National Cancer Control Programme

Objectives

The National Cancer Control Programme seeks to reduce India’s substantial cancer burden through prevention, early detection, diagnosis, treatment and palliative care. India was estimated to have 8 to 9 lakh new cancer cases, nearly 25 lakh existing cases and around 4 lakh cancer deaths each year, with tobacco-related cancers accounting for 40% of cases.[1]The programme directs cancer control efforts towards major cancer sites identified through registry data, including oral cavity, lung, oesophageal and stomach cancers among men, and cervical, breast and oral cavity cancers among women.[1]

• Promote primary prevention through health education on the hazards of tobacco consumption and the importance of genital hygiene in preventing cervical cancer.[1]
• Improve secondary prevention through early detection, diagnosis, screening and education on self-examination, particularly for cervical, breast and oro-pharyngeal cancers.[1]
• Strengthen cancer treatment facilities, which are described as inadequate, and provide palliative care for people with terminal cancer.[1]
• Use cancer registry evidence to identify cancer patterns and prioritise leading cancer sites for intervention.[1]

Implementation

The programme combines specialist cancer-centre investment, hospital and medical-college service strengthening, district-level delivery, registry-based information and non-governmental organisation outreach.[1][2]It evolved from investment in premier cancer institutions in 1975-76 to an increased focus on primary prevention and early detection from 1984-85, district cancer control from 1990-91, a modified district programme from 2000-01 and revisions following a 2004 evaluation.[1]The document does not specify routine performance indicators, reporting requirements, formal accountability arrangements or governance structures beyond the identified delivery institutions and nodal agencies.[1][2]

• Deliver specialised treatment through Regional Cancer Centres, government hospitals and government medical colleges, including recognition of new Regional Cancer Centres to expand capacity and reduce geographical disparities.[2]
• Strengthen existing Regional Cancer Centres and establish oncology wings in government hospitals and government medical colleges.[2]
• Implement the District Cancer Control Programme through a nodal Regional Cancer Centre, government medical college or government hospital with radiotherapy facilities.[2]
• Cover clusters of two to three districts through prevention, early detection, minimal treatment and supportive cancer care.[2]
• Support non-governmental organisations to undertake information, education and communication activities through camps, with funds channelled through a designated nodal agency.[2]
• Maintain population-based and hospital-based cancer registries through the National Cancer Registry Programme, initiated by the Indian Council of Medical Research in 1982, to describe the magnitude and patterns of cancer.[1]In 2008, the registry programme included 21 population-based registries and 6 hospital-based registries.[1]
• Use registry and medical-college data for the Atlas of Cancer in India to describe cancer patterns in covered areas and areas previously lacking registry coverage.[1]
• Allocate one-time grants from 1 January 2005 for recognising new Regional Cancer Centres, strengthening existing centres and developing oncology wings, while providing five-year grant-in-aid for each District Cancer Control Programme proposal and per-camp support for non-governmental organisation communication activities.[2]
• Review programme design through formal evaluation, including the National Institute of Health and Family Welfare evaluation undertaken in New Delhi in 2004, which informed programme revision in 2005.[1]

Monitoring & Evaluation

Cancer monitoring relies principally on the National Cancer Registry Programme, initiated by the Indian Council of Medical Research in 1982, which uses population-based and hospital-based registries to describe the magnitude and patterns of cancer. In 2008, the registry network comprised 21 population-based registries and 6 hospital-based registries.[1]

• Use registry and medical-college data to develop the Atlas of Cancer in India and describe cancer patterns in both covered and previously uncovered areas.[1]
• Focus control efforts on leading cancer sites identified through registry data, including oral cavity, lung, oesophageal and stomach cancers among men, and cervical, breast and oral cavity cancers among women.[1]
• Review programme performance through formal evaluation, including an assessment conducted by the National Institute of Health and Family Welfare, New Delhi, in 2004, followed by programme revision in 2005.[1]

The document does not specify routine performance indicators, numerical targets, reporting schedules, data-quality procedures, surveillance processes beyond cancer registries, public reporting arrangements, or formal accountability mechanisms.[1][2]

Costing & Financing

Financing combines historic central assistance with grant-based support for cancer treatment infrastructure, district-level cancer control and information, education and communication activities.[1][2]

• Provide central assistance of 2.5 Indian rupees per premier cancer hospital or institution for cobalt-machine purchases in 1975-76.[1]
• Provide one-time grants from 1 January 2005 for recognition of new Regional Cancer Centres, strengthening of existing centres, and development of oncology wings in government hospitals or government medical colleges.[2]
• Provide grant-in-aid for each District Cancer Control Programme proposal over five years.[2]
• Fund non-governmental organisation information, education and communication camps through a designated nodal agency.[2]

The document does not specify total programme expenditure, annual budget ceilings, recurrent operating costs, funding gaps, cost-effectiveness assumptions, or further resource-mobilisation mechanisms.[1][2]