The current state of cancer care in Bangladesh is, indeed, distressing. Although the number of cancer patients is increasing every year, diagnosis and treatment remain inaccessible to a vast majority of the population—particularly those from low-income groups and rural areas—as a result of overwhelming treatment costs, scarcity of trained professionals, and unavailability of crucial equipment. To cite just a few depressing examples: among the 36 government medical college hospitals, only 14 have oncology departments (which are understaffed and underequipped); radiotherapy machines of Dhaka and Mymensingh medical college hospitals have been out of order for years; and there are no radiotherapy machines available to people living in Khulna, Rangpur, and Barishal divisions. The list, unfortunately, goes on and on.

Despite such gaping holes in the provision of cancer care in the country, we are yet to adopt a national cancer control strategy, action plan and programme. Reportedly, patients in Bangladesh are being treated following the cancer protocol developed by the US National Comprehensive Cancer Network (NCCN) for their own citizens, even though our healthcare systems are nowhere near comparable.

According to a latest report by World Health Organization (WHO), there are around 1.5 million cancer patients in Bangladesh, and at least 150,000 deaths every year. About 200,000 new patients are diagnosed each year. However, there is no database to preserve detailed information on the actual number of patients in the country, the most common causes of cancer, and district-wise prevalence, without which it's impossible to prepare a cancer prevention and treatment strategy. In comparison, our neighbour India has 30 such databases which are centrally coordinated. Why, in 50 years, have we failed to simply initiate a database for cancer patients? There is no conceivable answer.

While early diagnosis and screening have proven to improve a patient's chances of survival and reduce the cost significantly, the government is yet to take effective strategies to integrate early detection in its national health system. Massive awareness is needed, especially in rural areas, to ensure early detection, as well as provision of screening services at the upazila level across the country. Meanwhile, the state of palliative care here is even more deplorable, with a majority of cancer patients suffering from immense pain in silence.

There are only 20-22 cancer service centres for a population of over 165 million, but according to WHO, there should be one for every one million, which underscores just how far behind we are in ensuring accessible care.

We urge the government to develop a national protocol for cancer diagnosis, treatment and care, and initiate a population-based cancer registry without any more delay.