Counting Cancer: Telangana’s Bold Step To Confront An Invisible Epidemic

On World Health Day 2026, which fell on April 7, the Government of Telangana made a decision that may well redefine cancer care in India: it declared cancer a notifiable disease. This is an acknowledgement that cancer is no longer merely a clinical entity treated within hospital walls, but a public health challenge that must be tracked, quantified, and confronted systematically.

As an oncosurgeon in private practice, I have witnessed firsthand the gap between perception and reality in cancer care. During screening camps in remote areas of Kothagudem and Khammam, we identified clusters of cervical cancer... not isolated cases, but pockets suggesting localized disease burden. These patterns, however, never enter official statistics. They remain invisible to policymakers.

In urban practice, a different but equally troubling reality emerges. A large proportion of women continue to present with stage IV breast cancer, despite years of awareness campaigns. The issue, therefore, is not merely awareness; it is the absence of a system that ensures awareness translates into early diagnosis.

Why Notification Matters

Public health rests on a simple truth: what is not measured cannot be managed. Until now, cancer data in India has been fragmented: limited to select registries, partial institutional reporting, and urban centres. Large sections of the population, especially in rural areas, remain underrepresented. By mandating reporting from all healthcare providers—and crucially, within a defined time frame of diagnosis—Telangana is moving toward near real-time cancer surveillance, rather than delayed, retrospective estimation.

The Telangana Cancer Registry

At the heart of this policy lies the creation of a statewide Telangana Cancer Registry—a centralized digital platform that transforms notification into actionable intelligence.

This registry will:

1. Capture every diagnosed cancer case across government and private sectors
2. Mandate time-bound reporting (within weeks of diagnosis)
3. Record type of cancer, stage at presentation, treatment details, and outcomes
4. Enable district- and sub-district-level epidemiological analysis

Institutions such as the Mehdi Nawaz Jung Institute of Oncology and Regional Cancer Centre are expected to anchor data validation and coordination. This is the critical shift: notification provides the mandate but the registry provides the machinery.

One of the most transformative aspects of this decision is the mandatory inclusion of private healthcare providers. In India, a substantial proportion of cancer care occurs in private hospitals. Historically, this data has remained outside public health systems. For the first time, private hospitals, diagnostic laboratories and oncology clinics will all contribute to a unified cancer database. This effectively brings the “invisible half” of cancer care into measurable reality.

Learning From Global And National Models

The importance of such systems is well established. The Surveillance, Epidemiology, and End Results Program in the United States and the National Cancer Registration and Analysis Service in the United Kingdom have demonstrated how robust registries can improve early detection, guide screening policies, and enhance survival outcomes.

In India, the National Cancer Registry Programme under the Indian Council of Medical Research has laid the foundation. Telangana’s move advances this by making reporting mandatory, comprehensive, and time-sensitive.

It will allow us to:

1. Identify high-burden districts
2. Validate cancer clusters such as those observed in cervical cancer
3. Understand patterns of late-stage presentation
4. Allocate infrastructure and manpower rationally

For the first time, we can move from assumption-driven planning to evidence-based intervention.

Financing Care

Data must be matched with access. Government initiatives such as Aarogyasri have significantly expanded access to cancer treatment by covering high-cost interventions. Simultaneously, the private sector has introduced cancer-specific insurance products, designed to address the prolonged and expensive nature of oncology care.

Together, these mechanisms reduce catastrophic expenditure, enable timely treatment and improve adherence to therapy. They are critical complements to surveillance; ensuring that diagnosis leads to treatment, not financial distress.

Screening must evolve into structured, population-based programs:

• Cervical cancer: HPV and VIA-based screening
• Breast cancer: Clinical examination and targeted imaging
• Oral cancer: Screening in high-risk populations

Crucially, screening must be digitally tracked and linked to care pathways.

Palliative Care Must Be Mainstreamed

A significant proportion of patients will continue to present at advanced stages. For them, palliative care is essential. This requires integration at district hospitals, access to pain relief, training in end-of-life care.

• Strengthening infrastructure and systems
• Expansion of district and regional cancer centres
• Increased radiotherapy capacity
• Digital integration for real-time monitoring
• Use of data for research and policy refinement

The true impact of this policy will be seen in district Telangana. For the first time:

• Local cancer patterns will guide local action
• Screening can be targeted
• Resources can be aligned with real need

The challenge will lie in ensuring compliance, data quality, and ethical data use. Cancer in India is not just a disease of late diagnosis but also a disease of incomplete measurement. By declaring cancer a notifiable disease and building a robust registry to support it, Telangana has taken a decisive step toward correcting that imbalance.

(This column was originally published in Eenadu. Republished here with permission. The author Dr. Geetha Nagasree N, MCh (Surgical Oncology) is a Senior Consultant Oncosurgeon at Care Hospitals in Telangana)

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