Nigeria's 'Major' Cancer Problem - Did Vice President Osinbajo Get His Facts Straight?

At a recent ceremony, Nigeria's vice president Yemi Osinbajo launched construction of a new cancer treatment centre at the Muhammadu Buhari Specialist Hospital in the northern state of Kano.

It would become Nigeria's top cancer treatment centre, Osinbajo said at the January 2020 launch, helping tackle what he described as a "major problem" in the country.

To highlight Nigeria's cancer burden, Osinbajo made three widely-reported claims. We fact-checked them.

Claim

The World Health Organization reports that in 2018, 4% of deaths in Nigeria were caused by cancer.

Verdict

Correct

Africa Check asked Osinbajo's media office for the source of the claims. They referred us to his official speech for the event. While the claim that 4% of deaths were due to cancer specifically cites the WHO, the speech doesn't give clear sources for the other two claims.

Nigeria does not have a country-wide cancer registry yet, Prof Ima-Obong Ekanem told Africa Check. She heads the Calabar cancer registry, one of the country's six population based cancer registries.

People working in this field therefore rely on data from these registries, Ekanem previously told us.

The Global Cancer Atlas would have national data on this, Prof Tanimola Akande, a consultant public health physician and professor at the University of Ilorin, told Africa Check.

The atlas is prepared by the International Agency for Research on Cancer, or IARC, a specialised unit of the World Health Organization. The latest edition gives data for 2018.

To estimate the number of cancer-related deaths in Nigeria, the IARC used a model based on the number of new cases and deaths from neighbouring countries. This, it said, was because Nigeria lacked data at the national level.

The agency estimated that, in 2016, there were 2.13 million deaths in Nigeria, 4% of them due to cancer. So Osinbajo is correct on this score.

The IARC estimated the country's often-disputed population at 186 million people.

Cancer deaths under-reported

In Nigeria, prostate cancer is the most common cancer in men. Cervical cancer accounts for most cases in women, followed by breast cancer. Non-communicable diseases caused 29% of all deaths, the data showed.

But most deaths, including cancer-related deaths, were under-reported in Nigeria, Akande said. The problem started at the detection stage.

Cancer cases, he said, were "under-diagnosed because of low utilisation of health services and poor health seeking behaviour. The expertise and equipment to properly diagnose cancer is also not available in most facilities."

Akande pointed to inaccurate cause of death records as a major challenge. Reasons for this included many patients dying at home, and autopsies not being done widely.

Osinbajo said he was optimistic the country's national 2018-2022 cancer plan would help reduce the burden of cancer. This US$308 million strategy seeks to improve early detection, cancer care, drug access and data collection, among other things.

Claim

Of over 100,000 cases that are reported in Nigeria, about 72,000 die annually of cancer.

Verdict

Mostly-correct

In our July 2018 report on how many Nigerians die from cancer every hour, we found the latest data from the IARC estimated that 71,571 people died of cancer in Nigeria in 2012. Newer data shows that the number of deaths fell slightly to 70,327 in 2018.

Africa Check asked the IARC why the estimate had dropped. Spokesperson Jacques Ferlay told us it was due to a "change in data and method" and not a "true change in risk".

The agency estimated the number of reported cancer cases in 2018 at 115,950. Osinbajo's claim is therefore in the ballpark.

Claim

Nigeria's cancer cases are about 15% of cases in West Africa.

Verdict

Incorrect

The vice president did not specify if he was referring to new or existing cases, or deaths. Data on this could also be found in the Global Cancer Atlas, Akande told Africa Check.

The atlas gives the most recent estimate for the "incidence" of cancer - new cases of the disease - in West Africa as 229,459, in 2018.

(Note: The agency counts 16 countries in the West Africa region.)

Existing cancer cases

The "prevalence" of cancer - existing cases - in Nigeria was estimated at 211,052 over five years. This was 54% of West Africa's total of 390,756 existing cases.

(Note: Some national media interpreted Nigeria's prevalence rate as "the highest in West Africa". Data sent to us by the IARC showed that two other countries - Ghana and Benin - had higher prevalence rates than Nigeria's, which is currently estimated at 108 cases per 100,000 people.)

Finally, Nigeria accounts for about 46%, or 70,327, of the 153,332 cancer-related deaths in all of West Africa.

None of the three estimates is 15%, as Osinbajo claimed.

Additional reading

Charity understates cervical cancer deaths in Nigeria as it unveils campaign

New data supports claim that 15 men die every day from prostate cancer in Nigeria

Do 10 Nigerians die from cancer every hour?

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