Management of lung cancer in Africa: Underdiagnosis and poor access to treatment – A close look at Nigeria and West African Sub-region

Okonta, Kelechi E.; Echieh, Chidiebere Peter; Abubakar, U.; Baiyewu, Lateef Ayodele; Nzewi, Onyekwelu

doi:10.25259/jpats_11_2021

Cited by 9 publications

(11 citation statements)

References 66 publications

(81 reference statements)

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“…Okonta et al [ 47 ] reviewed the available Nigerian and west African sub-region data, and linked the LC situation and poorer prognosis in each country with environmental, genetic and toxic aspects, finding differences between published studies. While Soussi et al [ 48 ] found based on a Tunisian cohort that age at diagnosis, PS, histological type, TNM stage, with haemoglobin level, leucocyte count, calcium, lactate dehydrogenase and levels of alkaline phosphatase are the independent prognostic factors related to survival.…”

Section: Discussionmentioning

confidence: 99%

Lung cancer in middle and southern Morocco

Tafenzi¹,

Choulli²,

Baladi³

et al. 2023

ecancer

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Purpose Determining risk factors associated with a fatal disease such as lung cancer (LC) remains an important key to understanding the factors related to its development and therefore using the correct emergent or accessible treatments. For that, we sought to highlight by describing, and analysing, the risk factors related to LC survival, reflecting the actual situation in Morocco. Patients and methods We included 987 LC patients diagnosed from 2015 to 2021 at the Medical Oncology Department at the Mohammed VI University Hospital of Marrakech. An overview of the LC situation was described, and analysed, to determine the risk factors related to survival. The independent prognostic factors were determined using Cox Proportional Hazards Regression Analysis. To create a distinction between different risks group in the survival curve, stratification was done, respectively, within sex, age, histology type, treatments and radiation therapy. Results We finally included 862 patients with 15 parameters among the 27 extracted, all meeting the inclusion criteria. 89.1% of the patients were male ( n = 768) and 10.9% were female ( n = 94), of whom 83.5% had a history of tobacco smoking ( n = 720). The median survival of both sexes was 716 (5–2,167) days. The average age at diagnosis was 60 years. Five hundred and thirty-four patients presented with advanced stage. Patients above 66 years were the more diagnosed category with adenocarcinoma at T4N2M1c pathological category, and endocrinal comorbidity, in addition to pleurisy syndrome. Moreover, family history was found to be a bad prognostic factor. Interestingly, smoking status was not a bad contributor to survival. Age at diagnosis, histology subtype, performance status, haemoglobin, numbers of cures of the first-line chemotherapy, radiotherapy, anaemia and treatments were identified as risk factors related to survival. Conclusion We established a descriptive and analytical overview of the current LC epidemiology situation in the oncology division of Mohammed VI University Hospital in a non-industrialised state taking into account smoking status.

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Section: Discussionmentioning

confidence: 99%

Lung cancer in middle and southern Morocco

Tafenzi¹,

Choulli²,

Baladi³

et al. 2023

ecancer

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“…There is, therefore, a need to investigate probable environmental, cultural or genetic factors driving these tumours in our locality. Also, the absence of lung cancer in the top five seen in Africa and Nigeria may indicate its lower prevalence in the African population or underdiagnosis of these cases [6,7,16]. The role of unsafe sexual practices on the high proportion of cervical cancer seen may need validation [3].…”

Section: Discussionmentioning

confidence: 99%

Cancer histotypes and trends in Azare, Northeast Nigeria: impact of diagnostic support disparity in data reporting

Ezenkwa¹,

Imam²,

Yusuf³

et al. 2023

ecancer

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Background: Definitive, affordable, and timely diagnosis of cancer is key to providing data for surveillance and control programmes. Care disparities have been shown to contribute to poorer survival, especially in resource-constrained populations. Here, we describe the profile of histologically diagnosed cancers in our hospital and highlight the possible effects of inadequate diagnostic support on data reporting. Methods:We designed a retrospective cross-sectional descriptive study to review histopathology reports archived at the Department of Pathology of our hospital spanning from January 2011 to December 2022. Cases diagnosed as cancer were retrieved and classified by systems, organs and histology types alongside the patient's age and gender. The trend in the volume of pathology requests and the corresponding malignant diagnosis yield over the period was also documented. Data generated were analyzed statistically using appropriate statistics and presented as proportions and means, with the level of statistical significance set at p < 0.05.Results: There were 488 cancers out of 3,237 histopathology requests received within the study period. Of these 316 (64.7%) were females. Overall mean age was 48.8 ± 18.6 years with a peak age at the sixth decade, females being significantly younger (46.1 versus 53.5 years; p < 0.001). The top five cancers were breast (22.7%), cervical (12.7%), prostate (11.7%), skin (10.7%) and colorectal cancers (8%). Among females, breast, cervical and ovarian cancers predominated, whereas prostate, skin and colorectal cancers, were commonest among males in decreasing order. Paediatric malignancies accounted for 3.7% of all the cases, most being small round blue cell tumours. The volume of pathology requests rose remarkably from 95 cases in 2014 to 625 cases in 2022 with a corresponding increase in cancer case diagnoses. Conclusion:Cancer subtypes and ranking in this study are similar to those from urban populations in Nigeria and Africa, despite the low number of cases recorded. Efforts to reduce the disease burden are warranted.

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“… 1 South and North African countries have a greater prevalence of lung cancer than East and West Africa. 4 This malignancy is known to have a poor survival rate, but an improvement in the overall survival rates can be attributed to personalized treatment and the introduction of targeted therapy. 5 In a Scandinavian study, an improvement in 1‐year survival was observed in nonsquamous cell carcinoma regardless of the stage of the malignancy at diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“… 9 , 10 Inadequate management and underdiagnosis of lung cancer are alarming issues in the health care of African settings. 4 , 10 Access to cancer screening and treatment is one of the major challenges in Kenya. 11 …”

Section: Introductionmentioning

confidence: 99%

“…In 2020, Globocan estimated 1,435,943 incidences of lung cancer, out of which 794 cases were from Kenya 1 . South and North African countries have a greater prevalence of lung cancer than East and West Africa 4 . This malignancy is known to have a poor survival rate, but an improvement in the overall survival rates can be attributed to personalized treatment and the introduction of targeted therapy 5 .…”

Section: Introductionmentioning

confidence: 99%

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Assessment of survival outcomes among lung cancer patients at the National and Referral Hospital in Kenya

Said

Degu

2023

Cancer Medicine

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Introduction Lung cancer has a low overall survival rate linked to late diagnosis and metastasis. Unfortunately, comprehensive data within the African continent are limited due to the lack of a registry, low public awareness of lung cancer, financial constraints, and inadequate screening and treatment facilities. In addition, there was a lack of conclusive data in our setting. Therefore, this study aimed to assess survival outcomes among lung cancer patients at Kenyatta National Hospital. Methods A hospital‐based retrospective cohort study was performed to examine the survival outcomes of 151 lung cancer patients. All eligible lung cancer patients diagnosed and treated in the facility between January 1, 2018, and December 31, 2020, were included. The patients were retrospectively followed from the date of primary cancer diagnosis until death or the last follow‐up period. The Statistical Package for the Social Sciences (SPSS) version 20.0 statistical software was used to enter and analyze the data. Kaplan–Meier survival and Cox regression analysis were employed to determine median survival and predictors of mortality, respectively. Results The mean and median follow‐time was 18.2 and 17.5 months, respectively. Most (98%) of the patients had non‐small cell lung cancer. The 2‐year survival rate was 66.7%, with 59.6% of patients having developed distant metastasis during the follow‐up, while 25.1% were deceased. The median cancer‐specific survival time among the study population was 18.0 ± 3.40 months. Cox regression analyses showed that patients with distant metastasis had five times more risk of dying (AHR: 4.74, 95% CI: 2.1–10.8, p < 0.001) than patients without distant metastasis. Conclusions The overall two‐year survival rate of lung cancer patients at the Kenyatta National Hospital was 66.7%, with most patients developed distant metastasis during the follow‐up period. Distant metastasis was the only significant predictor of mortality among lung cancer patients in our setting.

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Management of lung cancer in Africa: Underdiagnosis and poor access to treatment – A close look at Nigeria and West African Sub-region

Cited by 9 publications

References 66 publications

Lung cancer in middle and southern Morocco

Lung cancer in middle and southern Morocco

Cancer histotypes and trends in Azare, Northeast Nigeria: impact of diagnostic support disparity in data reporting

Assessment of survival outcomes among lung cancer patients at the National and Referral Hospital in Kenya

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