Using cancer survivorship experiences to inform cancer advocacy in Nigeria.

Background: Nigeria has a significant cancer burden, especially breast cancer (BC), which has the highest incidence and mortality in the country. However, like many countries in sub-Saharan Africa, the focus continues to be on infectious diseases to the detriment of addressing non-communicable diseases like cancer with a resultant paucity in available funding, health infrastructure and even health workforce geared towards cancer care. All these invariably lead to very low access to cancer care, with poor patient outcomes being recorded. The purpose of this study is to explore the experiences of BC survivors who are part of a non-profit cancer advocacy group to highlight important areas of cancer survivorship that can be targeted by cancer advocacy programs and interventions in Nigeria. Method: We used a qualitative descriptive approach and recruited 19 BC survivors through a purposive sampling method. The participants were engaged in four focus group discussions. Analysis of the data resulted in four main themes with direction implications for cancer advocacy among BC survivors in Nigeria. They include 'Strengthening care interaction quality'; 'Addressing delayed presentation'; 'Expanding access to informal support' and 'Alleviating the cost burden of cancer care.' Various recommendations were made, such as better management of the Nigerian Cancer Health Fund, comprehensive cancer coverage by the National Health Insurance Authority and the need for Nigeria's National Institute for Cancer Research and Treatment to consider retention and training policies for the oncology workforce in Nigeria. This paper highlights the importance of cancer advocacy, arguing that a better understanding of cancer survivorship can strengthen cancer advocacy in Nigeria. In turn, strong cancer advocacy will help to prioritise cancer issues and mitigate a looming cancer crisis in Nigeria.