Swift Biopsies Offer Hope

A collaborative project at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu is significantly reducing the time it takes for breast cancer patients to receive a core biopsy. An interim report from January to May 2025 reveals that the average time from a patient's first contact to receiving a core biopsy was a mere 0.22 days, less than six hours. All 34 patients enrolled during this period received biopsies within the two-day target, a marked improvement in a region where such delays often stretched into weeks or months.

This initiative, a partnership between JOOTRH, the Africa Cancer Foundation, and the Tiba Foundation, aligns with the World Health Organization's Global Breast Cancer Initiative (GBCI) recommendation of diagnosis within 60 days of initial symptoms.

Lingering Bottlenecks in Lab Analysis

Despite the rapid biopsy turnaround, a critical bottleneck persists in histopathology—the analysis of biopsy tissue. The average time for histopathology results stands at 19.1 days, with fewer than 10 percent of cases meeting the 10-day target. This internal delay is now identified as the primary obstacle to timely treatment.

Immunohistochemistry (IHC) testing, vital for determining cancer subtypes and guiding treatment, has shown better performance, with an average turnaround of under 12 days, well below the six-week global benchmark.

Community and Financial Hurdles Remain

Beyond the hospital's diagnostic improvements, deep-rooted challenges continue to delay patients' access to care. Patients at JOOTRH report a median delay of eight months from the first appearance of symptoms to their initial hospital visit. Poverty, social stigma, and a lack of awareness are major contributing factors.

While 94.7 percent of patients are enrolled under the government's Social Health Insurance Fund (SHA/SHIF), three out of four still reported that financial hardship delayed their care. Essential diagnostics, including histopathology, IHC, and CT scans, are only partly covered, leading to significant out-of-pocket expenses for patients.

In Kenya, breast cancer is the leading type of cancer, with an estimated 6,799 cases diagnosed in 2020 and 3,107 reported deaths. Late diagnosis is a significant contributor to these mortality rates, with about 80% of reported cancer cases in Kenya diagnosed at an advanced stage.

Government's Broader Health and Youth Initiatives

The government is simultaneously rolling out other significant programs. The National Youth Opportunities Towards Advancement (NYOTA) program, a KES 5 billion initiative, has officially commenced. Launched by President William Ruto, the program aims to empower 100,000 young people with start-up capital, training, and mentorship. It targets youth aged 18-29 (up to 35 for persons with disabilities) with Form 4 education or below, who are unemployed, underemployed, or in low-tier employment.

Additionally, Cabinet Secretary for Public Service, Human Capital Development and Special Programmes, Geoffrey Ruku, recently flagged off relief food to drought-hit Arid and Semi-Arid Land (ASAL) counties. This intervention targets 23 ASAL counties, where 2.15 million people urgently require food assistance.

Risks and Implications

The persistent delays in histopathology results at JOOTRH pose a significant risk to breast cancer patients, potentially leading to disease progression and poorer treatment outcomes. The financial burden on patients, despite SHIF enrollment, highlights gaps in insurance coverage for critical diagnostic services. Addressing these laboratory and financial challenges is crucial for improving breast cancer survival rates in Western Kenya. The success of the JOOTRH project in accelerating biopsies demonstrates that targeted interventions can yield rapid improvements, but comprehensive systemic reforms are still needed.

What to Watch

• The implementation of JOOTRH's three-pronged strategy to address community and financial barriers to care.
• Further government efforts to expand SHIF coverage for essential cancer diagnostics and treatment.
• The impact of the NYOTA program on youth employment and entrepreneurship across the country.
• The effectiveness and reach of ongoing relief food distribution in ASAL counties.