Analysis of cancer diagnoses from 2015-2019 within Machakos County, Kenya, support establishment of Cancer Centre in 2019 likely changing referral patterns

Background: In Kenya, cancer is an increasing public health challenge, with an estimated 48,000 new cancer cases and over 33,000 deaths recorded each year. Machakos County, Kenya, recently opened a cancer centre with an aim of bringing cancer services such as surgical oncology, chemotherapy, radiotherapy, and pathological services closer to the residents of Machakos County. The county is also one of four counties selected for the universal health coverage pilot programme making it uniquely poised to inform cancer control programs at the local, national, and international levels. Methods: : This study aimed to build a cancer database to enable future population-based cancer studies by reviewing cancer diagnosis records for selected major public hospitals in Machakos County from 2015-2019. Medical records data were retrieved from Machakos Level 5 Hospital and Kangundo, Matuu, Kathiani and Mwala Level 4 Hospitals. Results: : A total of 522 cancer cases were recorded across the study period with more than a third (N=172, 33%) diagnosed August-December of 2019 when the Machakos Cancer Centre opened. Among the cancers diagnosed, the majority were in women (59.2%), with cervix uteri (n=106, 34.3%) followed by breast (n=62, 20.1%) as the most common cancers. For males, oesophagus (n=52, 24.4%) followed by prostate (n=43, 20.2%) were the most common cancer types. The highest crude rates per 100,000 persons were for Kangundo 67.4 and Matungulu 53.2 subcounties. Conclusion: It is clear that access to cancer care treatment will change referral patterns for residents in Machakos County and with the establishment of this database we expect to enable future population-based surveillance of the cancer burden and research studies, to inform cancer control programs.