Estimating the burden of cancer attributable to tobacco in Bangladesh in 2020.

Abstract

Background: Information on the attributable fraction (AF) of cancer in Bangladesh is scarce. We aimed at estimating the AF of tobacco-related cancer in Bangladesh in 2020.

Methods: Data on prevalence of tobacco use (smokeless, smoking products, and second-hand smoke [SHS]) were derived from the Global Adult Tobacco Survey report (2009), while data on relative risks were derived from meta-analyses and large-scale Indian studies. The GLOBOCAN 2020 database was used to obtain the number of cancer cases and deaths. Concomitant use of both tobacco products was accounted for. Sex-specific and combined estimates were calculated, based on the counterfactual scenario of no exposure to tobacco.

Results: Smokeless tobacco was primarily responsible for oral (55.3%), esophageal (37.1%), laryngeal (33.4%) and pharyngeal (31.5%) cancer. Cigarette smoking was responsible mainly for esophageal (40.1%), pancreatic (34.2%) and lung (26.0%) cancer, while bidi caused mainly pharyngeal (49.2%), laryngeal (36.4%) and esophageal (33.3%) cancer. Overall, smokeless tobacco caused 14.6% of cases and 15.1% of deaths, while cigarette smoking caused 11.8% of cases and 15.3% of deaths and bidi smoking 14.1% of cases and 15.8% of deaths. SHS caused 0.6% and 0.8% of cases and deaths respectively. The combined use of tobacco products particularly contributed to esophageal and pancreatic cancers.

Conclusions: Tobacco was a major cause of cancer in Bangladesh in 2020, with smokeless and bidi smoking overcoming cigarette's contribution. Its control would greatly reduce cancer burden.