Background:
Gastric cancer (GC) represents a major global health challenge, with marked geographic variation in incidence, risk factors, and outcomes. While West Africa reports comparatively low incidence rates, mortality remains disproportionately high due to late diagnosis, limited diagnostic infrastructure, and constrained treatment resources. A regional synthesis is essential to guide evidence-based policies and targeted interventions.
Objectives:
To review the epidemiology, clinic pathological characteristics, molecular profiles, management patterns, and health system constraints associated with gastric cancer in West Africa, and to identify research gaps and policy priorities.
Methods:
A narrative review was conducted using literature from PubMed, Scopus, African Journals Online (AJOL), and grey literature sources published from 2000 to 2025. Studies were included if they reported data from West African populations on gastric cancer incidence, clinical presentation, histopathology, treatment modalities, or outcomes. Data were synthesised descriptively and compared with regional (sub-Saharan Africa) and global statistics.
Results:
West Africa shows a low reported incidence of GC (2–6 per 100,000) but a high mortality-to-incidence ratio (>0.85). Most patients present with advanced-stage disease (Stage III/IV in over 70%) following prolonged symptom duration (4–12 months). Non-cardia adenocarcinomas predominate, strongly associated with Helicobacter pylori infection and environmental risk factors. Molecular profiling studies are scarce, with limited application of the Cancer Genome Atlas (TCGA) subtyping. Surgical management is hampered by late presentation, and D2 lymphadenectomy is rarely performed. Radiotherapy and chemotherapy availability are inadequate, with most countries having fewer than one radiotherapy machine per 10 million people. Financial barriers and fragmented cancer control systems contribute to high treatment abandonment rates. Research output is limited, with an absence of population-based cancer registries and minimal clinical trial activity.
Conclusion:
Gastric cancer in West Africa is characterised by late presentation, limited diagnostic and therapeutic infrastructure, and poor survival outcomes. Strengthening endoscopy and pathology services, expanding radiotherapy and chemotherapy capacity, integrating GC into national cancer control plans, and establishing robust cancer registries are critical. Collaborative research on molecular subtyping, risk factor profiling, and region-specific treatment outcomes is urgently needed.