporting rather than primary care.
Statement-II of this PYQ says States are primarily responsible for organising health services, which is exactly why the Supreme Court asked States and UTs to consider notifying cancer.
Mains practice question
Making cancer a notifiable disease could strengthen cancer control in India, but it raises federal and data-governance challenges. Discuss. (150 words)
Model answer
A notifiable disease must be reported by hospitals, doctors and laboratories. On 11 August 2026 the Supreme Court asked 19 States and UTs that had not notified cancer to consider doing so; 17 already had.
Benefits
- Complete data: today the National Cancer Registry Programme (ICMR, since 1981) must actively search hospitals and laboratories because cancer is not notifiable.
- Planning: incidence and trends guide where to place oncology, diagnostics and radiotherapy, and forecast medicine demand.
- Early detection and follow-up of patients.
Federal challenges
- Public health is in the State List (Entry 6); the Centre can only advise, as with snakebite in 2024.
- Uneven adoption: Telangana mandated one-month reporting in April 2026, others have not.
Data challenges
- Cancer records are sensitive; confidentiality and cybersecurity are essential.
- Reporting burden on small clinics.
- Reported cases will rise initially, which must not be misread.
Way forward
- Union guidelines and a standard dataset, as the Court suggested.
- One interoperable digital platform with privacy safeguards.
Counting every case is the first step to treating every case.
The basics
Why this matters
A health system cannot plan for what it cannot count. India records many cancer cases, but because cancer is not a notifiable disease in much of the country, the count depends on registry staff finding patients rather than on every diagnosis being reported. The Supreme Court's order of August 2026 and the Indian Express opinion of 6 October push for a change. The topic links GS2 health governance with federalism and data protection.
What notification means
A Notifiable diseases must be reported by those who diagnose it. Infectious diseases such as tuberculosis or cholera are the usual examples, but the idea is now being extended to conditions like snakebite and cancer, discussed in Cancer as a non-communicable disease.
- 1DiagnosisA hospital, clinic or laboratory confirms a cancer case.
- 2ReportThe facility reports it within a set time; Telangana allows one month.
- 3ValidateA designated centre checks the record and removes duplicates.
- 4RegisterThe case enters the registry, adding to incidence and survival data.
- 5PlanGovernments use the data to place services and forecast needs.
Active versus passive registration
The National Cancer Registry Programme began in December 1981 with three population-based registries (Bangalore, Chennai, Mumbai) and three hospital-based ones (Chandigarh, Dibrugarh, Thiruvananthapuram). Without notification it works actively.
- Registry staff visit hospitals and laboratories to find cases
- Coverage depends on where registries exist
- Private facilities may be missed
- Every facility must report each diagnosis
- Data flow from the whole State
- Counts rise at first as hidden cases appear
Who decides
Under the Constitution, public health and hospitals fall in the State List, explained in Health in the Constitution's lists. That is why the Supreme Court asked States to consider notification instead of ordering the Centre to impose it.
Go deeper
In one line: An Indian Express opinion piece argues that cancer should be made notifiable everywhere so that every diagnosis is reported, building on a Supreme Court order that asked 19 States and UTs to consider it.
Why it matters for UPSC
GS2 regularly asks about public health systems and the role of the State. Cancer surveillance combines health policy, Centre-State relations and health data governance, and the NCRP is a likely Prelims fact.
The core idea
A Notifiable diseases must be reported by those who diagnose it. India's National Cancer Registry Programme has to search actively for cases because cancer is not notifiable in most places. Health is mainly a State matter under the Health in the Constitution's lists, so notification is a State decision. Extending notification to Cancer as a non-communicable disease is a newer idea, also used for snakebite.
Numbers and dates to remember
- 11 August 2026: Supreme Court order in Anurag Srivastava v. Union of India.
- 17 of 36 States and UTs had notified cancer; 19 asked to consider it.
- December 1981: NCRP started by ICMR; coordinating centre in Bengaluru.
- April 2026: Telangana makes cancer notifiable, with reporting within one month.
- November 2024: Health Ministry asks States to make snakebite notifiable.
- State List Entry 6: public health and sanitation; hospitals and dispensaries.
Where to go next
- Notifiable diseases: what notification means and how it works.
- National Cancer Registry Programme: how India counts cancer today.
- Health in the Constitution's lists: why States, not the Centre, decide.
- Cancer as a non-communicable disease: why reporting rules are spreading beyond infections.
Go deeper: mandatory reporting versus better registries
The case for notification, made by the Indian Express article and the petition, is that the present system undercounts. The National Cancer Registry Programme relies on staff visiting hospitals and laboratories, and its registries cover only parts of the country. Mandatory reporting would capture cases from private clinics and smaller towns, show where cancers cluster, and help plan oncology, diagnostics and radiotherapy. The Parliamentary Standing Committee on Health recommended it, and the Supreme Court's CJI asked why the Centre had not issued uniform guidelines.
The counter-arguments are practical. Notification without capacity produces paperwork, not data: small facilities need simple digital tools and training. A sudden rise in reported cases may alarm the public unless explained, a risk the article itself flags. Cancer records are sensitive, and a national database raises privacy and cybersecurity concerns; the article proposes a CoWIN-style platform with strong data protection, while critics of centralised health databases warn about breaches and misuse.
The federal question runs through it all. Under the Health in the Constitution's lists, public health is a State subject, so the Court asked States to consider notification and the Union can only frame guidelines and a standard dataset. Telangana's April 2026 order shows a State-led model, with a designated cancer institute validating data. For snakebite, the Union used advisories to States in 2024, an approach that could be copied.
Finally, there is the idea of extending surveillance to Cancer as a non-communicable disease. Notification was built for epidemics, where quick reporting stops spread. For cancer, its value is in planning and early treatment rather than containment, so the system design, with follow-up and outcome data, matters more than speed alone. See also Notifiable diseases.
Notifiable diseases
What notification means and how it works.
In one line: A notifiable disease is one that doctors, hospitals and laboratories are legally required to report to public health authorities.
Why it exists
Notification began as a tool against epidemics: if every case of a contagious disease is reported quickly, officials can trace contacts, isolate patients and stop spread. Tuberculosis, for example, has been notifiable in India since 2012.
How it is done in India
States usually notify diseases under their public health laws or other applicable legislation. The Epidemic Diseases Act, 1897 gives powers to deal with dangerous epidemic diseases. The Union can advise; for instance, in November 2024 it asked States to make snakebite cases and deaths notifiable under the State Public Health Act or other law.
Why it is in the news
The Supreme Court in August 2026 asked 19 States and UTs to consider making cancer notifiable, and a 6 October opinion piece argues for nationwide reporting.
Where to go next
- Health in the Constitution's lists
- Cancer as a non-communicable disease
National Cancer Registry Programme
How India counts cancer today.
In one line: The NCRP is the ICMR programme that collects cancer data through a network of population-based and hospital-based registries.
History
The ICMR started the NCRP in December 1981, with its coordinating centre in Bengaluru. It began with three population-based registries in Bangalore, Chennai and Mumbai and three hospital-based registries in Chandigarh, Dibrugarh and Thiruvananthapuram. It is now operated by ICMR's National Centre for Disease Informatics and Research (NCDIR), Bengaluru.
Two kinds of registry
Population-based cancer registries collect information on all cancer cases in a defined geographic population, which gives incidence rates. Hospital-based cancer registries record the treatment, management and outcome of patients registered in a particular hospital.
The gap
Because cancer is not notifiable, registration is active: staff visit hospitals, pathology laboratories and other sources routinely. Notification would turn this into a flow of reports from every facility.
Where to go next
Health in the Constitution's lists
Why States, not the Centre, decide on notification.
In one line: Public health and hospitals are State subjects, while preventing the spread of infectious diseases between States is in the Concurrent List.
The entries
Entry 6 of the State List covers public health and sanitation, and hospitals and dispensaries. Entry 29 of the Concurrent List covers prevention of the extension from one State to another of infectious or contagious diseases or pests affecting people, animals or plants. The Union also has powers over medical education and research institutions through other entries.
What it means for cancer
Cancer is not contagious, so the inter-State infection entry does not apply. Making it notifiable is therefore mainly a State decision, which is why the Supreme Court asked States and UTs to consider it and the Union can frame guidelines.
Why it is in the news
The CJI asked why the Union did not issue mandatory guidelines for uniform policy, a classic cooperative federalism question.
Where to go next
Cancer as a non-communicable disease
Why reporting rules are spreading beyond infections.
In one line: Cancer is a non-communicable disease, so reporting it serves planning and early treatment rather than stopping spread.
The shift
India's disease burden has moved towards non-communicable diseases such as cancer, heart disease and diabetes. Surveillance systems built for infections are being adapted: snakebite, also non-communicable, was the subject of a 2024 Union advisory asking States to make it notifiable, under a national action plan that aims to halve snakebite deaths by 2030.
What reporting adds
For cancer, complete reporting shows where and which cancers are common, which helps place screening, diagnostics and radiotherapy, and track whether patients are treated and survive. The opinion article also warns that counts will rise at first when hidden cases surface.
Why it is in the news
Telangana made cancer notifiable in April 2026 and the Supreme Court has urged other States to consider it.
Where to go next
- National Cancer Registry Programme
- Health in the Constitution's lists
Take the 6 October 2026 quiz: 30 Prelims-style questions with answers