• Saturday, July 13, 2024
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Nigeria’s late-stage cancer crisis could worsen by 2030

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By 2030, surgical oncologists currently in short supply will be busier with an escalated crisis of late-stage cancer diagnosis and presentation, depriving many Nigerian patients of the benefits of early detection, experts have warned.

They are calling for actions to reverse the conditions that enable cancer patients to go by for many years before their cases are picked.

Data from the World Health Organization (WHO) indicate that out of 2016 million patients with cancer globally, 17.3 million will need surgery by 2030.

Ten million of these patients needing surgery will come from low and middle-income countries like Nigeria where cases continue to build up without adequate facilities for detection.

“From my experience, cases are rising. More cases of late-stage cancers are being presented compared to the first quarter of 2022. The proportion between men and women has not changed,” Jimoh Mutiu, consultant clinical and radiation oncologist at Lakeshore Cancer Center, Victoria Island, said.

Colorectal cancer (CRC) patients in Nigeria are, for instance, presented at a younger age of 53 compared to 68 in the United States.

However, the stage of presentation is often much higher with the majority of stage 4 patients in Nigeria compared to the US, a study by the Africa Group for Oncology Consortium shows.

It is almost non-existent to have stage one tumours in Nigeria because screening CRC is generally not performed.

The group also found that survival in patients with CRC in Nigeria is poor. About 62 percent only survive for six months while only 48 percent survive under 12 months.

What it implies is that Nigeria loses 38 percent of such patients within six months and 52 percent in a year.

Peter Kingham, director of the Global Cancer Disparity Initiative at Memorial Sloan Kettering Cancer Centre, US, said it is a similar story in breast cancer with late-stage cancer in a presentation by the majority of women.

Seventy-nine percent of Nigerian women present locally advanced or metastatics breast cancer, he said, noting that only 28 percent of Nigerians survive in five years, whereas 85 percent of women present stage three disease of breast cancer.

“The largest part of my clinical practice here is treating stage four colorectal cancer in the liver and in that situation, we talk about five-year survival in cures. We don’t talk about one-year survival here in the US,” Kingham, who is the associate professor of hepato-pancreato-biliary surgery, said during a seminar on research and ideas.

“This is just reinforcing the fact that so many patients are arriving at the hospital with a very late stage four diagnosis and dying very soon after they are diagnosed.”

In 2020, the African Organisation for Research and Training in Cancer estimated that there were over 302,076 people struggling with treatments, with less than 10 radiotherapy machines available in the country. At least 200 machines are required.

Nigeria faces a 96-percent deficit of clinical oncologists as less than 100 oncologists practice in the country instead of 3,000.

Despite being preventable and curable, cancer still leads to 13 percent of deaths in Nigeria on the back of late presentation, lack of awareness, poor prognosis and patient denial, researchers say.

These data stress the importance of developing methods of screening for early diagnosis, and experts are pushing for them to be effectively applied.

Read also: More Nigerian women at risk of cervical cancer over cost of HPV vaccine

Risk factors

Until recently, Nigeria was not one of the countries associated with solid tumours or colorectal cancers or breast cancers, Kingham said.

The conventional trend has been a high rate of associated cancers but as lifestyle changes occur, factors such as diet are changing what tumours are developing.

A WHO report shows that around one-third of deaths from cancer are due to the five leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use.

Cancer is the second leading cause of death globally and was responsible for 8.8 million deaths in 2015, according to WHO.

The global health body also estimates that 12,075 cervical cancer cases and 7, 968 deaths are recorded in Nigeria annually.