Stakeholders in the medical industry have raised alarm over the use of unproven screening methods by healthcare facilities to detect cancer.
According to the experts, some of the tests being used are not in line with standard guidelines issued by the Ministry of Health (MOH) and the World Health Organization (WHO).
“While the hospitals are doing a good job by offering screening at reduced costs, we’re concerned that some of these institutions are using tests that haven’t been approved for mass screening of cancer in populations,” David Makumi, chairman of the Kenya Network of Cancer Organisations (KENCO) told the Business Daily.
To mark Breast Cancer Month, which is celebrated annually in October, many hospitals are encouraging Kenyans to undergo various cancer screening tests at their facilities by offering discounted rates.
The experts - comprising of cancer civil society groups, Non-Governmental organisations (NGOs) and patients – were reacting to promotional fliers by a private hospital indicating that it planned to use tumour markers to screen ovarian, breast, pancreatic, liver and colon cancers.
They say the test is not recommended for mass screening of the above cancer types in healthy populations.
The MOH guidelines endorses mammograms for mass screening of breast cancer in women above the age of 40 and a colonoscopy or sigmoidoscopy for detection of colorectal cancer.
The latter test involves the use of special cameras that enable doctors to look for any abnormalities in the colon.
For cervical cancer, the three tests recommended include: pap smears, DNA tests for HPV (virus that causes the disease) as well as visual inspection using acetic acid (VIA).
A tumour marker is a scientific term that refers to certain proteins that are usually associated with some types of cancers.
For instance, high levels of the CA-125 protein in the blood is associated with ovarian cancer.
Despite their link to cancer, tumour markers are not recommended for mass screening of the disease among healthy populations due to their inaccuracies.
“Just because you have elevated levels of a particular tumour marker doesn’t mean that you have cancer. The high levels may be due to other factors unrelated to the disease,” said Dr Joseph Kibachio, head of the Non-Communicable Disease (NCD) department at MOH.
He added that the since the markers are not foolproof, they can only help in diagnosing particular cancers when used in combination with other highly specific and accurate tests.
“They should be avoided unless it’s really necessary to use them, such as for screening cancer in high risk populations,” he added.
In medical practice, tumour markers are approved for use in assessing treatment progress in people who are already diagnosed with a particular cancer.
For example, among patients with ovarian cancer, doctors will periodically check the levels of the CA-125 protein to determine whether they are responding well to treatment.
“The levels are usually high at the beginning. But then they start to go down with treatment,” explained Makumi.
He noted that some hospitals are also urging women below the age of 40 to undergo ultrasound tests for breast cancer screening.
“But this is a follow–up test that should be done only after a physical breast examination reveals some abnormality or something suspicious.”
He called on all health facilities to provide accurate and evidence-based information regarding screening tests to the public, especially this month, when majority of Kenyans usually flock hospitals for cancer screening.
“We want facilities to follow the MOH guidelines and not just use whichever test for the sake of creating markets for their services,” said Kibachio.
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