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A single hospital visit can cost around Sh1,000 in transport—an unaffordable expense for many rural families/FILE

Capital Health

Cost, stigma, and fear: Obstacles fueling late detection of breast cancer

Stories like Miriam’s are tragically common across western Kenya, where fear, misinformation, poverty, and limited access to healthcare fuel a silent crisis: the late diagnosis of breast cancer among women.

KISUMU, Kenya, Oct 3 — When Miriam, not her real name, first discovered a lump in her breast, she waited six months before seeking medical help.

“I didn’t think it was cancer,” the 46-year-old mother of four from Manyatta in Kisumu recalls.

“I wasn’t sick and could still work…I thought cancer meant losing your hair and getting thin.”

Stories like Miriam’s are tragically common across western Kenya, where fear, misinformation, poverty, and limited access to healthcare fuel a silent crisis: the late diagnosis of breast cancer among women.

At Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu, doctors report that more than 70 per cent of breast cancer patients arrive when the disease is already in Stage 3 or 4—far beyond the point where treatment is most effective. Many never survive.

“We’ve lost 20 percent of the women we enrolled in our breast cancer program within just six months of diagnosis,” says Dr. Ng’ong’a Albert, a senior general surgery resident and lead clinician of the Kisumu Breast Cancer Project.

“They come too late, and that’s what we’re trying to change.”

For many women, the journey to diagnosis begins—and often ends—in the community. Low awareness and cultural misconceptions remain significant barriers.

Countless households never teach women how to examine their breasts—a basic, life-saving practice that could trigger early detection.

Even healthcare workers are not always well-informed.

“Just this week, I taught a hospital secretary how to do a self-breast exam,” recalls Dr. Ng’ong’a. “If she didn’t know, what about women in the villages?”

But even when symptoms are recognized, cost becomes the next overwhelming hurdle.

Costly treatment

A single hospital visit can cost around Sh1,000 in transport—an unaffordable expense for many rural families.

A full diagnostic process for breast cancer can exceed Sh50,000, excluding treatment. With 80 percent of women seen at JOOTRH either unemployed or in informal work, such costs are simply out of reach.

Then there is the healthcare system itself: only a handful of facilities in the region offer diagnostic services. JOOTRH remains one of the few centers equipped to comprehensively manage breast cancer cases.

In response, JOOTRH, in partnership with several organizations, launched the Kisumu Breast Cancer Project in January 2025.

The project has screened and supported 77 women, fully covering the costs of biopsies, lab tests, and treatment navigation through donor funding. Yet, late presentation continues to pose a major challenge.

Now in its second phase, the initiative is expanding into active community outreach. Beginning this October, JOOTRH will offer free breast cancer screenings every Tuesday and Friday.

According to Dr. Ng’ong’a, women will receive risk assessments, and those deemed high-risk—or aged over 40—will be offered free mammograms.

“Anyone found with suspicious lumps will receive biopsies and lab diagnostics at no cost, along with support navigating the healthcare system for treatment,” he said.

Cancer patients and survivors hope that JOOTRH’s recent elevation to parastatal status will accelerate the establishment of a long-awaited cancer treatment center.

Kevin Okaro, a throat cancer survivor diagnosed in 2019 and now cancer-free, stressed the urgency.

“There is a cancer centre building currently under construction at JOOTRH by the county government, but progress has been slow. With the hospital’s upgrade to Level Six status, I believe the project will now gain momentum,” he said.

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