Supreme Court Issues Notice In PIL Filed By AIIMS Doctor Seeking To Declare Cancer As 'Notifiable Disease'

The Supreme Court has issued notice in a Public Interest Litigation ('PIL') petition seeking directions to notify cancer as a notifiable disease within their respective jurisdictions to ensure uniform and mandatory reporting of all cancer cases across India.

The plea highlighted the absence of a centralized digital registry, causing fragmentation, duplication of efforts, and difficulty in tracking patients and treatment outcomes.

The Bench of Chief Justice Surya Kant, Justice Joymalya Bagchi and Justice Vipul M Pancholi issued notice in the PIL. 

Chief Justice Kant said, "We will like to examine it, that is why we are issuing notice. Some eminent doctor has come forward; therefore, we would like to consider it."

The Petitioner, Dr. Anurag Srivastava, is a distinguished academic surgeon and researcher of national repute, having served as the Head of the Department of Surgical Disciplines at the All India Institute of Medical Sciences (AIIMS), New Delhi, where he superannuated after more than three decades of exemplary service. 

He wanted to bring out alarming gaps in India’s cancer control framework, arising from the failure to declare cancer as a notifiable disease at the national level and the consequent absence of a unified, evidence-based system for prevention, surveillance, and treatment.

He has been instrumental in developing the AIIMS Breast & Endocrine Services, initiating the country’s first M.Ch. course in Breast & Endocrine Surgery, and conducting pioneering research in cancer biology, angiogenesis, and population-based cancer screening. His research contributions have been recognized globally, with over 200 scientific publications, 5,000+ citations, and authorship of key national policy documents, including the Operational Framework for Management of Common Cancers and the Standard Treatment Workflows (Oncology) issued by the Indian Council of Medical Research (ICMR). He has also served as Chairman of the Ethics Committee at the National Institute of Cancer Prevention and Research (NICPR–ICMR), where he contributed to the development and training modules for India’s National Cancer Screening Programme launched by the Ministry of Health and Family Welfare in 2017.

The Petition, filed by AoR Rani Mishra, stated, "Despite being one of the leading causes of death in India, cancer remains outside the ambit of mandatory notification, resulting in fragmented data, poor surveillance, and policy paralysis in addressing this growing epidemic."

The plea said that while health is primarily a State subject under Entry 6 of List II of the Seventh Schedule to the Constitution of India, both the Union and the State Governments have the power to legislate and notify diseases under their respective domains. It was stated that this concurrent jurisdiction has created a legal lacuna, with some States having notified cancer as a disease, while others have not. The absence of uniformity has led to disparities in reporting, monitoring, and early intervention across States. This inconsistency has caused a critical policy failure: patients in many States are detected only at advanced stages of cancer, where curative treatment becomes difficult, expensive, or impossible, the plea said.

It was submitted that the Indian Council of Medical Research (ICMR), through its National Cancer Registry Programme (NCRP), currently covers only around 10% of India’s population, with rural coverage as low as1%. Large States like Uttar Pradesh and Madhya Pradesh, Rajasthan, Andhra Pradesh, Telangana, and Odisha remain significantly underrepresented. The NCRP Policy Brief, 2020 and the 139th Report of the Parliamentary Standing Committee on Health and Family Welfare both categorically recommended that cancer be declared a notifiable disease to increase registry coverage, ensure accurate data collection, and guide effective policymaking. Yet, despite these authoritative recommendations, the Union, because of the delay in notifying Cancer as a Notified disease by States and UTs, has not been able to operationalize a national framework for mandatory cancer notification, the petitioner submitted.

"That this systemic failure has far-reaching public health consequences. The lack of a real-time, integrated, digital data platform means that patient information is often duplicated, delayed, or missing altogether. A centralized, app-based national cancer registry integrating all hospitals, diagnostic centers, and public health institutions, on the lines of the CoWIN portal, is urgently needed. Such a system would allow continuous data collection, seamless tracking of patient outcomes, and timely identification of high-risk regions. Without it, the country cannot develop reliable cancer statistics, efficient screening programs, or targeted interventions.", the plea stated.

The Petition has been filed arraying the Union of India, the National Institute of Cancer Prevention and all the States and Union Territories as Respondents. 

The PIL was filed due to various cause of actions, such as, the non-declaration of cancer as a notifiable disease in most states, resulting in incomplete data and underreporting of cancer incidence and mortality; the absence of a centralized digital registry to track patients and treatment outcomes, leading to fragmentation and duplication of efforts; the widespread reliance on non-evidence based and unscientific therapies, which delays access to evidence- based medical care; inadequate awareness campaigns and preventive measures to sensitize the population about early detection, risk factors, and lifestyle modifications; systemic lapses in death certification and audit, which obscure the true disease burden, delay policy interventions, and undermine accountability in healthcare delivery. 

The Petitioner submitted, "That in India, cancers of the breast, uterine cervix, and oral cavity constitute nearly 34% of all cancers, making them a public health priority. Among men, oral cancer caused predominantly by tobacco use is the leading cause of mortality, followed by cancers of the lungs, oesophagus, and stomach. Among women, breast and cervical cancers are the most common. It is crucial to note that these cancers- oral, breast, and cervical, are all amenable to early detection and treatment, which can drastically improve survival rates and reduce treatment costs...That despite these realities, a vast majority of cancer cases in India continue to be diagnosed at advanced stages, leading to a disproportionately high mortality-to-incidence ratio and placing an immense financial strain on patients and their families. Late-stage detection not only diminishes the effectiveness of treatment but also escalates the overall cost of care, thereby deepening healthcare inequities, especially among economically weaker sections and rural populations."

The Petitioner further sought directions to the Respondents to establish a centralised, real-time digital cancer registry, on the lines of the CoWIN portal, ensuring integration with existing datasets including NCRP, HBCR, PBCR, Ayushman Bharat–PMJAY, State health insurance schemes, mortality records and hospital information systems, with necessary safeguards for data accuracy, privacy and accountability; and to formulate and implement nationwide cancer screening programs at Primary Health Centers (PHCs) and Community Health Centers (CHCs), targeting high-risk and age-based groups.

The petition stated, "That under the framework of the National Cancer Registry Programme (NCRP), the Indian Council of Medical Research (ICMR) initiated Population Based Cancer Registries (PBCRs) with the objective of systematically collecting information on all new cancer cases occurring in a well-defined population. PBCRs are critical for generating reliable incidence and survival data, identifying geographic variations, and assessing the impact of cancer control measures. That the NCRP initially commenced in January 1982 with three PBCRs at Bengaluru, Chennai, and Mumbai. PBCRs systematically collect data on all new cancer cases occurring in a defined population through multiple sources such as government hospitals, private hospitals, nursing homes, clinics, diagnostic laboratories, imaging centres, hospices, and registrars of births and deaths. Over time, the PBCR network has expanded and presently covers 38 registries across the country, providing vital epidemiological data on incidence, prevalence, survival, and mortality, which is indispensable for assessing the community-level burden of cancer and framing preventive strategies."

Accordingly, the matter is now listed for a further date.

Cause Title: Anurag Srivastava v. Union of India and Ors. [W.P.(C) No. 1211/2025]