No complete registration system for cancer patients

Even after 53 years of independence, Bangladesh has yet to complete the official registration process for cancer patients. Although discussions began in 2020 about developing software to facilitate this process, as of 2025, no significant progress has been reported. Experts attribute this delay to a lack of proper leadership, political interference, and government negligence.

Cancer specialists emphasize that any effort to prevent or treat cancer must start with a reliable registry containing patients' names, cancer types, treatment details, and mortality rates. However, Bangladesh has yet to establish such a registry, nor has it conducted any area-based surveys on cancer patients.

Professor Dr. Md. Habibullah Talukder Rasakin, Project Coordinator of Gonoshasthaya Community-Based Cancer Hospital and Head of the Cancer Prevention Department, stated, "In my 30 years of experience in cancer prevention management, I have identified three major failures. The first is the lack of a cancer patient registry. Since the registration process is not in place, regular cancer screening is also absent. As a result, awareness remains low, leading to gaps in treatment facilities and medical equipment availability."

He further explained that without knowing the disease burden in a country, no preventive measures can be effectively implemented, which ultimately increases patient suffering.

Hospital-Based vs. Population-Based Cancer Registration

Dr. Rasakin, also the President of the Bangladesh Cancer Foundation, explained, "There are two ways to collect data on cancer patients: hospital-based registration and population-based cancer registration. Hospital-based registration provides an estimate of the number of patients seeking treatment at hospitals but does not reflect the actual scenario. In contrast, population-based cancer registration is far more effective, as it identifies the total number of cancer patients within a selected population."

"During my tenure as the department head, I tried my best to maintain a hospital-based cancer registry. However, after I left the position in 2022, no further information has been published. I have seen continuous government negligence in preserving cancer patient data."

Currently, around 500 VIA centers are operational in various government hospitals for cervical and breast cancer screening. Under a project initiated by BSMMU’s Gynecology Department with government support, women aged 30-60 can undergo initial screenings for cervical and breast cancer. However, Dr. Rasakin described this initiative as "disorganized, incomplete, and flawed."

He elaborated, "Currently, cancer screening is conducted mainly in hospitals. Patients either come voluntarily or are diagnosed while seeking treatment for other diseases. This is an unorganized approach. Over the past 20 years, only about 15% of the targeted female population has been screened. To improve this, a community-based organized screening program is essential."

Dr. Rasakin believes that public awareness campaigns are necessary to encourage people to attend screening centers. A national cancer screening program could have ensured better results.

Research Findings on Cancer in Bangladesh

During a presentation of a study titled “The Burden of Cancer in Bangladesh: A Population-Based Cancer Registry,” lead researcher and Associate Professor of Public Health and Informatics, Dr. Md. Khalequzzaman, shared findings from a research program in Hossainpur Upazila, Kishoreganj, which began in July 2023 and surveyed 200,000 people.

According to the study, Bangladesh has an estimated 106 cancer patients per 100,000 people, with 53 new cases emerging each year. Cancer accounts for 12% of total deaths in the country.

Among the 38 types of cancer found in Bangladesh, the five most common are breast, oral, stomach, respiratory, and cervical cancer. The top five cancers among men are respiratory, stomach, lung, oral, and esophageal cancer, while the most prevalent among women are breast, cervical, oral, thyroid, and ovarian cancer.

Additionally, 75.8% of male cancer patients were smokers, while 40.5% consumed smokeless tobacco products such as betel leaf and jorda. Among female cancer patients, 60.6% used smokeless tobacco, and 46% of all cancer cases were linked to tobacco consumption.

The study also found that 60% of cancer patients received combined treatment, while 7.4% did not receive any treatment.

Urgent Need for Nationwide Registration and Screening

While acknowledging the importance of the BSMMU study, Dr. Rasakin stated, "At best, this study provides an approximate estimate. However, conducting such a survey in just one upazila is not enough. It must be expanded to upazilas across all eight divisions of Bangladesh. Additionally, medical college hospitals in each division should maintain a cancer registry. Each upazila should have a dedicated team led by two doctors to identify new cancer cases and track patient outcomes."

He emphasized the need to revive and restructure the National Cancer Control Council, which has been inactive for the past 12 years. He also urged authorities to keep it free from political influence and bureaucratic inefficiencies.

Professor Swapan Kumar from the National Cancer Research Institute and Hospital stressed the importance of implementing a national cancer screening program specifically targeting breast, cervical, and oral cancer. He highlighted the need for collaboration among the government, professionals, NGOs, and volunteer organizations to achieve this goal.

Government's Response

When contacted, Dr. Md. Sayedur Rahman, Special Assistant Professor at the Ministry of Health, stated, "Efforts are underway to establish four additional cancer hospitals this year. Moreover, steps are being taken to expedite the import of essential medical equipment for cancer treatment in various hospitals, including cancer hospitals."

He also mentioned ongoing initiatives to develop a sustainable national cancer registration system, which will be online-based. However, no specific timeline for completion was provided.