JMIR Publications

ABSTRACT

Background:

Cancer is a significant public health challenge in India, contributing to 8.3% of deaths and 5.0% of DALYs in 2016—nearly double its burden in 1990. Fragmented service delivery, limited specialist availability, late presentation, and significant financial hardship continue to hinder access to timely and effective cancer care, particularly in rural and underserved regions. National initiatives such as the NP-NCD and Ayushman Bharat have expanded diagnostic and treatment coverage; however, critical gaps remain in infrastructure, human resources, and quality of care. A comprehensive, system-level assessment is essential to inform evidence-based planning and strengthen cancer services nationwide.

Objective:

This study aims to evaluate the availability, readiness, and geographic distribution of cancer care services in India and to identify disparities across rural–urban settings and healthcare sectors. A secondary objective is to develop a framework to strengthen cancer service delivery across the continuum of care.

Methods:

A cross-sectional, descriptive study will be conducted across 32 States/UTs over three years. Using proportionate sampling, districts will be selected based on rural and urban population distribution. Nodal hospitals—preferably those hosting Hospital-Based Cancer Registries—will coordinate data collection from primary, secondary, and tertiary cancer care facilities. A structured electronic pro forma will capture data across six quality-of-care domains: equitable, effective, patient-centred, safe, efficient, and timely. Data will be entered through an online portal and monitored centrally. Descriptive statistics will summarise service availability, while Chi-square tests will assess differences across facility types, sectors, and geographic strata.

Results:

Ethical approval was obtained from the ICMR-NCDIR Institutional Ethics Committee (NCDIR/IEC/3058/2022); no individual patient data will be collected, all responses will be anonymised, and participation will be voluntary

Conclusions:

This situational analysis will generate critical evidence on India’s cancer care landscape, highlighting disparities and system gaps. Findings will support policymakers and programme managers in strengthening infrastructure, workforce deployment, and service delivery to advance equitable and comprehensive cancer care nationwide.