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European Journal of Applied Sciences – Vol. 12, No. 6
Publication Date: December 25, 2024
DOI:10.14738/aivp.126.17974.
Langat, A. C., & Tanui, E. (2024). A Comprehensive Cervical Cancer Profile in Nairobi County in Between 2015 and 2019.
European Journal of Applied Sciences, Vol - 12(6). 317-330.
Services for Science and Education – United Kingdom
A Comprehensive Cervical Cancer Profile in Nairobi County in
Between 2015 and 2019
Anne Chepkemboi Langat
School of social and Human studies,
Atlantic International University, Pioneer Plaza,
900 Fort Street Mall 905, Honolulu, Hawaii 96813, USA
Evans Tanui
Kenya Nedical research institute, PO BOX 54840-
00200 off, Raila Odinga way, Nairobi, Kenya
ABSTRACT
Cervical cancer is the most prevalent cause of cancer-related deaths and morbidity
worldwide that is the most common in women aged 45-60, with a disproportional
burden in low- and middle-income countries compared to high-income countries.
The high illness burden in resource-limited settings is attributed to insufficient
knowledge of disease prevention and the lack of organized screening programs.
Low middle income countries account for 80% of cervical cancer cases globally.
Cervical cancer has a global incidence rate of 14 per 100,000 women. The present
study delves to determine the Prevalence of cervical cancer in Nairobi county, to
examine the age standard rates of cervical cancer and to determine the survival
rates of cervical cancer patients. The study utilized retrospective design where
patient records were reviewed to obtain data of Nairobi county women residents
who sought medical attention from health care facilities due cervical cancer
between the period of 2015-2019. Structured questionnaire obtained from the
Nairobi county Abstract form at cancer registry (KEMRI). The data was analyzed
using SPSS version 25 and can Reg 5. Descriptive statistics were utilized. The
Results revealed that the mean affected age is 49.53 years. Most patients were
diagnosed at stage 11 at 19.61%. Radiotherapy was the most preferred form of
treatment at 46.75%. The survival rate was at 80.52%..Cervical cancer is
considered the most common cancer in women. It is recommended that creating
awareness can alter the trajectory of the cervical cancer orientation; training
practitioners on high index cancer detection, early screening and adjustments on
government policies can increase the survival rate. Moreover, HPV vaccination can
prevent growth of malignant cervical cancer cells.
Keywords: Cervical cancer, human papilloma virus, HPV vaccine, awareness, sexual
behavior.
Abbreviations
Abbreviation Definition
WHO : World Health Organization
HIC : High-income countries
LMIC : Low- and middle-income countries
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Services for Science and Education – United Kingdom 318
European Journal of Applied Sciences (EJAS) Vol. 12, Issue 6, December-2024
WLHIV : Women Living With HIV
HPV : Human Papilloma Virus
HBM : Health Belief Model
TRA : Theory of Reasoned Action
PR : Prevalence Rate
MTRH : Moi Teaching and Referral hospital
KNH : Kenyatta national Hospital
ASDR : Age-standardized death rate
INTRODUCTION
Cervical cancer is the most prevalent cause of cancer-related deaths and morbidity
worldwide. According to WHO (2018) Cervical cancer is the most common in women aged 45-
60, with a disproportional burden in low- and middle-income countries compared to high- income countries account for 80% of cervical cancer cases globally. Cervical cancer has a
global incidence rate of 14 per 100,000 women (Serrano, Brotons, Bosch, &Bruni, 2018),
compared to 42.7 per 1000000 women in East Africa (Torre, Islami, Siegel, Ward, &Jemal,
2017). The high illness burden in resource-limited settings is attributed to insufficient
knowledge of disease prevention and the lack of organized screening programs (Mchome et
al., 2020) as well as poor diagnosis and high death rates limited health facilities, access and
treatment also contribute to the increased mortality rates (WHO, 2018).
Cancer is the third greatest cause of mortality, behind infectious illness and cardiovascular
disorders (Wambalala F.W et al., 2019). Cervical cancer ranks first after lung cancer. Cervical
cancer is more frequent among women in Sub-Saharan Africa. It is the top cause of mortality,
followed by breast cancer (Ferly, 2018). A proportion of patients are identified at stage (iii)
and (iv) advanced levels, where intervention attempts fail to impact, resulting in numerous
fatalities according to Sayed, et al. (2014).
In November 2020, the World Health Organization (WHO) launched the global strategy for the
elimination of CC as a public health problem, defining the 90-70-90 targets (Das, 2021).To
eliminate CC within a century, 90% of girls should be vaccinated by age 15, 70% of women
should be screened with a high precision test by 35 and 45 years of age, and 90% of women
with precancerous lesions and invasive CC should receive treatment and care at the national
level by 2030. In 2021, the WHO updated guidelines for screening and treatment of cervical
precancerous lesions, emphasizing particular recommendations for WLHIV, such as the age of
initial screening (WHO, 2021). Importantly, the WHO emphasizes the need for national and
worldwide quality management of screening programs, including data gathering to monitor
defined process, performance, and impact metrics.
Deaths due to cancer are expected to rise in every Country in the 21st Century. Most deaths
that occurred in Asia in 2018 considering males and females are due to cancer WHO (2018).
In Kenya cancer is rated the third leading cause of death at 7% per year. An estimated 39,000
new cases of cancer and 27,000 deaths per year; Breast cancer 34 per100,000 cervical at 25
per 100,000 prostate cancer at 17 per 100,000 and esophageal cancer at 9 per 100,000. Most
of the cancers are diagnosed at stage 3 and 4 (Kenya Network Cancer 2014) Breast cancer is
the most diagnosed type of cancer in 154 out of 185 countries. GLOBACON (2019) indicated
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Langat, A. C., & Tanui, E. (2024). A Comprehensive Cervical Cancer Profile in Nairobi County in Between 2015 and 2019. European Journal of
Applied Sciences, Vol - 12(6). 317-330.
URL: http://dx.doi.org/10.14738/aivp.126.17974
that one in 5 men and one in 6 women globally develop cancer in their lifetime of which one in
8 men and one in 11 women succumb to the cancer PLummer et al (2016)
Cancer burden in Kenya affects people at household and at national level; there is loss of
income from the most productive age and the loss of productive time due to palliative care
giving (Rutto, Muitta, Owino and Makokha, 2020). The costs attributed to cancer burden has
resulted to increase in government expenditure on treatment and care Samantha &Lawrence
(2019). Insufficient diagnostic equipment, inadequate facilities and illequipped radiotherapy
machine Ira et al (2019) has contributed to the rising cancer cases.
PROBLEM STATEMENT
Araghi, Soerjomathan, Jenkins, Brierly, Morris, Bray and Arnold (2019) in their study
concluded that cancer burden is associated with population growth, ageing, social and
economic orientation. Generally, cancer incidences in Kenya were estimated at 47,887 and
mortality at 32,987 deaths as at 2018. A report by Globacon (2018) indicated a high demand
for cancer treatment. However, the country is faced by insufficient diagnostic devices and
policy adjustments to accommodate the rising demands Wambalala FW et al (2019). There
are limited facilities that provide diagnosis and treatment. There is need to change the
government policy to allocate enough funds to health care sector. Kenyatta National Hospital
is the only public hospital with four cancer oncologists who are in charge of the facility. The
facility receives referrals from all the other counties. Diagnosis and treatment of cancer is a
major problem due to limited facilities and faulty radiotherapy machines. Ira et al (2019)
RESEARCH OBJECTIVE
1. To estimate the Age Standardized Incidence Rates (ASRs), Prevalence Rates of cervical
cancer in Nairobi county, Kenya for the period 2015-2019
2. To examine the trends of cervical cancer in Nairobi county over the period 2015- 2019
3. To identify the survival rates of cervical cancer patients for the same period in Nairobi
County.
4. To determine the stage of diagnosis and treatment among cervical cancer patients in
Nairobi.
MATERIALS AND METHODS
Research Design
The study utilized retrospective design where patient records were reviewed to estimate the
prevalence of cervical cancer in Nairobi County then cervical cancer cases were compared
with other types of cancers and finally the trends were monitored-between 2015-2019
following the introduction of HPV vaccine.
Study Area
The study was conducted in Nairobi using Cancer Registry records.
Study Population
The study targeted Nairobi county residents who sought medical attention from health care
facilities, hospices, laboratories, radiotherapy and oncology services from both public and
private hospitals within the Nairobi County.