The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) aims to prevent and control non-communicable diseases in India through behavior change, screening, early diagnosis, management, and capacity building. It was launched in response to NCDs surpassing communicable diseases as the leading causes of death in India. The program focuses on raising awareness, screening for common NCDs, establishing clinics for treatment, training healthcare workers, and monitoring progress towards targets such as reducing NCD mortality rates. It has expanded to include initiatives for cancers, chronic respiratory diseases, and other conditions.

1. NATIONAL PROGRAMME FOR PREVENTION AND
CONTROL OF CANCER, DIABETES, CARDIOVASCULAR
DISEASES AND STROKE (NPCDCS)
DR PANKAJ CHAUDHARY
JUNIOR RESIDENT
G.S.V.M MEDICAL COLLEGE KANPUR
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2. PRESENTATION OUTLINE
 Total no of slides: 54
 Background
 Magnitude
 Evolution
 Objectives
 Strategies
 Package of services
 Targets
 Achievements
 New initiatives
 Cancer component under NPCDCS
 References: National Action Plan & Monitoring Framework for Prevention & Control of NCDs
India, National Centre for Disease Control DGHS Ministry of Health and Family Welfare,
GOI, National Programme for Prevention and Control of Cancer, CVDs, Diabetes& Strokes,
Ministry of Health and Family Welfare, GOI & National Health Profile 2018.
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3. BACKGROUND
 India is experiencing a rapid health transition with a rising burden of Non-
Communicable Diseases (NCD) surpassing the burden of Communicable
diseases.
 The Non-Communicable Diseases like Cardiovascular Diseases (CVD), Cancer,
Chronic Respiratory Diseases, Diabetes and other NCDs are estimated to
account for around 60% of all deaths, thus making them the leading causes of
death.
 Losses due to premature deaths due to these NCDs are also projected to increase
over the years.
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4. MAGNITUDE OF NCD BURDEN IN INDIA
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5. EVOLUTION OF NPCDCS
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6. RISK FACTORS
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7. OBJECTIVES
 Prevent and control through behavior and life style changes.
 Provide early diagnosis and management.
 Build capacity at various levels of health care for prevention,
diagnosis and treatment.
 Train human resource within the public health setup viz. doctors,
paramedics and nursing staff to cope with the increasing burden of
NCDs.
 Establish and develop capacity for palliative & rehabilitative care.
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8. STRATEGIES
 Health promotion, awareness generation and
promotion of healthy lifestyle.
 Screening and early detection.
 Timely, affordable and accurate diagnosis.
 Access to affordable treatment.
 Rehabilitation.
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9. Prevention through behavior change
 Increased intake of healthy foods
 Increased physical activity through sports & exercise.
 Avoidance of tobacco and alcohol.
 Stress management.
 Warning signs of cancer etc.
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10. Early diagnosis
 Opportunistic screening of persons above the age of 30
years at the point of primary contact with any health care
facility.
 Simple clinical examination comprising of relevant
questions and easily conducted physical measurements such
as history of tobacco consumption and measurement of blood
pressure etc.
To identify those individuals who are at a high risk of
developing diabetes and CVD, warranting further
investigation/ action.
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11. Treatment
 “NCD clinic’’ established at CHC and District
Hospital.
 Screening, diagnosis and management (including diet
counselling, Lifestyle management) and home based
care will be the key functions.
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12. Capacity building of human resource
 Health personnel at various levels will be trained for
health promotion, prevention, early detection and
management by a team of trainers at identified
Training Institutes/Centers.
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13. Supervision, Monitoring and Evaluation
 Regular monitoring and review of the scheme will be
conducted at the District, State and Central level through
monitoring formats and periodic visits and review meetings.
 The evaluation is the integral part of the programme and will
be carried out concurrently and periodically, as & when
required.
 As under the programme those found negative on screening
in first year will be screened every 5 years.
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14. PACKAGE OF SERVICES
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17. PACKAGES OF SERVICES TO BE MADE
AVAILABLE AT DIFFERENT LEVELS UNDER
NPCDCS
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19. EXPECTED OUTCOMES
 Reduction in exposure to risk factors, life style
changes leading to reduction in NCDs.
 Improved quality of life.
 Early detection and timely treatment leading to
increase in cure rate / control and survival.
 Reduction in prevalence of physical disabilities
including blindness and deafness.
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20.  Providing user friendly health services to the elderly
population of the country.
 Reduction in deaths and disability due to trauma,
burns and disasters.
 Reduction in out-of-pocket expenditure on
management of NCDs and thereby preventing
catastrophic.
 Implication on affected individual.
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21. TARGETS
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23. ACTIVITIES TO ACHIVE TARGETS
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29. Algorithm for Screening and
Management of Diabetes
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34. Algorithm for Management
of Hypertension
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39. ACHIEVEMENTS
 For programme management, State NCD Cells have been established in all 36
States/UTs, and District NCD Cells have been established in 390
district headquarters till March 2017.
 Provision has been made under the programme to provide free diagnostic
facilities and free drugs for NCD patients attending the NCD clinics at the
District and CHC levels.
 Till March 2017, 388 District NCD Clinics and 2115 CHC NCD Clinics have
been established in the country.
 Also, 133 Cardiac Care Units (CCU) for emergency Cardiac Care and 82 Day
Care Centers for cancer chemotherapy have been set up in identified districts.
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40. NEW INITIATIVES UNDER THE PROGRAMME
 Guidelines for prevention and management of Chronic Obstructive
Pulmonary Disease (COPD) and Chronic Kidney Disease (CKD).
 Integration of AYUSH with NPCDCS.
 Pilot intervention has been initiated for the prevention and control of
Rheumatic Fever and Rheumatic Heart Disease under the platforms
of NPCDCS and RBSK (Rashtriya Bal Swasthya Karyakram).
 Integration of RNTCP with NPCDCS.
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41. CANCER COMPONENT UNDER NPCDCS
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42.  Cancer has emerged as a major public health challenge internationally
and in India. It is one of the leading causes of deaths. Prevalence of
cancer in India is estimated to be 28 lakh while the annual incidence and
mortality is estimated to be 11 lakh and 5 lakh respectively.
 In 1975-76 National Cancer Control Programme was launched with
objectives of prevention, early diagnosis and treatment which was further
revised in 1984-85 and December 2004.
 During 2010, the programme was integrated with National Programme
on Prevention and Control of Diabetes, Cardiovascular disease and
Stroke.
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43. OBJECTIVES
 Primary prevention of cancers by health education
 Secondary prevention i.e. early detection and diagnosis of
common cancers such as cancer of cervix, mouth, breast
and tobacco related cancer by screening and/ self
examination method.
 Tertiary prevention i.e. strengthening of the existing
institutions of comprehensive and palliative care.
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44. SCHEMES UNDER THE REVISED
PROGRAMME
• Regional Cancer Centre Scheme.
• Oncology Wing Development Scheme.
• Decentralized NGO scheme.
• IEC activities at central level.
• Research and training.
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45. TERTIARY CARE CANCER CENTRES (TCCC)
SCHEME
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46. Objective
To provide comprehensive care, training and research in all types of
cancers. The comprehensive care includes cancer prevention, early
detection, diagnosis, treatment, after care, palliative care and
rehabilitation.
To act as a regional referral center for the comprehensive management
(treatment) of difficult cancer cases.
To provide pain and palliative care and ensure availability of opioids
drugs for cancer patients.
To function as a center for creating/ imparting training of different
health professionals (Doctors, Nurse, technologists, technicians) where
possible.
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47. To facilitate in organizing workshops/training programmes
for human resource development.
To facilitate in developing modules/standard treatment
protocols for the common cancer.
To coordinate with other institutions, NGOs, medical
colleges and the general health care delivery infrastructure in
conduction of cancer related activities including peripheral
outreach services in their respective geographical areas/
region.
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48. Strengthening of Tertiary Care Cancer
facilities scheme
Envisaged to set up 20 State Cancer Institutes (SCIs) and 50 Tertiary
Care Cancer Centres (TCCCs) across the country.
The financial assistance of up to Rs.120 crore for SCIs and up to
Rs.45 crore for TCCCs can be provided under the scheme with State
Government share of 40% (10 % for North East and Hill States).
Maximum of 30% of the sanctioned amount can be utilized for
civil/electrical work (including renovation) and improvement of
infrastructure.
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49. SCI/TCCC will provide comprehensive cancer diagnosis, treatment
and care services.
SCI will be the apex institution in the State for Cancer related
activities.
SCI will provide outreach services, diagnosis and referral treatments,
develop treatment protocols, undertake research and enhance the
capacity of personnel in the State in this field.
TCCC will undertake similar activities, though at a lower scale.
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50. ROLE OF SCI AND TCCC
The SCI /TCCC will provide comprehensive cancer
diagnosis, treatment and care services.
SCI will be a role model and leader in this field. It will serve
as the nodal and apex Institution to mentor other Government
Institutes (including TCCC and RCC).
 TCCC should mentor cancer related activities including at
the district level and below in their respective footprint area
(the areas from where patients are accessing the TCCC).
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51. SCI/TCCC will promote prevention of cancer; participate in outreach
and other activities under NPCDCS and other related public health
programmes.
SCI/TCCC will help in training of doctors/health personnel for cancer.
SCI/TCCC will participate in the cancer registry programme.
SCI/TCCC will promote research activities for cancer.
Patients screened for cancer under NPCDCS and other Government
programmes will get Tertiary care diagnosis and treatment in TCCC
and SCI.
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52. NATIONAL CANCER REGISTRY PROGRAMME
• National Cancer Registry Programme was launched in 1982 by Indian
Council of Medical Research (ICMR) to provide true information on
cancer prevalence and incidence.
Objectives:
1. To generate authentic data on the magnitude of cancer problem in
India.
2. To undertake epidemiological investigations and advice control
measures.
3. Promote human resource development in cancer epidemiology.
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53. DISTRICT CANCER CONTROL PROGRAMME
This programme was launched in 1990-91.
State and Union Territory has advised projects on health education,
early detection, and pain relief measures.
For this they can get up to Rs.15 lakh one time assistance and Rs.10
lakh for four years recurring assistance.
For effective functioning each district have one District Cancer
Society that is chaired by District Magistrate/Chief Medical Officer.
Other members are Dean of medical college, Zila parishad
representative, NGO representative.
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54. ELEMENTS
1. Health education.
2. Early detection.
3. Training of medical & paramedical personnel.
4. Palliative treatment and pain relief.
5. Coordination and monitoring.
The District programmes are linked with Regional Cancer Centres/
Government Hospitals/ Medical Colleges.
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55. Community Based Assessment Checklist
(CBAC) Form for Early
Detection of NCDs
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60. THANK YOU
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