The current landscape of lifestyle and other non-pharmaceutical interventions in oncology in Africa: A review of registered clinical trials

Cancer is a significant public health issue in low--and middle-income countries, especially in Africa. While lifestyle and/or behavioral interventions such as exercise and dietary modifications are known to improve patient outcomes and quality of life, critical evidence from resource-limited settings like Africa is scanty. Here, we present a review of clinical trials on the current landscape of cancer associated lifestyle interventions in oncology in Africa. We comprehensively reviewed non-pharmacological/ lifestyle cancer-related clinical trials in Africa on ClinicalTrials.gov and ICTRP trial registries from 01 July 2005 to 30 October 2024. We employed descriptive analyses, primarily frequency and percentage, to analyze and report the data. Overall, 53 trials matching the criteria were identified. Most of the trials were in Egypt (38/53, 97.4%), Kenya (4/53,10.3%), and Nigeria (5/53, 12.9%). The top cancer types for the trials in Africa were breast 24/62, 45.3%), colorectal (6/62, 11.3%) and acute lymphoblastic leukemia (4/62, 7.5%). Concerning sponsorship, most trials were universities/academia-sponsored trials (45/53, 84.9%), locally sponsored (37/53, 69.8%), conducted among patients (88.7%), and 84.9% cancer survivors. Most trials involved physical activity interventions (25/53, 47.2%) and psychological and psychological interventions (10/53, 18.9%), with (32/53, 60.4%) trials completed and (13/53, 24.5%) trials ongoing. Non-pharmacological interventions for the management of cancer appear to be nascent in Africa. Oncology trials are needed to ensure the effectiveness of non-pharmaceutical/lifestyle interventions in Africa, especially sub-Saharan Africa (SSA). In the current era of precision medicine, pharmacological, and lifestyle interventions, it no longer suffices to assume that interventions in high--and upper-middle-income countries will be effective in low-middle-income countries, especially Africa.