Cost–benefit analysis of an organized community-based multi-cancer screening program in Bangladesh

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 US$69.02 million. Total annual economic benefits were estimated at US$106.77 million, yielding net benefits of US$37.76 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.