ILLUSTRATION: ADRIN SARWAR

Non-smokers are now facing elevated risks of lung cancer and respiratory disease simply by living in urban environments. Over years, this exposure becomes normalised, yet its health consequences are profound and long-lasting. “Around 87% of lung cancer cases are caused by smoking.

ADRIN SARWAR AND FARHAN MUSFIQUE

It develops without signs; exposure to carcinogens accumulates over years through food, air and water before symptoms appear.

Diagnosis typically comes late across gender, geography and class; by the time patients seek care, the disease is often beyond early intervention.

PATTERNS OF CANCER IN BANGLADESH

Among men, oesophageal, oral-cavity and lung cancers take a large share. Oesophageal cancer alone accounts for 15.1 per cent of new male cases and 20.9 per cent of cancer deaths. Tobacco remains a major factor, while occupational and ambient pollution also contribute: men in transport, construction, manufacturing and informal industries inhale polluted air for years.

For women, breast and cervical cancers dominate: breast cancer represents 18 per cent of new female cases and cervical cancer 13.3 per cent. Both are highly treatable if detected early; screening is limited outside urban centres, and stigma, low awareness and cost delay diagnosis. As Prof. Dr Syed Md Akram Hussain, Chairman of the Clinical Oncology Department at Bangladesh Medical University, reflects, “Most patients in our country come for treatment very late. There is a significant delay in diagnosis. Because of the stage at which they arrive, the chances of successful treatment decrease significantly. Consequently, the death rate is relatively high.”

Public debate often reduces cancer to individual choices—smoking, diet or genes—but those explanations no longer suffice. Rapid industrialisation and weak environmental enforcement have created shared exposure pathways: people are not choosing these risks; they live inside them.

MAN-MADE REASONS

Chromium from tanneries illustrates this. Untreated tannery effluent has been discharged into rivers and land for decades, contaminating soil and groundwater; studies report tannery solid waste repurposed into poultry and fish feed.

Dr Sayed highlights the broader problem of adulteration: “In Bangladesh, adulterated food is a major issue. For example, urea is used to whiten puffed rice (muri). With Ramadan approaching, you’ll see jalebis and other fried snacks being cooked in brake oil.” He adds, “Fast food often contains chromium. This chromium comes from poultry feed made from tannery waste. That poultry feed eventually enters the fast food chain. Our children now consume a lot of fast food. While there is no specific research yet, these factors have raised questions in our minds that this could be the cause.”

Lead and cadmium from informal battery recycling settle into nearby soil, homes and playgrounds. Small-scale smelters operate without protective equipment or oversight; children in affected areas show elevated blood-lead levels. Chronic lead exposure increases the risk of kidney, lung and other cancers later in life.

BREATHING IN POLLUTED AIR

Air pollution compounds these risks. Bangladesh frequently ranks among the world’s most polluted countries. Particulate matter from vehicles, brick kilns, diesel generators and factories penetrates deep into lungs, producing inflammation and cellular damage over years. For city residents polluted air is constant—during commutes, work and sleep.

Dr Sayed says, “The overall polluted air in Dhaka contains high levels of carbon monoxide, sulphur dioxide, and lead from vehicles. Various studies show this is even more dangerous than smoking.”

Non-smokers now face elevated risks of lung cancer and respiratory disease simply by living in urban environments. “Around 87 per cent of lung cancer cases are caused by smoking. This situation can be managed by reducing air pollution. To achieve this, the government, stakeholders, and NGOs must work extensively and collaboratively,” says Dr Kazi Mazur Ahmed, senior consultant & head of the department of clinical oncology & medical physics.

ARSENIC AND SLOW POISONING

Arsenic in groundwater remains a slow-poisoning crisis for millions who rely on tube wells. The problem is worsened by unregulated pesticide and chemical use in agriculture; recent evidence links heavy pesticide exposure to rising liver and stomach cancers among rural workers and urban consumers. Reflecting on this trend, Dr Manzur notes that farmers are increasingly falling victim to a toxic exposure of substances; improper handling of bleaching agents and detergent powders also contributes.

Cancer in Bangladesh is not only a medical challenge but also a mirror of social, environmental and industrial failures. Late diagnosis, contaminated food chains, polluted air and poisoned water have woven the disease into everyday life. Addressing it requires stronger regulation, improved screening and referral, public awareness campaigns and collaborative action by government, industry and civil society. Without urgent, coordinated measures, cancer will continue to claim lives silently. Now.