The state of cancer in Somalia: a comprehensive six-year retrospective study

Cancer incidence and mortality rates are increasing globally. Approximately 20 million new cancer cases and 10 million cancer-related deaths were recorded in 2022. Cancer incidence is projected to reach 35 million new cases by 2050. Cancer incidence in Africa constituted only 5.9% of global cancer; however, Africa has the highest cancer mortality rate (64.4%) compared to all other continents. Cancer mortality rate in Sub-Saharan Africa is alarmingly high compared to other World Health Organization African Region. In Somalia, due to the lack of cancer registries, cancer incidence and mortality rates from neighboring countries are used, and the true cancer burden in the country remains known.In this study, we performed a retrospective cross-sectional study and reviewed records of patients with histologically or radiologically confirmed cancer between January 2020 and July 2025. Patient records from the five major diagnostic centers in Mogadishu and Hargeisa, the two most-populous cities in the country, were selected and analyzed descriptively for this study. Mogadishu is in the southern part of the country, whereas Hargeisa - the second largest city in Somalia, is in the northwestern part of the country.In the study period, 2417 registered cancer cases, 1354 (56%) were reported in women, and 1063 (44%) were reported in men. The primary cancer types were esophageal cancer, which was diagnosed among 898 (37.2%) patients, of which 522 (58%) were women, and 376 (42%) were men. Breast cancer was the second most frequently diagnosed cancer after esophageal, 238 patients (9.8%), followed by prostate with 178 (7.4%) cases, leukemia with 156 (6.5%) cases, thyroid with 123 (5.1%) cases, liver with 123 (5.1%) cases, and colorectal cancer with 120 (5.0%) cases.Our multicenter study across Mogadishu and Hargeisa, Somalia, sheds light on the prevalence of cancer in Somalia and the dire need for accessible and affordable oncology services in Somalia. Although several institutions in the country provide oncology-related services, their service is limited to chemotherapy and surgery. The study also reveals the urgent to need to establish national or population-based cancer registries to determine cancer incidence, identify risk factors, and create national plan for cancer prevention, control, and treatment.