The unregulated proliferation of electronic nicotine delivery systems (ENDS) across low- and middle-income countries (LMICs) risks undermining decades of progress in global cancer prevention. Nepal's recent regulatory uncertainty, rooted in a mismatch between primary legislation and subordinate regulation, provides an instructive case for comparative policy analysis across the WHO South-East Asia Region, which already carries a disproportionate oral cancer burden attributable to smokeless tobacco use. Using Nepal, India, and Bangladesh as contrasting policy trajectories, we examine how statutory prohibition, legislative reversal, and contested enforcement intersect with this pre-existing burden. Although ENDS may confer harm reduction benefits among certain adults who smoke, realizing this potential depends on effective product regulation, prevention of youth access, and population-level surveillance; these conditions remain weak or nonexistent in many LMICs. We argue that failure to incorporate ENDS explicitly into primary tobacco control legislation constitutes an actionable governance gap. Explicit legislative coverage of ENDS and harmonization of regional surveillance systems represent minimum safeguards before exposure patterns become entrenched and long-term cancer risks can be reliably assessed.
Focusing on the Middle East, this narrative review examines how conflict contributes to delays across the cancer care continuum, including prevention, early detection, diagnosis, treatment, follow-up, survivorship, and palliative care. Mechanisms include the destruction of health facilities, workforce displacement, interrupted supply chains, constrained health budgets, and the diversion of services toward emergency response. These challenges reduce investment in prevention and restrict timely access to therapy, leading to poorer clinical outcomes and increased mortality. Sociocultural barriers, including stigma, misinformation, trauma, and limited public awareness, further delay patient presentation and undermine treatment adherence and continuity of care. This narrative review focuses on peer-reviewed studies and reports published between 2021 and 2026 (with older seminal studies for historical context) to clarify how conflict disrupts cancer care, analyze economic burdens and inequities, and map the relationships between health system fragility and sociocultural barriers. Drawing on this analysis, the review proposes a phased operational framework that tailors strategies—including mobile oncology, tele-oncology, decentralized diagnostics, cross-border referral, and supply chain safeguards—to the security and functional levels of each setting, as well as to governance and financing mechanisms.
PurposeAdolescents and young adults (AYAs) exhibit a distinct cancer profile between pediatric and adult malignancies. Data from West Africa remain scarce, particularly in Guinea, where evidence is largely based on hospital data because of the absence of a structured cancer registry. This study aimed to describe the burden and profile of cancers among AYAs treated at the largest national referral hospital in Guinea.Materials and MethodsThis was a retrospective descriptive study conducted from 2016 to 2023 in the oncology department of Donka University Hospital, Conakry. All AYAs (age 15-39 years) with histologically confirmed cancers were included. Sociodemographic and clinical data were collected from medical records, hospital registries, and the department's database.ResultsA total of 739 newly diagnosed AYAs were included, representing 27.7% of all histologically confirmed cancer cases. The number of cases increased from 28 in 2016 to 183 in 2023. The median age was 31 years (IQR, 26-35), and 71.2% were female. Breast cancer was the most common malignancy (38.2%), whereas lymphomas (15.0%) and liver cancers (12.2%) predominated among males. Sarcomas were the most common among 15- to 19-year-olds (44.4%). Overall, 58.9% were diagnosed at locally advanced stage and 27.7% were diagnosed with metastatic disease.ConclusionCancers among AYAs increased substantially over the study period in our context, with distinct age- and sex-related patterns. The predominance of advanced stages underscores ongoing challenges in early detection and access to care. These findings emphasize the need for strengthened cancer surveillance, earlier diagnosis strategies, and AYA-adapted supportive care in Guinea.
PurposeInvasive cervical cancer (ICC) cases remain a major public health concern for women in Nigeria. The purpose of this scoping review is to assess the reporting of common human papillomavirus (HPV) genotypes found in ICC cases among Nigerian women.MethodsWe searched five databases, including Embase, Ovid Medline, Scopus, Cochrane Database of Systematic Reviews, and Google Scholar, to identify studies reporting HPV genotypes found in ICC cases in Nigeria. Study selection and data extraction were conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Two researchers extracted data from each eligible article.ResultsA total of 668 records were identified, of which 422 studies were screened and six articles met the eligibility criteria. The included studies reported on HPV genotypes detected in ICC among Nigerian women. Across the studies, high-risk HPV (hrHPV) types 16, 18, 35, and 45 were identified in approximately 50% of ICC cases, whereas other detected genotypes included hrHPV types 31, 33, 51, and 52. Notably, in addition to globally predominant hrHPV types 16 and 18, hrHPV types 35 and 45 were also frequently detected, indicating their significant contribution to the ICC burden among Nigerian women.ConclusionAfter an extensive search, this study provides a comprehensive assessment of the overall prevalence and distribution of hrHPV genotypes in Nigerian women with ICC. The most common hrHPV genotypes detected in ICC in Nigeria are 16, 18, 35, 45, 31, 33, 51, and 52. hrHPV types 16 and 18 account for the majority of cases, but in Nigeria and among women of African descent worldwide, hrHPV types 45 and 35 are also significantly present in ICC cases.
