From Tumor Board Presence to Documented Review: A Coverage Cascade for Multidisciplinary Cancer Care in India

Background: Multidisciplinary tumor boards (MTBs) are a standard part of cancer care, yet India has no national measure of how many cancer patients are discussed at one. A national survey of hospitals in the National Cancer Registry Programme (NCRP), published in 2026, gives the first structured look at board presence and functioning. Objective: To describe how far hospital-level tumor board presence translates into all-case review, documentation and follow-up, and to define the data needed to measure patient-level coverage. Methods: Secondary analysis of published aggregate data: the ICMR-NCDIR survey of 229 hospitals in the NCRP hospital-based cancer registry (HBCR) network (October 2024), the HBCR 2021 report, national incidence estimates (ICMR-NCDIR 2022; GLOBOCAN 2024) and two published single-center MTB audits. We calculated proportions with Wilson 95% confidence intervals, non-response bounds across all 229 hospitals, and logical bounds for joint conditions. No individual-level data were used. Results: A total of 229 hospitals were invited and 172 responded (75.1%). Among the respondents, 137 (79.7%; 59.8% to 84.7% across all hospitals) reported a functional tumor board. Only 65 respondents (37.8%; 28.4% to 53.3%) reported boards that review all cases, 71 (41.3%) had a follow-up system, 50 (29.1%) used any electronic documentation and 7 (4.1%) always took part in cross-hospital reviews. The share of hospitals with both all-case review and a follow-up system could lie anywhere from 0% to 37.8% of respondents. Boards were reported more often in private (86.6%) than in public hospitals (72.5%). Two single-center audits reported about 800 case discussions (573 new patients) and 1,260 case discussions (about 917 patients) a year, but neither reported new registrations at the same hospital, so coverage could not be calculated. Conclusions: Tumor board presence is common in India, but evidence of all-case review, documentation and follow-up is much thinner, and the share of patients reviewed nationally is unknown. We propose six indicators that hospital-based registries could report to measure coverage directly.