NPCDCS — National Programme for Prevention & Control of Cancer, Diabetes, CVD, Stroke
Non-communicable diseases (NCDs) now cause over 63% of all deaths in India and have overtaken infectious diseases as the leading cause of mortality. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), launched in 2010, is India's flagship response — covering prevention, screening, diagnosis, treatment and rehabilitation for the four major NCD groups.
NPCDCS was launched in 2010 in 100 districts across 21 states, scaled up to all districts of India by 2017-18. It is implemented under the National Health Mission umbrella with 60:40 centre-state funding (90:10 for NE/Himalayan). The programme focuses on four disease groups that together account for over 50% of NCD mortality in India: Cancer, Diabetes, Cardiovascular Disease (CVD), and Stroke. India's burden: ~7 crore people with diabetes (largest in the world), ~25 crore with hypertension, ~11 lakh new cancer cases per year, and stroke incidence rising 8-10% annually.
- Prevent and control common NCDs through lifestyle modification and risk factor reduction
- Build capacity at all levels of the health system for NCD prevention, early detection and management
- Establish NCD clinics at CHC and District Hospital level
- Provide free diagnostics and essential drugs for hypertension, diabetes and common cancers
- Strengthen tertiary care facilities for cancer, stroke and cardiac emergencies
- Reduce premature mortality from NCDs by 25% by 2025 (WHO 25x25 target — India is a signatory)
NCD Cell at District Hospital
Each district hospital has an NCD clinic with a Medical Officer trained in NCD management, staff nurse, counsellor, and pharmacist. Free essential drugs (Metformin, Amlodipine, Atenolol, Enalapril, Glimepiride, Aspirin, Atorvastatin) are dispensed. Investigations free of cost: blood glucose, lipid profile, ECG, urine albumin. Patients with complications or uncontrolled disease are referred to the District NCD Day Care Centre or to tertiary care.
NCD Day Care Centre (NCD-DCC)
Day care centres established at district hospitals for chemotherapy administration, dialysis support, and day-care observation — avoiding unnecessary admissions and reducing out-of-pocket expenditure. As of 2024, ~700 NCD-DCCs are operational.
Tertiary Cancer Centres (TCCs)
Twenty state cancer institutes (SCIs) and 50 tertiary cancer centres (TCCs) have been strengthened under the programme, providing comprehensive cancer care including radiotherapy, chemotherapy, and surgical oncology.
The flagship operational arm of NPCDCS is Population-Based Screening (PBS) for common NCDs, launched in 2017. ASHAs conduct door-to-door screening of all adults aged 30 years and above using a structured questionnaire and basic measurements (BP, blood glucose). Three cancers are screened at the community level:
- Oral cancer: Visual inspection of oral cavity for premalignant lesions (leukoplakia, erythroplakia, submucous fibrosis) — targeted at tobacco users
- Breast cancer: Clinical Breast Examination (CBE) by trained female health worker at the PHC level — for women aged 30-65 years, every 5 years
- Cervical cancer: Visual Inspection with Acetic Acid (VIA) — for women aged 30-65 years, every 5 years
Screening-positive individuals are referred to PHC/CHC for confirmation and management. Population-based screening is now operational in all districts of India, though quality and coverage vary widely.
Under NPCDCS, three vertical cancer components operate:
- National Programme for Prevention and Control of Cancer (NPCCC): Awareness, early detection, treatment — focuses on the three most common screenable cancers (oral, breast, cervical)
- Tertiary Cancer Centres (TCC): Established at medical colleges and regional cancer centres (RCCs) for comprehensive cancer care
- State Cancer Institutes (SCI): Apex state-level cancer centres, 20 established across India with central funding for equipment and infrastructure
Financial assistance up to Rs 10 lakh per patient is provided through the Health Minister's Cancer Patient Fund (HMCPF) for BPL patients. NPCDCS also runs the 'Tobacco Cessation Programme' through designated clinics at all CHCs and district hospitals.
NPCDCS faces structural challenges unique to NCDs: (1) chronic diseases require lifelong treatment and follow-up, but India's primary care is still episodic-care oriented; (2) drug supply chains for chronic medications are weaker than for acute conditions; (3) population-based screening produces large numbers of screen-positive individuals who then overwhelm diagnostic capacity; (4) primary care physicians (PHC MOs) often lack confidence in managing complicated NCDs; (5) private sector handles over 70% of NCD care, with limited data flow into the public system. Reference: npcdcbs.mohfw.gov.in.
NPCDCS represents India's structural pivot from infectious-disease-centric public health to NCD-inclusive primary care. For UPSC CMS candidates, the population-based screening algorithm, the three screenable cancers, and the drug list are predictable PSM topics — and operationally, every MBBS doctor working at PHC level after 2025 will be doing NCD screening routinely.