The current landscape of pediatric oncology in Nigeria: a scoping review of diagnostic delays, treatment access, and outcomes

Abstract Background Pediatric cancer care in Nigeria is constrained by several patient- and system-related factors. In line with the World Health Organization’s Global Initiative for Childhood Cancer, this scoping review mapped the Nigerian literature on diagnostic delays, treatment access, clinical outcomes, and related system gaps. Methods We searched PubMed, Cochrane Library, Scopus, African Journals Online (AJOL), Taylor & Francis Online, and Google Scholar. Eligible studies were in English, published 2005–2025, and included individuals 0–18 years. Findings were synthesized thematically and narratively. Results Twenty-seven tertiary hospital-based studies ( n = 2,920) were included, representing all six geopolitical zones. Most were retrospective. Frequently reported malignancies included Burkitt lymphoma, nephroblastoma, retinoblastoma, Hodgkin lymphoma, and acute leukemias. Symptom-to-presentation intervals ranged from 2 to 157 weeks (median 79.5 weeks), and two studies separately reported symptom-to-diagnosis intervals of 13.4 weeks and 54.1 weeks, respectively. Contributors to delayed diagnosis and poor treatment access included low awareness, traditional or alternative care-seeking, initial misdiagnosis, financial barriers, long travel distances, limited insurance coverage, and broader health-system constraints. Using study-reported definitions, treatment completion was 3.3% in one study and 62.8% in another; treatment discontinuation was 6.3% in one study and 64.7% in another; mortality was 6.3% in one study and 45.1% in another; and cohort-level loss to follow-up was 6.6% in one study and 52.6% in another, reaching 81.8% among patients discharged on follow-up chemotherapy in one cohort. Conclusion Pediatric oncology care in Nigeria is marked by prolonged diagnostic pathways, interrupted treatment, and poor reported outcomes. Priorities include standardized referral pathways and integration of childhood cancer into national health insurance. Graphical abstract