Cocktail of trouble: Why Kenya has highest breast cancer risk in Africa

Kenyan women have the highest risk of developing breast cancer in sub-Saharan Africa, most due to unavoidable causes.

As many as one in 14 women in Kenya will develop breast cancer by age 74, making the disease a major killer of women.

“Approximately 7.3 per cent of Kenyan women will develop breast cancer by age 74, followed by Mauritius and Seychelles at 5.7 per cent,” the African Cancer Registry Network (AFCRN) published last week.

This is almost twice the risk in Uganda, 3.5 times over Nigeria, five-fold over South Africa, and more than 14 times over The Gambia.

AFCRN brings together cancer registries from sub-Saharan Africa, and includes the two in Kenya: the Nairobi Cancer Registry at the Kenya Medical Research Institute (Kemri), and the Eldoret Cancer Registry based at the Moi Teaching and Referral Hospital.

The authors of the AFCRN research, who include Anne Korir, the head of the Nairobi Cancer Registry, say breast cancer cases are on the rise across Kenya’s 47 counties.

“The highest rates, however, are observed in urban, more affluent areas like Nairobi,” wrote the authors in the International Journal of Cancer.

Worrying levels

This rapid increase in breast cancer rates has been attributed to a ‘Westernisation’ of lifestyles. This includes changing reproductive patterns, such as delayed age of first birth, having fewer children and reduced breastfeeding duration. Other factors are changes in diet, alcohol intake, obesity and genetics.

The Ministry of Health, in its Health Sector Strategic Plan, says the rate of obesity, especially among women, has reached worrying levels.

At least one in every seven women, the ministry says, has a weight problem.

“The rate of obesity among women in the country has reached epidemic proportions,” says the ministry.

However the rate of obesity in counties varies more than five-fold between regions, ranging from less than 15 per cent in northern Kenya to over 45 per cent in cities and the Central region.

Two-thirds of all obese women, the government plan shows, live in 10 counties, with the top three being Nairobi, Kiambu, and Mombasa.

 A few years ago Regina Mbochi, a nutritionist and researcher, sampled 365 women aged between 25 and 54 with high incomes in Nairobi.

She had no problem finding the smoking gun responsible for the high rates of obesity. Their kitchens, she said, were packed with beef, chicken, processed meats, eggs and alcohol, a sure recipe for weight gain.

The more rooms there were in these homes, she said, the more likely it was that the older women had bigger waistlines, carried a lot of fat and were big domestic spenders.

Data also shows women in Nairobi and other urban centres are also more likely to have few children, give birth later in life and use contraceptives.

Use of contraceptives, says the cancer registries study, has also been shown to increase breast cancer risk in current and recent users.

“The use of injectable and/or oral contraceptives has been associated with significantly increased breast cancer risk, and this increased risk persists for about five to 10 years after cessation,” the study said.

Contraceptives use in some counties, such as Kirinyaga, Makueni, Meru, Machakos, Tharaka-Nithi and Kiambu, ranges between 74 per cent and 81 per cent.

Women in these counties are giving birth to about three children, aside from Kirinyaga where the average is two children.

Almost half of the women in Kenya using contraceptives are on injectables, followed by implants at 18 per cent.

The study also warns that the now popular use of hormone-based skincare and hair products presents an increased risk of developing breast cancer.

In February, Adana AM Llanos of Rutgers University, USA, presented compelling data in Nairobi, showing several hair and personal care products mainly targeting Africans increase the risk of developing breast cancer.

“Emerging data suggests that products used predominately by black and African American women may contain more hormonally-active compounds that have been linked to increased breast cancer risk,” said Prof Llanos.

The cancer network also suggests women in Kenya may not be eating enough fruits and vegetables, which protect against many cancers. A national study by the Ministry of Health in 2015 showed about 94 per cent of Kenyans do not eat the recommended servings of fruits and vegetables.

The World Health Organisation recommends the consumption of at least 400 grammes, or five servings, of fruits and vegetables per day.

Against popular belief, Kenya men were found to eat more fruits and vegetables than women, despite women being the more likely buyers of food.

 “Women are likely to buy, prepare and serve the man of the house and the children, most likely leaving nothing for themselves,” said Abby Olenda, a nutrition consultant in Nairobi.