Traditional Medicine, Environmental Exposures, and Cultural Practices in Cancer Risk: Insights from Low-and Middle-Income Countries

Thabiso Victor Miya¹Rahaba Makgotso Marima¹Tebogo Marutha¹Thifhelimbilu Emmanuel Luvhengo²Zilungile Lynette Mkhize-Kwitshana³Nkhensani Chauke-Malinga¹Gugulethu Mazibuko⁴Zodwa Dlamini^1*

• ¹Pan African Cancer Research Institute (PACRI), University of Pretoria, Hatfield, South Africa, Pretoria, South Africa
• ²Department of Surgery, University of the Witwatersrand, Johannesburg 2193, South Africa, Johannesburg, South Africa
• ³University of South Africa, Roodepoort, South Africa, Johannesburg, South Africa
• ⁴Faculty of Humanities, Department of African Languages, University of Johannesburg, South Africa, Johannesburg, South Africa

Abstract 25 Cancer is a growing public health concern in low-and middle-income countries (LMICs), influenced 26 by cultural practices, environmental exposures, and dependence on traditional medicine in addition to 27 biological risk factors. Evidence from peer-reviewed publications published between 2010 and 2025 28 was combined in this narrative review. According to studies, traditional and complementary medicine 29 (T&CM) is used by 35% to 79% of cancer patients in LMICs, which frequently delays biomedical 30 treatment and complicates care. Over 2.4 billion people use biomass fuels for household air pollution 31 (HAP), which has been associated with a two-to three-fold increased risk of lung cancer, especially in 32 women. Furthermore, tobacco smoking contributes to about 2.7 million new cases of cancer in less 33 developed areas each year, highlighting ongoing exposure to avoidable dangers. Findings show that 34 the cancer burden in LMICs is further exacerbated by poor food storage, alcohol use, pesticide 35 exposure, unregulated consumer chemicals, and stigma. These cultural and environmental factors must 36 be addressed in preventative initiatives in addition to biological therapy. Strengthening T&CM 37 regulations, enhancing food safety, upholding alcohol and tobacco legislation, lowering exposures at 38 work and in the home, and introducing culturally-based education to dispel stigma and myths are 39 among the top priorities. 40 This is a narrative review rather than a systematic one; the goal is to map thematic evidence throughout 41 Africa, Asia, and Latin America, providing insights for policy design. Integrated, context-specific, and 42 community-driven approaches are required to eliminate inequities and promote equitable cancer 43 control in LMICs.