Expanding Access to Life-Saving Oncology: India Strengthens National Cancer Care Infrastructure

NEW DELHI — In a major effort to reduce treatment delays and financial strain for oncology patients, the Union Ministry of Health and Family Welfare has outlined a series of structural expansions aimed at decentralizing cancer diagnosis and tertiary treatment across India.

In a written response to the Rajya Sabha, Union Minister of State for Health and Family Welfare Shri Prataprao Jadhav detail-mapped the country’s growing cancer care grid. Under the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), India has established 770 District NCD Clinics, 524 Day Care Cancer Centres (DCCCs), and 6,410 NCD clinics at Community Health Centres.

The government’s strategy relies on a multi-tiered public health response: combining community-level screening through Ayushman Arogya Mandirs with financial safety nets under the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and advanced tertiary facilities across AIIMS campuses, Tata Memorial Centres, and specialized regional institutes.

The Scale of the Challenge

Cancer remains one of the fastest-growing non-communicable diseases (NCDs) in India. According to estimates from the Indian Council of Medical Research (ICMR), the country sees over 1.4 million new cancer diagnoses annually, with oral, breast, and cervical cancers accounting for a significant share of cases.

historically, specialized oncology infrastructure was heavily clustered in major metropolitan hubs. Patients from rural and semi-urban districts often faced grueling journeys, high out-of-pocket costs, and severe delays in starting chemotherapy or radiation—delays that can significantly lower survival rates.

+-----------------------------------------------------------------------+
|                 INDIA'S DECENTRALIZED CANCER CARE GRID                |
+-----------------------------------------------------------------------+
|  PRIMARY / COMMUNITY LEVEL                                            |
|  • 6,410 CHC NCD Clinics                                              |
|  • Population Screening (Oral, Breast, Cervical via Frontline Workers)|
+-----------------------------------------------------------------------+
                                   │
                                   ▼
+-----------------------------------------------------------------------+
|  DISTRICT / INTERMEDIATE LEVEL                                        |
|  • 770 District NCD Clinics                                           |
|  • 524 Day Care Cancer Centres (Hub-and-Spoke Chemotherapy Model)     |
+-----------------------------------------------------------------------+
                                   │
                                   ▼
+-----------------------------------------------------------------------+
|  TERTIARY / ADVANCED LEVEL                                            |
|  • 22 AIIMS Campuses with Oncology Units                              |
|  • 19 State Cancer Institutes & 20 Tertiary Care Cancer Centres       |
|  • 6 Tata Memorial Centre Satellite Hospitals                         |
|  • National Cancer Institute (Jhajjar) & CNCI Campus (Kolkata)        |
+-----------------------------------------------------------------------+

Early Detection: Population-Based Screening at the Grassroots

While tertiary centers provide specialized medical, surgical, and radiation treatments, health experts stress that survival rates depend primarily on early detection. Late-stage diagnoses continue to drive high mortality rates in low- and middle-income regions.

To address this, the National Health Mission (NHM) has rolled out population-based screening for adults aged 30 and above through Ayushman Arogya Mandirs. Frontline healthcare staff—specifically Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs)—conduct initial screenings for three common cancers:

• Oral Cancer: Visual inspection and clinical evaluation.

• Breast Cancer: Clinical breast examination and self-examination training.

• Cervical Cancer: Visual inspection with acetic acid (VIA) or swab sampling.

“When cancer is caught at Stage I or II, curative intent treatments are far more effective, less invasive, and significantly less expensive,” notes Dr. Rajesh Sharma, a public health oncologist not affiliated with the ministry’s report. “Training community health workers to spot early warning signs shifts the healthcare model from reactive crisis management to proactive intervention.”

Decentralizing Chemotherapy: The Hub-and-Spoke Model

For patients undergoing routine chemotherapy cycles, frequent travel to distant regional centers creates severe financial and logistical stress. To reduce this burden, the Ministry of Health is deploying Day Care Cancer Centres (DCCCs) in district hospitals through a hub-and-spoke model.

Under this framework:

1. The Hub (Tertiary Institutes/State Cancer Institutes): Handles complex surgeries, high-dose radiation therapy, and complex multi-agent systemic treatment planning.

2. The Spoke (District DCCCs): Administers routine, protocol-based chemotherapy infusions closer to patients’ homes under distant or local oncological oversight.

This decentralization frees up high-capacity beds in major institutes while ensuring patients can receive care near family and support systems.

Tertiary Expansion and Financial Protection

To build capacity for complex surgical, medical, and radiation oncology, major national investments have expanded high-end tertiary facilities:

Mitigating Financial Distress via AB-PMJAY

Specialized physical infrastructure is effective only if care remains financially accessible. Under the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), eligible families receive ₹5 lakh ($6,000 USD approx.) per year for secondary and tertiary care hospitalization.

The scheme covers 1,961 medical and surgical procedures across 27 specialties, including extensive packages for:

• Medical Oncology: Cashless access to targeted therapies, chemotherapy cycles, and supportive medications.

• Surgical Oncology: Complex tumor resections, organ-sparing surgeries, and post-operative care.

• Radiation Oncology: Advanced linear accelerator treatments, intensity-modulated radiation therapy (IMRT), and brachytherapy.

Individual States and Union Territories also retain the flexibility to customize health benefit packages to address regional cancer trends and specialized local needs.

Public Health Impact, Challenges, and Nuances

While the rapid expansion of clinics and financial schemes marks a key milestone, independent healthcare policy experts point out ongoing operational challenges:

1. Human Resource Shortages: Expanding physical facilities requires a matching increase in trained personnel—including medical oncologists, surgical oncologists, medical physicists, radiation therapy technologists, and specialized nurses. Training specialized staff requires years of targeted academic investment.

2. Maintenance and Quality Control: High-end radiation equipment (such as linear accelerators) requires rigorous maintenance, ongoing calibration, and strict quality control measures to function safely and effectively in remote regional centers.

3. Public Awareness & Stigma: Despite the presence of 6,410 Community NCD clinics, public uptake for voluntary screening remains uneven due to social stigma, fear of diagnosis, and limited health literacy.

Because health remains primarily a State subject under India’s constitutional framework, the Union government provides technical and financial support through the National Health Mission, while execution relies heavily on local state health administrations. Smooth coordination between state implementation teams and central funding agencies will determine how quickly these facilities reach full operational efficiency.

References

1. Ministry of Health and Family Welfare, Government of India. (2026, July 21). Update on Availability of Cancer Care Centres [Press Release ID: 2286948]. Press Information Bureau (PIB), Delhi.

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.