Bangladesh has made significant progress in reducing child and maternal mortality and infectious diseases over the past few decades. But non-communicable diseases like breast cancer and cervical cancer are still rapidly expanding. Every year, an estimated 13,000-15,000 women develop breast cancer and 8,000-9,000 women develop cervical cancer in the country. In fact, breast cancer is the most commonly diagnosed cancer among women (nearly 36 percent), followed by cervical cancer (more than 11 percent). And women from poor, marginalised and underserved communities are bearing the greatest burden of these diseases.
Most patients seek medical care only when the disease reach late stages and treatment becomes more complex and expensive. As a result, the likelihood of recovery decreases substantially, families face significant financial hardship, and premature death often becomes unavoidable.
In a country where nearly three-quarters of health expenditure is still paid out of pocket, cancer is not merely a health issue but a profound social and economic crisis, with multiple biological, social, environmental and health-system factors interacting to increase the risk.
The primary cause of cervical cancer is infection with the Human Papillomavirus (HPV). In Bangladesh, factors such as early initiation of sexual activity due to child marriage, frequent pregnancies, lack of awareness about menstrual hygiene, and limited access to regular health check-ups and screening elevate the risks. In many rural and low-income households, safe and hygienic menstrual management remains out of reach. Many adolescent girls and women lack access to clean sanitary products, safe water, privacy or adequate information. Social stigma and cultural taboo surrounding menstruation further discourage women from seeking appropriate health services. Longstanding, untreated infections and chronic inflammation may contribute to harmful changes in cervical cells and worsen the HPV infection.
For breast cancer, advancing age, family history, obesity, physical inactivity, unhealthy dietary habits, environmental pollution, and prolonged exposure to chemicals and heavy metals are important risk factors.
Heavy metal contamination, particularly lead pollution, has emerged as a growing public health concern in Bangladesh in recent years. A large proportion of these batteries are recycled or discarded through unsafe and unregulated methods, which leads to toxic lead getting released into the environment, from where it can enter the human body and increase the risk of cancer.
Although the country has an extensive network of community clinics, union health and family welfare centres, and upazila health complexes, many of these facilities suffer from shortages of personnel, limited service capacity, inadequate supervision, insufficient equipment, and shortages of medicines. The situation is even more challenging in urban areas, where effective primary healthcare services are largely absent. Consequently, most people, especially women, lack access to regular health counselling, preventive screening, and early diagnosis services.
As a result, opportunities for early detection of breast and cervical cancer are often missed. In many unions and urban wards, women have little or no access to routine breast examinations, cervical cancer screening using visual inspection with acetic acid (VIA), health education, or risk identification services. The shortage of trained community health workers, weak referral systems, and the absence of integrated electronic health information systems further complicate the situation.
Yet, cervical cancer is one of the most preventable cancers in the world, and breast cancer can be successfully treated in most cases if detected early. These cancers may become one of the greatest public health challenges facing Bangladesh in the coming decade, and addressing this crisis requires a coordinated national response now.
First, Bangladesh must establish strict policies and effective regulatory mechanisms for the safe collection, recycling and disposal of used lead-acid batteries. Environmental pollution should be treated as a public health issue. Second, awareness programmes on menstrual hygiene, women’s health, and cancer prevention should be strengthened in schools, colleges and communities. Access to safe sanitary products and hygienic facilities must be ensured.
Third, efforts to prevent child marriage, expand girls’ education, and empower women should be viewed as integral components of cancer prevention strategies. Fourth, strong primary healthcare units should be established in every union and urban ward, offering regular breast and cervical cancer screening, health education, and referral services. Trained community health workers can play a vital role in raising awareness, identifying at-risk women, and facilitating timely referrals.
Fifth, Bangladesh should urgently introduce nationwide school- and community-based HPV vaccination programmes to achieve the highest possible coverage among eligible girls. A vaccine administered today can prevent cancer tomorrow. This investment is not only critical for public health but also for safeguarding the lives of future generations of Bangladeshi women.
The premature loss of a mother, wife, sister or daughter is not only a tragedy for a family but also a loss for society as a whole. The time has come to prioritise prevention, because the most powerful weapons against cancer are awareness, early detection, and a strong primary healthcare system.
SM Ziauddin Hyder is prime minister’s special assistant on health affairs and a former senior health and nutrition specialist at the World Bank Group.
Views expressed in this article are the author's own.
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