Let’s step up breast cancer screening, early diagnosis - Patrick Amoth

As the Breast Cancer Awareness Month comes to an end, it helps to reflect on the steps we have taken to reduce mortality to breast cancer. Breast cancer is the commonest cancer in Kenya.

An estimated 6,799 cases were diagnosed in 2020, compared to 5,985 new ones in 2018 indicating a rising burden of the disease. Deaths due to breast cancer also rose from 2,553 in 2018 to 3,107 in 2020, making it the second-leading cause of all cancer deaths.

Breast cancer is a contributor to premature deaths as it occurs a decade earlier in Kenya with the majority of patients aged between 35-50 as compared to 50-55 years in the West.

To address this, the Ministry of Health has developed a Breast Cancer Screening and Early Diagnosis Action Plan 2021-2025 whose goal is to ensure women with breast cancer are diagnosed in the early stage for earlier intervention.

Through joint actions in implementation of the identified priority activities, review of progress and shared accountability, it is anticipated that breast cancer mortality can be reduced by 2.5 per cent annually until 2040 averting nearly over 1,000 premature deaths.

In Europe and US, the number of deaths to breast cancer declined by between 13-36 per cent between 1990 and 2010. This decline was attributed to two factors: early detection through mammography and advances in diagnostics and adjuvant treatment.

Early detection of breast cancer through annual screening by mammography for women between aged 40-55 and early diagnostic strategies such as clinical breast examination and breast health awareness with appropriate linkages to rapid diagnosis and timely treatment in Kenya, will definitely have the same significant gains.

Cancer chemotherapy services have been decentralised to ten regional county cancer centres in Nakuru, Mombasa, Garissa, Embu, Meru, Machakos, Nyeri, Bomet, Kakamega and Kisumu where patients can access surgical care, chemotherapy, palliative care and rehabilitative services, among other services in our journey towards Universal Health Coverage.

The availability of radiotherapy services in the regional centres will further improve access to comprehensive breast cancer care. The expansion of access to rapid diagnostic breast cancer facilities will be of immediate priority to reduce unnecessary delays.

The world is experiencing an epidemiological transition and a transformation of causes of death. Trends in the global burden of disease are showing infectious diseases gradually declining while chronic, degenerative diseases, accidents and pandemics such as Covid-19 increasingly having a significant impact on global morbidity and mortality.

The rise of chronic diseases like cardiovascular disease, cancer and diabetes is fast becoming a priority agenda in global health. Tackling these emerging conditions requires ambitious public policies ranging from prevention across the continuum of care, acting on the social determinants of health including health inequity and gender disparities.

Sustainable Development Goal 3 calls for a reduction by one-third of premature mortality from Non-Communicable Diseases including cancers by 2030, through prevention, treatment as well as promotion of mental health and well-being.

That said, we call for joint action bringing all stakeholders together in implementing a harmonised comprehensive scale-up for breast cancer screening and early diagnosis. Indeed, early detection of breast cancer can and will save lives!

-Dr Patrick Amoth is the acting Director-General for Health in the Ministry of Health and Chairman of the Executive Board of the World Health Organisation (WHO)