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Background The mortality from breast cancer (BC) is still high in Nigeria and other low-and medium-income countries (LMICs) especially among adolescents and young adults. This is partly due to late presentation for diagnosis and treatment. It is recommended that to optimize the effectiveness of treatment, the total time which is the interval from symptom onset to initiation of treatment, should be less than 90 days as recommended by the World Health Organization (WHO). The aim of this study was to determine the extent of delays in accessing care and possible reasons for such delays among young adult females with breast cancer in Nigeria. Methods A mixed-method convergent parallel study design was used. The study was conducted at two academic hospitals in southwest Nigeria. Data were collected using a semi-structured assessment tool and an in-depth interview guide. Both the quantitative and qualitative data were collected concurrently. This approach was adopted to aid in the collection of different but complimentary data at the study sites to enrich the interpretation of the results. Results A total of 46 female participants were recruited into the quantitative component of the study, and the mean age was 34.2 ± 4.4 years. Most had higher education, were married, and were in a lower earning bracket. Majority participants had low knowledge of symptoms and signs of breast cancer. As low as 7 (15.2%) patients had the time between symptom discovery and treatment initiation [Total Treatment Time (TT)] within 90 days (median 281.5; range 31-5260). Twenty-seven (58.6%) participants had diagnostic interval within 60 days (median 40 days [Inter Quartile Range (IQR) 7–4745 days]. Most participants interviewed 39 (85%) knew that breast lump was a possible sign of breast cancer while a sizable number 19 (41%) could not name risk factors for breast cancer. Family history was the most recognised risk factor for breast cancer by 21(46%) of participants interviewed. Conclusion Breast health awareness is low among adolescents and young adults with breast cancer in Nigeria, as most participants 33(72%) lacked knowledge of early symptoms and signs of breast cancer. Very few 7(15%) of the participants commenced treatment within the WHO recommended 90 days of noticing breast symptoms. Sixty percent of the participants met the diagnostic interval of within 60 days as against recommended 80%. There is need to intensify the education of young Nigerian females on breast cancer and the importance of breast self-examination.

Purpose Globally, black women experience poorer breast cancer outcomes suggesting the need for effective health promotion approaches to increase perceived susceptibility and improve screening practices. Although narrative communication by patients or survivors is increasingly considered an effective approach for better breast cancer outcomes, there is limited information on its use in Nigeria. This study assessed the perception, willingness and generalized self-efficacy of breast cancer patients and survivors at the University College Hospital, Ibadan, to implement narrative communication interventions. Material and Methods This was a cross-sectional study, and a mixed-method convergent parallel design was utilized for data collection. Written informed consent was obtained from each study participant for in-depth interviews and a semi-structured questionnaire. Five patients were recruited for in-depth interviews and a semi-structured questionnaire was used to obtain data from 102 patients. Data were analysed using thematic analysis for qualitative data, and descriptive and inferential statistics for quantitative data. Results The mean age of the respondents was 49.3 ± 10.2 years. There was a good perception (97.1%) towards narrative communication interventions. Ninety-eight percent were willing to implement narrative communication interventions and 79.4% had a high generalized self-efficacy. Respondents’ educational attainment was significantly associated with the generalized self-efficacy to implement narrative communication intervention programs (P < .05). Most of the in-depth interview participants opined that a pre-diagnosis discussion with a breast cancer patient or survivor would have increased their perceived susceptibility and motivation to screen. Conclusion This study highlights the potential of breast cancer patients and survivors as breast health educators, sharing their lived experiences to empower and motivate women on prevention and screening. Findings could guide the design of population-level, breast cancer prevention and screening interventions.

Background. Breast cancer among adolescents and young adult (AYA) females aged 15-39 years is associated with different patterns of aggressiveness, as well as psychosocial and economic issues. At present, the burden of breast cancer among this age group is unknown in Nigeria. There is a need to determine the proportion of AYA with breast cancer in Nigeria. This will inform the development of breast cancer care programs appropriate for this age group. Objective. The objective of this study was to highlight the burden of breast cancer with an emphasis on AYAs in Nigeria and its implications. Methods. A retrospective review of data from cancer registries in Nigeria between 2009 and 2016 was carried out. Results. Among AYA females in Nigeria, breast cancer was by far the most common cancer, constituting 50% of all cancers and 51% (2798 of 5469) of all breast cancer cases. IA third (30.8%) of breast cancer cases in all centers studied were AYAs. Conclusion. The high proportion of AYA with breast cancer is an important feature suggesting that urgent actions are required to ensure early detection and improve breast cancer care among this age group.

Introduction Prostate cancer is the most common cancer in men. It was initially a disease of older men above the age of 55 years. Of recent, there has been reports of increase in the number of young men <55 years with prostate cancer (PCa). The disease in this age group has been reported to be more lethal because of aggressive characteristics and metastatic potential. Different populations have different proportions of young-onset PCa. The aim of this study was to determine the proportion of young men aged <55 years with PCa in Nigeria. Methods Data on the prevalence of young men <55 years with PCa was extracted from the 2022 report of the prevalence of cancer in Nigeria from 2009 to 2016 based on the records of 15 major Cancer Registries in Nigeria. This was a publication of the Nigerian Ministry of Health and represents the most up to date data. Results In 4864 men diagnosed with malignancies before age 55, PCa was the second common, following liver cancer. Out of a total of 4091 cases of PCa in all age groups, 355 were diagnosed in men <55 years representing 8.86%. Furthermore, the proportion of young men with the disease in the Northern part of the country was 11.72%, whereas in the South, it was 7.77%. Conclusions PCa is the second most common cancer in young Nigerian men aged< 55 years preceded by liver cancer. The proportion of young men with PCa was 8.86%. It is therefore important to consider PCa in young men as a different entity and develop appropriate ways to control this disease to ensure survival and good quality of life.

Aim:The aim of this systematic review was to synthesise and summarise evidence surrounding the clinical use of fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) for target volume delineation (TVD) in rectal cancer radiotherapy planning.Methods:PubMed, EMBASE, Cochrane library, CINAHL, Web of Science and Scopus databases and other sources were systematically queried using keywords and relevant synonyms. Eligible full-text studies were assessed for methodological quality using the QUADAS-2 tool.Results:Eight of the 1448 studies identified met the inclusion criteria. Findings showed that MRI significantly delineate larger tumour volumes (TVs) than FDG-PET/CT while diffusion-weighted magnetic resonance imaging (DW-MRI) defined smaller gross tumour volumes (GTVs) compared to T2 weighted-Magnetic Resonance Image. CT-based GTVs were found to be larger compared to FDG-PET/CT. FDG-PET/CT also identified new lesions in 15–17% patients and TVs extending outside the routinely used clinical standard CT TV in 29–83% patients. Between observers, delineated volumes were similar and consistent between MRI sequences, whereas interobserver agreement was significantly improved with FDG-PET/CT than CT.Conclusion:FDG-PET/CT and DW-MRI appear to delineate smaller rectal TVs and show improved interobserver variability. Overall, this study provides valuable insights into the amount of attention in the research literature that has been paid to imaging for TVD in rectal cancer.

Objective Clinical research has faced new challenges during the COVID-19 pandemic, leading to excessive operational demands affecting all stakeholders. We evaluated the impact of COVID-19 on clinical research strategies and compared different adaptations by regulatory bodies and academic research institutions in a global context, exploring what can be learned for possible future pandemics. Methods We conducted a cross-sectional online survey and identified and assessed different COVID-19-specific adaptation strategies used by academic research institutions and regulatory bodies. Results All 19 participating academic research institutions developed and followed similar strategies, including preventive measures, manpower recruitment, and prioritisation of COVID-19 projects. In contrast, measures for centralised management or coordination of COVID-19 projects, project preselection, and funding were handled differently amongst institutions. Regulatory bodies responded similarly to the pandemic by implementing fast-track authorisation procedures for COVID-19 projects and developing guidance documents. Quality and consistency of the information and advice provided was rated differently amongst institutions. Conclusion Both academic research institutions and regulatory bodies worldwide were able to cope with challenges during the COVID-19 pandemic by developing similar strategies. We identified some unique approaches to ensure fast and efficient responses to a pandemic. Ethical concerns should be addressed in any new decision-making process.

High dose rate (HDR) brachytherapy is a promising therapeutic approach for localised prostate cancer. Optimised treatment plans have been shown to improve disease control and reduce toxicity on the organs-at-risk (OAR). To report findings from the treatment plan parameters (TPPs) obtained from two different HDR brachytherapy treatment regimens at the University College Hospital, Ibadan Nigeria. The treatment plans of 90 patients, who had HDR brachytherapy to the prostate gland between August 2020 and October 2023 were considered. All were treated with Bebig Saginova machine, housing Cobalt-60 source, the first multi-channel unit in the country then. 44% of patients received dose of 18 Gy in 2 fractions (category A), while the remaining received 27 Gy in 2 fractions (category B). Treatment plans were generated on the Sagiplan 2.0 treatment planning system from Eckert & Ziegler, BEBIG and relevant TPP were extracted and analysed using IBM SPSS 27. The mean age(years) of patients in Categories A and B were 65.3 ± 6.59 and 66.5 ± 5.32, respectively; their gleason score and prostate-specific-antigen were (7 ± 1; and 7 ± 1) and (12.83 ± 16.32; and 12 ± 17 ng/mL), respectively. The mean volume (cm ) of prostate volume (PVol.) for both categories were 46 ± 21 and 31 ± 8, respectively. The paired -test performed on TPP from patients in both categories was statistically significant ( < 0.005), except their age ( < 0.873) and dose homogeneity index ( < 0.639). Also, the regression analysis showed that V is statistically dependent ( < 0.05) on Total Reference Air Kerma, conformal index, Rectum D and PVol. in both categories. Although, some level of optimal dose coverage around the prostate gland was achieved for some of the patients, especially those in Category B, there is still room for improvement to minimise the dose to OAR.

Evasion of apoptosis is associated with treatment resistance and metastasis in colorectal cancer (CRC). Various cellular processes are associated with evasion of apoptosis. These include overexpression of pro-apoptotic proteins (including p53 and PD-L1), anti-apoptotic proteins (BIRC7/Livin and Bcl-2), chemokine receptors (including DARC), and dysregulation of DNA mismatch repair proteins (including MSH2 and PMS2). The aim of this study was to determine the effect of folinic acid, 5-FU and oxaliplatin (FOLFOX) as a single agent and aspirin plus FOLFOX in various combinations on the aforementioned proteins in human CRC, SW480 cell line and rat models of N-Methyl-N-Nitrosourea (NMU)-induced CRC. In addition, effects of the NMU-induced CRC and chemotherapeutic regimens on haematological and biochemical parameters in the rat models were studied. Immunohistochemistry, immunofluorescence and immunoblot techniques were used to study the expression pattern of the related proteins in the human CRC cells pre- and post-treatment. Double contrast barium enema, post-mortem examination and histological analyses were used to confirm tumour growth and the effect of the treatment in vivo in rat models. Notably, we found in human mucinous CRC, a significant increase in expression of the BIRC7/Livin post-FOLFOX treatment compared with pre-treatment ( p = 0.0001). This increase provides new insights into the prognostic role of BIRC7/Livin in evasion of apoptosis and facilitation of treatment resistance, local recurrence and metastasis particularly among mucinous CRCs post-FOLFOX chemotherapy. These poor prognostic features in the CRC may be further compounded by the significant suppression of DARC, PD-L1, PMS2 and overexpression of MSH2 and anti-apoptotic Bcl-2 and p53 proteins observed in our study (p < 0.05). Importantly, we found a significant reduction in expression of BIRC7/Livin and reactivation of DARC and PD-L1 with a surge in Annexin V expression in rat models of CRC cells post-treatment with a sequential dose of aspirin plus FOLFOX compared with other treatments in vivo ( p <0.05). The mechanistic rational of these effects underscores the importance of expanded concept of possible aspirin combination therapy with FOLFOX sequentially in future CRC management. Validation of our findings through randomized clinical trials of aspirin plus FOLFOX sequentially in patients with CRC is therefore warranted.

Prostate cancer (PCa) is the most prevalent and leading cause of cancer-related deaths among men in most countries around the world, with sub-Saharan Africa being among the most severely affected regions. Indeed, PCa is more common and lethal in indigenous African men, African Americans, and Afro-Caribbean men as compared to their age-matched white counterparts. While the fundamental aetiology of PCa and the role of androgen signalling are well understood, the basis of this racial disparity in PCa incidence and progression remains poorly understood. In this review we revisit the potential association of human papilloma virus (HPV) and PCa. While several studies support an association between HPV and PCa progression and aggressiveness, the importance of HPV in PCa is not without controversy. Here we evaluate studies that both support and challenge a mechanistic role for HPV in PCa and discuss limitations of these studies. We offer suggestions for future studies to address the contribution of HPV to the racial disparity in PCa incidence and outcomes.

Prostate cancer is the most commonly diagnosed malignancy in adult males. High dose rate brachytherapy (HDRB) recently became available in the country for the management of localized prostate cancer in addition to other treatment modalities. HDRB offers a less invasive option to radical prostatectomy and also has a better side effects profile. To report the socio-demographic features of the patients treated with HDRB, the clinicopathologic pattern of their disease and possible predictors of these features. A retrospective study of patients with histopathologically confirmed prostate cancer, who had HDRB at the Department of Radiation Oncology, University College Hospital, Ibadan, Nigeria, between July 2020 and 2023 was done. Patients' socio-demographic and clinicopathologic characteristics were extracted from their treatment records. A total of 73 patients had HDRB within the period under review. The median age was 66 years (51-78 years). About 40% had prostate cancer diagnosed following routine prostate-specific antigen (PSA) screening. The median screening PSA was 20.5 ng/mL (5.83-75.35 ng/mL). About a quarter (24.7%) were asymptomatic at presentation while frequency (60.3%), nocturia (45.2%) and urgency (35.6%) were the most common symptoms. The median initial PSA was 26.00 ng/mL (5.10-124.50 ng/mL) and the median PSA before brachytherapy was 6.25 ng/mL (0.03-175.30 ng/mL), the majority (75.3%) had androgen deprivation therapy before brachytherapy. Forty-seven patients (64.4%) presented with TNM stages 1 and 2 while grade group 2 (24.7%) and high risk (76.7%) were the commonest grade group and risk group, respectively. There was a significant association between age group and TNM stage ( = 0.043), level of education (LOE) and TNM stage ( = 0.037) as well as PSA screening and grade group ( = 0.007). The majority of the patients who presented for prostate brachytherapy were elderly, had higher initial PSA, were in the high-risk group and had early-stage disease. About 25% of the patients were asymptomatic at presentation. Patients with tertiary LOE and elderly patients presented more with stage 1 and 2 diseases.