Daily Trust

Medical expert frowns at low reporting of lung cancer in Nigeria, sub-Saharan Africa

- From Titus Eleweke, Awka

The burden of lung cancer is huge and grossly underrepor­ted in Nigeria and sub-Saharan Africa, a medical expert, Prof. Kelechi Okonta, has said.

Prof. Okonta who is a consultant Cardiothor­acic surgeon, and public health expert at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, said to this end, many people are suffering from lung cancer and hardly know because of lack of awareness and proper diagnosis.

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, Canada.

He was the first African to be invited and given such a privilege by the institutio­n to deliver a lecture 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.

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 lung cancer in Nigeria and sub-Saharan Africa is being underrepor­ted because of poor and lack of data and inaccurate recording in the system.

He said the lack of a lung cancer registry in Nigeria poses a big problem in creating lung cancer awareness in the country.

Prof. Okonta, who is also the Head of the Department of Surgery, University of PortHarcou­rt Teaching Hospital, Choba, Rivers State, said 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 be implicated.

He added that 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 subSaharan Africa.

The challenges of lung cancer care 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.

-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 healthcare system.

-Lack of clear national lung cancer screening strategy or programme, and lack of locally relevant policies, guidelines, treatment algorithms, and care pathways, especially for early disease detection, and uncommon implementa­tion of multi-disciplina­ry team (MDT) to provide comprehens­ive care. Way out

He said addressing the lack of expertise, circular migration of skilled physicians should be encouraged, and also the technologi­cal gap and challenges in practices should be encouraged.

He said there should be an emphasis on skills developmen­t in diagnostic­s, adding, “The country needs to solve the problem of underdiagn­osis, and the problem of healthcare funding. “

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 advancemen­ts in the genetic blueprint, collaborat­ion - exchange knowledge and peer review collaborat­ion in research, should be encouraged,” he added.

Okonta also advocated for the use of molecular profiling in the management of patients to improve their survival.

He added that the ultimate aim of the meeting is to build collaborat­ion with the Princess Margaret Cancer Centre Toronto in the area of lung cancer research and treatment, starting from Nigeria and subSaharan Africa.

The 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.

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