It is an outdated reference to breast cancer following the discovery, in the 1700s, that celibate Catholic nuns had an extremely high incidence of breast cancer.
They continue to pay this painful price for their chastity. Today, there is evidence women who never have children are at an increased risk of breast, ovarian and uterine cancers, compared to mothers.
So, three dons from a local university were unpleasantly surprised that despite their elevated risk, most nuns from the Catholic Archdiocese of Nairobi have never had any breast cancer screening, mostly due to fear of having the disease and lack of money.
“Our findings revealed that a third of the nuns had breast cancer screening which is relatively lower considering higher risk among nuns,” Alfena Julie and her colleagues from JKUAT’s department of community health nursing reported in their findings published recently.
Catholic nuns vow to live by chastity, poverty and obedience to their superiors. They give up any money they make to the church, which they trust to provide a stipend to cover minimum living expenses.
Alfena Julie, Grace Mbuthia and Rosemary Kawira, all lecturers at JKUAT, mid last year interviewed 384 nuns (out of the total 594) aged 18 to 49 from the five orders in Nairobi archdiocese.
Nuns with breast cancer and on treatment, and those above 49 years, were excluded.
“Only three in ten nuns from within the reproductive age said they do [breast exam], compared to more than 40 per cent of women in Kenya’s general population who have regular breast examination,” the dons reported.
Their study, published in the Pan African Medical Journal, is titled “Prevalence and associated factors of breast cancer screening among nuns in the Catholic Archdiocese of Nairobi.” The research was approved by the diocese.
The dons also discovered that despite devoting their lives to service, most nuns (53.4 per cent) never visit hospitals for their own checkups.
“The factors hindering access to check-up included fear (50.4 per cent) and lack of resources (19.7 per cent), among others,” the authors noted.
The dons also found extremely low health insurance coverage among the nuns and only a few received help from believers.
One of the nuns is reported to have said: “Because we don't have an insurance, some of us cannot be able to go for breast cancer screening because it is expensive.”
Currently, Kenyatta University Teaching and Research Hospital offers ultrasound at Sh1,500, mammograms at Sh2,000, and breast MRIs at Sh23,000.
The National Health Insurance Fund covers most breast cancer screening costs.
Only 29.9 per cent of nuns have insurance cover, and just 14.1 per cent said they receive congregational financial support.
“Congregational financial support is one of the ways that nuns have access to finances and thus those who have access to these funds are able to pay for their cancer screening,” the dons reported.
The findings revealed that nuns working in health services were more likely to go for screening or do self-breast exams.
The study established that most nuns have tertiary-level education with 40.6 per cent having diplomas, 24.7 per cent degrees and 13.85 having post-graduate qualifications.
The dons called for “aggressive” campaigns to promote breast cancer screening among Catholic nuns.
“There is need to create adequate awareness be created and the Catholic reverend sisters educated through aggressive education campaign programs so as to eliminate misconceptions relating to the breast cancer screening,” they said.
They added: “In addition, there is need to provide health insurance cover for nuns to alleviate the challenge of financial support in seeking breast cancer screening.”
According to the American Institute for Cancer Research, pregnancy and breastfeeding lowers a woman’s risk of breast cancer.
Lactation may delay a new mother’s menstrual periods, reducing lifetime exposure to hormones like estrogen, which is linked to breast cancer risk, says the Institute’s Diet, Nutrition, Physical Activity and Breast Cancer report, which updates the global scientific evidence on breast cancer.
“The shedding of breast tissue after lactation may also help rid cells with DNA damage,” the report says.
Several other studies suggest women who have never given birth have a higher number of ovulatory menstrual cycles, and an increased number of cycles affects cancer risk.
Breast cancer is the most common cancer in Kenya with 5,985 new cases annually (12.5 per cent of all new cancer cases), according to the National Cancer Institute.
Kenya’s National Cancer Screening Guidelines, and the National Cancer Control Strategy (2017-2022), strongly recommend early cancer screening and prevention.
