Published Apr 08, 2026 | 12:40 PM ⚊ Updated Apr 08, 2026 | 12:40 PM
Notification was signed by Dr Christina Z. Chongthu, Principal Secretary to the Government. Credit: iStock
Synopsis: Telangana has declared cancer a notifiable disease, requiring all healthcare facilities to report cases within a month of diagnosis. The April 2026 order aims to build a real-time surveillance system, strengthen screening, and improve treatment planning. MNJ Institute of Oncology will validate data, while district officers ensure compliance. Telangana joins 16 other states, highlighting India’s urgent need for nationwide notification.
Telangana government has declared cancer a notifiable disease, making it mandatory for every healthcare facility in the state to report diagnosed cancer cases to a centralised portal within one month of diagnosis.
The move, formalised through G.O. Ms. No. 17 issued on 6 April 2026 by the Health, Medical and Family Welfare Department, places Telangana among a growing but still small group of Indian states to have taken this step.
The central government is yet to act on over a decade of recommendations to do the same.
The notification covers all cancers, including in situ and invasive types, and applies to government and private hospitals, clinics, AYUSH facilities, pathology and radiology laboratories, NGOs, insurance companies and the Registrar of Births and Deaths.
Cancer has quietly become one of India’s most pressing public health crises, yet the country has no reliable, real-time national data on how many people are diagnosed, where, or with what type of cancer.
The existing system relies on Population-based Cancer Registries (PBCRs) under the National Cancer Registry Programme (NCRP), run by the Indian Council of Medical Research (ICMR) since 1981. But these cover only 16.4 percent of India’s total population, across 38 registries in 22 states and union territories.
The data that does exist is retrospective, laborious to collect, and often years out of date. Even global agencies such as GLOBOCAN have a time lag of two to four years before figures enter the public domain.
What policymakers are left with, in the words of one study, amounts to little more than a “shot in the dark.”
The G.O. is unambiguous about what it seeks to fix.
“The burden of non-communicable diseases is increasing steadily and has become a major public health concern. Cancer has emerged as a significant cause of morbidity and mortality, underscoring the need for a systematic and institutional mechanism to capture reliable and timely information on the disease burden in the state,” the order stated.
The objective, it says, is to build a surveillance system that estimates cancer incidence, prevalence and mortality; strengthens preventive screening and early detection; assists in planning diagnostic and treatment facilities; and supports evidence-based policy formulation, monitoring and research.
“A uniform cancer registry for the state will serve as a centralised platform for estimation of cancer incidence and prevalence,” the order noted.
The notification was signed by Dr Christina Z. Chongthu, Principal Secretary to the Government.
The state has also outlined how it expects cancer cases to move through the system, from suspicion to diagnosis to treatment.
S. Sangeetha Satyanarayana, Commissioner of Health and Family Welfare, explained that probable cases would emerge through multiple pathways before ever reaching a hospital.
“For women, these may be identified at Aarogya Mahila Clinics, where screening for cervical or breast-related symptoms can reveal early signs of disease. Similarly, during NCD screenings, when surveys or questionnaires are conducted, certain red flags may be identified and patients are referred for further evaluation,” she told South First.
Once referred to government general hospitals, diagnoses would be confirmed. From there, the plan follows a hub-and-spoke model.
“We are planning a system where the first round of chemotherapy or initial medical management will take place at the hub institutions, such as MNJ or NIMS. Subsequently, if travel becomes difficult for patients and they prefer treatment closer to home, chemotherapy sessions can be continued at district cancer care centres,” Satyanarayana said.
The approach, she added, is designed not just for treatment but for building a living database of cancer in Telangana.
“This will help create a comprehensive database, mapping different types of cancers as well as patient distribution across districts. It will enable us to identify patterns, understand which cancers are more prevalent in specific regions, and support research. Ultimately, this will also make treatment planning and management more efficient,” she said.
At the district level, the District Medical and Health Officer (DMHO) is responsible for ensuring all hospitals, laboratories and other facilities under their jurisdiction comply with the reporting requirement.
Each facility must maintain a designated cancer register in a prescribed format, recording both existing and new cases from the date of the notification.
Hospitals empanelled under the Rajiv Aarogyasri Health Scheme will be automatically registered on the state portal. All other facilities must register independently to obtain login credentials.
The Mehdi Nawaz Jung Institute of Oncology and Regional Cancer Centre (MNJIORCC), Hyderabad, has been designated as the Centre of Excellence for cancer care in the state. It will be responsible for periodically scrutinising and validating all reported data before submitting it to the ICMR’s National Cancer Registry.
The Director of Public Health and Family Welfare will monitor the quality and timeliness of all submissions.
All data collected is to be treated as strictly confidential, used solely for public health purposes, and stored and transmitted securely. Personally identifiable information will not be disclosed.
Telangana’s move comes against the backdrop of a long-standing gap in national health policy.
A notifiable disease, by definition, is one that must be reported to authorities by law due to its frequency, severity or threat to public health. Cancer clearly meets that threshold, yet India has not made it notifiable at the central level.
The ICMR first recommended doing so in 2008. A parliamentary panel reiterated the recommendation in its 139th report submitted to the Rajya Sabha in September 2022, titled ‘Cancer Care Plan and Management: Prevention, Diagnosis, Research and Affordability of Cancer Treatment.’ The Ministry of Health and Family Welfare has not acted on either.
The ministry’s stated position is that data collected through the NCRP is sufficient for policy formulation, and that since cancer is a non-communicable disease that does not spread from person to person, there is no need to declare it notifiable.
Critics and researchers have long challenged that view.
As of December 2024, only 16 Indian states had made cancer notification mandatory: Haryana, Karnataka, Kerala, Tamil Nadu, Punjab, West Bengal, Assam, Mizoram, Tripura, Sikkim, Gujarat, Manipur, Rajasthan, Arunachal Pradesh, Andhra Pradesh and Himachal Pradesh. Telangana was not among them. The April 2026 order changes that.
Internationally, mandatory cancer notification is well established, particularly in developed countries.
Denmark set up its cancer registry as far back as 1942, covering its entire national population. England and Wales, Scotland, the Nordic countries, the United States, Canada, Australia, New Zealand, Israel, Cuba, Puerto Rico and Gambia all have nationwide cancer registration systems.
In Norway, reporting is obligatory even when cancer is merely suspected. Australia mandates reporting of all cancers, with the exception of basal cell carcinoma and squamous cell carcinoma of the skin.
The United States has had mandatory cancer notification since 1997. The federal cancer registry programme, supported by the Centres for Disease Control and Prevention and the National Cancer Institute, publishes an annual report titled ‘Annual Report to the Nation on the Status of Cancer,’ with the latest edition in April 2025 also examining the impact of the COVID-19 pandemic on cancer incidence rates.
India, with a population of 1.4 billion, has much to learn from these models.
A mandatory notification system is fundamentally different from a cancer registry, and the distinction matters.
Registries rely on active, retrospective data collection. They are time-consuming, geographically limited and prone to duplication when patients move between hospitals seeking better care. The NCRP’s 38 PBCRs cover just over a sixth of the country’s population, and the data they produce is routinely extrapolated to regions where no registry exists, yielding estimates rather than true figures.
Notification, by contrast, creates a legal obligation to report at the point of diagnosis. It produces real-time data, eliminates duplication, standardises reporting across facilities and makes India’s figures comparable with global benchmarks.
It also has a direct bearing on patients. Timely notification can trigger the mobilisation of support services including counselling, palliative care and rehabilitation, at a stage when families are most in need of them.
The argument for mandatory notification is not only epidemiological. It is also economic.
Cancer imposes a staggering toll through reduced productivity, unemployment, loss of labour, and premature death. Between 2020 and 2050, the global economic burden of cancer is projected at $25.2 trillion, a figure that exceeds China’s entire GDP in 2020. Three-quarters of cancer deaths occur in low- and middle-income countries, yet the financial burden is disproportionately borne by wealthier nations.
In India, hospital-based studies have found that households spend an average of Rs 36,812 on cancer therapy alone, excluding non-medical costs. Out-of-pocket expenditure on cancer is, on average, 2.5 times higher than the average cost of hospitalisation.
Investment in screening, early diagnosis and treatment, researchers argue, could yield substantial health and economic returns, particularly in lower-income settings.
Researchers who have studied mandatory cancer notification in India are candid about the obstacles.
The first is infrastructure. Implementing a mandatory system requires budget, manpower, training and a functioning digital ecosystem across both public and private facilities.
The second is data security and confidentiality, ensuring that patients and caregivers trust the system enough to engage with it honestly.
The third is political will. Long-term viability of any such programme depends on sustained commitment at both state and national levels.
The fourth, and perhaps most complex, is data integration. India has a mixed health system, with a large and fragmented private sector. A common digital dashboard for all stakeholders has been proposed as one workable solution.
Finally, there is the challenge of incomplete reporting. Insufficient clinical information, lack of awareness among health workers and inadequate training can all compromise the quality of notifications submitted.
Researchers writing in the narrative review ‘Mandatory Cancer Notification and Need for a Pan India Health Policy Instrument’ have called for urgent national action.
“Since 2008, only 16 Indian states have so far made cancer notification mandatory. At this rate, it may take still one or two decades to cover all the states and union territories. We have to urgently address this gap of compulsory notification by making it a legal duty to report diagnosed cases of cancer to a central authority,” the authors wrote.
They argue that the model of tuberculosis reporting under the National Tuberculosis Elimination Programme offers a useful template, with grassroots health workers including ASHAs playing a key role in identifying and reporting cases. Financial incentives for ASHAs reporting new cancer cases, and assured support for patients themselves, could further encourage self-reporting.
The integration of cancer notification into the Ayushman Bharat Digital Health Mission (ABDM), through individual Ayushman Bharat Health Accounts (ABHA), is seen as a significant step forward that India’s digitalisation push has made increasingly feasible.
For now, Telangana has moved ahead of the curve. Whether the centre follows is another matter.
