Notifiable Disease

Why in the News?

Recently, there have been calls to designate cancer as a notifiable disease in India.

• Notifiable Disease – A notifiable disease is one that physicians are legally required to report to public health authorities.
• The primary purpose of disease notification is to ensure that contagious diseases are kept under check.
• Legal mandate – Notification of infectious diseases is a legal mandate, and failing to report designated diseases could lead to legal consequences.
• Infectious diseases – These diseases typically include infectious diseases such as tuberculosis, cholera, malaria, and COVID-19.
• Epidemic Diseases Act, 1897 – This act provides the legal framework for notifying diseases in India.
• Integrated Disease Surveillance Programme (IDSP) – The IDSP monitors notifiable diseases in India.
• The list of notifiable diseases differs from state to state as state governments are responsible for bringing out the notification.
• Snake bite – In 2024, the Indian government asked states to announce snakebites a notifiable disease to improve reporting and response mechanisms.
  • In 2024, snakebite was made a notifiable disease, despite being a non-communicable condition.
• Cancer as notifiable disease – There has been argument to make cancer as notifiable disease to enhance surveillance, early detection and resource allocation.

Issues in Designating Cancer as a Notifiable Disease:

• Lack of immediate public health threat – Unlike infectious diseases, cancer does not spread through direct transmission or cause sudden outbreaks.
  • Cancer requires long-term management rather than emergency interventions.
• Complex diagnosis – It is a diverse group of diseases rather than a single condition, and its detection often requires complex diagnostic procedures.
• Legal burden – Mandatory reporting could impose unnecessary legal obligations on physicians.
• Social stigma – Cancer still carries social stigma, discouraging patients from seeking timely diagnosis.
• Privacy concerns – Notifiability generally does not account for privacy because disease notification is meant to preserve public health over individual confidentiality.

Alternative Approach

• The World Health Organization advocates mainly cancer registries, which mention notification as an option at the individual level alone.
  • Expanding the National Cancer Registry Programme (NCRP).
  • Encourage voluntary reporting for accurate data collection.
  • Enhancing cancer screening initiatives for early detection.
  • Implementing robust follow-up mechanisms to track treatment outcomes.

India’s National Cancer Registry Programme (1982) functions as a data collection mechanism for compiling crucial information on the demographics of cancer patients.

Reference

The Hindu | Should cancer be a notifiable disease