Why screening for cervical cancer is low

Cervical cancer screening in Kenyan women is still low despite the launch of a less-uncomfortable self-testing kit.

Due to stigma attached to pap smear method, where a patient physically visits a doctor, pathology labs introduced a new kit which allows a woman to collect samples from the comfort of her home for testing in labs.

The kits are low priced at Sh200, but the lack of awareness of the self-testing method and the high cost of testing the samples in a lab which ranges from Sh4,000, contributes to the low uptake.

Doctors are banking on the self-testing kits to easily detect human papilloma virus (HPV) infection which causes cervical cancer, a top killer of Kenyan women.

The Cobas HPV test, a soft tube-like device that collects samples by swabbing of the cervix to check the presence of the HPV is not available in public hospitals and can only be accessed in Lancet laboratories. The Cobas test picks out the DNA of the HPV and identifies any of the 14 different high-risk strains of the virus.

Dr Ahmed Kalebi, the CEO of Lancet Laboratories, who is advocating for enhanced cervical cancer screening in Kenya says the new method is not known though it is the most accurate and cost-effective compared to a Pap smear.

“It costs Sh4,000 and can be done ones in 10 years while a Pap smear is done annually and very expensive,” says Dr Kalebi.

Dr Paul Mitei, a gynecologist and obstetrician said that a robust public education campaign is needed to educate the women about the new technology.

He says less than 10 per cent of women go for the tests and if they do they go when the cervix is already diseased.

Dr Mitei says everyone, including doctors, gets a bit embarrassed about having a pap smear. But that shouldn’t deter anyone from going for screening.

To have two out of three patients dying from the disease is a crisis that demands immediate attention. One way to improve these numbers is to have the necessary cancer conversation in our homes. Awareness campaigns need to kick off in high gear,” he said.

The HPV virus is spread through sexual intercourse and in most cases it is cleared away naturally by the immune system and causes no damage. However, at times it persists and causes cervical cancer.

It leads to the uncontrolled abnormal growth of cells in the cervix which can develop into tumours and over time full-blown cancer characterised by severe bleeding and backaches, among other symptoms.

The push to educate more women in the self-testing kits comes as the Health ministry plans to vaccinate more young girls against cervical cancer this year.

A free HPV vaccine programme was piloted in Kitui five years ago with 42,000 girls aged nine to 13 years receiving the injection.

Dr Collins Tabu, the head of the National Vaccines and Immunization Programme said they will target 10 to 14 year-olds this year.

“We have known what exactly happened during piloting. The mistakes will help us move forward. We are looking at how to introduce the vaccine to all so that in future they are fully protected against cervical cancer,” said Dr Tabu.

Dr Catherine Nyongesa, an oncologist at the Kenyatta National Hospital Texas centre said if the vaccine is included as part of immunisation, so many lives will be saved.

Currently, the vaccine is only found in private hospitals at Sh6,000 and not in public hospitals while the cost of delivering the vaccine through schools to each girl was put at Sh4,600 which was still too much to sustain a national programme.