The cancer burden in Africa is large and growing, with rising cases and deaths exposing major gaps in prevention, early diagnosis and access to treatment, according to a new study published in The Lancet Oncology.
The study, based on Global Burden of Disease 2023 data, found that cancer cases increased by 229 per cent between 1990 and 2023, rising from an estimated 467,000 cases to 1.54 million. In 2023, cancer was linked to about 923,000 deaths and 33.94 million disability-adjusted life years (DALYs).
DALYs measure years of healthy life lost because of illness, disability or premature death.
Africa accounted for an estimated 306,000 cancer deaths and 10.7 million DALYs in 2023. Researchers say the continent has experienced a worrying rise in both cancer incidence and mortality over the past three decades, in contrast to declines recorded in high socio-demographic index regions.
The researchers attribute the disparity partly to late-stage diagnosis and limited access to cancer treatment services, including surgery, chemotherapy, radiotherapy and rehabilitation.
Specialised oncology facilities remain scarce and are largely concentrated in urban areas. Access to mammography, which can help detect breast cancer early, is also limited by infrastructure and financial barriers.
Breast cancer illustrates the disparity. Despite relatively low incidence compared with some high-income regions, Africa has some of the highest breast cancer mortality rates globally. Researchers say late presentation and limited access to diagnosis and treatment contribute significantly to poor outcomes.
Cervical cancer presents another major challenge. It remains the leading cause of female cancer mortality and cancer-related DALYs in Africa, with the absolute burden having doubled since 1990.
The study links the continued burden to gaps in human papillomavirus, or HPV, vaccination and screening. Fewer than 35 per cent of African countries have national HPV vaccination programmes, while coverage remains below 50 per cent.
The researchers warn that Africa is therefore off-track to meet the World Health Organization’s 2030 cervical cancer elimination targets.
They recommend expanding vaccination, decentralising screening and improving access to multidisciplinary cancer treatment.
Gastrointestinal cancers are also emerging as a major concern. They accounted for about a quarter of cancer cases and DALYs and one-third of cancer deaths in Africa in 2023.
The study points to an epidemiological transition, with some infection-related cancers declining while cancers associated with metabolic and lifestyle factors increase.
Stomach cancer has declined in part because of improved management of H. pylori infection. At the same time, colorectal and pancreatic cancers are increasing.
Although colorectal cancer screening can be cost-effective, its expansion is being held back by financial barriers, geographical inequalities and limited population-based screening guidelines in low-income settings.
remains another leading cause of cancer deaths in Africa, driven largely by hepatitis B and hepatitis C infections.
The study highlights the low coverage of hepatitis B birth-dose vaccination in the region. Only about 18 per cent of newborns in the WHO African Region receive the birth dose, compared with 45 per cent globally.
The researchers also identify major gaps in cancer data across the continent. Population-based cancer registries are unevenly distributed, often concentrated in urban centres and completely absent in some countries.
This means researchers must rely on statistical estimates and predictive models for some countries and cancers, increasing uncertainty around the true burden.
The study further identifies preventable risk factors as an important part of the problem. About a third of cancer mortality and DALYs in Africa are attributable to modifiable risks.
Unsafe sex, tobacco use, unhealthy diets and high body-mass index are among the leading risk factors. Behavioural risks accounted for 27 per cent of cancer deaths, followed by metabolic risks at 5.9 per cent and environmental and occupational risks at 2.9 per cent.
The burden is also particularly severe among children. Africa recorded an estimated 104,000 childhood cancer cases and 54,700 deaths among those aged 0 to 19 in 2023. The continent accounted for about 28 per cent of global childhood cancer cases and nearly 38 per cent of childhood cancer deaths.
Researchers warn that the growing burden threatens global efforts to reduce deaths from non-communicable diseases. It also puts Africa at risk of falling further behind commitments under the Sustainable Development Goals and the African Union’s Agenda 2063.
The study projects that Africa’s annual cancer burden could nearly double by 2045, reaching about 1.4 million new cases and one million deaths.
The researchers call for continent-wide action focused on prevention, early detection and equitable access to treatment. They recommend decentralising screening services, expanding vaccination, strengthening cancer registries and improving access to surgery, chemotherapy, radiotherapy and rehabilitation.
They say coordinated, evidence-based strategies are needed to ensure that progress in global cancer control also reaches Africa’s most vulnerable populations.
