Navigating prostate cancer control in Nigeria

• Published in: The lancet oncology Vol. 20; no. 11; pp. 1489 - 1491
• Main Authors: Chidebe, Runcie C W, Orjiakor, Charles T, Pereira, Ian, Ipiankama, Sampson C, Lounsbury, David W, Moraes, Fabio Y
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01.11.2019; Elsevier Limited
• Subjects: Breast; Cervix; Community; Education; Ethnicity; Knowledge; Low income groups; Medical screening; Mortality; Patients; Pharmaceuticals; Prostate cancer; Religion; Risk factors; Social networks; Trust; Nigeria; Africa
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(19)30625-4

The government committed to screening 50% of at-risk men by 2022.2 Some men know the importance of early detection and are willing to engage in screening and treatment, but this varies across populations, regions and ethnicities, and data on prostate cancer knowledge and attitudes across Nigeria's diverse populations is scarce.3–7 Numerous hospital and population-based cancer registries have been created in Nigeria since the 1960s to assist in the planning of cancer care of Nigeria's communities, but many did not endure.8 In 2009, the Ministry of Health created the Nigerian National System of Cancer Registries. [...]barriers to education, screening, treatment, and data collection still exist, including cultural norms that stigmatise cancer, low patient and family understanding of risk factors and symptoms, and poor adherence to medical recommendations, especially in those with lower levels of education and income.3,4 The US Patient Navigation Research Program was a multicentre clinical trial examining patient navigation versus usual care for patients who were predominantly from low-income households, uninsured or publically insured, and from racial and ethnic minorities with screen-detected breast, cervical, colorectal, or prostate cancer. The most benefit was seen in centres with the greatest baseline delays in follow-up.9 In the absence of national coordination, we hypothesised that organised prostate cancer education, screening, and patient navigation targeting at-risk men would be possible through a non-governmental organisation (NGO). A low level of knowledge combined with harmful traditional biases deters men from seeking medical attention, including screening, diagnosis, and treatment. [...]Nigeria's diverse ethnicities and languages mean that a one-size-fits-all approach to education will not work.