For years, early detection of breast cancer has been touted as one of the best ways to manage the disease. Unfortunately, we still have few patients receiving early diagnosis. Data from the Kenya National Cancer Registry 2014-2019 shows that seven out of 10 cancers are diagnosed at advanced stages despite early detection.
Additionally, only 14 percent of women in Kenya have had a clinical breast examination and 25 percent have performed a self-breast examination, according to 2014 Kenya Demographic Health Survey.
This statistic is unsettling, especially because breast cancer accountsfor 16.1 percent of all cancers, according to the World Health Organization’s International Agency for Research on Cancer, Global Cancer Observatory (GLOBOCAN).
It further notes that breast cancer is the second leading cause of deaths in the country with an annual incidence of over 6,700 new cases.
What this tells us is that we must step up efforts to drive regular medical check-ups to facilitate early detection. Studies show that lack of awareness, inadequate diagnostic facilities, lack of treatment facilities and a high poverty index has led to 70-80 percent of cancer being diagnosed in late stages. In addition, cancer treatment continues to be expensive and out of reach for the poor.
Living in rural and marginalised communities also puts women at a disadvantage of screening for breast cancer due to lack of accessibility.
Additionally, those of lower to no education levels, poor economic status and unable to insure are less likely to be screened for breast cancer.
The World Health Organization recommends mammography as the most effective way for early diagnoses and subsequent treatment of breast cancer, especially in low-income areas where health care systems may be weak. It also encourages clinical examination due to its cost-effectiveness.
In Kenya, although clinical breast examination is recommended by policy due to the opportunity it presents to educate women about breast health, it is not considered a replacement for mammography.
The advantages of early detection of cancer cannot be overemphasized. We must step up efforts to drive regular medical check-ups to facilitate early detection. And unless urgent action is taken to improve breast cancer screening and early diagnosis, breast cancer will compound Kenya’s disease burden, increase poverty and gender inequalities as well as reverse current gains against maternal mortality
The National Cancer Treatment Protocols 2019 recommend that all women found to have suspicious breast lesions should undergo a triple assessment that involves clinical examination preferably by an experienced clinician or breast surgeon, bilateral breast imaging and core biopsy.
In breast cancer diagnosis, timeliness of the service to avoid excessive delay, availability of diagnostic imaging studies of the breast and axilla, staging studies to detect metastatic disease and tissue sampling methods are important
It is also important for policymakers to consider place and group-specific education and interventions on increasing breast cancer screening in Kenya.
The Government of Kenya has established a Breast cancer screening and Early diagnosis action plan 2021-2025 aimed at ensuring that women with breast cancer are diagnosed in the early stages.
The action plan will be achieved through putting in specific mechanisms to improve uptake of mammography screening in the eligible populations, ensuring that at least 90 percent of symptomatic women are linked to timely further evaluation and management within 60 days from their first encounter with a healthcare worker.
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