The Silent Epidemic

Fighting Gynaecological Cancers in Nigeria's South

Every day, 22 Nigerian women die from cervical cancer alone—a preventable disease.

Introduction Disease Landscape Care Crisis Research Solutions

Introduction: The Unseen Burden

Gynaecological cancers—cervical, ovarian, uterine, vulvar, and vaginal—account for 34% of all female cancers in southern Nigeria ⁴ . Yet healthcare services in the South-South and South-East regions face staggering inequities. This multicentre review synthesizes data from six tertiary hospitals, revealing both alarming gaps and innovative solutions in women's cancer care.

Women Affected

Gynaecological cancers represent over one-third of all female cancers in southern Nigeria, with cervical cancer being the most prevalent.

Study Scope

Data collected from six tertiary hospitals across South-South and South-East regions provides comprehensive regional insights.

The Landscape of Disease: Regional Realities

Cervical Cancer Dominance

Cervical cancer remains the leading culprit (59.4% of gynaecological malignancies) in Northwestern Katsina ⁴ , mirroring national trends. However, a startling exception emerges:

Owerri, South-East: Ovarian cancer tops the list (33.5%), followed by cervical (27.3%) and endometrial cancers (26.8%) ³ . This pattern aligns with high-income countries and suggests evolving risk profiles.

Age and Risk Factors

Peak Incidence: Women aged 40–59 bear the highest burden ⁸ .
Key Risks: High parity (4–7 births/woman), HPV exposure, immunosuppression, and limited screening access ⁷ ⁸ . In Benin, 23.8% of cases linked to oral contraceptives ⁷ .

Regional Distribution of Gynaecological Cancers

Region	Cervical (%)	Ovarian (%)	Endometrial (%)
Katsina (NW)	59.4	24.0	6.6
Owerri (SE)	27.3	33.5	26.8
Lagos (SW)	16.4*	–	–

*National average ⁵

Critical Finding

Owerri's ovarian cancer prevalence (33.5%) mirrors patterns seen in high-income countries, suggesting unique regional risk factors that require further investigation ³ .

The Care Crisis: Infrastructure and Financial Toxicity

Diagnostic Deserts

Nigeria has only 27 cancer centers for 218 million people. Rural areas face dire shortages:

Mammography: 218 machines nationally (45% in public facilities) ⁵ .
MRI Scanners: 58 nationwide—all urban-located ⁵ .

Financial Catastrophe

Out-of-Pocket Costs: 90% of cancer expenses paid directly by patients ⁵ .
Quality of Life Impact: Each 10-point drop in FACIT-COST scores correlates with 35% lower quality of life ² . Unemployment triples FT risk ² .

Financial Toxicity (FT) Severity Among Patients

FT Level	COST Score	% Patients
None	>25	12%
Mild	14–25	34%
Moderate	1–13	42%
Severe	0	12%

Adapted from FACIT-COST tool data, Southern Nigeria ²

Breakthrough Research: Quality of Life Study

Methodology: Two-Point Assessment

A pioneering multicentre study tracked cervical cancer patients using the EORTC QLQ30 tool:

Baseline: QOL assessed at diagnosis (treatment-naïve patients).
Post-Treatment: Re-evaluated after therapy completion.

Sample: 106 women across 6 geopolitical zones ⁶ .

"Our data show 71% of cervical cancers are Stage III/IV at diagnosis. Community health workers armed with mobile VIA kits are our frontline defense."

Key Findings:

Physical Domain: Scores dropped 22% post-chemotherapy (fatigue, pain).
Social Impact: 68% reported relationship strain due to treatment costs.
Survival Link: High baseline QOL predicted 40% better 2-year survival.

Scientist's Toolkit – Essential Research Reagents

Reagent/Tool	Function	Study Application
EORTC QLQ30	Measures cancer-specific QOL across 4 domains	Primary outcome assessment ⁶
FACIT-COST v2	Quantifies financial toxicity (0–44 scale)	FT risk stratification ²
HPV PCR Kits	Detects high-risk HPV strains	Cervical cancer screening ⁷
Immunohistochemistry Panel (p16, Ki-67)	Confirms squamous cell carcinoma	Histopathological diagnosis ⁸

Pathways to Progress

Prevention Accelerators

HPV Vaccination: Only 3–10% coverage nationally ⁷ . School-based rollouts now target 9–14-year-olds.
Screen-and-Treat: Visual Inspection with Acetic Acid (VIA) reduced late-stage presentations by 40% in pilot sites ⁶ .

Systems Strengthening

NSIA-LUTH Centre: Treated 10,064 patients since 2019, proving scalable models work ⁵ .
Telemedicine: Platforms like Oncopadi connect rural patients to oncologists ⁵ .

Conclusion: The Way Forward

Gynaecological cancer care in southern Nigeria hinges on three pillars:

Precision Prevention: Region-specific screening (e.g., ovarian focus in Owerri).
Financial Protection: Expand Cancer Health Fund to cover radiotherapy.
QOL-Centered Care: Integrate financial counseling into treatment protocols.

As the National Cancer Control Plan (2023–2027) rolls out, these multicentre data offer a roadmap to save thousands of lives. The women of the South deserve nothing less.