Cancer situation in Kenya

Mercy Steps Cancer Program

In Kenya, cancer ranks third as a cause of death after infectious diseases and cardiovascular diseases. It causes 7% of total national morality every year. Although population based data does not exist in the country, it is estimated that the annual incidence of cancer is about 28,000 cases and the annual mortality to be over 22,000. Over 60% of those affected are below the age of 70 years. In Kenya, the risk of getting cancer before the age of 75 years is 14% while the risk of dying of cancer is estimated at 12%. In many developing countries the rapid rise in cancers and other non-communicable diseases has resulted from increased exposure to risk factors which include tobacco use, harmful use of alcohol and exposure to environmental carcinogens. Other risk factors for some cancers include infectious diseases such as HIV/IDS (Kaposi’s sarcoma and lymphomas), Human Papilloma Virus(HPV), Hepatitis B & C (Liver cancer), bacterial infections such as Helicobacter Pylori (cancer of stomach) and parasitic infestations such as schistosomiasis (cancer of bladder)The leading cancers in women are breast, oesophagus and cervical cancers. In men, oesophagus and prostate cancer and Kaposi sarcoma are the most common cancers. Based on 2002 data from the Nairobi Cancer Registry, of all the cancers registered breast cancer accounted for 23.3%, cervical cancer for 20% and prostate cancer for 9.4%. In 2006, around 2,354 women were diagnosed with cervical cancer and 65% of these died of the disease. Despite the fact that non communicable diseases such as cardiovascular diseases, cancers, diabetes and chronic respiratory diseases are on the increase, the health systems in the country have traditionally concentrated on the prevention and control of communicable diseases. As a result, health and development plans have not adequately invested in the prevention and control of these diseases. The silent epidemic of non communicable diseases now imposes a ‘double burden of disease’ to the country which unless it is addressed will over whelm the country in the near future. This bias in the system has resulted in weakness in programmes that should be addressing non communicable diseases and their risk factors in the country.

According to the regional cancer registry at KEMRI, about 80% of reported cases of cancer are diagnosed at advanced stages, when very little can be achieved in terms of curative treatment. This is 2011 – 2016 largely due to the low awareness of cancer signs and symptoms, inadequate screening services, inadequate diagnostic facilities and poorly structured referral facilities.

The country has few cancer specialists who are concentrated in a few health facilities in Nairobi. This makes it difficult for a great majority of the population to access cancer treatment services resulting in long waiting times causing some previously curable tumours to progress to incurable stages. The reason for this sad situation is that cancer treatment infrastructure in Kenya is inadequate and some cancer management options are not readily available necessitating some Kenyans to seek cancer treatment abroad. Within the health care systems, cancer is treated through medical, surgical or radiation therapy. Effective treatments require that all these modalities of treatment be available in the same setting to avoid distant referral and delays in treatment administration. The essential drugs list does not include chemotherapy for cancer. Some of the very essential drugs for pain management are rare to find in most public hospitals. There is therefore need for clear policies concerning terminal pain management, supportive and palliative care for cancer patients in Kenya. Some of the main impediments to palliative care in Kenya include shortage of financial and human resources, lack of awareness and legal restrictions on the use and availability of opioid analgesics. Cancer research in Kenya is not commensurate with the magnitude of the problem. This is due to inadequate funding and training facilities in cancer research. There is also no comprehensive cancer surveillance system and no population based cancer registry.

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