Cervical Cancer: A Kenyan doctor’s call to action on World Cancer Day

Cervical Cancer: A Kenyan doctor’s call to action on World Cancer Day

Dr. Diana Marion 

One of the most heart-wrenching moments in my medical career is breaking the devastating news to a cervical cancer warrior and their family that nothing more could be done.

When cervical cancer advances to stage four, the reality is harsh and painful - palliative care becomes the only option. It is a moment filled with sorrow and helplessness, but alongside that heartbreak and pain, there is also a deep sense of frustration.

Frustration is an understatement, it is annoying because cervical cancer is preventable. No Kenyan should have to endure this suffering, and no family should have to watch their loved one fade away from a disease that could have been stopped early.

The fact that early detection and intervention could make all the difference makes its persistence simply unacceptable. Yet, every year, thousands of women in Kenya receive a late-stage diagnosis when the battle is already lost.

On World Cancer Day 2025, I choose to focus on raising awareness about prevention. Cervical cancer remains the second most common cancer among women in Kenya and the leading cause of cancer-related deaths, with over 5,000 new cases and 3,000 deaths annually. These numbers are not just statistics—this “monster,” as I often think of it, is taking away our mothers, sisters, daughters, friends, co-workers, schoolmates, and agemates, cutting their lives short.

This should not be happening. As a country, we have the tools to fight this disease. First, we must understand cervical cancer—it develops in the cells of the cervix, the lower part of the uterus that connects to the vagina.

It is primarily caused by persistent infection with high-risk types of the human papillomavirus (HPV). HPV is a common virus transmitted through sexual contact, and while most infections clear on their own, some lead to precancerous changes that, if untreated, can progress to cancer over time. The truth is, we are all exposed to different types of HPV throughout our lifetime, but not all lead to cancer.

The body’s immune system can fight off most infections, but in some cases, persistent high-risk HPV infections cause abnormal cell changes in the cervix. If these precancerous changes are not detected and treated early, they can develop into cervical cancer over several years.

Prevention is Our Strongest Weapon. The fight against cervical cancer can be won through HPV vaccination, which protects against the most common cancer-causing HPV strains, and regular screening (Pap smear & HPV testing), which detects precancerous changes before they turn into cancer. Early treatment of precancerous lesions stops cancer before it starts.

However, many women do not access these services due to barriers such as cost, fear, cultural beliefs, or lack of awareness.

When Should I Get the HPV Vaccination? Many people ask this question. The HPV vaccine is most effective when given before exposure to the virus, ideally between 9–26 years of age, before the onset of sexual activity. In Kenya, HPV vaccination is available for girls in the 9-14 age group under the routine immunisation programme. However, uptake remains low due to myths and misconceptions.

If you missed the HPV vaccination before becoming sexually active, all is not lost. Screening and early detection help catch precancerous changes before they turn into cancer. The two common tests used are: Pap smear, which detects abnormal cells in the cervix. HPV test, which identifies high-risk HPV infections that could lead to cancer.

The Government of Kenya should prioritise and ensure that regular early screening is accessible under the new Universal Healthcare Model – Social Health Authority (SHA). Many women and girls have the information and are aware of what they should do, but they cannot afford regular screening, leading to delayed diagnosis and poorer outcomes.

What Happens When Cervical Cancer Develops? If not detected early, cervical cancer progresses from precancerous changes to early-stage cancer and eventually to advanced-stage cancer. In its early stages, the disease may have no symptoms, but as it progresses, signs may include: abnormal vaginal bleeding (especially after sex or between periods), unusual vaginal discharge, pelvic pain or pain during intercourse.

Since more than 90% of cases in Kenya are diagnosed late, many women require aggressive treatments such as surgery, chemotherapy, or radiotherapy, which can be costly, painful, physically demanding and mentally draining.

Despite the availability of vaccination and screening programmes, barriers persist. Lack of awareness is  a big problem.  Many women do not know about the importance of HPV vaccination and screening.

Cost and accessibility are also another barrier because  Screening and treatment are unaffordable for many, despite government initiatives. Stigma and myths lead to misconceptions about HPV vaccination and cervical cancer and discourage uptake.

There are no two ways about cervical cancer management as a country. We must advocate for better policies to improve access to vaccination, screening, and treatment services. It is preventable, treatable, and curable if detected early. No woman or girl should lose her life to a disease that we have the tools to screen, prevent, and treat. Every woman, every girl deserves access to these life-saving interventions. Every family deserves hope instead of heartbreak. We must do better as a country. We must do it fast.

Dr. Diana Marion is a senior medical specialist Obstetrician, Gynaecologist and Gynaecological Oncology Fellow at the University of Nairobi. She is also the Secretary General, Kenya Medical Association.

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