Expert frowns at low reporting of lung cancer in Nigeria, Sub-Saharan Africa

Titus Maduako Eleweke

Lung cancer which is one of the terminal diseases in Nigeria and sub-Saharan Africa is highly unreported and lacking in awareness creation.
To this end, many people are suffering from lung cancer and they hardly know because of a lack of awareness and proper diagnosis.

This is the position of a medical expert, Prof. Kelechi Okonta who is a consultant Cardiothoracic surgeon, and public health expert at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.

He disclosed this while delivering a lecture titled " Epidemiological Molecular Characteristics and Challenges with the Management of Lung Cancer: An Inquisitive Look at Nigeria and Sub-Saharan Africa at the Princess Margaret Cancer centre, Prosserman Centre for Health Research, Mount Sinai Hospital at the University of Toronto University, Canada.
He was the first African to be invited and given such privilege by the institution to deliver a ecture on lung cancer. Thus clearly identifying Prof Okonta's expertise in the area of Lung cancer research in the world.
The lecture was monitored in Awka Anambra state Nigeria by our Reporter via Zoom.
His Host, Prof Geoffrey Liu in his opening statement stated how Prof Okonta was selected all the way from Pretoria, South Africa following his extensive publications in the area of lung cancer. He further stated that he was looking forward to collaborating with Prof Okonta and their Institution in the area of lung cancer.
Prof Okonta said poor reportage of lung cancer in Nigeria and sub-Saharan Africa poses a serious challenge to the health system of the region.
He said that lung cancer in Nigeria and sub-Saharan Africa is being underreported because of poor and lack of data and inaccurate recording in the system.
Okonta said that the lack of a lung cancer registry in Nigeria poses a big problem in creating lung cancer awareness in the country.
According to Prof Okonta, who also is the Head of, the Department of Surgery University of Port-Harcourt Teaching Hospital, Choba Rivers State Lung cancer risk is higher in Human Immunodeficiency virus (HIV) infected populations than in general populations and it is most common in non -acquired immunodeficiency syndrome deficiency malignancy and poor diagnostic facilities.
He also stated that lung cancer has a consistent association with cigarette smoking but noted that most of the patients with lung cancer in our environment are non-smokers giving credence to the fact that other carcinogens possible from the inhalation of petroleum products may beimplicated.
According to him, polycyclic aromatic hydrocarbon compounds present in tobacco and Petroleum products cause lung cancer.
"Various chemical products in refineries can cause cancer following prolonged exposure to some of the emitted carcinogens.
He further said that increased Refinery activities, urban dwellers' pollution, and occupational and environmental activities increase the risk of lung cancer in Nigeria and sub-Sahara Africa.
The challenges of lung cancer in Nigeria,
Prof Okonta identified the challenges as follows:

Gross resource limitations, poor general awareness of the enormity of the disease burden, and the currently available resources for diagnosis and care.

The deregulation poorly addressed the issue and negative impact of cigarette smoking and the lack of a centrally coordinated structure population base lung cancer registry with full proof database.
Lack of centrally coordinated, well-designed actionable, and evidence-based national lung cancer control plan. Persistently cumbersome referral system within the overall national Health care system.

Lack of of clear national lung cancer screening strategy or program and lack of locally relevant policies guidelines, treatment algorithms, and care pathways especially for early disease detection, and uncommon implementation of MDT to provide comprehensive care.


Solution :

He said that "the country needs to solve the problem of underdiagnosis, and the problem of health care funding'.

Addressing the lack of expertise, circular migration of skilled physicians should be encouraged. Address the technological gap and challenges in practices.

There should be an emphasis on skills development in diagnostics.

He also called for a minimally invasive method of obtaining a biopsy of lung cancer and subjecting the sample to molecular testing to identify targetable drive mutation and create lung cancer website awareness information and collations of data. Newer target therapies, as well as advance in the genetic blueprint, collaboration - exchange knowledge and peer review collaboration in research, should be encouraged"

He finally described the burden of lung cancer in Nigeria as huge and grossly underreported, and its huge gap of unmet needs in sub-Sahara Africa.

He also advocated for the use of molecular profiling in the management of patients to improve their survival.
According to him,the ultimate aim of this meeting and exchange is to build a collaboration with the Princess Margaret Cancer Centre Toronto in the area of lung cancer research and treatment starting from Nigeria and Subsaharan African.

Our health system here in nigeria. Very bad!