Cancer is one of the leading causes of death in the world and is currently a growing burden. In 2021, the world crossed a sobering new threshold – an estimated 20 million people were diagnosed with cancer, and 10 million died. Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, lung, cervical and thyroid cancer are the most common among women. All cancers can indeed be treated and prevented or cured. However, like so many other diseases, cancer care reflects the inequalities and inequities of our world.
The global cancer burden continues to rise, putting enormous physical, emotional, and financial strain on individuals, families, communities, and health systems. Many cancers are highly likely to be cured if diagnosed early and treated appropriately. More people than ever before are living their full lives following cancer treatment. However, in low- and middle-income countries, many systems are ill-equipped to manage this burden, and a large number of cancer patients lack access to timely, quality diagnosis and treatment. Whereas, in countries with robust health systems, survival rates of many types of cancers are improving, thanks to early detection and quality care. It is also important to note that cancer care depends on the type of cancer, its location, size, spread, and the patient’s overall health. The available treatments include surgery, chemotherapy, radiotherapy, hormone therapy, immunotherapy, and gene therapy. Early detection and appropriate care of patients who develop cancer also helps to improve the chances of successful treatment outcomes at lower costs and with fewer (or less significant) side effects for patients.
In Nigeria, cancer leads to over 70,000 deaths per annum. Breast cancer (25.7%), cervix uteri (14.6%), prostate (12.8%), non-Hodgkin lymphoma (5.3%) and liver (5.0) are the top five most common types of cancer. While estimated mortality rates are: breast cancer (18.6%), cervix uteri (16.8%), prostate (9.4%), liver (8.3%), and non-Hodgkin lymphoma (6.0%). Breast cancer is currently the leading cancer death in Nigeria, while cervical cancer is the second and prostate cancer third.
Cancers can be caused by many different factors, including lifestyle habits, genes, and environmental exposure to cancer-causing agents. Cancer can also spread from one spot to other parts of the body.
Closing the care gap
Cancer has been on the increase in many regions of the world. However, there is a significant variation in treatment availability between countries of different income levels; comprehensive treatment is reportedly more available in developed than developing countries like Nigeria. Incidence rates remain highest in more developed regions, but mortality is much higher in less developed countries due to a lack of early detection and access to treatment facilities. Many patients are diagnosed with cancer at late stages (stages III & IV), with few patients having access to the limited treatment facilities. Furthermore, a recent survey by the World Health Organization showed that cancer services are covered by a country’s largest government health financing scheme in an estimated 37% of low- and middle-income countries, compared to at least 78% of high-income countries. This means that the cancer care and treatment burden is more on out-of-pocket healthcare expenses, particularly in lower-income countries.
‘Close the care gap’ is a three-year campaign dedicated to raising awareness about the numerous barriers that exist for people worldwide to access the cancer care they need. Closing the gap will help lighten the burden on the patients and their families, improve early cancer dictation, and also increase the availability of comprehensive treatment facilities. WHO has highlighted the need for a national cancer centre to ensure a comprehensive approach to cancer treatment. Countries need to establish a cancer centre and strengthen services in existing centres by providing the necessary infrastructure, human resources, and equipment. It is also critical to step up efforts to scale high-quality cancer programs at international, national, and community levels.
We look forward to what this means for Nigeria and Africa.