ObjectivesTo evaluate the economic benefits of implementing an organized community-based screening program for oral, breast, and cervical cancers in rural Bangladesh. MethodsA cost-benefit analysis was conducted over a one-year time horizon, with program costs estimated from the provider perspective and economic benefits assessed from the household perspective. Screening costs were estimated using primary data from a 2024 pilot implementation and extrapolated to all rural areas nationally. Economic benefits were defined as savings from averting late-stage cancer through early detection and included avoided direct medical and non-medical costs, income loss of patients and caregivers, and intangible benefits related to pain and distress. Benefit estimates were derived from a facility-based survey of 346 patients with oral, breast, or cervical cancer and extrapolated to the rural population using an incidence-based approach. Parameter uncertainty was assessed using one-way and probabilistic sensitivity analyses. ResultsThe total annual cost of implementing the screening program in rural Bangladesh was estimated at US69. 02 million. Total annual economic benefits were estimated at US106. 77 million, yielding net benefits of US37. 76 million and a benefit-cost ratio of 1. 55. Probabilistic sensitivity analysis indicated a high likelihood of cost-benefit, with 98. 9% of simulations exceeding unity. ConclusionsAn organized community-based screening program for oral, breast, and cervical cancers in rural Bangladesh is economically favorable and robust to uncertainty, even under conservative benefit assumptions. The findings support a transition from opportunistic to organized screening in Bangladesh, and provide policy-relevant evidence for cancer control planning in other resource-constrained settings.
Azim et al. (Tue,) studied this question.