A growing number of Nigerians aged between 18 and 39 are being diagnosed with cancer, with oncologists increasingly encountering cases that are difficult to predict and often fall outside the age brackets targeted by routine screening programmes.
Clinical Oncologist and Chief Executive Officer of Pearl Oncology Specialist Hospital, Dr Omolola Salako, raised the concern while speaking during an interview on ARISE NEWS on Sunday.
Salako said the emergence of cancer among young adults was particularly troubling because many of them are considered too young for conventional age-based cancer screening.
“And for young cancers, that’s another thing we’re seeing in oncology, there are young people between the ages of 18 and 39 that are developing cancers and these cancers are unpredictable, too young to recommend cancer screening in the first place.”
According to the oncologist, the trend underscores the importance of cancer awareness and prompt medical evaluation, particularly when symptoms persist or recur.
Tobacco use remains major risk factor
Salako identified tobacco use as one of the significant preventable risk factors for cancer, warning that the substance contains thousands of chemicals capable of initiating cancerous changes in the body.
“Smoking contains tobacco. And in tobacco, there are more than 3,000 chemicals that are known to trigger cancer or start cancer.”
She warned that the danger is not limited to people who smoke directly, stressing that exposure to second-hand tobacco smoke can also increase health risks.
“Whether you’re smoking it or you’re leaving or hanging around the person who’s smoking, all of that are risk factors, so the first thing I would say is when we speak cancer control, there’s several pillars. So the first pillar is cancer prevention.”
Salako also warned against assuming that alternative smoking products are automatically safer, saying products containing tobacco, including electronic cigarettes, remain a concern.
Prevention and early detection
The oncologist said cancer control should begin with prevention, urging Nigerians to make greater use of primary healthcare services for vaccination and other preventive interventions.
She said a significant proportion of cancers could be prevented through measures such as vaccination, healthier lifestyles and early intervention.
“And 40% of cancers are preventable. So it’s important women and men are presented at the primary care health care levels to get screened, get vaccinated against hepatitis B virus, human papillomavirus.”
Salako said vaccination against hepatitis B and human papillomavirus could help reduce the risk of cancers associated with the two viruses.
She, however, stressed that prevention alone would not eliminate the disease because some cancers cannot be prevented entirely.
“On the second pillar is early detection. So, you know, 40% of cancers can be prevented, but some cancers can’t be prevented, but we can detect them early, like breast cancer, prostate cancer, part of the challenges we have with the available resources in the government, public sector and the private sector, we have underutilisation of the services. So I would like to pin more on public education.”
She called for greater public awareness to encourage people to use available healthcare services before diseases become advanced.
Cost of treatment forces patients to abandon care
Beyond late diagnosis, Salako identified the high cost of cancer treatment as another major obstacle confronting patients in Nigeria.
She said some patients who initially present early eventually discontinue treatment because they cannot sustain the financial burden.
“Where treatment is costing anywhere from 10 million to 15 to 60 million, in reality, many cancer patients are presenting to the hospital early, but they are dropping out of treatment.”
Salako explained that cancer treatment is not a single procedure but may involve several modalities depending on the type and stage of the disease.
“There are about six treatment modalities, surgery, chemotherapy, radiotherapy, immunotherapy, target therapy and hormone therapy, we do have health insurance, but very few Nigerians are health insured. And then there’s a huge cap on cancer care.”
She said inadequate health insurance coverage means many families are forced to shoulder substantial portions of treatment costs out of pocket.
Annual medical checks advised
The oncologist urged Nigerians to make routine medical check-ups part of their healthcare habits, regardless of age or gender.
“As Nigerians, we should focus on our annual medical checkup. That would be the first thing for every age and every gender.”
She also advocated age-appropriate screening, citing specific checks that should be considered as people grow older.
“From age 21, we want you to start getting a pap smear for women. We want you to do your clinical breast examination for men. From age 40, we want you to do the prostate-specific antigen test. From age 45, we want Nigerians to start doing their colonoscopies.”
Salako said persistent symptoms should never be ignored, particularly where treatment fails to resolve the underlying problem.
“The second thing is when a symptom persists, present to the hospital. If you are not satisfied with the resolution of the symptom, or the symptom continues, it comes, it goes, it’s persistent, then seek a second opinion.”
She stressed that early diagnosis could significantly improve the chances of successful treatment.
“The goal is to cure it. We can cure it when it’s, it’s potentially curable at stage one and stage two.”
Stage-four cancer is not always a death sentence
While early detection remains critical, Salako cautioned against assuming that a diagnosis of stage-four cancer automatically means there is no treatment option.
She said some patients with advanced cancer could continue to live for extended periods, depending on the organs affected, the extent of spread and the patient's overall health.
“So it depends where the cancer spreads to.”
According to her, the location of secondary cancer deposits can significantly influence prognosis.
“When cancer spreads to other places like the brain, the liver, the lungs, those are essential organs that we can’t do without.”
She explained that some patients with advanced disease could still receive treatment if their vital organs remained sufficiently functional.
“So sometimes patients present with advanced disease and it’s not that there’s no treatment. It is that the organs are not optimal enough, are not working well enough to receive that type of heavy treatment within the body.”
Family history can signal increased risk
Salako also identified a strong family history of cancer as a warning sign that should prompt specialist assessment.
She said people from families where several relatives have developed cancer may require additional evaluation and, in some cases, genetic testing.
“Another challenge I must highlight are those with a strong family history of cancer.”
She advised people with significant family histories to consult specialists who can determine whether genetic tests or other interventions are appropriate.
“When there’s a strong family history, you should see a specialist, you should do some genetic tests and there are some drugs and tests that can be done to detect the cancers when they are at stage zero, pre-cancers, when they are microscopic.”
Salako also mentioned other health conditions and lifestyle-related factors that could contribute to serious health complications, including kidney disease, uncontrolled hypertension and micronutrient deficiencies.
“So, of course, kidney diseases leading to renal failure, requiring renal transplant is a big issue, uncontrolled hypertension, I would like to say micronutrient deficiency.”
Colon cancer increasingly affecting younger adults
The oncologist expressed particular concern about colorectal cancer among younger Nigerians, noting that younger patients often delay seeking care because cancer is not among the conditions they expect at their age.
“And with the younger adults, they tend to present, you know, late because that’s the last thing on a 20-something years old mind, so with smoking, the causative agent is tobacco.”
She said the growing incidence of cancer among younger people reinforces the need for increased awareness and greater attention to symptoms that might otherwise be dismissed because of age.
Alcohol, cannabis and UV exposure
Salako also discussed other potentially harmful exposures, cautioning against viewing cannabis as a universally healthy alternative.
“But it doesn’t mean it’s a healthy option, It’s the chronic, heavy alcohol consumption that stresses the liver, induces chronic inflammation and can cause other types of cancers.”
She also warned about prolonged exposure to ultraviolet radiation, particularly among people with lighter skin and those living with albinism, who have lower levels of melanin and therefore less natural protection against UV damage.
“And so with that less protection and being exposed to harsher UV radiation, there’s more skin damage that is seen as sunburns.”
According to Salako, chronic inflammation is a common pathway through which several risk factors can contribute to cancer development.
“At the end of the day, almost everything leads to inflammation.”
She explained that repeated injury and damage to cells can create opportunities for abnormal cells to survive and eventually develop into cancer.
“The problem with cancer is, it just takes one arrow in one cell and finds a way to hide. And that’s how cancer can develop.”
With cancer increasingly being diagnosed across different age groups, Salako's message is that prevention, vaccination, regular medical checks, prompt investigation of persistent symptoms and access to treatment must remain central to Nigeria's cancer-control strategy.