BWS saw a problem that needed solution (Nigerians are presenting with cancers at late and advanced stages). The incidence and prevalence of cancer and non-communicable diseases is increasing in Nigeria. Some of the challenges, as found by BWS from community outreaches, published local and international statistics that justified the premise for which BWS was formed include, but are not limited to:

• Lack of Awareness

Of the unhealthy western culture we have imbibed, lifestyle habits, unhealthy diet, physical inactivity and other risk factors of cancer and other non-communicable diseases.

Of prevention strategies such as vaccination, physical activity, healthy local foods & modes of preparing them, avoidance of tobacco smoke and other prevention strategies for cancer and other non-communicable diseases with shared risk factors.

Of how to conduct Breast Self Examination among Nigerian women. Those who know about it do not know how it is done.  Even the very few who know how it, do not examine their breasts regularly.

Of the fact that due to its porous borders, Nigeria seems to be a ‘dumping ground’ for all sorts of products. Our people are not used to the culture of reading the labels of food items, body care products, cosmetics etc before they buy them in stores for use.

• Procrastination and Forgetfulness

Many Nigerians feel screening is not really important at the moment and that they can as well seek screening   ‘tomorrow’ with the hope that it will not be too late… But ‘tomorrow’ never comes.

Issues such as the need to ‘survive through each day’ seemingly increases the propensity to ignore or forget the need to seek education and health screening.

•  Myths and Misconceptions

Many Nigerians still believe that cancer is a boil, an innocuous lump

Many Nigerians do not yet see ‘screening’ as something to be conducted when they are ‘apparently healthy’ and free of symptoms. Many still believe they only need to seek healthcare when they fall ill or become symptomatic.

Fear and Denial that ‘something might be found’ causes many Nigerians not to seek health screening services even where they are available.

Many Nigerians believe in the misconception that ‘what you do not know will not kill you’ and have justified their need not to take up available health screening services.

•  Superstition and Cultural Biases

Fellow Nigerians are still of the opinion that cancer is a mysterious disease which is due to some diabolical reasons, witchcraft, family enemies, poison, etc’

•  Fear and Denial

Many Nigerians, especially women fear stigmatization and abandonment by spouse following diagnosis and usually mastectomy and would rather keep quiet and refuse to seek health care even when symptoms indicate that something might be wrong.

•  Loss –to –Follow-Up’ cases.

Patient whose lumps are discovered early are sometimes lulled into a false sense of confidence, because they are not yet feeling ill. Such patients usually abandon compliance with tests and treatment due to minor financial challenges. They show up later in the hospitals with advanced-stage disease.

•  Health Services and Professionals

Some Nigerians who are genuinely aware sometimes seek health opinions on screening services, clinical symptoms and signs from unqualified persons.

These aforementioned idiosyncratic Knowledge, Attitude and Practice are further compounded by lack of an integrated approach to these scourges from the grassroots through primary care to tertiary care and paucity of oncology specialists,  oncology centres, screening, diagnostic and care facilities.

Poverty, unaffordable healthcare, healthcare facilities that are not easily accessible and low clinical index of suspicion by healthcare providers for cancers in general are also some of the challenges to be overcome.

According to World Health Organization, in 2008, an estimated 36 million of the 57 million global deaths were due to non-communicable diseases, principally cardiovascular diseases, cancers, chronic respiratory diseases and diabetes and that nearly 80 per cent of those deaths occurred in developing countries.

Each year, over 12 million people receive a cancer diagnosis and 7.6 million die of the disease. The World Health Organization (WHO) estimates that 84 million people will die of cancer between 2005 and 2015 if there’s no intervention; and the low-income and medium-income countries will be harder hit than the high-resource countries.

The Union for International Cancer Control (UICC) has proven scientifically that up to 30% of cancer deaths are avoidable through prevention and another 30%, by early detection.