Health officials in Kisumu County have raised concern over the slow uptake of breast cancer screening among women, warning that the slack could be contributing to late diagnosis and poor treatment outcomes.
The county says more women are accessing cervical cancer screening than breast examinations, despite breast cancer being the most common cancer affecting women in Kenya and screening opportunities becoming increasingly available.
Kisumu County Executive Committee Member for Health and Sanitation Gregory Ganda says the difference in screening uptake was worrying and called for breast examination to be incorporated into other routine health services, particularly cervical cancer screening.
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Speaking at Aga Khan Hospital, Kisumu, during a Breast Cancer Awareness Month walk, Dr Ganda said women should use every visit to a health facility as an opportunity to have cancer screening, rather than waiting until they develop symptoms.
He said data from the Kenya Demographic and Health Survey conducted in Kisumu in 2022 showed that only 12 per cent of women of reproductive age had ever undergone a breast examination.
In comparison, nearly 25 per cent of women had undergone cervical cancer screening, meaning the number of women who had been screened for cervical cancer was almost twice that of those who had received a normal breast examination.
“We have twice as many women who have cervical cancer screening than those who have just a normal breast examination. And that is worrying,” Ganda said.
He said the disparity was particularly concerning because the breast is an organ that can be examined physically, allowing abnormalities to be detected before a patient develops advanced disease. He is urging health workers to integrate breast screening whenever women appear for other preventive health services.
Dr Ganda says the county’s approach was to ensure that screening becomes part of a wider wellness programme rather than being viewed as a service that women should seek only during awareness campaigns.
“When we do cervical cancer screening, let us also incorporate the breast. Because the breast is also one of the biggest causes of death in women. And it can be detected earlier,” he said.
His remarks came as Kenya joined the rest of the world in marking Breast Cancer Awareness Month, observed every October to raise awareness about breast cancer, encourage early detection and promote access to treatment and support.
Alfred Mayani, a consultant oncologist at Aga Khan Hospital, Kisumu, said this year’s awareness campaign was also aimed at reminding women that breast cancer experiences differ from one patient to another.
Dr Mayani said the global message recognises that every patient’s story is unique, while Kenya’s message for the month is “Integrate actions for all”.
Mayani said breast cancer remains the most common cancer among women in Kenya, with about 7,000 women diagnosed with the disease every year.
He, however, said the country was facing a greater challenge beyond the number of new cases being recorded.
According to Mayani, the critical issue is the stage at which women are diagnosed, with between 70 and 75 per cent of breast cancer patients presenting at stages three and four.
At these advanced stages, he said, the possibility of cure is reduced for some patients and treatment becomes more difficult.
“The main problem is not even about diagnosis. It is about at what stage these patients are being diagnosed,” Dr Mayani said.
“More than 70 to 75 per cent are being diagnosed at stage three and stage four, where cure is limited or almost impossible for some of the patients.”
He said the message of integrating action for all therefore requires greater emphasis on prevention, screening and early detection.
Mayani urged women to come forward for breast cancer screening before they develop symptoms, saying early identification provides an opportunity for patients to receive treatment before the disease advances.
He said focus should not only be on creating awareness during October but on ensuring that screening becomes part of routine healthcare throughout the year.
The call has also been backed by Aga Khan Hospital, Kisumu, Medical Director Simon Onsongo, who said the hospital had partnered with the county government to spread awareness about breast cancer and encourage residents to seek screening.
Dr Onsongo said early detection could significantly improve the chances of successful treatment and urged people across Kisumu and other parts of the country to make use of available screening services. “As a hospital, today we come together to partner with the county government to spread the message of Breast Cancer Awareness Month,” Onsongo said.
He urged residents to treat every visit to a health facility as an opportunity to screen for cancer.
“Any opportunity when someone comes to a health facility should be taken as an opportunity to screen and detect cancer,” Onsongo said.
He said although October focuses attention on breast cancer, screening should also cover other cancers where appropriate.
While the county has raised concern over the low uptake of breast screening, Dr Ganda said Kisumu had made significant investments in improving its ability to diagnose and manage breast cancer.
He said the county now has breast surgeons, oncologists, sonographers and specialised pathologists, representing an expansion of human resource capacity compared with previous years.
According to Dr Ganda, the county previously did not have breast surgeons, but now has specialists who focus on breast cancer. He also said the number of oncologists had increased over the years.
“A few years ago, I was the only oncologist. Then we were two. Now I think we are six,” he said.
The county has also increased its diagnostic equipment, with Dr Ganda saying there are now two mammography machines.
“Previously, there was no mammography machine. There are now two,” he said. He said sonographers had also acquired skills to perform breast ultrasounds, while pathologists had developed specialised capacity to examine tissue samples used in cancer diagnosis.
“We used to have general pathologists. Now we have pathologists who are specialised in looking at samples. It’s called histopathology,” he said.
Dr Ganda said the improvement in infrastructure, equipment and specialised personnel means the county has increased its capacity to manage patients with breast cancer. The challenge, he said, is now ensuring that women make use of those services.
“Our capacity has improved and so we need to now get our people to come so that they benefit from all this capacity that we have created over time,” he said.
He particularly encouraged women aged 40 and above to consider mammography, saying screening can help identify cancer before it spreads. He noted that access to mammography remains relatively low, with few women presenting themselves for the examination.
“Exposure or chance to get a mammogram is very low. Very few people come to get a mammogram,” Ganda said.
He said women should take advantage of the availability of the machines in the county and seek screening as part of their preventive healthcare. Dr Ganda also pointed to the importance of making screening more accessible through the county’s wider wellness programme.
He said Kisumu began developing its wellness programme several years ago, including the establishment of wellness centres in wards.
The wellness centres were intended to provide residents with an entry point where they could assess their health according to their age and individual risk factors.
The county is now seeking to extend this approach from physical facilities to digital platforms. Dr Ganda said Kisumu was moving towards virtual wellness, beginning with a mental wellness application and eventually incorporating other health services.
The system is intended to connect residents, community health workers and healthcare providers through health records.
He added that once other services are incorporated, the system could identify women who are due for screening but have not undergone the recommended tests.
The Breast Cancer Awareness Month campaign is consequently not only about raising awareness of the disease but also about changing the point at which women interact with the health system.