ABS 016: Lung Cancer Screening in Sub-Saharan Africa: A Scoping Review and Thematic Analysis​

Ameena Momand ¹ , Emmanuel Odame ¹

¹ School of Public Health, University of Alabama at Birmingham

Van Wickle (2025) Volume 1, ABS016

Introduction: Lung cancer is a significant public and global health challenge that poses a devastating disease burden. It is currently the leading cause of cancer-related deaths worldwide, transcending borders and impacting countries at all stages of development. In low- and middle-income countries (LMICs), particularly in sub-Saharan Africa (SSA), lung cancer surveillance and screening programs remain underdeveloped. This scoping review utilizes the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework in exploring the barriers to implementing lung cancer screening across SSA. We conducted a comprehensive search of databases such as PubMed, Scopus, and Google Scholar with key search terms in both text and medical subject headings (MeSH) forms including “lung cancer,” "lung neoplasms"[MeSH Terms], “screening,” "early detection of cancer"[MeSH Terms], and “sub-Saharan Africa” to yield relevant studies. Emerging themes and subthemes from the review are: (1) adapting screening guidelines, (2) feasibility and appropriateness of lung cancer screening in SSA, (3) challenges in implementing screening within resource-limited, high-burden environments, (4) marginalization of screening in a strained healthcare system, (5) missed opportunities for early detection, and (6) patient perceptions on screening uptake. Our study aims to discuss these themes and subthemes in the light of improving lung cancer screening and broader health outcomes in SSA. It signifies the urgent need for increased education, advocacy and well-coordinated research efforts to address prevailing health disparities in LMICs.

Methods: A literature search was conducted to identify articles discussing lung cancer screening in Sub-Saharan Africa. PubMed, Scopus, Google Scholar, and an article search was conducted using key search terms in both text and medical subject headings (MeSH) forms including “lung cancer,” "lung neoplasms"[MeSH Terms], “screening,” "early detection of cancer"[MeSH Terms], and “sub-Saharan Africa” to yield relevant studies. The PubMed search yielded 192 articles, Scopus produced 18 (with 10 duplicates overlapping with PubMed), and Google Scholar yielded 2 additional articles, with an article search yielding 13 articles. After removing duplicates, a total of 213 articles were initially reviewed. We further excluded 208 articles that focused on non-lung cancers, non-screening interventions, other diseases and/or studies outside of SSA. ​

Results: Our review found that clinician/provider limitations, health system deficiencies, and patient-level barriers critically impede the implementation of lung cancer screening programs in Sub-Saharan Africa. Limited diagnostic capacity, fragmented healthcare pathways, inadequate infrastructure, and funding gaps delay program development and reduce screening uptake. Cultural stigma, lack of awareness, and financial barriers further prevent early detection efforts. Together, these systemic issues obstruct the establishment of effective, sustainable lung cancer screening initiatives, perpetuating late-stage diagnoses and poor outcomes.

Discussion: Lack of LDCT Utilization: No studies reported the use of low-dose computed tomography (LDCT) for lung cancer screening in SSA, highlighting a major gap in early detection efforts.​
Geographic Limitation: All five studies were conducted in South Africa, which has the highest lung cancer mortality rate in the region. This may not reflect challenges faced in other SSA countries.​
Key Focus Areas: The 12 identified themes centered around three core areas, emphasizing persistent barriers to screening, healthcare system constraints, and patient-related factors.