Cancer Diagnostics Pathways In Nigeria; Challenges And Opportunities

March 10. Anthony Olayemi.Nzube Ekpunobi.Tunde Animashaun

Cancer, a formidable global health challenge, manifests with distinctive complexities in Nigeria, a country where healthcare systems grapple with a myriad of issues. Cancer remains a significant public health concern globally, and Nigeria is no exception. The effectiveness of cancer care pathways in the country is influenced by various factors, including accessibility, infrastructure, awareness, and socio-economic disparities. Cancer diagnosis and care in Nigeria is faced with significant challenges, reflecting a confluence of factors that impede effective prevention, early detection, and treatment.  However, amidst these challenges lies a landscape rife with opportunities for improvement, innovation, and transformative change.

 Nigeria continues to grapple with limited healthcare resources, including funding, trained personnel, and advanced medical technologies. This scarcity continues to hamper the comprehensive and timely treatment of cancer patients, limit the geographic accessibility of quality cancer care, especially for those residing in rural or underserved areas, and contributes to delays in diagnosis, treatment initiation, and follow-up care for Cancer patients. A large number of the existing cancer treatment facilities in Nigeria struggle with outdated equipment and technology, which in turn restricts the ability to provide state-of-the-art interventions and impacts the quality and effectiveness of cancer care (Adebamowo et al., 2018). Access to advanced cancer therapies, such as targeted therapies and immunotherapies, is limited in Nigeria and in the few cancer centres where they are available, the cost of these treatments, coupled with their limited availability, restricts treatment options for patients, particularly those with specific types of cancers that may benefit from these innovations.

Late Diagnosis is a pervasive challenge in cancer care with profound implications for treatment outcomes and patient survival. Several factors contribute to delayed diagnosis in cancer care, and addressing these issues is crucial to the improvement of the overall prognosis. Olasehinde et al. (2018) pointed out many of such factors including limited awareness, stigma, and inadequate screening programs. Late-stage cancer diagnosis is not only prevalent in Nigeria, but it has led to reduced treatment options, poorer prognosis and a high mortality rate.

 

Another challenge that has continually stricken cancer care in Nigeria is healthcare disparities. Healthcare disparities in cancer care in Nigeria are multifaceted and largely influenced by various factors that contribute to uneven access, diagnosis, and treatment. A report by Oladimeji and others in 2020, depicted that in Nigeria, disparities in healthcare infrastructure and resources between urban and rural areas contribute to differential access to cancer care and emphasized the need for targeted interventions in rural areas. Gender-related factors also play a role in health disparities, with variations in cancer prevalence and access to care between men and women. For example, Breast and cervical cancers disproportionately affect women while Prostate cancer affects men (Makama et al., 2019).

 

Research has also shown that cancer-related stigma can hinder early detection and timely treatment, and as such, pose significant challenges in cancer care. People usually avoid seeking medical help due to fear of judgment or social repercussions which may affect mental health, exacerbating anxiety and depression among cancer patients (WHO, 2019). These societal misconceptions and fear of social isolation may discourage individuals from seeking medical help, resulting in delayed diagnosis and treatment initiation in Nigeria. Efforts to combat cancer stigma involve public awareness campaigns, education, and support programs. Integrating psycho-social support into cancer care, as suggested by the World Health Organization, can help mitigate the emotional toll of stigma on patients and their families. Stigma remains a significant barrier to cancer care in Nigeria.

 

The cost of cancer treatment is a significant challenge in Nigeria, affecting both access to and quality of care. The financial burden of cancer care is a substantial challenge for many in Nigeria. Firstly, cancer treatments, including chemotherapy, radiation therapy, and targeted therapies, are often expensive, making them financially burdensome for many individuals. Additionally, the lack of comprehensive health insurance coverage leaves a large portion of the population without adequate financial support for cancer care. Diagnostic procedures, such as imaging tests and biopsies, specialized medical equipment and skilled professionals also contribute to the overall cost.  Limited availability of these resources in many healthcare facilities can force patients to seek care in more well-equipped centres, incurring additional costs for transportation and accommodation. (Ogunbiyi, 2019).

      OPPORTUNITIES FOR IMPROVEMENT.

Investment in Healthcare Infrastructure will not only allow for the upgrading of existing healthcare facilities but also, the establishment of new, specialized cancer centres. These centres can be equipped with state-of-the-art diagnostic tools, such as advanced imaging machines, pathology laboratories, and molecular testing facilities.
Having modern and efficient equipment ensures accurate and timely cancer diagnoses, improving the overall quality of healthcare services including;

  • The implementation of telemedicine solutions, allowing remote consultations, second opinions, and collaboration between healthcare professionals across different regions.

 

  • The development of healthcare facilities in under-served regions, reduces geographical barriers to cancer diagnosis.

 

  • Increased funding to support research initiatives focused on developing more cost-effective and efficient diagnostic methods for cancer, as well as, contributing to the identification of biomarkers, improved imaging techniques, and innovative diagnostic tools, enhancing the accuracy and early detection of cancer.

 

 

Training and Capacity Building of healthcare professionals in oncology and expanding the workforce can improve the overall quality of cancer care. This includes specialized training for oncologists, nurses, and other support staff with specialized knowledge in cancer care, including the latest advancements in diagnostics, treatment modalities, and patient management. Ohaeri in his study, stated that building a cadre of well-trained oncologists, radiologists, pathologists, and laboratory technicians ensures a more accurate and efficient cancer diagnosis process. This will in turn, improve the precision and reliability of cancer diagnosis, enabling tailored treatment strategies.

Promoting Early Detection Programs and Community Education can significantly impact cancer outcomes. These programs should focus on raising awareness, providing accessible screenings, and fostering a culture of regular health check-ups. Public awareness and education campaigns, educating the population about the importance of early cancer detection and the availability of diagnostic services. Also, Increased awareness encourages individuals to seek medical attention promptly, leading to earlier diagnoses and better treatment outcomes

 

Enacting governmental policies that prioritize cancer care, allocate sufficient funds, and establish frameworks for effective cancer management are critical. Government support is essential for sustainable improvements in cancer care pathways.

Conclusion:

Improving the effectiveness of cancer care diagnostics pathways in Nigeria requires a multifaceted approach addressing challenges in resources, infrastructure, awareness, and healthcare disparities. By investing in healthcare, prioritizing education, and implementing policies that support comprehensive cancer care, Nigeria can work towards ensuring better outcomes for individuals affected by cancer (Ogunlana, 2020).

In moving forward, a collaborative approach involving government agencies, non-governmental organizations, healthcare professionals, and the community is essential. By synergizing efforts and implementing targeted interventions, Ogunbode et al., 2019 said, Nigeria can make significant strides in transforming its cancer diagnosis pathway, ultimately improving outcomes and reducing the burden of this pervasive disease.

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