Cancer Notification: SC Push Puts All States On One Surveillance Grid; Experts Say More Needs To Be Done

Even as the Centre remains hesitant to make cancer nationally notifiable despite the rising cancer burden, the Supreme Court has pushed the 19 States and Union Territories yet to notify cancer to do so, a move that could mark an important shift in India’s approach to cancer surveillance.

But experts say the Court’s intervention is only the beginning: unless notification is backed by uniform standards, wider participation and integration with existing cancer registries, India may continue to have a fragmented picture of a disease that is already placing a growing burden on its health system.

The issue goes to the heart of a basic public-health question: how can a country plan its cancer services if it does not know, with reasonable accuracy and timeliness, where cases are occurring, whom they are affecting and how the disease is changing?

A notifiable disease is one whose occurrence is required to be reported to designated public-health authorities.

For cancer, mandatory reporting would mean that newly diagnosed cases become part of a systematic surveillance mechanism rather than being captured only through selected population-based or hospital-based registries.

Welcoming the Supreme Court’s intervention, Jyotsna Govil, Chairperson, Indian Cancer Society (ICS), which has advocated stronger cancer notification for more than a decade, said, “Making cancer nationally notifiable is an important step towards building a comprehensive and reliable cancer surveillance system in India.”

But notification by itself, she cautioned, will not solve the problem.

“What India needs is a uniform national framework covering definitions, reporting standards, data fields and protocols so that information generated by different states can be compared and integrated.”

That distinction is important. If each state follows its own reporting mechanism, mandatory notification could simply produce several parallel datasets rather than one national picture.

Dr Pragya Shukla, Head of Department, Clinical Oncology at Delhi State Cancer Institute, too said cancer required structured and timely data collection to understand its epidemiology, identify emerging trends and regional and demographic disparities, and assess the effectiveness of prevention and treatment programmes.

“A national framework for cancer notification would enable policymakers to identify areas of high disease burden, detect changing patterns of cancer, strengthen prevention and early-detection strategies, and ensure more equitable allocation of healthcare resources,” she said.

India has had a cancer registry programme for decades. The National Cancer Registry Programme (NCRP), coordinated by the ICMR-National Centre for Disease Informatics and Research, remains an important source of information on cancer incidence and patterns.

But registries have inherent limitations when used as the sole basis for national surveillance.

A review published in Preventive Medicine Research & Reviews in March 2026, titled ‘Mandatory Cancer Notification and Need for a Pan India Health Policy Instrument: A Narrative Review’, argues that India needs continuous, robust and unbiased information on cancer occurrence and that compulsory reporting could complement the existing registry system.

The authors—Dr Vijay K. Barwal, Dr Manish Gupta, Dr Gopal Ashish Sharma and Dr Anmol Gupta of Indira Gandhi Medical College (IGMC), Shimla—point out that the existing population-based registry network covers only a fraction of the country. The review cites 38 Population Based Cancer Registries covering about 16.4% of India’s population.

Consequently, large parts of rural and underserved India remain inadequately represented in direct population-based surveillance.

The problem is not merely geographical. Cancer registry data takes time to collect, verify, process and analyse. Information may also have to be gathered from multiple hospitals and other sources before a reliable estimate can be produced.

The authors said, “Notification will provide us the complete, valid and real-time data with true incidence and prevalence,” while also allowing public-health authorities to respond more quickly to emerging patterns.

For oncologists, the value of notification will ultimately be measured not by the number of forms filed but by what the resulting data enables governments to do.

Dr Adhip Arora, Consultant Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi said, "As a medical oncologist, I welcome the Supreme Court’s direction to strengthen cancer notification across States and Union Territories."

“A uniform reporting system can provide India with better information on the true burden and distribution of cancer, helping policymakers plan healthcare resources more effectively. This is particularly important as many patients continue to present with advanced disease."

“Cancer notification can also strengthen cancer registries and improve planning of screening and diagnostic services. However, its real benefit will come when reporting is linked to timely diagnosis, referral and treatment. This is an important step towards building a more organised and equitable cancer care system in India.”

That linkage is crucial.

Dr Tanshi Daljit, Senior resident, Radiation Oncology from Lok Nayak Hospital, Delhi, agreed even as she termed the Supreme Court’s move as an important step for the Indian cancer care sector.

“It will give us a true cancer burden, rather than just relying on selected population/hospital registries from metropolitans."

“But then good notification is not equivalent to a good cancer registry. So, this notification system should be designed around clinical and outcome data rather than merely counting cases. Only then will we have proper geographic mapping, with proper identification of areas with a high burden of a particular cancer, thereby strengthening screening, prevention, plan infrastructure and workforce there.”

Recently, the Supreme Court was informed that 17 of India’s 36 states and union territories have already notified cancer, leaving 19 yet to do so. The move follows recommendations of the Parliamentary Standing Committee on Health and Family Welfare and a PIL filed by an ex-AIIMS doctor through advocate Gaurav Bansal.

Among the States and UTs that have already notified cancer are Haryana, Karnataka, Kerala, Tamil Nadu, Punjab, West Bengal, Assam, Mizoram, Tripura, Sikkim, Gujarat, Manipur, Rajasthan, Arunachal Pradesh, Andhra Pradesh and Himachal Pradesh. Telangana became the latest State to join the list in April 2026.

But the existence of State-level notification does not automatically mean that India has a uniform surveillance system. The Union Health Ministry has maintained that notification frameworks have traditionally been applied to communicable diseases, citing the non-communicable nature of cancer and the absence of person-to-person transmission.

Stating that the Ministry’s position has been critically challenged at several forums, as the absence of a legal mandate has resulted in limited population coverage of the National Cancer Registry Programme—currently capturing only about 16% of India’s population—thereby undermining accurate burden estimation and equitable cancer control planning, an editorial ‘Mandatory Pan-India Cancer Notification: from Policy Gap to National Priority’, published in the Indian Journal of Surgical Oncology in February 2026, noted that notification practices differ across States and that implementation remains inconsistent.

Some systems rely on voluntary reporting, while others lack robust enforcement mechanisms, said Dr Pankaj Kumar Garg and Dr Pallvi Kaul of Department of Surgical Oncology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Shri Guru Ram Rai University, Dehradun in the review.

“This fragmented approach limits the effectiveness of state-level efforts and underscores the need for a uniform national mandate,” they said.

Nevertheless, India’s expanding digital-health architecture could provide an opportunity to build such a system.

The 2026 review pointed to the potential integration of cancer notification with the Ayushman Bharat Digital Mission (ABDM) and Ayushman Bharat Health Account (ABHA). A properly designed interoperable system could allow information to move with the patient across institutions, reduce duplication and make surveillance faster.

But technology cannot substitute for policy.

A functional national system would require clearly defined reporting responsibilities, common terminology and data fields, reporting timelines, interoperability standards and safeguards for patient confidentiality.

Public and private hospitals, pathology laboratories, diagnostic centres and oncology facilities would all have to be part of the reporting architecture, said the health experts.

According to the International Agency for Research on Cancer (IARC), the World Health Organisation’s specialised cancer agency, India recorded 14.13 lakh new cancer cases and 9.17 lakh cancer deaths in 2022. More than 32.5 lakh people were estimated to be living with cancer diagnosed during the preceding five years. Breast cancer was the most common cancer, followed by cancers of the lip and oral cavity and cervix uteri. Among men, lip and oral cavity cancer was the leading cancer, while breast cancer dominated among women.

The figures, however, are estimates based on available surveillance data rather than a complete national enumeration of every diagnosed case.

This is where the significance of notification lies.