NPCDCS
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Direct answer
Cancer, diabetes, cardiovascular disease and stroke share one programme because they share risk factors, and the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), launched in 2010 and since broadened and renamed the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), is India's answer to the fact that non-communicable diseases now cause the majority of deaths in the country. Its machinery is population-level screening of everyone aged 30 and above for hypertension and diabetes, screening of women aged 30 to 65 for oral, breast and cervical cancer, NCD clinics at district and community health centre levels, and a global commitment to cut premature NCD mortality by a quarter by 2025.
What you must remember
- NPCDCS began in 2010-11 in 100 districts and expanded nationwide; renamed NP-NCD, adding COPD, chronic kidney disease, fatty liver disease and oral cancer.
- Screening package: every adult 30 and above for raised blood pressure and blood glucose; women 30 to 65 for cervical cancer (visual inspection with acetic acid), breast cancer (clinical breast examination) and oral cancer — the latter also for men 30 and above.
- The global goal is "25 by 25" — a 25% relative reduction in premature mortality from NCDs between the ages of 30 and 69 by 2025, monitored against the WHO's nine voluntary targets.
- WHO's 5 by 5 framework names five risk factor groups: tobacco, harmful alcohol use, physical inactivity, unhealthy diet and air pollution (added to the original four in 2018).
- Frontline delivery: the CBAC (community-based assessment checklist) flags risk at the doorstep, measurement follows at Ayushman Arogya Mandirs, and referral flows to district NCD clinics.
- Diagnostic thresholds: hypertension from 140/90 mmHg on repeat measurement; diabetes from fasting glucose of 126 mg/dL or above or random 200 mg/dL or above, confirmed another day.
- Cervical cancer screening in the programme uses VIA, a one-minute acetic acid application, rather than cytology, because it is cheap, immediate and treatable-on-the-spot by cryotherapy where positive.
- CERVAVAC, India's indigenous quadrivalent HPV vaccine, positions schoolgirl vaccination against cervical cancer to join NCD prevention.
One day at an Ayushman Arogya Mandir
A 42-year-old porter walks in for a knee complaint. The community health officer runs through his CBAC: tobacco chewing, yes; waist circumference high; family history of stroke in his father. His blood pressure reads 156/94, repeated after rest 152/92 — likely hypertensive. Random glucose is 168 mg/dL; a fasting sample two days later reads 132 mg/dL, below the diabetes threshold but in the impaired range. He enters the NCD follow-up register, gets lifestyle advice framed in rupees and thali-sizes rather than abstractions, and a monthly review. His wife, 38, is called for her due screening: VIA negative, clinical breast examination normal, and an oral examination catching a small leukoplakia against her pan-tobacco habit, referred to the district NCD clinic for biopsy and cessation. One clinic morning, two cancers' worth of prevention.
Numbers worth knowing
Three numbers are repeatedly examined. First, the ages: 30 and above for hypertension, diabetes and oral cancer screening; 30 to 65 for breast and cervical — candidates writing "21 and above for cervical" quote Western Pap guidance, not the Indian VIA protocol. Second, 25 by 25: premature mortality means death between 30 and 69 years, measured from a 2015 baseline. Third, the mortality share: NCDs cause roughly two-thirds of deaths in India. Two confusable structures also appear: the district NCD clinic versus the cardiac care unit, and this programme versus Ayushman Bharat insurance — NP-NCD delivers prevention and continuity of care, PM-JAY pays for hospitalisation.
Frequently asked questions
When was NPCDCS launched and what does it cover now?
Launched in 2010-11 in 100 districts as a programme against cancer, diabetes, cardiovascular disease and stroke; it has since been expanded and renamed NP-NCD to include COPD, chronic kidney disease, fatty liver disease and other NCDs across all districts.
Which cancers are screened under the programme, at what ages and with which tests?
Oral cancer by visual examination in men and women aged 30 and above; breast cancer by clinical breast examination and cervical cancer by visual inspection with acetic acid in women aged 30 to 65, with referral of positives.
What is the "25 by 25" target?
A 25% relative reduction in premature mortality (deaths between ages 30 and 69) from the major NCDs by 2025, compared with a 2015 baseline — the centrepiece of the WHO global NCD monitoring framework to which India is committed.
What is CBAC in NCD screening?
The community-based assessment checklist completed by ASHA or community health officer at the doorstep — capturing age, tobacco and alcohol use, physical activity, family history, waist circumference and symptoms — to triage who needs formal measurement at the facility.
What does the 75/25 initiative aim to achieve?
Ensuring 75 million (7.5 crore) people with hypertension and diabetes are identified and maintained on protocol-based treatment by 2025, using team-based primary care and drug refills closer to home.