Non-communicable diseases (NCDs) in Kenya are a growing threat to the health of the population that has increased rapidly in recent history. Of the many different types of NCDs that are becoming more prevalent in Kenya, cancer has quickly emerged as one of the top causes of death. Accounting for about 7% of all deaths in Kenya, cancer comes in many forms and effects all people differently. There are many risk factors that raise the chance of a person developing cancer from biological factors like genetics to environmental and lifestyle factors like air pollution and alcohol/tobacco consumption. Around the world, 5-10% of cancers are caused by biological factors while 90-95% can be attributed to environmental and lifestyle factors. In women the three leading types of cancers are cervical, breast and esophageal. However in men, the leading cancers are prostate, Kaposi sarcoma, and esophageal. According to a report from the KANCO, there were 37000 new cases in 2012. In the same report, it was also found that 28000 Kenyans died from cancer in that year. Even this year, cancer has claimed the lives of prominent figures in Kenya such as Bob Collymore: The CEO of Safaricom, Joyce Laboso: a politician, and Ken Okoth: also a politician.
Types of cancers at Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH) from 2008–2012
This disease has become an issue for a number of reasons. First, most cases of cancer in Kenya are diagnosed at late stages where treatment is no longer effective. This issue can be solved with more advanced screening methods as well as participating in cancer screenings more often. Next, cancer treatment is very expensive with one session of treatment costing around 3600 KSH and with a single patient needing around 20 to 30 sessions per month means that on average, a cancer patient will have to spend between 72000 and 108000 KSH per month on treatment alone. However, the price of the treatment is only part of the larger issue. There are only around 35 oncologists in Kenya each tasked with a burden of servicing around 3000 patients (in comparison oncologists in the U.S. and China are only responsible for around 150 patients). Oncologists in Kenya also have service patients from neighboring countries because many of the border countries have very few or no oncologists of their own which further adds difficulty in servicing the growing population of cancer patients in Kenya. Additionally, there only exist 12 treatment centers available in the country to seek medical assistance for cancer with one of the main centers being Kenyatta National hospital but, KNH only has three functional radiotherapy machines so the wait to use these machines is often long.
Although there seems to be a lot against cancer patients in Kenya, all hope is not lost. The Government has enacted the Kenya National Cancer Control Strategy to combat the disease on a country wide scale. The plan’s goals include reducing the burden of cancer in Kenya, creating effective framework, increasing primary prevention and early detection, and increasing access to quality diagnostics and treatment as well as palliative care by the year 2022. The strategy hopes to achieve these goals with five pillars which lay out specific objectives as well as the role different governmental and non-governmental organizations will play in achieving the goals as well as the role of the public. The first pillar focuses on prevention, early detection, and cancer screening. One of the biggest objectives of this pillar is to reduce the exposures that Kenyans face that will increase their risk of developing the disease. The second pillar focuses on cancer diagnosis, registration, and surveillance. Diagnosis is one of the main sources of problem that the Kenyan health system is facing because many cases of cancer are either misdiagnosed or diagnosed too late for any effective treatment to be administered. This pillar also emphasizes the importance of making diagnosis affordable to the public. The other parts of the pillar are equally as important though. Cancer registration refers to the continuous collection of data surrounding the disease including information about the cancer itself, patients, treatment, and exposure factors. Cancer surveillance focuses on analyzing the occurrence and trends of different types of the disease. The two areas, registration and surveillance, have been poor in the past which can be attributed to factors such as stigma surrounding the disease, lack of screening/diagnosis, and lack of health seeking behaviors.
Moving onto the third pillar, this portion of the strategy focuses on cancer treatment, palliative care, and survivorship. In Kenya, around 70-80% of cases of cancer diagnosed are at an advanced stage where treatment is no longer very effective. This high percentage can be contributed to a number of factors from poor referral systems to challenges of geographical access. The other points of the pillar involve palliative care which refers to end of life care that is meant to care for the body, mind, and spirit of the patient and their family. Another important part of the pillar is to increase the number of qualified individuals who can provide care in the country which will solve the problem the few oncologists in the country are currently facing. The fourth pillar focuses on coordination, partnerships, and financing for cancer control. It aims to improve coordination at different levels of government (national, county, sub-county) and establish sustainable financing for prevention and control. The fifth and final pillar focuses on monitoring, evaluation, and surveillance. This ensures that the program is being operated effectively and that the services are reaching the individuals who need the help. It also works to diversify research being done on cancer as well as integrating the data from this research better into the health care field. These goals will take time to achieve and hopefully by 2022 a majority, if not all, of them will come to fruition. With guidance from the NCCS and future programs the burden of cancer can be decreased in Kenya and the country and government can work towards building a healthier population