Understanding the Trajectory of Cancer Diagnosis and Treatment Delay in Nigeria (Published)
Despite the fact that cancer is one of the most important public-health issues in Nigeria, the poor survival rate is not due to the incidence of cancer, but the time interval between the onset of the first recognisable symptom and the initiation of definitive treatment. This paper argues that cancer diagnosis and treatment delay in Nigeria is a multi-faceted process, spanning the appraisal, help-seeking, diagnostic and treatment intervals, and that it is preventable if targeted interventions are coordinated and implemented at the intervals, instead of relying on incidence alone to drive messages. It collates and analyses literature from 2020 to 2026 from both the international and Nigerian context, and suggests that the major drivers to this advanced presentation of cancer in Nigeria are low symptom appraisal and cancer stigma, catastrophic out of pocket expenses and poor diagnostic and radiotherapy infrastructure which work synergistically. The paper argues that the nursing workforce, which is at each point in the chain of care, is the most practical and cost-effective way to shorten these delays, since they can be measured in terms of lives lost for every four-week delay in the process. It finds that formalised nurse navigation, improved oncology and palliative care skills, and increased health-insurance coverage and localised delay research are the key responses.
Keywords: Cancer, diagnostic delay, late-stage presentation. oncology nursing; Nigeria, treatment interval