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. 2022 Nov;7(11):e009849.
doi: 10.1136/bmjgh-2022-009849.

Cancer research across Africa: a comparative bibliometric analysis

Miriam Mutebi  1 , Grant Lewison  2 , Ajay Aggarwal  3 , Olusegun Isaac Alatise  4 , Christopher Booth  5 , Miska Cira  6 , Surbhi Grover  7   8 , Ophira Ginsburg  9 , Julie Gralow  10 , Serine Gueye  11 , Benda Kithaka  12 , T Peter Kingham  13 , Lofti Kochbati  14 , Jennifer Moodley  15 , Sulma Ibrahim Mohammed  16 , Alex Mutombo  17 , Ntokozo Ndlovu  18 , Christian Ntizimira  19 , Groesbeck Preer Parham  20   21 , Fiona Walter  22 , Jeannette Parkes  23 , Delva Shamely  24 , Nazik Hammad  25 , Janet Seeley  26 , Julie Torode  27 , Richard Sullivan  28 , Verna Vanderpuye  29
Affiliations

Cancer research across Africa: a comparative bibliometric analysis

Miriam Mutebi et al. BMJ Glob Health. 2022 Nov.

Abstract

Introduction: Research is a critical pillar in national cancer control planning. However, there is a dearth of evidence for countries to implement affordable strategies. The WHO and various Commissions have recommended developing stakeholder-based needs assessments based on objective data to generate evidence to inform national and regional prioritisation of cancer research needs and goals.

Methodology: Bibliometric algorithms (macros) were developed and validated to assess cancer research outputs of all 54 African countries over a 12-year period (2009-2020). Subanalysis included collaboration patterns, site and domain-specific focus of research and understanding authorship dynamics by both position and sex. Detailed subanalysis was performed to understand multiple impact metrics and context relative outputs in comparison with the disease burden as well as the application of a funding thesaurus to determine funding resources.

Results: African countries in total published 23 679 cancer research papers over the 12-year period (2009-2020) with the fractional African contribution totalling 16 201 papers and the remaining 7478 from authors from out with the continent. The total number of papers increased rapidly with time, with an annual growth rate of 15%. The 49 sub-Saharan African (SSA) countries together published just 5281 papers, of which South Africa's contribution was 2206 (42% of the SSA total, 14% of all Africa) and Nigeria's contribution was 997 (19% of the SSA total, 4% of all Africa). Cancer research accounted for 7.9% of all African biomedical research outputs (African research in infectious diseases was 5.1 times than that of cancer research). Research outputs that are proportionally low relative to their burden across Africa are paediatric, cervical, oesophageal and prostate cancer. African research mirrored that of Western countries in terms of its focus on discovery science and pharmaceutical research. The percentages of female researchers in Africa were comparable with those elsewhere, but only in North African and some Anglophone countries.

Conclusions: There is an imbalance in relevant local research generation on the continent and cancer control efforts. The recommendations articulated in our five-point plan arising from these data are broadly focused on structural changes, for example, overt inclusion of research into national cancer control planning and financial, for example, for countries to spend 10% of a notional 1% gross domestic expenditure on research and development on cancer.

Keywords: cancer; health services research.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Disability adjusted life years compared to overall life expectancy. DALYs, disability-adjusted life years; AO, Angola; BI, Burundi; BF, Burkina Faso; CF, Centra African Republic; DZ, Algeria; EG, Egypt; GM, Gambia; LY, Libya; MA, Morocco; MU, Mauritius; MW, Malawi; MZ, Mozambique; RW, Rwand; TN, Tunisia; ZA, South Africa.
Figure 2
Figure 2
Research output domains in Africa. WoS, Web of Science.
Figure 3
Figure 3
Distribution of country research by initiator. CM, Cameroon; DZ, Algeria; EG, Egypt; ET, Ethiopia; GH, Ghana; KE, Kenya; MA, Morocco; NG, Nigeria; SD, Sudan; SSA, sub-Saharan African; TN, Tunisia; TZ, Tanzania; UG, Uganda; ZA, South Africa.
Figure 4
Figure 4
Research output versus country’s gross domestic product. CM, Cameroon; DALYs, disability-adjusted life years; DZ, Algeria; EG, Egypt; ET, Ethiopia; GDP, gross domestic product; GH, Ghana; KE, Kenya; MA, Morocco; NG, Nigeria; SD, Sudan; TN, Tunisia; TZ, Tanzania; UG, Uganda; ZA, South Africa.
Figure 5
Figure 5
Comparison of research output versus disability adjusted life years. BW, Botswana; CM, Cameroon; DALYs, disability-adjusted life years; CI, Cote d'Iviore; DZ, Algeria; EG, Egypt; ET, Ethiopia; GH, Ghana; KE, Kenya; LY, Libya; MG, Madagascar; MU, Mauritius; MW, Malawi; NG, Nigeria; SD, Sudan; TN, Tunisia; TZ, Tanzania; UG, Uganda; ZA, South Africa; ZM, Zambia.
Figure 6
Figure 6
Distribution of authorship by position in different countries. BW, Botswana; CM, Cameroon; ET, Ethiopia; GH, Ghana; KE, Kenya; MW, Malawi; NG, Nigeria; SD, Sudan; SN, Senegal; SSA, sub-Saharan African; TZ, Tanzania; UG, Uganda; ZA, South Africa; ZM, Zambia; ZW, Zimbabwe.
Figure 7
Figure 7
Percentages of SSA cancer research outputs on different cancers, 2009-20, versus the percentages of the total African cancer disease burden in 2015 (WHO data). Diagonal line represents equivalence; dashed lines represent output either twice or half the amount corresponding to the burden. BLA, bladder; BLO, Blood; CER, cervical; COL, bowel; CNS, brain; DALYs, disability-adjusted life years; KID, kidney; LIV, Liver; LUN, Lung; MAM, breast; MOU, head & Neck; OES, oesophageal; OVA, ovarian; PAN, pancreatic; PRO, prostate; SKI, malignant melanoma; STO, gastric.
Figure 8
Figure 8
Research outputs by cancer domain. CLIN, clinical research; DIAG, early diagnosis; DRUG, systemic therapy; EPID, epidemiology; GENE, genetics; PALL, palliative care; PATH -laboratory medicine; PROG, biomarkers; QUAL, quality of life; RADI, radiotherapy; SCRE, screening; SURG, surgery.
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