Cancer and the National Cancer Control Programme
Understanding Cancer
Cancer is not a single disease, but a large group of diseases involving abnormal cell growth. In a healthy body, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.
In cancer, this orderly process breaks down. Abnormal or damaged cells survive when they should die, and new cells form when they are not needed. These cells divide without stopping and form solid masses of tissue called tumours.
- Benign Tumours: These are non-cancerous. They do not spread to other parts of the body and are usually not life-threatening.
- Malignant Tumours: These are cancerous. They invade and destroy nearby healthy tissues.
- Metastasis: This is the most dangerous stage of cancer, where malignant cells break away from the original tumour, travel through the blood or lymph system, and form new tumours in other organs of the body.
Causes of Cancer (Carcinogens)
Cancer is caused by changes (mutations) to the DNA within cells. Agents that cause these genetic mutations are called carcinogens. They are classified into three types:
- Physical Carcinogens: Ultraviolet (UV) radiation from the sun and ionizing radiation like X-rays.
- Chemical Carcinogens: Tobacco smoke, asbestos, and certain harmful industrial chemicals. Tobacco use is the single greatest preventable cause of cancer globally.
- Biological Carcinogens: Infections from certain viruses and bacteria. For example, the Human Papillomavirus (HPV) causes cervical cancer, and Hepatitis B and C viruses cause liver cancer.
The Cancer Burden in India
Cancer is a major public health concern in India. The disease profile is heavily influenced by lifestyle and socio-economic factors.
- In Men: The most common are cancers of the oral cavity and lungs, overwhelmingly driven by the high consumption of tobacco (both smoking and smokeless forms like gutkha) and alcohol.
- In Women: The most common are breast cancer and cervical cancer.
National Cancer Control Programme (NCCP)
The Government of India launched the NCCP in 1975 to combat the rising burden of the disease. Today, the NCCP is integrated into the broader National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD).
The strategy of the NCCP rests on four major pillars:
1. Primary Prevention (Health Education)
- Focuses on preventing cancer before it occurs.
- Key actions include massive anti-tobacco campaigns, promoting healthy diets, and regulating industrial exposure to carcinogens.
2. Secondary Prevention (Early Detection and Screening)
- Cancer is highly curable if detected in its earliest stages.
- Under the Ayushman Bharat scheme, the government conducts mandatory population-level screening for the three most common cancers—oral, breast, and cervical—for all citizens above 30 years of age at Health and Wellness Centres (AB-HWCs).
3. Tertiary Care (Diagnosis and Treatment)
- Strengthening the medical infrastructure to provide surgery, radiotherapy, and chemotherapy.
- The government heavily funds Regional Cancer Centres (RCCs) and state cancer institutes across the country to provide affordable, high-quality care. The establishment of the National Cancer Institute (NCI) in Jhajjar, Haryana, is a landmark step in advanced cancer research and treatment.
4. Palliative Care
- For advanced stages where a cure is no longer possible, the focus shifts to palliative care. This involves providing strong pain relief (such as regulated morphine) and psychological support to improve the quality of life for terminal patients.
Preventive Vaccination Initiatives
A significant recent advancement in cancer control is the push for preventative vaccines. The government is working towards integrating the HPV (Human Papillomavirus) vaccine into the universal immunization schedule for young adolescent girls, which can successfully prevent the vast majority of cervical cancer cases.
