Beyond Limitations: Practical Strategies for Improving Cancer Care in Nigeria

Background: The burden due to cancers is an emerging public health concern especially in resource-limitedcountries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS andmalaria combined. As people in Nigeria and other developing countries are beginning to survive infectiousdiseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks anorganized and comprehensive strategy to deal with cancers. Materials and
Methods: This article reviewed30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care inNigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequatemanpower (in terms of quality and quantity) as well as limited treatment options.
Results: This review led tothe formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies usedin Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis ontobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primarycancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDSwill improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals,hub-and-spoke implementation of screening services, as well as investment in effective treatment options andincreased research in cancer care are essential. International ‘twinning collaborations’ between institutions inricher countries and Nigeria will enhance effective knowledge translation and improve the quality of patientcare.
Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcomethe present limitations which help contribute to the observed increases in cancer morbidity and mortality rates.Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategiesproposed here.