Medicine:Cancer in Ghana

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Current estimates indicates that over 24,000 new cases of cancer are recorded each year at Ghana.[1] In 2020, 15,802 Ghanaians died from cancer.[2][3] A 2015 study in Kumasi recorded breast and cervical cancer raked high records among females. Prostate cancer recorded the highest among males. Breast, liver and cervical were leading in both sexes.[4]

History

For many years, the mere mention of cancer was deemed a taboo in Ghana as it signals contamination or death.[5]

The first cancer registry in Ghana was established in Kumasi as the first population-based cancer registry in 2012 to provide information on cancer cases.[6]

Treatment

Ghana has a national cancer control plan. However, cancer rates are in an increasing trend due to unpreparedness. The country is faced with limited cancer care and lack of cancer education for care workers. Top quality care is only offered in the two main tertiary hospital that are in the two major cities of Ghana. Cancer care costs are expensive which proves tough for patients at the advanced stages of cancer. These coupled with no health insurance cover for cancer and the competition with alternative medicine. The country has made some advances in relation with care facilities and treatments. There are occurrences of misdiagnoses and inability for patients to afford medication.[5]

Childhood cancer in Ghana

Over a thousand childhood cancer cases are recorded in the country each year. These cases are often reported late making treatment difficult and expensive.[7][8] In 2022, four childhood cancers were covered under the National Health Insurance Scheme (NHIS): acute lymphoblastic leukaemia, Burkitt lymphoma, retinoblastoma, and Wilms tumour.[9][10] Only 30% of children with cancer seek healthcare due to financial difficulties.[11]

The country has two comprehensive Paediatric Oncology units at the Korle Bu and Komfo Anokye Teaching Hospitals. There are eight paediatric oncology fellows in training, three paediatric oncology pharmacists and 18 nurses in paediatric oncology.[7]

In 2022 the first Lady of Ghana commissioned a hostel for children cancer patients to alleviate transportation costs in seeking health care.[12]

The largest referral hospital in the country Korle bu has pledged to reduce childhood cancer by 2030 with a vision for every child patient to obtain equal access to treatment.[13]

Cancer by type

Breast and cervical cancer

Breast cancer is the most common cancer among females in Ghana.[14] In 2020, there were 4400 cases of breast cancer and 2797 estimated cervical cancer cases.[15] Over 3,000 women are diagnosed with cervical cancer each year and more than half of the figure die in Ghana.[16] In 2018, it was estimated that over four thousand cases of breast cancer will be diagnosed and about 1800 women could die from cancer.[17]

In Ghana, breast cancer is the leading malignancy.[18] In 2007, breast cancer accounted for 15.4% of all malignancies, and this number increases annually.[18] Roughly 70% of women who are diagnosed with breast cancer in Ghana are in the advanced stages of the disease.[19] In addition, a recent study has shown that women in Ghana are more likely to be diagnosed with high-grade tumors that are negative for expression of the estrogen receptor, progesterone receptor, and the HER2/neu marker.[20] These triple negative breast tumors are more aggressive and result in higher breast cancer mortality rates.[20]

Explanations for the delayed presentation among women in Ghana have been traced to the cost of, and access to, routine screening mammography.[19][21] Furthermore, women with breast cancer in Ghana describe a feeling of hopelessness and helplessness, largely due to their belief in fatalism, which contributes to denial as a means of coping.[21] Mayo et al. (2003) concludes, however, that lack of awareness may be a more critical variable than fatalism in explaining health care decisions among women in Ghana.

Over the past decade, international delegations and nongovernmental organizations have started responding to the growing problem of breast cancer in Ghana. In particular, the Breast Health Global Initiative, and Susan G. Komen for the Cure are helping to increase early detection and reduce the breast cancer mortality rate in the country. Through public education, awareness, training, and particularly promotion of early detection practices, international aid groups have helped in improving the situation in Ghana.[22]

Liver cancer

Liver Cancer is the leading cause of cancer related deaths in the Volta Region of Ghana.[23]

Prostate cancer

In 2020, Korlebu recorded over 1000 cases of prostate cancer. Most prostate cancer cases are often reported to the hospital at advanced stages due to reliance on herbal treatment.[24]

See also

  • Healthcare in Ghana

References

  1. ↑ "Over 24,000 cancer cases recorded annually". February 8, 2022. https://www.theghanareport.com/over-24000-cancer-cases-recorded-annually/. 
  2. ↑ "Cancer killed 15,802 Ghanaians in 2020---Globacan" (in en). https://www.modernghana.com/news/1059598/cancer-killed15802-ghanaians-in-2020-globacan.html. 
  3. ↑ Witzel, Isabell (2020). "Male Breast Cancer Patients: Lack of Evidence". Breast Care 15 (1): 3–5. doi:10.1159/000505636. ISSN 1661-3791. PMID 32231491. PMC 7098273. http://dx.doi.org/10.1159/000505636. 
  4. ↑ Amoako, Yaw Ampem; Awuah, Baffour; Larsen-Reindorf, Rita; Awittor, Fred Kwame; Kyem, Gloria; Ofori-Boadu, Kwame; Osei-Bonsu, Ernest; Laryea, Dennis Odai (2019-03-25). "Malignant tumours in urban Ghana: evidence from the city of Kumasi". BMC Cancer 19 (1): 267. doi:10.1186/s12885-019-5480-0. ISSN 1471-2407. PMID 30909876. 
  5. ↑ 5.0 5.1 "Cancer in My Community: Working to Eliminate the Stigma of Cancer in Ghana" (in en). 2021-09-14. https://www.cancer.net/blog/2021-09/cancer-my-community-working-eliminate-stigma-cancer-ghana. 
  6. ↑ Laryea, Dennis O; Awuah, Baffour; Amoako, Yaw A; Osei-Bonsu, E; Dogbe, Joslin; Larsen-Reindorf, Rita; Ansong, Daniel; Yeboah-Awudzi, Kwasi et al. (2014-05-23). "Cancer incidence in Ghana, 2012: evidence from a population-based cancer registry". BMC Cancer 14 (1): 362. doi:10.1186/1471-2407-14-362. ISSN 1471-2407. PMID 24884730. 
  7. ↑ 7.0 7.1 "Over 1,000 childhood cancers diagnosed in Ghana annually" (in en-gb). https://www.graphic.com.gh/news/general-news/over-1-000-childhood-cancers-diagnosed-in-ghana-annually.html. 
  8. ↑ "GRAPHIC TV: Latest Ghana News Videos - Over 1200 Ghanaian children are diagnosed with cancer every year - Dr Emma Mitchell" (in en-gb). https://www.graphic.com.gh/ghana-news-videos/video/over-1200-ghanaian-children-are-diagnosed-with-cancer-every-year-dr-emma-mitchell.html. 
  9. ↑ "NHIS now covers childhood cancers: Sickle cell drug also catered for - Bawumia" (in en-gb). https://www.graphic.com.gh/news/general-news/nhis-now-covers-childhood-cancers-sickle-cell-drug-also-catered-for-bawumia.html. 
  10. ↑ "NHIS now covering four childhood cancers" (in en-US). 2022-08-26. https://citinewsroom.com/2022/08/nhis-now-covering-four-childhood-cancers/. 
  11. ↑ GNA (2021-11-12). "Children with cancers relieved of transportation challenges" (in en-US). https://gna.org.gh/2021/11/children-with-cancers-relieved-of-transportation-challenges/. 
  12. ↑ GNA (2021-11-12). "Children with cancers relieved of transportation challenges" (in en-US). https://gna.org.gh/2021/11/children-with-cancers-relieved-of-transportation-challenges/. 
  13. ↑ GNA (2021-01-28). "Korle-bu Teaching Hospital to reduce childhood cancer by 2030" (in en-US). https://gna.org.gh/2021/01/korle-bu-teaching-hospital-to-reduce-childhood-cancer-by-2030/. 
  14. ↑ Amoako, Yaw Ampem; Awuah, Baffour; Larsen-Reindorf, Rita; Awittor, Fred Kwame; Kyem, Gloria; Ofori-Boadu, Kwame; Osei-Bonsu, Ernest; Laryea, Dennis Odai (2019-03-25). "Malignant tumours in urban Ghana: evidence from the city of Kumasi". BMC Cancer 19 (1): 267. doi:10.1186/s12885-019-5480-0. ISSN 1471-2407. PMID 30909876. 
  15. ↑ GNA (2022-10-19). "Rebecca Foundation launches project to reduce breast, cervical cancers" (in en-US). https://gna.org.gh/2022/10/rebecca-foundation-launches-project-to-reduce-breast-and-cervical-cancers/. 
  16. ↑ "3,000 women diagnosed with Cervical Cancer annually – Health officials" (in en-US). 2019-02-23. https://citinewsroom.com/2019/02/3000-women-diagnosed-with-cervical-cancer-annually-health-officials/. 
  17. ↑ "1,800 Ghanaian women could die of breast cancer in 2018 – Study" (in en-US). 2018-10-03. https://citinewsroom.com/2018/10/1800-ghanaian-women-could-die-of-breast-cancer-in-2018-study/. 
  18. ↑ 18.0 18.1 Clegg-Lamptey, J.N.A; Hodasi, W (2007). "A study of breast cancer in Korle Bu teaching hospital: assessing the impact of health education". Ghana Medical Journal 41 (2): 72–77. doi:10.4314/gmj.v41i2.55305. PMID 17925846. 
  19. ↑ 19.0 19.1 Kirby, A (2005). "Early Detection of Breast Cancer in Ghana, West Africa". Journal of Investigative Medicine 53: S80.5–S80. doi:10.2310/6650.2005.00005.15. 
  20. ↑ 20.0 20.1 Stark, A.; Kleer, Celina G.; Martin, Iman; Awuah, Baffour; Nsiah-Asare, Anthony; Takyi, Valerie; Braman, Maria; e. Quayson, Solomon et al. (2010). "African Ancestry and Higher Prevalence of Triple-Negative Breast Cancer: Findings from an international study". Cancer 116 (21): 4926–4932. doi:10.1002/cncr.25276. PMID 20629078. 
  21. ↑ 21.0 21.1 Mayo et al. (2003). "Fatalism Toward Breast Cancer Among the Women of Ghana". Health Care for Women International 24 (7): 608–615. doi:10.1080/07399330390217752. PMID 14627208. 
  22. ↑ "BHGI and Ghana combat breast cancer together". http://www.afrol.com/articles/31120. 
  23. ↑ Adadey, Samuel M; Languon, Sylvester; Ayee, Richmond; Quansah, Darius NK; Quaye, Osbourne (June 2020). "Incidence and mortality of cancer in the Volta Region of Ghana". Experimental Biology and Medicine 245 (12): 1058–1065. doi:10.1177/1535370220931514. ISSN 1535-3702. PMID 32498552. PMC 7357145. http://dx.doi.org/10.1177/1535370220931514. 
  24. ↑ GNA (2021-11-13). "KBTH records over 1, 000 cases of prostate cancer in 2020" (in en-US). https://gna.org.gh/2021/11/kbth-records-over-1-000-cases-of-prostate-cancer-in-2020/. 



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