Assessment of the availability of radiotherapy services across Nigeria.

Abstract

e13572 Background: Radiotherapy is an important treatment mode in managing cancers, more so in Africa and Nigeria in particular, where most patients with cancers tend to present with advanced disease. Chemoradiation is the recommended treatment in advanced cervical cancer. The aim of this survey was to review the availability of radiotherapy facilities across Nigeria given the importance of cervical cancer as the second commonest cause of cancer death among Nigerian women. Methods: The list of all hospitals rendering cervical cancer care and the availability of radiotherapy machines; both Medical Linear Accelerator (LINAC) and High Dose Rate (HDR) brachytherapy, were reviewed across the six geopolitical zones in Nigeria. Results: Nigerian population is estimated be over 200 million with 44% of these been women. There are 33 teaching hospitals, 24 Federal Medical centres, 22 Specialist hospitals and hundreds of private hospitals. However, there are only seven Linear Accelerators and six Brachytherapy machines available for care of cancer patients in the country. Nigeria is divided into six Geopolitical zones: North-Central (NC), North-East (NE), North-West (NW), South-South (SS), South- West (SW) and South-East (SE). NC zone with over 46 million population, has only two LINACs and one Brachytherapy machine, located at the National Hospital, Abuja. NW zone with over 49 million population has two LINAC and one HDR brachytherapy at UDUTH Sokoto, Muhammadu Buhari Specialist Hospital Kano, and ABUTH Zaria respectively. NE with over 26 million population has two brachytherapy machines at Federal Teaching Hospital Gombe and the University of Maiduguri Teaching Hospital (UMTH) and a non-functional linear accelerator machine IN UMTH. SS zone with over 28 million population, has a single government-owned radiotherapy centre and one privately owned facility with a functional LINAC. SW zone with over 46 million population has one HDR in the University College Hospital (UCH), Ibadan. A Public-private partnership in Lagos University Hospital/NSIA has both LINAC and HDR while a privately owned centre (Marcellus Ruth Cancer Centre) has a LINAC. The SE zone with over 21 million population has one LINAC in the University of Nigeria (UNN), Nsukka. Majority of the government owned Radiotherapy services provide epileptic services as most of the machines are faulty leading to increased patient waiting time. Conclusions: Despite the high cancer burden in Nigeria, there are few radiotherapy machines leading to suboptimal and epileptic treatment of cervical cancer. The privately owned centres provide more reliable and prompter but expensive care. There is a need for more investment in cancer treatment and continued global support towards provision of radiotherapy machines and cancer treatment in general to reduce its associated morbidity and mortality in Nigeria and other LMICs.