Cancer in Ghana

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] Nearly 95,000 cases of cancer were reported in Ghana in 2019.^[4] 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.^[5]

For many years, the mere mention of cancer was deemed a taboo in Ghana as it signals contamination or death.^[6]

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.^[7]

Ghana has a national cancer control plan.^[8] 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.^[6]

Over a thousand childhood cancer cases are recorded in the country each year. These cases are often reported late making treatment difficult and expensive.^[9][10] In 2022, four childhood cancers were covered under the National Health Insurance Scheme (NHIS): acute lymphoblastic leukaemia, Burkitt lymphoma, retinoblastoma, and Wilms tumour.^[11][12] Only 30% of children with cancer seek healthcare due to financial difficulties.^[13]

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.^[9]

In 2022 the first Lady of Ghana commissioned a hostel for children cancer patients to alleviate transportation costs in seeking health care.^[13]

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.^[14]

Breast cancer is the most common cancer among females in Ghana.^[15] In 2020, there were 4400 cases of breast cancer and 2797 estimated cervical cancer cases.^[16] Over 3,000 women are diagnosed with cervical cancer each year and more than half of the figure die in Ghana.^[17] In 2018, it was estimated that over four thousand cases of breast cancer will be diagnosed and about 1800 women could die from cancer.^[18]

In Ghana, breast cancer is the leading malignancy.^[19] In 2007, breast cancer accounted for 15.4% of all malignancies, and this number increases annually.^[19] Roughly 70% of women who are diagnosed with breast cancer in Ghana are in the advanced stages of the disease.^[20] 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.^[21] These triple negative breast tumors are more aggressive and result in higher breast cancer mortality rates.^[21]

Explanations for the delayed presentation among women in Ghana have been traced to the cost of, and access to, routine screening mammography.^[20][22] 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.^[22] 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.^[23]

Liver Cancer is the leading cause of cancer related deaths in the Volta Region of Ghana.^[24]

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.^[25]

• Healthcare in Ghana