Clinicopathological Profile, Geographical Catchment, and Survival Outcomes of Cervical Cancer at a Regional Cancer Centre in Kenya: A Retrospective Cohort Study (2018–2024)

Cervical cancer is a disease that begins in the neck of the womb, often caused by a common virus that most people carry without knowing it. In many parts of the world, this disease is rare because regular screening can find it early, long before it causes harm. However, in many low-income regions, the disease remains a leading cause of death for women, largely because it is not caught until it has spread deep into the body. When cancer is found early, it is often treatable; when it is found late, the chances of survival drop sharply. Understanding exactly who gets sick, where they come from, and what happens to them after diagnosis is crucial for doctors and policymakers trying to save lives. Without this clear picture, efforts to build clinics or launch screening programs can miss the people who need help the most.

A team of researchers recently looked closely at the records of women treated for this disease at a major regional hospital in Kenya. They focused on the Nakuru Regional Cancer Centre, a facility that serves as a hub for a large area known as the Central Rift Valley. The team gathered information on every woman diagnosed with cervical cancer there between May 2018 and December 2024. They wanted to know the age of the patients, their jobs, whether they had health insurance, and where they lived. They also examined the type of cancer each woman had, how advanced it was when found, what treatments she received, and whether she was still alive a year or three years later. By mapping where the patients came from, they could see how far people traveled to get care and whether distance made a difference in how sick they were when they arrived.

The study included 338 women, and the picture that emerged was one of a disease that strikes women in the middle of their lives. The typical patient was 50 years old, though the group ranged from young women in their twenties to older women in their nineties. Most of these women were married, but nearly half were unemployed, and more than a quarter had no health insurance at all. This lack of financial security is a significant hurdle, as cancer treatment is expensive and requires many visits to the hospital. The most common type of cancer found was a form called squamous cell carcinoma, which accounted for more than 90 percent of the cases. This specific type is strongly linked to the virus that causes the disease.

Perhaps the most striking finding was that most women arrived at the hospital when the cancer was already very advanced. More than half of the patients were diagnosed at a stage where the disease had spread beyond the cervix to nearby tissues or distant parts of the body. Only a small fraction of women were found to have the disease while it was still confined to the neck of the womb. This pattern of late discovery is a major reason why so many women die from the disease. The researchers found that the women who were diagnosed early had a much better chance of surviving. Those with early-stage disease had a very high likelihood of being alive one year and three years after diagnosis. In contrast, women with advanced disease faced a much steeper struggle, with survival rates dropping significantly.

The location of the patients told another important story. The vast majority of the women came from the county where the hospital is located, but the facility also drew patients from 19 different counties across the country. The researchers noticed a clear pattern: the further a woman lived from the hospital, the fewer cases were recorded. This suggests that distance acts as a barrier, preventing many women from seeking care. Furthermore, women who traveled from far away were more likely to be diagnosed with advanced disease, likely because they waited longer to seek help or had fewer opportunities for early screening in their home areas. Within the local county, one specific area had a notably high number of cases, which the researchers suspect might be linked to the heavy use of chemicals in local farming, though this connection requires more study.

Treatment was another critical factor in survival. The study showed that women who received any form of treatment had a much better chance of living than those who did not. Chemotherapy was the most common treatment given, followed by radiation therapy. Surprisingly, surgery was rarely performed. A significant number of women, about one in four, never started treatment at the hospital, often due to financial constraints or the difficulty of traveling. For those who did receive care, the type of treatment mattered. Women who received a combination of chemotherapy and radiation, or who underwent surgery followed by other treatments, generally had better outcomes than those who received no treatment at all. However, the researchers noted that many women still dropped out of care or were lost to follow-up, meaning the hospital could not track whether they were alive or dead, which complicates the full picture of survival.

The analysis confirmed that the stage of the cancer at the time of diagnosis was the strongest predictor of whether a woman would survive. Women diagnosed with advanced disease faced a risk of death that was nearly eight times higher than those diagnosed early. The grade of the tumor, which describes how aggressive the cancer cells look under a microscope, also played a role; higher-grade tumors were linked to worse outcomes. While many women had other health issues like high blood pressure or HIV, these conditions did not show a strong independent link to survival in this specific group of patients, though the presence of HIV is known to make the disease more aggressive in other contexts.

This study provides a clear and sobering snapshot of the battle against cervical cancer in this region of Kenya. It reveals that the disease is a heavy burden on women who are often financially vulnerable and that it is frequently discovered too late to be easily cured. The findings highlight that simply having a hospital is not enough; the system must reach women before the disease spreads. The researchers suggest that expanding screening services closer to where people live and making treatment more affordable are urgent priorities. By understanding exactly where the gaps are—whether in distance, money, or timing—health officials can design better strategies to catch the disease early and save more lives. This work serves as a vital baseline, a starting point to measure whether future efforts to control cancer in Kenya are truly making a difference.