Nigeria needs N19.46bn to prevent 70,327 cancer deaths yearly

*Experts seek disease mortality register, plan study on annual cost in country
*Breast, cervical, prostate, colorectal tumours constitute 52.7% of all cases

To stop the deaths of 70,327 lives lost yearly to cancer, Nigeria needs over N19.46 billion yearly for prevention, diagnosis and treatment, hospice and palliative care, advocacy, data management and research, and governance and finance.

According to the National Cancer Control Plan (NCCP) 2018 –2022, Nigeria needs to spend N97,321,725,422.53 (N97.3 billion) on cancer treatment and care in five years. A breakdown showed that the country plans to spend N19.46 billion on cancer treatment and care yearly.

The NCCP 2018 –2022 has provided cost estimates for the five-year period of the NCCP so that stakeholders know the cost required to operationalise the plan. It also provided the cost estimates to be used for advocacy and resource mobilisation from stakeholders (international donors and local private sector, civil society, and government in the fight against cancer in Nigeria.

A further breakdown of the figures showed that N60,508,390,843.09 (N60.5 billion) is for prevention; N59,508,662.50 (N59.5 million) for diagnosis and treatment; N272,032,497.06 (N272 million) for hospice and palliative care; N418,153,850.83 (N418.15 million) for advocacy; N419,787,613.31 (N419.78 million) for data management and research; N35,551,788,079.18 (N35.55 billion) for supply chain management (logistics); and N92,063,876.56 (N92 million) for governance and finance.

Also, current mortality estimates from modelling using incidence mortality rates derived from cancer registry data in GLOBOCAN 2018 showed cancer killed 70,327 and afflicted 115,950 Nigerians in 2018.

The GLOBOCAN 2018 data for Nigeria showed breast, cervical, prostate, and colorectal tumours constitute 52.7 per cent of all cases.

GLOBOCAN 2018 is an online database providing estimates of incidence and mortality in 185 countries for 36 types of cancer, and for all cancer sites combined.

Meanwhile, unlike in the United States (US) where the overall lost earnings were $94.4 billion, and $191,900 per cancer death and lost earnings were $29.0 million per 100,000 population overall, according to a new United States (US) analysis published in JAMA Oncology, Nigeria does to have such figures.

Why? A professor of Radiology, College of Medicine, University of Nigeria Nsukka (UNN), Enugu, Enugu State, Ifeoma Okoye, and the Medical Director, International Research Centre of Excellence, (IRCE) Institute of Human Virology, Abuja, Dr. Elima Jedy-Agba, told The Guardian that the amount of money Nigeria loses to cancer yearly is difficult to compute because the country does not have national mortality register and does not know the exact numbers of deaths from cancer.

Okoye and Jeddy-Agba said another reason is that the cancer cases particularly those in rural Nigeria or who are self employed like traders do not have information on their annual income that is for those who work and support families and whose income would be lost should they die from cancer.

Okoye, who is also the Director of UNN Centre For Clinical Trials, said this could be a research question, which needed to be investigated in a proper research study, “To estimate the annual cost of cancer in a particular state or geographic region in Nigeria” or “The annual cost of cancer care in Nigeria”.

Until now, several studies have shown that cancer deaths impose significant economic burden in Nigeria because of productivity losses due to premature death. Experts are unanimous that accurate information on the economic burden of cancer mortality can help in setting policies and prioritizing resources for cancer prevention and control.

However, contemporary data are lacking for not just in Nigeria but also in the United States nationally and by state.

According to the JAMA Oncology study, a total of 492,146 cancer deaths occurred in people ages 16 to 84 in the in 2015, translating to a total of 8,739,939 life years lost. The study identified which cancers and which states are associated with the greatest cost.

To update estimated lost earnings due to death from cancer, investigators led by Dr. Farhad Islami calculated person-years of life lost using numbers of cancer deaths and life expectancy data in individuals aged 16 to 84 years who died from cancer in the United States in 2015. They created estimates for cancer deaths overall and for the major cancers in the United States nationally and by state. The estimates are for lost earnings alone, and do not include other costs associated with cancer, including costs of treatment and caregiving.

Islami said: “Years of life lost and lost earnings were high for many cancers for which there are modifiable risk factors and effective screening and treatment, which suggests that a substantial proportion of our current national mortality burden is potentially avoidable.

“Applying comprehensive cancer prevention interventions and ensuring equitable access to high-quality care across all states could reduce the burden of cancer and associated geographic and other differences in the country…”

Health care professionals can contribute to achieving this goal because they play a central role in the delivery of cancer prevention, screening, and treatment.”