Kenyans shun cancer screening over costs, fear of diagnosis — study

High cost of cancer treatment is scaring many Kenyans away from getting screened for the disease, medics have said.

As such, thousands of Kenyans only surrender to hospitals with stage four advanced cancer, when the disease is challenging to treat.

Many cancers can be effectively treated if detected early, giving the patient a healthy long life.

But medics say in Kenya about 75 per cent of new patients at Kenyatta National Hospital and Moi Teaching and Referral Hospital present for treatment with late-stage disease.

In recently published results of a study carried out at the two referral hospitals, the medics said cost also comprises the travel to specialised health facilities.

“Anxiety over the cost of cancer care emerged as a significant factor, increasing the likelihood of late diagnosis by over fivefold,” the medics said.  

The cost of cancer treatment in Kenya depends on the type of cancer, the modality of treatment, the cost of medicines and the type of inpatient admission. The greatest contributors are currently the cost of medicines and inpatient admissions.

The medics spoke to 192 patients, including 64 cases with advanced cervical cancer and 128 controls with earlier stages.

The cost of travel to cancer centres also emerged as a prominent contributor among patients who presented late.

Individuals whose transportation costs exceeded Sh800 ($6.1) were more than six times more likely to experience late-stage diagnosis.

Additionally, age played a role, with individuals over 50 years being almost five times more likely to face late diagnosis.

Their findings, titled, “Factors associated with late diagnosis of cervical cancer at two national referral hospitals, Kenya,” are published in the Gynecologic Oncology Reports.

Interestingly, undergoing ultrasound examination during the evaluation of symptoms was associated with a higher likelihood of late-stage diagnosis.

The medics said this could be because patients presenting with pelvic symptoms or even chronic vaginal discharge are presumed to have other diagnoses like pelvic inflammatory disease.

Any time lost in investigating alternative diagnoses could then be a contributor to late diagnosis.

“In addition, an ultrasound examination reported as normal may give the woman a false reassurance, even when they have persistent symptoms,” they said.

The authors of the paper are Ministry of Health’s Valerian Mwenda, Gladwell Gathecha, Joseph Kibachio, Robert Too, Zeinab Gura, Martin Mwangi and Marleen Temmerman of Aga Khan University Hospital. 

Cervical cancer is the leading cancer in women in Kenya, contributing to about 5,236 new cases and 3,211 deaths, according to the National Cancer Institute.

Although the National Health Insurance Funds covers some costs, the cost of treatment of cancer patients is prohibitively high for many patients in Kenya.

Kenya is ranked in the top 20 countries globally with the highest rates of cervical cancer.

Last year, about 42,000 Kenyans were diagnosed with different types of cancer.

Currently, about  82,000 people in Kenya are living with different forms of cancer, the Ministry of Health says.

Cancer, which refers to about 100 closely-related conditions, kills about 27,092 Kenyans every year.

The Ministry of Health’s National Cancer Control Strategy (2023–2027) estimates that at least 58,000 Kenyans will be diagnosed with cancer every year from 2028, based on the growing incidence of the disease.

The ministry says the numbers will continue to rise because of improved diagnosis and increased life expectancy.

Currently, the old age population (above 60 years) is the fastest growing segment of the population and the most predisposed to cancer.

The ministry said overall, the Kenya’s population growth, increased urbanisation and increase in risk factors for cancer will lead to more numbers.

“Going by the current trends, it is projected that there will be an estimated 58,000 new cancer cases in Kenya in the year 2028 increasing to an estimated 95,217 incident cases by 2040,” the National Cancer Control Strategy (2023–2027) says.

Cancer is the third leading cause of death in Kenya after infectious diseases and cardiovascular diseases.