Population-level cancer screening and cancer care in Bhutan, 2020–2023 - a review

Sep 21, 2026

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Cancer screening and cancer care programmes are critical for lowering both incidence and mortality. Bhutan implemented a time-bound population-level screening programme from 2020 to 2023 for gastric, cervical and breast cancers with 91.2% coverage of eligible people. Among H pylori screenings, 32.4% were positive; gastric cancer was found in 0.07% of endoscopy and biopsy cases. HPV DNA positivity was 9.3% with cervical cancer at 0.13% after colposcopy and biopsy. Breast cancer detection reached 0.10% using clinical examination and mammography, alongside palliative care considerations, with stakeholder onboarding across all districts.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Summary

Introduction

Screening programme implementation and coverage

Results by cancer type

H pylori and gastric cancer

HPV DNA, colposcopy and cervical cancer

Clinical breast examination, mammography and breast cancer

Stakeholder participation across districts

Review Population-level cancer screening and cancer care in Bhutan, 2020–2023: a review Thinley Dorji,a,∗ Sangay Wangmo,b Sonam Dargay,c Namkha Dorji,d Yeshey Dorjey,e Birendra Pradhan,f Dechen Pema,g Choney Dema,h Jamyang Choden,i Tandin Dorji,j Mimi Lhamu Mynak,h Pempa,i and KingaJampheli aDepartment of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan bDepartment of Surgery, Central Regional Referral Hospital, Gelephu, Bhutan cDepartment of Surgery, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan dDepartment of Obstetrics and Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan eDepartment of Obstetrics and Gynaecology, Phuentsholing General Hospital, Phuentsholing, Bhutan fDepartment of Pathology and Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan gDepartment of Radiodiagnosis and Imaging, Central Regional Referral Hospital, Gelephu, Bhutan hNational Medical Services, Ministry of Health, Thimphu, Bhutan iDepartment of Health Services, Ministry of Health, Thimphu, Bhutan jAdvocates for Public Health, Thimphu, Bhutan Summary Screening of cancers is an important intervention in reducing the incidence and mortality related to cancers. Bhutan is one small country that is witnessing an increasing incidence and mortality related to cancers. The government implemented a time-bound population-level screening for gastric, cervical and breast cancers from 2020 to 2023 with an overall coverage of 91.2% of the eligible population. Among 370,225 individuals screened for H pylori, 32.4% tested positive; among 53,182 who underwent upper gastrointestinal endoscopy and biopsy, 255 (0.07%) had gastric cancer. Among 10,749 tested for HPV DNA, 9.3% were positive; among 9887 evaluated with colposcopy and biopsy, 154 (0.13%) had cervical cancer. For breast cancer screening, 72,283 underwent clinical breast examination, 845 mammography and cancer was detected in 73 (0.10%) individuals. In this article, we review how Bhutan implemented a population-level cancer screening programme with on boarding of multiple stakeholders and the participation of people across all districts. Copyright © 2024 The Author(s) . Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)). Keywords: Breast self-examination; Early detection of cancer; Endoscopy; Malignancy; Mammography; Mass screening; Palliative care; Pap smear The Lancet Regional Health - Southeast Asia 2024;24: 100370 Published Online xxx [https://doi.org/10](https://doi.org/10) . 1016/j.lansea.2024 . 100370 Introduction Cancer is a leading cause of death globally with 19.3 million new cancer cases and 10.0 million cancer deaths in 2020 .1 The overall burden of cancer incidence is increasing globally reﬂecting a shift in the epidemiological risk factors and increasing availability and accessibility to screening and diagnostic tests. Globally, the highest proportions of incident cancer cases were female breast, lung, colorectal, prostate and stomach cancers while the highest proportions of mortality were due to lung, colorectal, liver, stomach and female breast *Corresponding author. E-mail addresses: [dorji.thinleydr@gmail.com](dorji.thinleydr@gmail.com) (T. Dorji), wangmo. [sangaydr@gmail.com](sangaydr@gmail.com) (S. Wangmo), [sdargay@jdwnrh.gov.bt](sdargay@jdwnrh.gov.bt) (S. Dar gay), [namji2002@gmail.com](namji2002@gmail.com) (N. Dorji), [yesheydorjey@gmail.com](yesheydorjey@gmail.com) (Y. Dorjey), [birenpradhan@gmail.com](birenpradhan@gmail.com) (B. Pradhan), dpema1278@gmail. com (D. Pema), [choneyd@nms.gov.bt](choneyd@nms.gov.bt) (C. Dema), [jchoden@health.gov](jchoden@health.gov). bt (J. Choden), [tandorji@gmail.com](tandorji@gmail.com) (T. Dorji), [mlmynak@nms.gov.bt](mlmynak@nms.gov.bt)[ ](mlmynak@nms.gov.bt)(M.L. Mynak)

FAQs

What cancer screening programme did Bhutan implement from 2020 to 2023?

Bhutan implemented time-bound population-level screening for gastric, cervical and breast cancers between 2020 and 2023, covering 91.2% of the eligible population.

What were the key findings from gastric cancer screening?

Among those screened for H pylori, 32.4% tested positive. Among people undergoing upper gastrointestinal endoscopy and biopsy, gastric cancer was detected in 0.07%.

How were cervical and breast cancers screened and how often were cancers detected?

Cervical cancer screening used HPV DNA testing and, where evaluated with colposcopy and biopsy, detected 0.13% cervical cancer. Breast cancer screening used clinical breast examination and mammography, with cancer detected in 0.10% of individuals.

Sep 21, 2026

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