- The top three cancers in Kenya are breast (15.9 per cent) followed by cervix (13.3 per cent) and oesophagus (11.8 per cent), according to the NCI report.
- Prostate cancer accounts for a quarter of male cancers while half of the female cancers are cervical and breast cancers.
An old, feared way of detecting prostate cancer is still the only available method for Kenyan men in primary health facilities.
The Ministry of Health says most health centres with screening services only offer digital rectal examination (DRE), with only a few offering a blood test called prostate-specific antigen (PSA) test.
Digital exam is a cheap way of finding abnormal prostate and was the primary method of detecting prostate cancer prior to the blood test.
For this method, which leads some men to avoid screening services, the doctor inserts a gloved, lubricated finger into the rectum to feel the prostate gland.
The Status of Cancer Report, released by the National Cancer Institute, says this remains the most readily available screening method in Kenya.
Prostate cancer screening is recommended for men aged 40 years and above.
“Among the primary healthcare facilities that provided prostate cancer screening services, nine per cent provided DRE, while four per cent provided PSA rapid test,” the report says. "None of the primary healthcare facilities provided both of the tests."
The survey, conducted in public hospitals (Levels 4, 5 and 6) and primary health facilities (Levels 2, 3 and 4) sought to establish the availability of screening services for cancers of the breast, cervix, colon, oesophagus and prostate.
Primary health facilities in 29 counties do not provide screening for prostate cancer at all.
Most health facilities above level 4 provide a mix of all the test methods.
“Cancer screening provides an opportunity for the detection of disease in asymptomatic individuals, improving treatment outcomes, and in turn reducing morbidity and costs of treatment,” the report says.
Kenya’s National Cancer Screening Guidelines recommend three screening methods: the blood test, digital rectal examination and biopsy, which is the most definitive diagnosis.
The blood test measures the level of PSA in the blood. PSA is a substance made by the prostate, and the levels of PSA in the blood can be higher in men who have prostate cancer.
The guidelines also appear to discourage the finger exam.
“Most prostate cancers are located in the peripheral zone of the prostate. DRE may not pick small, central or anteriorly-located cancers. DREs are also subjective,” the guidelines say.
But medics say the finger exam is important in determining the local stage of the patient or to know the extent of the spread of cancer.
Some countries such as the US no longer recommend the finger exam as a primary method.
Prostate cancer is the fourth leading cause of cancer deaths in Kenya and the most common cancer among elderly men.
Dr Angela Mcligeyo, an oncologist, said patients and testing procedures should not be stigmatised because most cancers diagnosed early are often treated successfully.
“We are living in an era where cancer is not a death sentence and the many survivors we have are a testimony to that. It has gotten better,” she said.
According to Dr Ravjit Sagoo, a consultant interventional radiologist at Aga Khan University Hospital, an enlarged prostate is not necessary due to cancer.
Dr Sagoo says many men above 60 years old are likely to have an enlarged prostate, also referred to as benign prostatic hyperplasia.
“This is a non-cancerous increase of prostate tissue, which can cause blockage of the bladder and urine flow,” he said.
“Treatment is only necessary if symptoms become bothersome. Several treatment options are available, depending on the severity of symptoms.”
The top three cancers in Kenya are breast (15.9 per cent) followed by cervix (13.3 per cent) and oesophagus (11.8 per cent), according to the NCI report.
Prostate cancer accounts for a quarter of male cancers while half of the female cancers are cervical and breast cancers.
Last year, only 642 cases of prostate cancer were reported in Kenya and most of these men (64), live in Nairobi, while 58 are in Machakos and Nakuru counties each. Most of the others are in Kiambu, Makueni and Kitui.
Overall, most cancers in Kenya are diagnosed in Nairobi, followed by Nakuru then Kiambu, Machakos and Nyeri in that order.
In total, about 47,000 Kenyans were diagnosed with different types of cancer last year, and 22,000 of them died.
The ranking was reported by the NCI, an independent agency under the Ministry of Health.