Cancer control policy implementation in West Africa: A comparative narrative review and the emerging role of Nigeria's NICRAT.

BACKGROUND

West Africa faces a rising cancer burden marked by late diagnosis, limited treatment access, and persistent inequities. Despite national cancer control plans, implementation evidence remains fragmented. This narrative review compares cancer control policy implementation in Ghana, Senegal, Mali, Côte d'Ivoire, and Nigeria, highlighting shared health system challenges and emerging coordination mechanisms, including Nigeria's National Institute for Cancer Research and Treatment (NICRAT).

METHODS

A structured narrative policy review was conducted using literature retrieved from PubMed and Google Scholar, and publicly available national cancer policy documents published between 2010 and 2025. Eligible sources included peer-reviewed articles, strategic plans, and policy reports addressing cancer control implementation. Data were thematically synthesized using a comparative health systems framework encompassing governance, financing, workforce capacity, service delivery, health information systems, and access to medicines and vaccines.

RESULTS

All five countries have established national cancer control strategies. However, implementation challenges persist across multiple health system domains. Commonly reported constraints include inadequate financing, limited insurance coverage, workforce shortages, centralized oncology services, weak cancer registries, low screening uptake, and uneven HPV and hepatitis B vaccination coverage. Although some countries have expanded awareness initiatives, vaccination programs, and selected screening services, standardized evidence demonstrating sustained reductions in cancer incidence or mortality remains limited. NICRAT represents an emerging institutional approach to strengthening coordination and implementation oversight in Nigeria.

CONCLUSION

Despite policy adoption, weak health systems hinder cancer control in West Africa. Improved governance, sustainable financing, workforce development, modernized registries, and stronger regional collaboration are essential for better cancer outcomes.