🇧🇩 Cancer in Bangladesh

The Hospital Cancer Registry Report 2025, published by the institute's Department of Cancer Epidemiology in January 2026, records that 42,494 patients attended the outpatient department in 2025, of whom 31,046 were newly diagnosed with cancer; 30,831 (99.3%) with documented evidence of cancer were included. 15,809 (51.3%) were women and 15,022 (48.7%) men; mean age was 49.93 years (range 1 to 109); 61.4% were illiterate and 18.8% had primary education. Its top-ten table puts lung first at 4,626 (15%), then breast 3,800 (12.3%), cervix 3,632 (11.8%), connective tissue 1,433, lymph nodes 1,386, liver 1,271, stomach 1,215, oesophagus 1,030, cheek and buccal mucosa 828 and colon 825; the report's own text gives 4,274 for lung, so the two disagree. In men lung accounted for 3,574 (23.79%); in women breast 3,737 (23.64%) and cervix 3,632 (22.87%). 1,518 (4.9%) were children aged 0 to 18, with blood cancers commonest, and 6,713 (about 22%) were 65 or older. 69.9% arrived with a histopathological diagnosis, 9.2% cytological, more than 16% radiological only and 4.7% clinical only.

Table VI of the 2025 report gives, for men, 7,869 ever smokers (52.38%), of whom 1,243 (8.27%) were current smokers, and 4,802 ever chewers (31.96%), 905 (6.02%) current. For women it gives 238 ever smokers (1.51%), 86 (0.54%) current, and 5,701 ever chewers (36.07%), 1,365 (8.64%) current. The report summarises that men mainly use tobacco by smoking and women more often by chewing. Cancers of the lip, oral cavity and pharynx (ICD-O C00 to C14) were 2,683 patients, 8.7% of the total, and oral cavity cancer was among the ten commonest in both sexes (447 men, 599 women). These are proportions among patients who reached one hospital, not the prevalence of tobacco use in the population, and the registry does not attribute any cancer to tobacco.

The institute's history page states that it began the country's first hospital-based cancer registry in 2005. The 2025 report records that the registry started officially on 1 January 2005, and its editor, Dr Md. Johirul Islam, writes that it first reported in 2006, with reports for 2005 to 2007 and 2008 to 2010, a draft for 2011 to 2013, an online report for 2014 on the Directorate General of Health Services website, and reports for 2015 to 2017 and 2018 to 2020; work on 2021 to 2024 was nearing completion, and he credits automation for the faster 2025 report. The director's message describes the registry as a vital source of information 'particularly in the absence of a nationwide population-based cancer registry'. The national cancer strategy of 2008 planned to extend hospital registration nationwide and named a population-based registry at Gazipur and a planned one by the oncology department of the medical university at Matlab, Chandpur and Mirsarai, Chittagong; OnCo found no published incidence figures from them.

The National Cancer Control Strategy and Plan of Action 2009-2015 was published by the line director for Non Communicable Diseases and Other Public Health Interventions at the Directorate General of Health Services in December 2008, and approved by the National Cancer Control Council on 7 December 2008. Its goals were to reduce incidence through primary prevention, ensure screening and early detection, ensure diagnosis and treatment, and improve quality of life through support, rehabilitation and palliative care. It reported, from the institute's and the medical university's hospital registries, that more than 66% of cancers occurred at ages 30 to 65, that about 20 to 25% were diagnosed at a localised stage, about two thirds when regional, and fewer than 15% with distant metastasis. The National Strategy for Cervical Cancer Prevention and Control covered 2017 to 2022. OnCo found no successor to either on the Directorate's or the institute's websites.

The Health Economics Unit's sixth round of the Bangladesh National Health Accounts, covering 1997 to 2020, was presented in January 2023; at the launch its focal person reported that 68.5% of total health expenditure in 2020 was paid out of pocket, up from 56% in 1997, 62% in 2012 and 67% in 2015, and that public spending was 23.1%. The Health Care Financing Strategy 2012-2032 had set a target of 32% by 2032. Households spent 64.6% of their health expenses on drugs, 13.4% on ambulatory providers and 11.7% at medical and diagnostic laboratories. These figures are quoted from The Business Standard's report of the launch, because the report itself could not be downloaded. WHO's Global Health Expenditure Database, as republished by the World Bank (updated 8 October 2026), gives out-of-pocket spending as 79.3% of current health expenditure in 2023 and 77.0% in 2020; the WHO series is a share of current health expenditure, which leaves out capital spending, and is WHO's own estimate, so it does not match the national accounts.

The institute's citizen charter (in Bengali, dated 20 September 2025) states that outpatient tickets are bought for a fixed fee or online, that services are given first come first served, and that a list of user fees is displayed in each department. It states that poor and entitled patients ('অসচ্ছল ও প্রাধিকারভুক্ত রোগী') receive services free of charge, and that medicines are provided free subject to supply, though some medicines may have to be bought from outside. The hospital has free beds, paying beds and cabins, at fees set by the government. Admitted patients receive cancer surgery, chemotherapy, physiotherapy, rehabilitation and other treatment under specialists, and radiotherapy 'subject to the machines being operational', and day-care chemotherapy is available. The charter does not list the fees themselves, and OnCo did not find a published price for a course of radiotherapy or chemotherapy at the institute.

The Department of Social Services' page for the 'financial assistance programme for people with cancer, kidney disease, liver cirrhosis, paralysis, heart disease, leukaemia and thalassaemia' (in Bengali, last updated 18 October 2026) cites articles 15(a) and 15(d) of the Constitution and states that the programme aims to help poor and helpless patients afford treatment and protect their families. It covers all types of cancer diagnosed by a cancer specialist that need chemotherapy, radiotherapy, surgery or other costly treatment. It states that every finally selected patient receives a one-off 1,00,000 (one lakh) taka from the 2026-27 financial year. Applications are made online by the patient, a family member or a guardian; the signed printout, with the latest prescription and attested test reports no more than a year old (for cancer, a histopathology, cytopathology, bone marrow or biopsy report), goes to the upazila, city or hospital social services office. An applicant can receive the grant no more than once in a financial year and three times in a lifetime. The page's table of the programme, which covers all seven illnesses, shows an allocation of 650 crore taka for 65,000 patients in 2026-27, against 300 crore taka for 60,000 patients in 2025-26 and 561 patients in its first year, 2013-14; it does not say how many of them had cancer.

The Health Economics Unit's procurement notice of 16 February 2023 describes the scheme as a model of social health insurance for below-poverty-line households under the Health Care Financing Strategy 2012-2032: piloting began in one upazila of Tangail district in March 2016, was extended to two more upazilas in September 2017, and had then expanded to all upazilas and municipalities of Tangail, six more districts and the North and South Dhaka city corporations, with Barishal district next. At launch in March 2016, The Daily Star reported a health ministry statement that cardholders and their families could receive free care for 50 diseases, including complicated heart, kidney and gallbladder ailments, at upazila and district public hospitals, with the government paying an annual premium of 1,000 taka per household for care up to 50,000 taka a year. Neither source names cancer, and the scheme's current benefit list could not be read because the Unit's website did not respond.

The Directorate General of Drug Administration's 2024-25 annual report records that, on the health ministry's instruction, the National List of Essential Medicines was updated and published in the gazette, and lists among its functions registration, licensing and price-setting; the anti-cancer therapeutic class carries code 010 in its classification. OnCo found no health technology assessment agency, cost-effectiveness threshold or published reimbursement decision for cancer medicines in the regulator's, the health ministry's or the Health Economics Unit's material that could be reached. With out-of-pocket spending at about 70 to 80% of health spending and 64.6% of household health spending going on drugs, the practical question for most patients is the pharmacy price and whether the public hospital has the medicine in stock.

The Drugs and Cosmetics Act 2023 (Act 29 of 2023, Bangladesh Gazette of 18 September 2023) consolidated and updated the existing drug laws, the regulator's annual report says, and its section 65 governs pre-clinical and clinical trials of medicines, vaccines and devices. The Directorate's Guidelines for Reliance on other NRAs in Bangladesh, issued on 21 August 2023 and implemented from 31 August 2023, cite the National Drug Policy 2016 and Drug Control Committee meetings 248 and 250 as the legal basis, and list in Annexure 1 eight reference authorities for vaccines and biological products: the US Food and Drug Administration, the European Medicines Agency, Australia's Therapeutic Goods Administration, Japan's PMDA, the UK's MHRA, Germany's Federal Institute for Drugs and Medical Devices, Swissmedic and France's regulator, with WHO-prequalified products considered case by case. For vaccines and biologicals already approved by a reference authority, the guideline says the Directorate 'does not review again' and registers them on the basis of that evaluation or a Certificate of Pharmaceutical Product, and that a molecule registered by a reference authority in a given strength and form is considered safe and effective when a new drug is considered locally. The Directorate also takes part in WHO's collaborative registration procedure. Its 2024-25 report says it is working towards WHO maturity level 3, and it publishes no approval times.

The Directorate's 2024-25 annual report (in Bengali) states that about 98% of domestic demand for medicines is produced locally and exported to more than 150 countries including in Europe and America; that high-technology medicines such as vaccines, insulin and anti-cancer medicines are made in the country; and that most raw materials are still imported, with 44 plots allocated to active ingredient makers in an API park at Gazaria, Munshiganj, where three had begun production. Approved exports in 2024-25 were 29,374,614,433 taka, and the Directorate issued 1,412 Certificates of Pharmaceutical Product, 129 Free Sale Certificates, 3,040 export licences and 58 Good Manufacturing Practice certificates. Its National Drug Control Laboratory tested 2,882 samples and found 84 substandard. Incepta Pharmaceuticals, which says it exports to more than 102 countries, sponsored a completed phase 1 comparison of its proposed trastuzumab biosimilar with Roche's in 80 healthy adults in Dhaka (NCT06886659).

The National Strategy for Cervical Cancer Prevention and Control 2017-2022 records that the government chose visual inspection with acetic acid in October 2003, piloted it in 16 districts in 2005 with providers trained at the medical university, formally launched the National Cervical and Breast Cancer Screening Program in 2006 with the university and UNFPA, and extended it to upazila level from 2012; screening then ran at around 400 centres and was described as predominantly opportunistic. The strategy set screening for women aged 30 to 60 every five years with a target of at least 40% coverage, and 'see and treat' for screen-positive women at colposcopy. Nessa et al. (2025) describe screening at 600 facilities and put the target population at 29.43 million women; aggregated data for 2014 to 2024 show coverage of 17.9% (5.3 million). In the case-based electronic register from January 2018 to May 2023, 3.3% of 1,557,002 women tested positive and 40.4% of those attended colposcopy. No national mammography programme was found.

The National Cervical and Breast Cancer Statistics dashboard (programme office at the medical university, data source the national DHIS2), as archived by the Internet Archive on 18 March 2025, showed for the case-based system 2019 to 2025: 5,272,966 women enrolled, 2,874,216 (54.5%) in community clinics; 2,805,215 visual inspection screens with 82,965 (3.0%) positive; 63,521 colposcopy tests with 27,411 (43.2%) positive; and 2,807,789 clinical breast examinations with 26,028 (0.9%) positive. For the aggregated system 2014 to 2025 it showed 5,490,164 visual inspection screens with 239,589 (4.4%) positive and 5,548,979 breast examinations with 78,983 (1.4%) positive. The live dashboard returned 'not found' on 4 November 2026, so these figures are from the archived copy. The national cancer institute separately runs free breast screening campaigns for women each December, which its history page dates to 2015.

On 6 November 2015 the WTO's TRIPS Council extended until January 2033 the period during which the key pharmaceutical provisions of the TRIPS Agreement do not apply to least developed countries, which may choose whether to protect pharmaceutical patents and clinical trial data before then; the decision covers pharmaceutical products in least developed countries. Bangladesh was scheduled to leave the category on 24 November 2026; on 30 October 2026 the UN General Assembly, without objection, approved a G-77 proposal to defer the graduation of Bangladesh and Nepal by three years, so Bangladesh is now to graduate in November 2029, as Prothom Alo reported from the plenary. The regulator's report that about 98% of domestic demand is met locally, including anti-cancer medicines, describes the industry as it works under these terms; OnCo has not found a source that measures how much of its growth the exemption explains. What graduation will mean for the price of cancer medicines in Bangladesh is debated and is not stated here.

The national programme began aggregated reporting in DHIS2 in 2013 and a case-based register on its tracker component in January 2018 (Nessa et al., 2025). From January 2018 to May 2023 it enrolled 1,562,963 women at 497 screening facilities and 6,398 community clinics, with primary facilities doing 74.4% of enrolments and 72% of tests; of women treated for precancer, 81.6% (5,062) had thermal ablation and 17.6% (1,089) loop excision. The authors set screening coverage of 53.9% in Thailand, 78.0% in England and 3.0% to 7.1% in Ghana, Uganda and India beside Bangladesh's, write that those countries do not have electronic enrolment and tracking systems like Bangladesh's, and name Burkina Faso, Côte d'Ivoire, Guatemala and the Philippines as examples of the few countries reporting use of the DHIS2 tracker for cervical screening. Only 40.4% of screen-positive women attended colposcopy, and the authors suggest telephone follow-up of women who do not attend, decentralised colposcopy and mobile reminders.

OnCo's trial records carry the countries ClinicalTrials.gov lists for each study; across 6,501 trials and 95 distinct country names, none is Bangladesh or any spelling of it. A query of the ClinicalTrials.gov API on 4 November 2026 found 846 studies of any condition with a location in Bangladesh, and 48 returned by its 'cancer' condition search, which also matched studies of polycystic ovary syndrome and nutrition; 8 of the 48 were recruiting. The commonest sponsor of the cancer studies is the national medical university, under its old or new name, for example trastuzumab with capecitabine and oxaliplatin (NCT05997524, phase 2), venetoclax with hypomethylating agents in acute myeloid leukaemia (NCT07773909), brachytherapy schedules (NCT02765919) and nerve blocks for cancer pain (NCT07653906). The icddr,b research centre is testing locally made nutritional supplements for cancer cachexia (NCT07613125). Industry trials are rare; the only one found from a Bangladeshi company is Incepta's trastuzumab biosimilar study (NCT06886659).

OnCo's OpenAlex extract (built 8 September 2026, works whose primary topic is in the Oncology subfield, whole counting by author country) gives 209 works in 2021, 239 in 2022, 247 in 2023, 298 in 2024 and 469 in 2025, 1,462 in total, of which 1,020 are open access. These count any paper with a Bangladesh-affiliated author, including large international collaborations, so they measure participation rather than leadership. The National Institute of Cancer Research and Hospital's history records that the Cancer Journal of Bangladesh began publication with an ISSN in 2020, and its publications page lists issues from volume 1 (July 2020) to volume 7, and a first institutional yearbook, for 2023, published in 2024. The institute has offered MD and MS courses in radiation, medical and surgical oncology since 2004.

The 2008 national strategy described a population-based registry at Gazipur and a planned one at Matlab and Mirsarai; OnCo found no report of incidence from either. The National Institute of Cancer Research and Hospital's 2025 report says its 2021 to 2024 report is nearing completion. The earlier reports for 2014, 2015 to 2017 and 2018 to 2020 are posted on its reports page but were not read for this page, so no trend across years is given. Survival data for Bangladesh were not found.

heu.portal.gov.bd timed out. The Internet Archive's copy of its publications list (19 May 2025) names Research Paper No. 35, Bangladesh National Health Accounts 1997-2020 (January 2023), but the archived link points to a different file, Research Paper No. 32. The out-of-pocket figures from that report are therefore quoted as The Business Standard reported them from the launch. nccbcst.bsmmu.ac.bd returned 404, and the medical university's old domain bsmmu.ac.bd did not respond; its new site is bmu.ac.bd. The Directorate General of Drug Administration's Bengali annual report is set in a legacy font, and figures were taken from the numerals printed in it.

The Directorate's 2024-25 annual report gives counts of certificates, licences and tests but no time from application to registration, and the reliance guideline sets no deadlines. Bangladesh's medicine price-setting rules and the retail prices of cancer medicines were not surveyed. The national cancer institute's citizen charter says radiotherapy is given subject to the machines working, but no official count of linear accelerators or cobalt units in Bangladesh, or of how many were working, was found; press reports of new machines were not used. HPV vaccination was not researched for this page.