In Nigeria, outcomes for people with cancer are typically poor.1 Stigma, limited coverage for care costs and a lack of oncologists mean that many people do not receive or complete cancer treatment.2-4 In 2017, Dr Omolola Salako with support from the Sebeccly Cancer Care and Support Centre launched an online digital clinic called Oncopadi.2 This platform offers access to information and resources, as well as telephone or video consultations with oncologists. Oncopadi has helped more than 1,000 people, and there are plans to expand its functionality.2 4 5
In 2020, almost 125,000 new cancer diagnoses were reported in Nigeria.6 This figure is likely to be higher, as high medical care costs, widespread poverty and limited access to screening programmes result in many cases not being diagnosed or reported.3 Outcomes for people with cancer are generally poor, with the mortality rate estimated at 80% across all cancers.1
Many people diagnosed with cancer do not seek medical attention until it is at an advanced stage.3 4 They may have a limited understanding of cancer and ways to access care, or may experience stigma and fear around the disease.4 It is common for people to seek help from religious leaders, sometimes for years, before presenting at a healthcare facility. In addition, many people cannot afford cancer treatment and this may contribute to a high drop-out rate – one study found that 67% of people who initiated private cancer treatment did not complete it.3
Despite the high burden of cancer, Nigeria only has 100 clinical oncologists and most are based in large cities.2 The ratio of oncologists to new cancer patients is 1 to 1,250,2 compared with 1 to 184 in Germany.7 People seeking care for suspected or newly diagnosed cancer could wait up to 12 weeks to be seen by a specialist, depending on their location and financial resources.2 They typically have to travel long distances and spend money on transport and accommodation.
In 2017, oncologists at the Sebeccly Cancer Care and Support Centre launched the Oncopadi Startup, an online platform that aims to improve access to specialist care and support.2 4 The centre is a non-governmental organisation based in Lagos, but Oncopadi is available nationally to people with suspected cancer and those seeking treatment or palliative care.4 Staff at the centre chose to develop an online platform in the knowledge that many people in Nigeria have constant access to the internet and would be comfortable taking part in online consultations with healthcare professionals, including oncology specialists.8
After an initial assessment, the platform connects people with an oncologist.2 They are offered an hour-long audio or video consultation via the app or telephone consultation, after which they receive a written summary of their appointment and a referral to their closest public or private oncology hospital or diagnostic centre depending on the need of the patient.9 Family members and caregivers can also use the platform to ask for advice or to request a second opinion. Oncopadi houses educational resources for people with cancer, including patient guides and information on diagnoses, treatment and living with the disease.5 This group accounts for more than 70% of the app users.
By November 2021, 25 of the 81 oncologists in Nigeria were registered on the platform – half of them use Oncopadi to see their current patients,9 while the others volunteer their time to see new patients seeking help via the platform.4 New patients are often referred to appropriate cancer facilities so they can receive in-person care.
What has been achieved?
Since its launch, Oncopadi has supported more than 1,000 people.2 Many of the platform’s users are women, potentially reflecting the fact that breast and cervical cancers are among the most common cancers in Nigeria.4
In early 2020, Oncopadi was released as a smartphone app to help navigate the first wave of the COVID-19 pandemic.2 Oncologists were able to manage disruptions to cancer care by using the app to:
- educate cancer patients about the COVID-19 pandemic
- give people with cancer access to advice and support
- dispatch medications through partnerships with pharmacies
- assess and triage people to be seen in hospital, providing a written note to help people travel to hospital during lockdown
- provide counselling and support to people with advanced cancer and their families, as part of palliative care.2
In March 2021, Oncopadi’s founder and Chief Executive Officer Dr Omolola Salako was awarded the Astellas Pharma C3 (Changing Cancer Care) Grand Prize for the ‘best idea in cancer care beyond medicine’.10 The reception of this award coincided with the creation of a mobile research team at Oncopadi, which is working to identify other healthcare innovators developing patient-centred digital solutions in Nigeria.4
The team behind Oncopadi is working to establish a virtual tumour board platform in public hospitals with a high volume of cancer patients and no clinical oncologists. This platform will connect hospitals without oncologists to specialists in other areas of Nigeria.4 Oncologists across the country will also be able to use the platform to discuss complex cases. The virtual tumour boards will be based on a platform piloted in three hospitals in 2021, in partnership with the Nigerian Ministry of Health.4
The Oncopadi website
- Unah L. 2017. 'I thought cancer was a disease for the elderly': tackling Nigeria's 80% mortality rate. [Updated 20/03/17]. Available here: https://www.theguardian.com/global-development-professionals-network/2017/mar/20/nigeria-cancer-mortality-rate-addressed-ngo [accessed: November 2021]
- Union for International Cancer Control. 2021. Innovations in cancer care bring health closer to patients in LMICs. [Updated 05/08/21]. Available here: https://www.uicc.org/news/innovations-cancer-care-bring-health-closer-patients-lmics [accessed: October 2021]
- Fapohunda A, Fakolade A, Omiye J, et al. 2020. Cancer presentation patterns in Lagos, Nigeria: Experience from a private cancer center. J Public Health Afr 11(2): 1138-38
- Salako O, Momodu A. 2021. Interview with Catherine Hodge at The Health Policy Partnership [video call]. [accessed: November 2021]
- Oncopadi. 2021. Cancer care. Available here: https://oncopadi.com/cancer-care [accessed: October 2021]
- Global Cancer Observatory. 2020. Nigeria. Available here: https://gco.iarc.fr/today/data/factsheets/populations/566-nigeria-fact-sheets.pdf [accessed: November 2021]
- de Azambuja E, Ameye L, Paesmans M, et al. 2014. The landscape of medical oncology in Europe by 2020. Annals of Oncology 25(2): 525-28
- Salako O, Okediji P, Agaga LA, et al. 2018. E-Patients: Online Health Seeking Behaviour of Cancer Patients in South Western Nigeria. Journal of Global Oncology 4(Supplement 2): 18s-18s
- Adebowale A. 2020. #WomenInTech - How Lola Salako is helping cancer patients access the right specialist care through Oncopadi. [Updated 15/05/20]. Available here: https://technext.ng/2020/05/15/womenintech-how-lola-salako-is-helping-cancer-patients-access-the-right-specialist-care-through-oncopadi/ [accessed: November 2021]
- Astellas. 2021. Astellas Oncology announces Grand Prize winner of Fifth Annual C³ Prize® Challenge. [Updated 24/03/21]. Available here: https://www.astellas.com/us/news/5561 [accessed: November 2021]