It's essential to make equity a central pillar of Kenya's cancer response

On the National Cancer Institute of Kenya’s website, numbers tell the grim story of the ravages of cancer in the country: More than 47,000 Kenyans are diagnosed with the disease every year while over 32,000 die from cancer-related complications annually.

This makes cancer the third leading cause of death in Kenya, after infectious diseases and heart conditions. This is despite the fact that 30 per cent of cancers are curable if detected early, and another 30 per cent can be treated with prolonged survival if diagnosed early.

But even as families and the healthcare system continue to bear the brunt of the burden of cancer, there is even a deeper crisis that requires urgent attention: The unequal access to cancer care across the country. Whereas many Kenyan urban dwellers have better access to cancer screening, diagnosis, treatment, and palliative care, those living in rural areas, low-income, or marginalised areas, have to endure long delays, which often lead to deaths.

A recent study shows that despite efforts to decentralise cancer care, including the establishment of regional cancer centres in Garissa, Nakuru, and Mombasa, access to screening, diagnostics, and treatment remains constrained, particularly in rural areas.

Most counties still lack adequate cancer screening equipment or trained oncology personnel. Radiotherapy services remain centralised in a few facilities, forcing patients to travel long distances for care. In the process, many are either diagnosed too late or give up entirely because they can’t afford the cost of travel, accommodation, and treatment.

The study involving 25 cancer patients – 12 males and 13 females – receiving treatment at Wajir County Referral Hospital – found that delays in diagnosis were significant, with 12 per cent of patients waiting over six years, 24 per cent waiting four to six years, and 40 per cent waiting one to three years before seeking care. The delays were attributed to lack of awareness and poor access to cancer care.

Overall, 70 per cent of cancer cases in Kenya are diagnosed at late stages (3 or 4), making survival chances slim as treatment becomes less effective and more expensive. For poor families already struggling to meet basic needs, the emotional toll and financial burden of such a diagnosis is devastating.

This is why it’s essential to urgently make equity a central pillar of Kenya’s cancer response. The place to start is to decentralise cancer services to all counties so that no patient has to travel long distances for basic cancer care. The Health ministry must move from establishing regional cancer centres to ensuring every county offers cancer screening, diagnosis, treatment, and palliative care.

It was refreshing to hear Health Cabinet Secretary Aden Duale announce during the recent Second National Cancer Summit in Nairobi that the government was expanding community-based screening for common cancers such as breast, cervical, and prostate. If implemented well, this will help establish the true burden of cancer in the country.

Related to this is the need to strengthen community health education to improve early detection and dispel harmful myths such as the belief that cancer is witchcraft. Community health promoters need to be empowered with cancer information, which they can share with people at the grassroots. This strategy worked with government campaigns against HIV and Aids. Furthermore, once essential services like screening and diagnosis are brought within range, the government can use its agents on the ground such as chiefs and their assistant to sensitise the people.

Personnel at local hospitals, which are the first to interact with patients, should be well-informed and equipped to offer screening services for early detection. A 2017 study found that poor attitude of health workers was a deterrent to cancer screening and treatment. The attitudes were due to lack of knowledge, social, cultural beliefs and personal biases. This, coupled with poor doctor-to-patient communication, can determine whether patients seek treatment or not.

Finally, the government should address the prohibitive cost of cancer treatment.