New insights from Gatefield’s Public Health Practice suggest that Nigeria’s high cancer mortality rate, particularly among women, is driven less by medical limitations and more by systemic policy failures that prioritise late-stage treatment over prevention and early detection.
According to the report obtained by PREMIUM TIMES, an estimated 125,000 Nigerians are diagnosed with cancer every year, with about 80,000 deaths recorded annually, including 46,000 women.
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Breast and cervical cancers, which are among the most preventable and treatable cancers globally when detected early, account for a significant share of these deaths.
The report finds that Nigeria’s health system largely responds only after cancer has advanced, driving up treatment costs and worsening outcomes.
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Late response, high costs
Gatefield noted that while Nigeria has cancer strategies on paper, financing and implementation remain misaligned.
Prevention and screening are underfunded, early detection is treated as optional, and primary healthcare facilities, where most women interact with the health system, are rarely equipped to provide routine cancer screening.
“Many Nigerian women access healthcare mainly through primary health centres, yet cancer prevention and screening are often excluded from routine services,” the report stated.
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As a result, the system reacts late, when disease progression is advanced, and treatment costs are highest, outcomes that Gatefield describes as “predictable and preventable”.
Lessons from other countries
The report contrasted Nigeria’s approach with countries that have rapidly reduced women’s cancer mortality, including Rwanda, Australia, and parts of Latin America.
The findings show that rather than focusing primarily on treatment expansion, these countries invested in upstream interventions, embedding screening into primary care, financing prevention through fiscal policy, and treating early detection as core health infrastructure.
In Rwanda, for instance, human papillomavirus (HPV) vaccination coverage has exceeded 90 per cent, placing future generations on track for the near-elimination of cervical cancer.
In Australia, strong fiscal policies on tobacco have contributed significantly to declining cancer rates.
Nigeria introduced the HPV vaccine into its national immunisation programme in 2023, but Gatefield noted that misinformation, stigma, and weak community engagement continue to limit its impact.
“Where misinformation and social stigma go unaddressed, policy remains theoretical,” the report stated.
Structural barriers persist
Beyond funding gaps, the report identified deeper structural challenges, including fragmented financing models, weak primary healthcare infrastructure, and low health-seeking behaviour driven by misinformation and social penalties.
These factors, Gatefield argued, explain why women with the same cancers experience vastly different outcomes across countries.
“Across income levels, health systems are producing sharply different outcomes for women with the same cancers”.
“The divergence is not driven by medical science alone. It reflects policy architecture.”
LIVEBTR approach
The findings underpin the work of LIVEBTR, Gatefield’s health initiative, which frames cancer as a system and policy challenge rather than solely a clinical issue.
The programme focuses on upstream interventions, including awareness campaigns, countering misinformation, early detection, and strengthening primary healthcare as the first line of defence.
Through community outreach, HPV vaccination campaigns, and policy advocacy, LIVEBTR seeks to bridge the gap between policy design, public behaviour, and lived experience.
Evidence-based interventions
Gatefield identified three evidence-based interventions capable of shifting cancer outcomes at the population level.
It said the first is the use of fiscal policy as a prevention tool, noting that taxes on tobacco, alcohol, and sugar-sweetened beverages are among the most cost-effective cancer prevention measures globally.
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Gatefield also said effective cancer control strategies treat education as infrastructure, continuous, local, and culturally grounded, to normalise screening, counter myths, and encourage early health-seeking behaviour.
It noted that bringing screening closer to where people live by integrating it into primary healthcare is also important. “Where primary care is excluded from cancer strategies, late-stage diagnosis becomes the norm and costs escalate rapidly.”
Call for scale and political will
Omei Bongos, who leads Gatefield’s Public Health Practice, said evidence on early detection is no longer in question.
Ms Bongos said that visibility changes behaviour, and prevention is effective only when people understand the risks, trust the system, and can act early without facing social or financial penalties.
“Early detection is proven. The question now is scale. Cancer outcomes are inseparable from the social determinants that shape people’s lives, and solving this remains one of the most solvable policy failures in global health,” she said.
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