Cancer registry records 3,172 new cases from 2019 to 2022, with stomach and cervical cancers among the leading concerns
Cancer remains a growing public health concern in Bhutan, with the national cancer registry recording thousands of new cases and deaths, underscoring the need for stronger prevention, early detection, treatment access and support for patients and their families.
The Population-Based Cancer Registry of Bhutan (PBCR), established in June 2014 at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), recorded 3,172 new cancer cases between 2019 and 2022, comprising 1,457 men and 1,715 women. During the same period, the registry recorded 1,461 cancer deaths, including 734 men and 727 women.
The figures are contained in the registry’s second report, covering 2019–2022, following its first report published in February 2020 for the period 2014–2018.
The registry was established with support from the Ministry of Health, in collaboration with Tata Memorial Hospital and the International Agency for Research on Cancer (IARC) Hub for Cancer Registration in South-East Asia. It brings together clinical and administrative personnel, investigators, data abstractors and technical advisers to strengthen cancer surveillance and inform national health planning.
The report provides an important evidence base for understanding the types of cancer affecting Bhutanese people and identifying priorities for prevention, screening and care.
Stomach and cervical cancers among leading concerns
The five leading cancer types identified in the report are stomach, cervical, head and neck, colorectal and lung cancers.
Stomach and cervical cancer rates are among the highest compared with neighbouring cancer registries included in the report. However, the registry cautions that the increase in recorded cases may partly reflect mass screening activities conducted between 2021 and 2023, rather than an increase in new disease alone.
Digestive organ cancers account for 52.6 percent of cancer cases among men and 34.6 percent among women, highlighting the substantial contribution of digestive system cancers to the national burden.
The registry also recorded 59 childhood cancer cases, representing 1.9 percent of all reported cases, with leukaemia identified as the predominant type.
The higher number of cases among women than men further highlights the importance of sustained prevention and screening, particularly for cervical and breast cancers.
Lifestyle and infectious risks
The report identifies tobacco use, alcohol consumption, infections and dietary habits among the factors associated with cancer risk in Bhutan.
Tobacco-related cancers account for an estimated 23 percent of cancers among men and 13.9 percent among women. Meanwhile, 40.2 percent of adults aged 15–69 were reported to consume alcohol.
Among women aged 30–65 screened for high-risk human papillomavirus (HPV), prevalence stood at 11.2 percent. HPV infection is a major risk factor for cervical cancer.
Other concerns include areca nut use, reported among 59.7 percent of adults aged 15–49, and Helicobacter pylori (H. pylori) infection, reported at 32.4 percent and associated with stomach cancer.
Dietary habits are another area of concern, with 74.6 percent of adults reportedly not consuming the recommended five daily servings of fruit and vegetables. Traditional diets, including salted butter tea and dried or fermented meats, alongside processed foods and limited access to fresh produce in some highland communities, may also influence risk profiles.
These findings reinforce the need for culturally appropriate public health education, healthier food choices and greater awareness of preventable cancer risks.
Screening and prevention efforts expand
Bhutan has introduced several initiatives to strengthen cancer prevention, screening and treatment. The Bhutan Cancer Control Strategy 2019–2025, supported by a Royal Command on cancer control, provided a policy framework for national action. The National Cancer Control Programme was established in 2020 under the Department of Public Health.
During the 12th Five-Year Plan, the Health Flagship Programme for 2020–2023 expanded screening for cervical, gastric and breast cancers across all 20 districts. Reported screening coverage reached 90.81 percent for cervical cancer, 90.17 percent for gastric cancer and 93 percent for breast cancer.
The country has also strengthened cervical cancer prevention through school-based HPV vaccination, with reported coverage exceeding 90 percent for two doses. Since 2021, HPV DNA testing has been introduced to replace cytology-based screening.
Other measures include H. pylori testing, the installation of two mammography machines and clinical breast examinations to support earlier detection.
Awareness and patient assistance
Cancer awareness activities in 2025 reached 14 districts and 103 communities, engaging approximately 12,000 people, according to Bhutan Cancer Society (BCS) Executive Director, Karma Tobgay. The programme also involved 21 healthcare professionals and nine cancer survivors and family members.
Activities covered breast, cervical, stomach, colorectal, lung and head and neck cancers, as well as childhood cancers, including leukaemia and lymphoma. Community engagement and National Cancer Survivor Month were also part of the initiatives.
Alongside prevention, practical and financial support remains important for patients navigating diagnosis and treatment.
Reported expenditure on assistance for affected people amounted to Nu 1.86 million. Support includes patient navigation, transportation, monthly assistance for essential needs, assistive devices, nutritional supplements and financial assistance for review and treatment referrals.
An average of 10 patients requires transportation support each month, with a reported allocation of Nu 50,000. Eligible patients receive Nu 3,000 monthly for logistics and essential needs, while one-time assistance of Nu 10,000 is provided per referral for review and treatment.
Sustained action remains essential
Meanwhile, the registry’s findings underline the importance of combining reliable cancer data with prevention, vaccination, screening, timely diagnosis and accessible treatment.
Sustained tobacco control, healthier diets, public awareness and improved access to healthcare are particularly important for communities facing geographical and financial barriers. Equally critical is ensuring that patients and families receive compassionate care and practical support throughout treatment.
According to the BCS, strengthening these efforts will be essential for Bhutan to reduce preventable cancer risks, improve early detection and enhance outcomes for people affected by the disease.
Sangay Rabten, Thimphu
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