🇳🇬 Cancer in Nigeria

The GLOBOCAN 2024 fact sheet gives 44,196 breast cancers (21,309 deaths), 24,396 prostate cancers (15,176 deaths) and 12,312 cervical cancers (7,599 deaths), followed by colorectal cancer (10,212) and liver cancer (3,783). Together breast, prostate and cervix are 80,904 of 152,261 cases, 53%. In men the leading cancers are prostate, colorectum and liver; in women breast, cervix and colorectum. The risk of developing a cancer before age 75 is 11.2% for men and 13.0% for women, and there are an estimated 292,934 people living within five years of a cancer diagnosis. Deaths divided by new cases give 0.60 for 2024; the 2026 to 2030 national cancer control plan, quoting IARC's 2022 figures of 127,763 cases and 79,542 deaths, calls its ratio of 0.62 an unacceptable level that points to a high likelihood of death after diagnosis. The plan also cites about 6,000 new childhood cancers in 2022, with approximately 95% presenting at late stages, and a 2024 study at one teaching hospital found 66.2% of patients with breast cancer had stage III disease or later at presentation.

The National Cancer Control Plan 2026 to 2030 counts 83 federal tertiary health institutions: 35 federal teaching hospitals, 25 federal medical centres and 23 specialty hospitals. Of the 60 teaching hospitals and medical centres, 13 offer chemotherapy, surgery and radiotherapy; the Ministry is upgrading six of them as centres of excellence, at Katsina, Benin, Jos, Zaria (Ahmadu Bello University Teaching Hospital), Lagos (Lagos University Teaching Hospital) and Enugu (University of Nigeria Teaching Hospital), with linear accelerators, brachytherapy and CT simulators. The plan reports that about 30 of 36 states provide some form of systemic therapy, mainly through teaching hospitals and private institutions in cities, and that 38 institutions in 24 states offer some paediatric oncology, four with dedicated wards. Molecular and genetic testing is not readily available, so specimens are sent abroad or to private laboratories, and out-of-pocket payment is the main way patients pay for pathology. Imaging equipment per million people is below the regional expectation: 0.18 mammography units against 1.48, 0.26 MRI against 0.67, 0.89 CT against 1.036.

The Ibadan registry was set up in 1960 in the Pathology Department of University College Hospital and contributed to the first three volumes of Cancer Incidence in Five Continents before economic and political upheaval stopped its submissions. The Nigerian National System of Cancer Registries, conceived in 2009 by the Federal Ministry of Health, the Society of Oncology and Cancer Research of Nigeria and the Institute of Human Virology Nigeria, rebuilt registration; its 2015 report lists Abuja covering 1,406,239 people and Ibadan 2,549,265. The 2024 National Cancer Registry Regulations made cancer a notifiable disease and created the National Cancer Registry of Nigeria, which the 2025 imPACT Review describes as 26 population-based and hospital-based registries; NICRAT's 2023 to 2027 plan had counted 34, with 13 population-based and 24 hospital-based, figures that do not add up as printed, and set a target of raising registration from under 10% of cases a year to over 70% by 2027. The review found most registries have no dedicated budget and that the last census, in 2006, limits incidence rates. In 2026 NICRAT reported training more than 100 registrars, accrediting eight registries, signing a three-year agreement with the African Cancer Registry Network and validating national registry procedures on 29 June 2026.

The National Health Insurance Authority Act 2022, Act No. 17 of 19 May 2022, replaced the National Health Insurance Scheme with an Authority charged to ensure that health insurance is mandatory for every Nigerian and legal resident (section 3) and states in section 14 that every person resident in Nigeria shall be required to obtain health insurance. Sections 25 and 26 establish a Vulnerable Group Fund, financed from the Basic Health Care Provision Fund, a health insurance levy and government allocations, to subsidise insurance for vulnerable people and pay premiums for the indigent; the Act defines the vulnerable group as including children under five, pregnant women, the aged, the physically and mentally challenged and the indigent. The Act does not mention cancer. On 25 September 2026 the Authority reported more than 23 million people enrolled, against IARC's 2024 population estimate of 232.7 million. The 2025 imPACT Review records that out-of-pocket payments are 76% of current health expenditure, that about 60% of health services are provided privately, and that the Basic Health Care Provision Fund package included self breast examination as its only cancer component.

Wuraola and colleagues followed 71 patients treated with curative intent for breast cancer at a tertiary hospital in south-west Nigeria from 2019 to 2022: the mean cost of care was 5,192.77 US dollars against a mean annual capacity to pay of 2,866.93, between 56 (78.9%) and 71 (100%) faced catastrophic health expenditure depending on the definition, and 66% had no health insurance. The NHIA said on 25 September 2026 that its benefits and payment structure covers mammography, CT and MRI scans, cancer-related diagnostic tests and radiotherapy, and that it is improving access to selected oncology medicines through cost sharing with Roche. In February 2025 its Director General was reported announcing a 50% subsidy on radiotherapy capped at 400,000 naira, and saying cost sharing with Roche and Pfizer had reached over 200 patients at seven tertiary centres; OnCo could not find the scheme's rules on the NHIA's own site. The 2026 to 2030 plan sets out to include all anticancer medicines in health insurance, and estimates palliative care coverage under the NHIA at below 1%.

The 2025 imPACT Review describes the National Cancer Health Fund, implemented by NICRAT, as supporting chemotherapy and radiotherapy for patients with breast, cervical and prostate cancers in six public comprehensive cancer centres, and as providing free systemic therapy for indigent patients; NICRAT's 2023 to 2027 plan noted it covered only those three adult cancers. NICRAT's activity report for January to August 2026 records a Childhood Cancer Fund live at Federal Medical Centre Abeokuta, Usmanu Danfodiyo University Teaching Hospital Sokoto and Jos University Teaching Hospital, and, at a joint meeting of the Nigeria Cancer Access Partnership and the Cancer Health Fund, more than 10,000 patients accessing care through their platform. The access partnership, run with the Clinton Health Access Initiative, buys specific originator medicines directly from manufacturers, and the 2026 to 2030 plan says it reduces their price to patients by 50 to 60%. NICRAT reported in June 2026 that the network had grown from 18 to 24 centres and aims for 30; the 2023 plan had counted it in 20 of 44 cancer treatment centres. Partners at the June 2026 meeting named funding as a particular challenge.

On 22 September 2026 the NHIA reported that the Coordinating Minister of Health and Social Welfare had inaugurated a National Health Technology Assessment Steering Committee to oversee the national system, prioritise topics, guard against conflicts of interest and give findings a route into benefit-package design, strategic purchasing and reimbursement. The NHIA's Director General described the steps so far: a Strategic Purchasing Department with a dedicated assessment division set up in 2025; an assessment framework, reference case, process guidelines and conflict of interest policy; Nigerian researchers trained at Mahidol University; a Nigerian EQ-5D-5L valuation study so that quality-adjusted life years reflect local preferences; and three pilot assessments, of kidney replacement therapy, colorectal cancer screening and sorafenib for advanced liver cancer. The committee includes NAFDAC's Director General and a NICE adviser. The announcement gives neither the pilots' results nor any cost-effectiveness threshold, so OnCo cannot say what was decided about sorafenib.

NAFDAC's guideline DR&R-GDL-035-00, effective 10 September 2024, covers drugs, vaccines and in vitro diagnostics registered or authorised by a stringent regulatory authority as the World Health Organization defines it. NAFDAC may rely on that authority's assessment reports and its inspection reports, which must be no more than three years old, for an abridged assessment of quality, safety and efficacy, while it retains its sovereignty in decision-making; it verifies that the product is identical or similar to the one the reference authority approved. It may rely on laboratory reports from WHO-prequalified or ISO 17025 laboratories and from regulators at maturity level 3 or 4, and may still test the product itself. After dossier review, risk-based categorisation of the manufacturing site and any laboratory analysis, the product goes to the Food and Drugs Registration Committee, and the guideline states that NAFDAC will make its decision within 60 working days, about 90 calendar days. NAFDAC was set up by Decree No. 15 of 1993, though its own page dates its official establishment to October 1992, and now operates under the NAFDAC Act Cap N1 of 2004.

The State House statement of 11 August 2025 reports that the World Health Organization re-benchmarked NAFDAC from 28 to 30 May 2025, after a formal re-benchmarking in November 2024 and five institutional development plan review meetings between February and April 2025, and quotes its verdict that NAFDAC has maintained a regulatory system that operates as a stable, well-functioning and integrated framework for regulating medicines and vaccines (non-producing). Maturity level 3 matters for patients because other regulators can lean on the work of authorities at that level; NAFDAC's own reliance guideline, for example, lets it accept laboratory reports from regulators at maturity level 3 or 4. The national cancer plan for 2026 to 2030 asks regulators to streamline review and clearance of new cancer screening, diagnostic and treatment products and of products for clinical trials. NAFDAC publishes no median approval time for cancer medicines that OnCo could find; this is named under gaps.

The National Guidelines for Cervical Cancer Screening, developed by the National Task Force on Cervical Cancer Elimination by adapting the WHO's 2021 guidelines, put lifetime screening coverage at less than 12% nationally, with over 70% of patients presenting at an advanced stage. They recommend primary HPV testing with partial genotyping; for the general population a target age of 30 to 49, starting at 30 and screening every 10 years (twice in a lifetime, by 35 and again by 45); for women aged 50 to 65 not previously screened, screening immediately and every 5 to 10 years until 70; for women living with HIV, every 5 years from 25 to 65. Both self-sampling and provider sampling are recommended, point-of-care testing where feasible, and thermal ablation as first-line treatment, with triage by VIA or colposcopy for HPV types other than 16 and 18. On 14 October 2026 the Minister of State for Health listed the programme's first rollout in Owerri, Imo State, among the taskforce's achievements; NICRAT's 2026 report records launches in Imo and Niger States and about 20 women treated for precancerous lesions. The 2025 imPACT Review put cervical screening coverage at less than 10%.

The 2025 imPACT Review states that national programmes for breast, cervical, prostate and colorectal cancer screening had not yet been fully established, that clinical breast examination has been integrated at primary care level, and that mammography has been introduced at secondary and tertiary hospitals as part of an opportunistic strategy; the 2026 to 2030 plan counts 0.18 mammography units per million people against an expected 1.48 for the region. The review recommends that national guidance advise against routine prostate-specific antigen (PSA) blood testing to screen for prostate cancer. NICRAT's 2023 to 2027 plan aimed for more than 50% screening of the eligible population by 2027, and its 2026 report records more than 4,000 people screened through community outreach, primary health centres and partners, and eight preventive oncology clinics. On prevention, the HPV vaccine entered routine immunisation in October 2023 as a single dose, a National Taskforce on Cervical Cancer Elimination was set up in August 2024, and hepatitis B birth-dose vaccination is part of childhood immunisation, with national coverage estimated at 67% in 2023. For the HPV vaccine the review gives campaign coverage rather than a national figure: 80% of the multi-age cohort in 21 states in phase 1 and 96% in 16 states in phase 2. OnCo did not find a published national HPV vaccination coverage figure.

NICRAT's 2023 to 2027 plan states that the country does not have medical oncology as a specialty, that those trained as radiation oncologists also train in giving chemotherapy, and that in some centres surgeons administer chemotherapy. The 2025 imPACT Review counts 74 practising clinical oncologists, all trained in radiation therapy, six training programmes with 70 registrars in 2024, and 62 medical physicists against an estimated need of 150; it recommends reducing reliance on non-oncologists such as general surgeons for chemotherapy. The 2026 to 2030 plan records eight paediatric oncologists with specialised training, so general paediatricians treat children with cancer in most centres, and notes that surgical oncology residency and fellowship training has begun with accreditation by the West African College of Surgeons. Its illustrative projection is that raising the share of medical graduates entering oncology from about 1% to 3 to 5% would take new entrants from 44 to 88 a year to about 264 to 440.

The 2025 imPACT Review counts 15 functional external beam machines, 13 linear accelerators and 2 cobalt units, in eight states including Lagos, Enugu, Kano and Sokoto, plus seven brachytherapy afterloaders; radiotherapy at Ibadan, Maiduguri and Zaria was not functioning at the time of the visit. Because over half of people with cancer are estimated to need radiotherapy, it puts the need at more than 120 machines. Under public and private partnership arrangements at cancer centres in Enugu, Sokoto, Ebonyi and Lagos, with service contracts in place, machine uptime rose above 95% and waits for the start of treatment fell to an estimated less than one month; outside them, power cuts and the lack of maintenance contracts interrupt treatment. The Lagos centre at Lagos University Teaching Hospital now trades as Medserve-LUTH Cancer Centre. In October 2026 an article on the NHIA's site, co-written by its Director General, described MedServe as the healthcare subsidiary of the Nigeria Sovereign Investment Authority and a 154 million US dollar oncology investment by MedServe with the International Finance Corporation, and pictured one of 18 new diagnostic and oncology centres. NICRAT reported in September 2026 a memorandum for 35 additional linear accelerators with a local servicing hub.

OnCo's ClinicalTrials.gov data has four trials with a Nigerian site: two phase 2 studies registered under the name TARMAC, NCT06291064 from the University of Chicago, of chemotherapy in Nigerian women with triple-negative breast cancer, and NCT04771871 from University College Hospital, Ibadan, of microRNA profiles in the same disease; NCT06529523, a Memorial Sloan Kettering phase 2 trial of tislelizumab for mismatch repair-deficient colorectal cancer; and NCT05904886, Roche's phase 3 trial of atezolizumab and bevacizumab with or without tiragolumab in liver cancer, with sites listed in 27 countries and territories, which ClinicalTrials.gov showed as active but no longer recruiting on 4 November 2026. OpenAlex counts 1,494 oncology papers with a Nigerian author from 2021 to 2025, rising from 264 in 2021 to 356 in 2025, and ClinicalTrials.gov counted 459 studies of any condition with a site in Nigeria when OnCo built its country file on 8 September 2026. A study of 1,136 women with breast cancer in Ibadan found that one in eight cases resulted from an inherited mutation in BRCA1, BRCA2, PALB2 or TP53, and 86.1% of those with a recorded stage were diagnosed at stage III or IV. In 2026 NICRAT reported four competitive research grants awarded, a national cancer biobank in operation and a new Nigeria Journal of Cancer Research; its clinical trials page read under construction on 4 November 2026.

NICRAT's National Strategic Cancer Control Plan 2023 to 2027, a costed plan with eight priority areas, followed the expired 2018 to 2022 plan; the 2025 imPACT Review notes that its scope was limited to federal-level activities and that awareness of it in the states was low. The Nigeria National Cancer Control Plan 2026 to 2030, developed by the Federal Ministry of Health and Social Welfare's National Cancer Control and Nuclear Medicine Programme, was launched by the Minister of State for Health on 4 February 2026 alongside the first National Nuclear Medicine Policy. Its stated objective is to reduce cancer incidence and mortality in Nigeria by 50% by 2030; the Vice President, in a July 2026 speech delivered by a representative, spoke of a commitment to reduce the cancer burden by at least 30% by the end of the decade. Its strategies include HPV and hepatitis B vaccination, screening with diagnostic confirmation within 60 days for 80% of positive tests by 2030, inclusion of all anticancer medicines in health insurance, an annual cancer burden report from population-based registries, and the use of artificial intelligence in registration.

NICRAT's activity report for January to August 2026 describes the Nigeria Cancer Burden Report 2024 as the country's first national statement of cancer incidence and mortality produced from Nigerian registries reporting to one common standard, moving beyond GLOBOCAN estimates, and says the Federal Ministry of Health has asked NICRAT to lead a working group for the next estimate. An announcement on OncoDaily gave a launch date of 18 August 2026 in Abuja. On 4 November 2026 NICRAT's National Cancer Statistics page read under construction, its documents page did not list the report, and the national registry site showed no figures to a plain request. Until the report is published, the registry figures on this page are those of individual city registries from 2009 to 2014.

The NHIA's operational guideline page links a PDF of its 2023 operational guidelines that returned HTTP 404 on 4 November 2026, and the Internet Archive held no copy of it; the benefit package page carried no list. The Cancer Health Fund page on NICRAT's site read under construction, so the fund's eligibility rules, the amount it pays per patient and its budget are not stated; press reports of its funding conflict with each other and are not used. The radiotherapy subsidy of 50% capped at 400,000 naira is quoted from a press report of the Director General's announcement in February 2025, not from an NHIA document.

NAFDAC's reliance guideline sets a decision within 60 working days for products already approved by a stringent regulator, but OnCo did not find a published timeline for the standard registration route, a median time actually achieved, or a list of cancer medicines registered in Nigeria with their dates. Third-party regulatory consultancies quote review times for the standard route; they are not used here. Whether a registered medicine is stocked, priced within reach, or covered by insurance or the Nigeria Cancer Access Partnership is a separate question this page cannot answer medicine by medicine.

No Nigerian population-based survival figures were found in the sources read. IARC's detailed data sources and methods page for Nigeria loads only in a browser, so the registries IARC used are taken from the 2025 imPACT Review rather than from IARC. A national HPV vaccination coverage figure was not found in a primary source; the 2025 imPACT Review gives only campaign coverage by phase (80% in 21 states, 96% in 16 states). The NHIA's three pilot health technology assessments are named on its site without their results. The 2023 to 2027 plan's registry count (34 registries, 13 population-based and 24 hospital-based) does not add up as printed and is quoted as written. A Vice President's statement that Nigeria accounts for about 10.5% of Africa's cancer burden in 2024 is not used, because OnCo's own GLOBOCAN 2024 file does not reproduce it. All scanned documents were read by optical character recognition, with numbers checked against the page image.