The World Cancer Day 2020, which was commemorated across the world on February 4, presented another opportunity for the nation’s health authorities and other stakeholders to appraise the increasing cancer burden in the country. The annual World Cancer Day should remind them to work together to halt cancer spread in the country.
Cancer, according to the Nigeria Cancer Society, is a disease in which abnormal cells grow and reproduce uncontrollably and invade nearby tissues by spreading to other parts of the body. There are several types of cancer, but the three most common in Nigeria are breast cancer, cervical cancer and prostate cancer. Prostate cancer is the leading cause of death among men. Liver and colorectal cancers are also common in Nigeria.
About 281, 308 Nigerians were killed by cancer in the past four years, even as over 464, 000 cases were diagnosed within the same period. The Nigerian Cancer Society has estimated that more than 80,000 people are killed by cancer every year while 250,000 new cancer cases are recorded in the country annually. The International Agency for Research on Cancer (IARC) reported last year that in 2018, 70, 327 deaths were recorded from cancer in the country while 115, 950 new cases were reported.
It is worth pointing out that some cancer cases are never reported owing largely to ignorance and in some cases, religious or cultural factors. Many people are also ignorant of the disease, hence they take those down with the condition to religious or herbal homes where the patients die.
It is disturbing that the country lacks the capacity to adequately tackle the deadly disease. While a number of hospitals offer surgery and chemotherapy services for cancer patients, only eight Nigerian teaching hospitals are equipped with radiotherapy machines.
The hospitals are the Lagos University Teaching Hospital (LUTH), Idi-Araba; University of Benin Teaching Hospital, Benin; Usmanu Danfodiyo Teaching Hospital, Sokoto; Federal Teaching Hospital, Gombe; University College Hospital, Ibadan; National Hospital, Abuja, Ahmadu Bello University Teaching Hospital, Zaria, and University of Nigeria Teaching Hospital, Enugu.
Sadly, only the machines in two of the eight hospitals are in use, while the rest are currently out of service. Even if the radiotherapy machines in the eight tertiary hospitals are working, they are inadequate to handle thousands of cancer patients in a country of 200 million people. The World Health Organisation (WHO) recommends that Nigeria requires at least 180 radiotherapy machines to handle the growing cancer cases.
The high cost of cancer treatment is a major problem in Nigeria where over 130 million people are said to be living below the poverty line. Cancer patients in Nigeria pay up to N800, 000 for radiotherapy services in the few hospitals with the machines. Unfortunately, cancer treatment is not covered by the National Health Insurance Scheme (NHIS), and poor patients have to pay out-of-pocket.
Another challenge is the dire shortage of experts needed to tackle the disease. About 3,000 radiation oncologists are needed in Nigeria, but only 70 are currently available, while only 20 of the 70 work in centres that have the required facilities.
The WHO says that by 2040, there would be a 60 per cent increase in cancer cases in Nigeria and other developing countries unless urgent steps are taken to equip health centres with facilities to prevent, diagnose and treat the disease. The global health agency reveals that the greatest increase in new cases will occur in countries such as Nigeria where survival rates have been quite low.
However, it is comforting that cancer should not be a death sentence if diagnosed and treated early. The major problem in Nigeria is that many cases are presented late. Only a few people willingly visit health facilities to undergo medical tests that might reveal their health conditions.
If detected early, cancer can be cured with effective treatment. But most cancer patients are unaware of their condition until very late, when treatment is expensive and a cure doubtful.
We lament the increasing cancer cases in Nigeria and other countries and call on the federal and state governments as well as civil society organisations to prioritise advocacy and awareness campaign on the scourge. Nigerians should be enlightened on cancer, its causes, prevention and how to access treatment.
We urge the federal and state governments to establish more cancer screening centres across the country, while the teaching hospitals should be equipped with the required facilities for cancer treatment. Government should also invest more in the training of oncologists.