Journal of Primeasia
Lung Cancer in Bangladesh: Epidemiological Burden, Tobacco and Environmental Risk Determinants, Diagnostic Delay, and Survival Challenges — A Systematic Narrative Evidence Synthesis
Safkat Faruk Sezan1*, Mahe Jabeen2, Md. Imran Jewel3, Abdullah Al Imtiaz4
Journal of Primeasia 7 (1) 1-8 https://doi.org/10.25163/primeasia.7110752
Submitted: 10 March 2026 Revised: 13 May 2026 Accepted: 19 May 2026 Published: 21 May 2026
Abstract
Lung cancer remains one of the most consequential cancer burdens worldwide, yet its epidemiological and clinical pattern in Bangladesh is still not fully understood because national-level evidence remains fragmented. This review synthesizes recent evidence on the burden, risk determinants, clinical characteristics, survival patterns, and health-system challenges associated with lung cancer in Bangladesh. A PRISMA-informed systematic evidence synthesis was conducted using published studies and credible reports from 2020 to 2025. Searches were performed across PubMed, Scopus, Web of Science, Embase, Google Scholar, and manual reference lists. After screening 168 records, 22 studies were included for narrative synthesis. The available evidence suggests that lung cancer in Bangladesh is characterized by a strong male predominance, diagnosis at older age, socioeconomic vulnerability, and frequent late-stage presentation. Tobacco exposure remains the most consistent and dominant risk determinant, although the disease pattern cannot be explained by smoking alone. Ambient air pollution, biomass fuel exposure, secondhand smoke, occupational hazards, and limited access to early diagnostic services appear to contribute meaningfully, particularly among women, non-smokers, and rural or low-income populations. Histological evidence indicates a predominance of non-small cell lung cancer, with squamous cell carcinoma and adenocarcinoma representing major subtypes. Survival outcomes remain poor, largely due to delayed diagnosis, comorbidities, weak referral pathways, high treatment costs, and limited access to advanced oncology care. Overall, the review highlights the urgent need for stronger cancer registries, tobacco-control enforcement, air-pollution mitigation, early detection strategies, and more equitable treatment access. More prospective and population-based studies are needed to clarify Bangladesh-specific risk pathways and improve national cancer-control planning.
Keywords: Lung cancer; Bangladesh; tobacco exposure; air pollution; diagnostic delay; survival outcomes
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