Economic burden of breast, cervical, and oral cancer in Bangladesh: a cost-of-illness study.

[BACKGROUND] Breast, cervical, and oral cancers are leading causes of morbidity and mortality in Bangladesh, placing a heavy economic burden on households and the health system. Yet, this burden remains poorly understood, as no prior study has comprehensively examined their economic impact. Moreover, the profound psychological suffering experienced by patients are often overlooked in existing global evidence. Therefore, this study aims to estimate the comprehensive economic burden of breast, cervical, and oral cancers in Bangladesh from the household perspective.

[METHODS] Using a cross-sectional design, primary data were collected through structured interviews with 346 cancer patients. A cost-of-illness approach was employed. Direct medical and direct non-medical costs were estimated based on respondent-reported expenditures. Indirect costs, i.e.income loss, were calculated using the human capital approach. Intangible costs, reflecting pain and discomfort, were quantified using the willingness-to-pay method.

[RESULTS] The average total cost per patient was US$12,117, with breast cancer accounting for the highest burden. Intangible costs comprised 47.7 % of the total, underscoring the substantial psychological impact of cancer on patients. The combined national economic burden exceeded US$1.17 billion. Catastrophic health expenditure was nearly universal (99.1 %), with average treatment costs exceeding the catastrophic threshold by 44-fold. Expenditures were significantly higher among wealthier households, patients with longer disease duration, and those seeking care from multiple facilities.

[CONCLUSION] Breast, cervical, and oral cancers impose a major financial and psychological burden on households in Bangladesh. The near-universal catastrophic health expenditure and high intangible costs highlight the urgent need for accessible and affordable cancer care.

[POLICY SUMMARY] Policies should strengthen financial protection, decentralize diagnosis and treatment, introduce insurance with cancer-specific benefits, establish an effective referral system, integrate psychosocial support and strengthen early detection programs.