SC asks 19 states, UTs to declare cancer ‘notifiable disease’ for early detection

The Supreme Court on Tuesday asked the 19 remaining states and Union territories to declare cancer a “notifiable disease” to ensure early detection and proper care of patients.

The top court’s direction came after it was informed that 17 of the 36 states and UTs have so far notified cancer as a “notified disease” in light of the recommendations made in a parliamentary standing committee report.

The court had, on December 12 last year, issued notices and sought responses from the Centre and all the states and UTs on a public interest litigation (PIL) matter filed by renowned doctor Anurag Srivastava, seeking a direction to declare cancer a “notifiable disease” across the country to ensure early detection and proper care of patients.

On Tuesday, a bench of Chief Justice of India (CJI) Surya Kant and Justices Joymalya Bagchi and V Mohana asked the Centre as to why it is not issuing “some mandatory guidelines for all states/UTs”, saying there should be uniform policy.

Additional Solicitor General Anil Kaushik, appearing in the court for the Centre, said health is a state subject.

“Moreover, 17 states have notified the disease,” the law officer said.

“We direct remaining states/UTs to consider the above-stated recommendations and take appropriate decisions. Compliance affidavits have to be filed,” the CJI said.

In his plea, Srivastava has highlighted the failure on the part of the Union health ministry and the states to declare cancer a notifiable disease across India.

“Issue an appropriate writ … nature of mandamus against the Respondent No.1 (Union Ministry of Health and Family Welfare) to notify cancer as a notified disease for ensuring uniform and mandatory reporting of cancer cases in India,” the plea says.

“The continued non-notification of cancer, despite its alarming and escalating burden in India, amounts to a grave abdication of the State’s constitutional duty under Articles 14 and 21 of the Constitution, as it denies uniform treatment to similarly-situated citizens and undermines their fundamental right to health and a life with dignity,” it has said.

Besides the Centre and all the states, Srivastava, the former head of the Department of Surgical Disciplines at the All India Institute of Medical Sciences (AIIMS), New Delhi, has made the National Institute of Cancer Prevention and Research a party to the PIL.

The plea says the absence of mandatory reporting has led to fragmented data, poor surveillance and a “policy paralysis” in addressing India’s growing cancer epidemic.

The petition has urged the bench to direct authorities to declare cancer a notifiable disease nationwide and establish a unified, real-time digital cancer registry akin to the CoWIN platform launched during the COVID-19 pandemic.

The plea says although health is primarily a state subject under the Constitution, both the Centre and the states hold concurrent authority to notify diseases.

This duality, the plea submits, has resulted in a “legal vacuum”, wherein some states have notified cancer while many others have not and this has led to severe inconsistencies in reporting and early detection.

According to the petition, the absence of uniform notification has created stark disparities in cancer surveillance, resulting in delayed diagnosis, higher treatment costs and poor patient outcomes.

It says patients in many states are frequently diagnosed only at advanced stages, where curative treatment becomes “difficult, expensive or impossible”.

The PIL highlights major deficiencies in the National Cancer Registry Programme (NCRP) operated by the Indian Council of Medical Research (ICMR).

The registry currently covers only about 10 per cent of the country’s population, with rural coverage as low as 1 per cent.

“Adding to this crisis is the growing menace of unscientific and unverified alternative cancer treatments, such as the widely-circulated claim of Gomutra (cow urine) as a cure for cancer.

“An RTI filed before the Rashtriya Ayurveda Sansthan revealed that no scientific research has ever established Gomutra as an effective therapy for cancer. Yet, due to lack of regulation and public awareness, patients continue to fall prey to such misleading claims, resulting in delayed treatment and preventable deaths,” the plea has said.

This reflects an urgent need for the government to issue a clear policy statement distinguishing scientifically-validated therapies from untested claims, ensuring that only evidence-based treatments, modern or traditional, are permitted to be practised or promoted in India, it has added.

“In the above circumstances, it is most respectfully prayed that this Hon’ble court may graciously be pleased to issue appropriate writs, orders or directions in the nature of mandamus directing the respondent authorities to take immediate, coordinated and legally-enforceable measures for strengthening the national response to cancer,” the plea has said.

It has sought a direction to establish a centralised, real-time digital cancer registry integrated with the NCRP, hospital databases, state insurance schemes and mortality records.

It has also sought a direction to implement nationwide cancer screening.