Trends and Burden of Breast and Cervical Cancer in Bangladesh: A Data-Driven Analysis and Future Outlook

IntroductionAmong women in Bangladesh, breast and cervical cancers remain the most frequently diagnosed malignancies. To strengthen early detection, In 2005, a national VIA-based cervical cancer screening initiative was launched, followed later by the addition of CBE for breast cancer and later integrated Clinical Breast Examination (CBE) for breast cancer screening. Since 2013, the Ministry of Health and Family Welfare (MOHFW) has implemented an electronic reporting system based on DHIS2 for aggregated health data, complemented by a case-based reporting stream established under the National Centre for Cervical and Breast Cancer Screening and Training (NCCBCST). This study reviews and evaluates VIA, colposcopy, and CBE screening data from 2024-2025 to assess the effectiveness, reliability, and overall performance of the electronic reporting system. MethodsA descriptive approach was employed, using secondary data obtained from both the aggregated and case-based DHIS2 electronic databases. The study included women aged 30-60 years screened for cervical cancer using VIA and all women undergoing CBE across multiple levels of health facilities, including community clinics, upazila and district hospitals, medical colleges, tertiary hospitals, and BSMMU. Data from 2024-2025 were cleaned and analysed in Microsoft Excel to assess screening volumes, positivity rates, and division-wise variations. Aggregated and case-based datasets were compared to evaluate completeness, consistency, and functionality of the reporting system. ResultsAcross 2024-2025, a total of 917,845 VIA tests and 964,228 CBE tests were performed nationwide. The national VIA-positivity rate was 9.7%, with the highest rates observed in Mymensingh (12.1%) and Rangpur (11.4%). A total of 20,819 colposcopy tests were conducted, showing a high national colposcopy-positivity rate of 147.2%, indicating a substantial number of referrals originating outside routine VIA screening. CBE positivity averaged 4.9%, with notable regional variation--highest in Rangpur (7.1%) and lowest in Barishal (2.9%). Screening participation was highest in the Dhaka division, whereas Sylhet consistently exhibited the lowest levels of service use. Aggregated and case-based reporting displayed strong alignment for key indicators, though referral pathway inconsistencies were observed. ConclusionsElectronic reporting through DHIS2 both aggregated and case-based proved effective for monitoring cervical and breast cancer screening activities in Bangladesh, enabling large-scale data capture, geographic analysis, and programme oversight. However, substantial inter-divisional disparities, low screening uptake in specific regions, and referral-linkage gaps between VIA and colposcopy highlight areas for improvement. Improving quality control mechanisms, adopting unique identifiers, and reinforcing referral pathways could enhance overall equity and efficiency of the national cancer-prevention programme.