Prospects for Population-Based Breast Cancer Screening in Nigeria: An Integrative Literature Review

Area of Science:

• Oncology
• Public Health
• Health Systems Research

Background:

• Breast cancer is a leading cause of death for women in Nigeria, with significantly lower survival rates compared to the United States.
• Despite screening promotion, data on the Nigerian health system's capacity for large-scale cancer screening is scarce.
• Effective breast cancer screening is vital for reducing mortality and improving patient outcomes.

Purpose of the Study:

• To assess the readiness of the Nigerian healthcare system to support organized breast cancer screening activities.
• To identify barriers and facilitators for implementing effective breast cancer screening programs in Nigeria.
• To inform future research, practice, and investment in cancer screening services.

Main Methods:

• An integrative literature review was conducted using multiple databases (Web of Science, African Journal Online, OVID Medline, CINAHL, Embase, PsycINFO).
• Relevant studies were searched using specific keywords related to breast cancer screening and the Nigerian health system.
• A narrative synthesis of 44 included studies was performed, guided by the Wilson-Jungner framework.

Main Results:

• Limited access to diagnostic facilities, predominantly concentrated in urban areas.
• Significant cultural, religious, and socioeconomic barriers hinder the utilization of available imaging services.
• High out-of-pocket expenses pose a substantial financial burden, limiting access to diagnosis and treatment.

Conclusions:

• The Wilson-Jungner framework highlights substantial barriers to effective breast cancer screening in Nigeria.
• Recommendations include prioritizing cost-effective investments in infrastructure and training.
• Focus should be on enhancing early diagnosis for symptomatic women and strengthening cancer registries.