Cancer and HIV remain among leading causes of death among Kenyan women today

courtesy The Kenya Vital Statistics Report 2024 shows that 4,498 out of 50,926 females died of cancer in 2024. Pneumonia followed closely in second place with 4,438 deaths. In ascending order, the other leading causes of death were cardiovascular disease, hypertension, anaemia, prematurity and birth asphyxia, diabetes, heart disease, kidney disease, and, finally, HIV, closing the top ten list. Year-on-year data from the Kenya National Bureau of Statistics (KNBS) shows that cancer has become increasingly lethal in the Kenyan population, rising from the fifth leading cause of registered deaths in health facilities in 2021, to fourth in 2022, and second in 2023. Rising mortality HIV featured among the top ten causes of death among females, but not among males. At the 2024 Maisha Conference held in Mombasa, we met Zipporah Kalama, a woman who has battled both HIV and cervical cancer. "I am both an HIV and cervical cancer survivor! But if I had to choose between the two diseases, I would choose HIV," she told this reporter. Compared with HIV, she said cancer caused her more pain, physically, financially, and psychologically. Kalama was diagnosed with cervical cancer in March 2019, following two weeks of heavy bleeding and significant weight loss. According to Dr. Elly Odongo, a gynaecological oncologist, HIV weakens the immune system by killing immune cells that help the body fight infections and diseases. Cervical cancer is caused by the Human Papillomavirus (HPV) in more than 95 per cent of cases, according to the World Health Organisation (WHO). "With HIV causing immunosuppression, it makes it easier for women to be infected with HPV," he says. Cancer risk The problem, Dr. Odongo explains, is not the HPV infection itself, as the virus is quite common, but rather persistent infection. "Many women become infected with HPV. Usually, if they have a strong immune system, the infection clears on its own within a year," he explains. "If the infection persists for one reason or another, it can cause cervical cancer. HPV infects the cells in the epithelial lining of the cervix," he adds. "Over a long period, it changes the genetic material in the cells, making them cancerous and leading to cervical cancer." Dr. Odongo cites scientific evidence showing that most people living with HIV have an increased risk of persistent HPV infection by up to eight times, and a risk of developing cervical cancer up to four times higher than the general population. Of all cancers affecting women in Kenya, cervical cancer is the most lethal. According to the GLOBOCAN 2020 Report by the World Health Organization's International Agency for Research on Cancer, 3,268 women in Kenya out of 5,250 diagnosed with the disease die annually. This translates to about nine lives lost every day. The same report shows that women, in general, are disproportionately affected by cancer compared to men. Early prevention Fortunately, for young girls, there is a vaccine that works best when administered before a girl becomes sexually active. The vaccine is now available in Kenya and is largely free. The vaccine, Dr. Odongo says, is one of the best tools available in the fight against cervical cancer. While not as deadly as cervical cancer, breast cancer is the most common cancer affecting women in Kenya. A simple breast self-examination (BSE), Dr. Odongo says, can help women identify symptoms such as lumps or an orange-peel texture, which can then be examined further by medical professionals. "Early detection is the key. Doctors can treat the disease completely when it is detected early," he says. It is not yet fully understood why healthy cells turn cancerous. "What we know so far is that several factors contribute to cell mutation. These include ionising radiation such as cosmic rays, the human body, rocks, soil, and medical X-rays," says Dr Catherine Nyongesa of Texas Cancer Centre. "Apart from HIV/AIDS-related immunosuppression and HPV infection, cancer can also be caused by lifestyle factors, such as smoking and alcohol consumption."

Cancer and HIV remain among leading causes of death among Kenyan women today

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