PATRICK AMOTH

As the Breast Cancer Awareness Month came to an end in October, it helps to reflect on the steps we have taken as a country, to reduce deaths from the disease. 

Breast cancer is the commonest cancer type in Kenya. An estimated 6,799 cases were diagnosed in 2020, compared to 5,985 new cases 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 in the country.  

In Kenya, the majority of patients suffering from breast cancer are 35-50 years, compared to 50-55 years in the Western World. 

To address this growing public health concern, 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 as outlined in the implementation matrix, review of progress and shared accountability, it is anticipated that breast cancer mortality can be reduced by 2.5 per cent per year until 2040 averting nearly over 1,000 premature deaths for women aged between 35 and 55 years. 

In Europe and the United States , the number of deaths due to breast cancer declined by 13 to 36 per cent between 1990 and 2010; a period in which the number of new cases remained relatively stable.

This decline in deaths was attributed to two major factors: early detection, advances in diagnostics and adjuvant treatment. 

Early detection of breast cancer through annual screening by mammography for women between the ages of 40-55 years 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-as have been attained in high income countries. 

Chemotherapy services have already been decentralised to 10 regional county cancer centres in Nakuru, Mombasa, Garissa, Embu, Meru, Machakos, Nyeri, Bomet, Kakamega and Kisumu; where women diagnosed with breast cancer can get access to surgical care, chemotherapy, palliative care and rehabilitative services, among other services in our journey towards achievement of 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 in implementing this action plan to reduce unnecessary delays that contribute to poor outcomes. 

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 are increasingly having a significant impact on global morbidity and mortality. 

The rising incidence of chronic disease like cardiovascular disease, cancer and diabetes is fast becoming a priority agenda in global health. 

Tackling these emerging conditions requires development of 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.

We call for joint action bringing all stakeholders together in implementing a harmonised comprehensive scale up for breast cancer screening and early diagnosis program in Kenya, with shared learning and accountability. Indeed, early detection of breast cancer can and will save lives! —The writer is the acting Director General for Health in the Ministry of Health and the chairman WHO Executive Board