Parliamentary panel recommends setting up of cancer registries in rural areas

A parliamentary committee has recommended setting up population-based cancer registries in rural areas to help data-driven and evidence-based policy formulation.

It has also suggested raising taxes on tobacco products citing that increasing their market price would make them less affordable. This will result in lower consumption and decrease the risk of tobacco-related diseases, including cancer, the panel said.

The health ministry must pursue with the Department of Revenue to expedite the decision on raising taxes on tobacco products, the Department-related Parliamentary Standing Committee on Health and Family Welfare said in its 147th report. It was presented in Rajya Sabha on Friday.

It said for better policy formulation on cancer treatment and uniform distribution of cancer care, there is an urgent need to have realistic information about the incidence and type of cancers across the country.

The committee said that the health ministry should take appropriate steps to persuade state governments to participate in the formulation of the cancer atlas so that the entire Indian population is covered under Population Based Cancer Registries (PBCRs). This will help in data-driven and evidence-based policy formulation, it said.

It suggested that PBCRs can be linked to the Ayushman Bharat Digital Mission to record data of cancer patients to get real-time information on cancer-related illnesses.

"The committee has taken note that currently PBCRs cover 16 per cent of the Indian population only. Therefore, it is quite necessary that the National Cancer Registry Programme cover the population of India extensively, in order to have a unified national database for scientific understanding of epidemiology of cancer," the report said.

Stressing a robust screening mechanism for cancer, the committee suggested that one day in a month can be fixed for cancer screening.

While appreciating the government's impetus on an institutional framework for cancer care and management and financial support for combating cancer, the committee said cancer must be dealt with separately instead of being a part of other lifestyle and non-communicable diseases.

It recommended the demerger of the National Cancer Control Programme (NCCP) from the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) to have a better focus on screening, early diagnosis and management of cancer. In its report, the committee said that in all the leftover districts Non-Communicable Diseases (NCD) clinics should be set up at the earliest and more healthcare professionals be trained for screening of common cancer. The panel highlighted that adequate human resource in cancer centres is crucial for their complete operationalisation and recommended setting up subsidised or free accommodation for patients and their relatives near cancer hospitals.

The National Health Authority (NHA) should consider including all types of cancer diagnostic tests under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), it said.

It appreciated that in compliance with the committee's recommendations, the NHA has approved the inclusion of diagnostic tests under the AB-PMJAY with respect to breast, cervical and oral cancer. The committee noted that the health ministry has set up the e-Sanjivini Ayushman Bharat-Health Wellness Centre (AB-HWC), where doctor-to-doctor telemedicine services can be delivered through the hub and spoke model.

It recommended that this model should be strengthened so that the opinions of experts can be provided to cancer patients in isolated and backward areas.

The ministry should instruct National Cancer Grid (NCG) officials to explore group negotiation of commonly used high-value cancer drugs with pharmaceutical companies through a transparent central tendering platform to have substantial discounts on cancer drugs.

Since the mandate of the National Pharmaceuticals Pricing Authority is to ensure the availability of drugs at affordable prices, the committee reiterated that the pricing of cancer drugs should not be guided by profit as in the case of the other businesses.

If it is not possible to reduce the profit margin of such drugs, the government may subsidise it, it said in its report.

"The committee feels that the submission made by the Secretary, Department of Pharmaceutical, before the committee that over a period of about eight years or so the actual price increase in the drugs had been only between two to four per cent, does not mean that each manufacturer keeps the price of the drug below 10 per cent, as the mechanism permits them to make the hike up to 10 per cent," the report said.

The committee said the government should rationalise the annual price hike limit of cancer drugs from 10 to five per cent in order to rescue poor cancer patients.

It also suggested the ministry look at subsidising the healthcare cost for cancer patients and declare radiotherapy service as an essential commodity.

The ministry should take the matter on board immediately and declare radiotherapy service as an essential commodity so that patients can get some relief from bearing the high cost of the service, it said.