Barriers to Breast Cancer Screening in Kenya
For many Kenyan women, fear and stigma continue to be significant obstacles when it comes to breast cancer screening. A recent study highlights that few people discuss the disease openly, and even fewer talk about undergoing examinations. This lack of dialogue leads to late diagnoses, which in turn result in poorer treatment outcomes.
Dr Josephine Kibaru-Mbae, an obstetrician-gynaecologist and former director general of the National Council for Population and Development, considers herself fortunate. In 2020, she had a mammogram that found no issues with her breasts. When she noticed a small lump in her left breast in May 2022, she took caution and underwent another mammogram, ultrasound, and needle biopsy. The wait for results was agonizing, as she recalls, “those were the longest days of my life.” The results confirmed a breast cancer diagnosis, and she embarked on a journey that included chemotherapy, surgery, radiotherapy, and immunotherapy. She is now on long-term hormonal therapy.
Kibaru-Mbae chose to speak out to help others overcome their fears and the stigma surrounding breast cancer. She acknowledges the challenges faced by medical professionals who often suffer in silence due to the stigma attached to illness. “I have not been very vocal in advocacy, partially because I recognize the stigma,” she says. “There are many medics suffering in silence with all kinds of illnesses, but we find it difficult to share our stories. I believe part of this is due to our training to take care of others. But I want to tell my fellow medics, it is okay to let others take care of us; we also deserve care.”
Her openness has sparked a broader conversation about why screening uptake remains low in Kenya and how silence continues to cost lives. A study published in the Plos One journal in April revealed that only 13.91% of women aged 15-49 have ever undergone a clinical breast examination by a health professional. Women with higher media exposure were more likely to get screened. The study, titled ‘Clinical breast cancer screening uptake and associated factors among reproductive-age women in Kenya,’ found that women living in communities with greater media exposure had significantly higher rates of clinical breast cancer screening than those in areas with limited exposure.
Breast cancer is Kenya’s most common cancer among women. According to the National Cancer Institute, there are approximately 6,799 new cases annually, accounting for around 16.1% of all new cancer cases. While Kenya’s National Cancer Screening and Early Diagnosis Action Plan outlines steps to improve early detection, implementation remains uneven. Many public hospitals lack the personnel and facilities needed to offer routine breast examinations, and few counties have sustainable outreach programs targeting women with low media exposure.
Early detection is crucial for improving survival rates, but treatment options are limited and costly when diagnosed at a later stage. About 3,000 women die from breast cancer in Kenya each year, primarily due to late diagnosis.
The Plos One study also identified age, education, and income as key factors influencing screening uptake. Women with primary education or higher were more likely to undergo clinical breast cancer screening. Wealth also played a role, as women from the richest households were 2.19 times more likely to be screened than those from poorer families. Information exposure emerged as a powerful enabler, meaning women who regularly encounter health information through radio, TV, or social media are more likely to seek screening.
These findings align with Kibaru-Mbae’s personal experience: awareness, education, and support networks can make the difference between early action and delay. She questions how women in areas like Kibera or Kiandutu slums manage the nutritional and medical needs related to breast cancer. The doctor advises women not to ignore changes in their breasts and to seek professional examinations and emotional support. She also urges fellow health workers to prioritize their own wellbeing and undergo regular check-ups, despite social expectations that they must always be caregivers.