Late detection of cancer claims 8,600 lives annually in BiH: First comprehensive cancer research presented

(Patria) - The results of the first comprehensive cancer prevention research in Bosnia and Herzegovina were presented today at the final conference in Sarajevo, confirming the country's readiness to move towards organized cancer screening programs in line with European standards.

The research represents the most complete assessment to date of cervical, breast, colorectal, and prostate cancer prevention in Bosnia and Herzegovina and offers an operational roadmap for establishing organized screening programs aligned with European Union standards. The research was conducted within the framework of a joint EU and UN project, financed by the European Union with 900,000 euros and the United Nations with 100,000 US dollars.

The project is implemented by UNFPA and WHO in cooperation with the Ministry of Civil Affairs of Bosnia and Herzegovina, the Federal Ministry of Health, the Ministry of Health and Social Welfare of Republika Srpska, and the Department of Health of the Government of Brčko District of Bosnia and Herzegovina.

“This research represents an important step for Bosnia and Herzegovina. For the first time, we have a common and comprehensive basis for better planning of prevention, early detection, and control of four types of cancer. Our goal is clear: for the results of this research to become the foundation for concrete policies, sustainable prevention programs, and better treatment outcomes for patients. Bosnia and Herzegovina needs a system. A system that will not wait. A system that actively invites, monitors, registers, and guides the patient through the entire journey, from preventive examination, through diagnostics, to treatment itself,” said Dubravka Bošnjak, Minister of Civil Affairs of Bosnia and Herzegovina, who also opened the Conference.

Based on the research results, the European Union will allocate an additional 11.5 million euros for a comprehensive cancer prevention program, which will support the establishment of organized screening systems across the country in accordance with the European Cancer Plan.

“Cancer prevention saves lives. That is why the European Union supported this research, helping Bosnia and Herzegovina align its preventive health system with the highest European standards and best practices. The findings presented today provide a clear plan for a comprehensive national cancer prevention program, and the EU will continue to support the country in strengthening public services, improving healthcare, and ensuring a better quality of life for all citizens,” said Adebayo Babajide, Deputy Head of the EU Delegation to BiH.

Cancer represents one of the most serious public health challenges in Bosnia and Herzegovina. Every year, approximately 14,000 new cases of the disease are recorded, and about 8,600 deaths occur. Many forms of cancer are detected late, when treatment is more difficult and survival rates are lower, despite the fact that a significant number of cases can be prevented or successfully treated thanks to early detection and screening.

The research shows that Bosnia and Herzegovina already has a strong foundation for further development: legal frameworks, clinical capacities, and foundations for improving population-based cancer registries in all three administrative systems. However, none of the four types of cancer – cervical, breast, colorectal, and prostate – are yet covered by an organized screening program.

Currently, examinations are mostly carried out individually, not through a systematically organized program, with about 70% of patients entering the healthcare system only after the onset of symptoms. Prevention also proves to be economically viable: the cost of saving one year of life through organized screening ranges between 220 and 2,905 euros, which is significantly below the internationally accepted threshold for the cost-effectiveness of health investments. Data also show that a large number of cancer cases are detected in late stages: up to 22% of cervical cancer cases and 29% of breast cancer cases are diagnosed in advanced stages III and IV, when treatment is more demanding and uncertain.

What is now needed are operational decisions: adoption of prevention programs, establishment of special information systems that will systematically invite and monitor individuals covered by screening, consistent application of regulations that guarantee free preventive services, and sustainable financing for programs to survive in the long term.

Over the past year, the research analyzed cancer prevention and early detection practices in all three administrative systems – the Federation of Bosnia and Herzegovina, Republika Srpska, and Brčko District – using a rigorous approach of combined methods that included collecting institutional data, analyzing the health system, assessing the epidemiological burden, qualitative research among the population, and field visits to healthcare institutions across the country. The analysis was compared with nine key quality standards defined by the European Union guidelines for cancer screening.

Breast cancer screening is currently the most developed, with widely available mammography, but mostly through an opportunistic approach. Cervical cancer prevention combines PAP smear and HPV vaccination, which represents a strong foundation that has not yet been integrated into a population-based model.

Colorectal cancer screening is still in its early stages: diagnostic capacities exist, but structured programs and citizen invitation systems are lacking. Early detection of prostate cancer is based on opportunistic PSA testing, in line with the European approach that prioritizes risk assessment over universal screening.

“The evidence is now clear: for all four types of cancer, the cost of saving one year of life through organized screening represents only a small fraction of the gross domestic product per capita. With continued political commitment and further investment in coordination and quality, thousands of lives can be saved through early detection of the disease – a goal that is entirely achievable,” said Justine Coulson, UNFPA Representative in Bosnia and Herzegovina.