Breast Cancer Screening and Incidence in Rural Central and Western Kenya: A Community-based Program

Materials and Methods: We conducted a retrospective analysis of prospectively collected programmatic data from the ABCCP, implemented between September 28, 2012, and March 18, 2020, across 55 public health facilities and cancer screening clinics in Central and Western Kenya. Adults aged ≥18 years were mobilized through community engagement activities and underwent standardized clinical breast examination (CBE) performed by trained healthcare workers. Participants with palpable breast abnormalities underwent confirmatory clinical assessment followed by biopsy and histopathological evaluation where indicated. Demographic, clinical, and screening data were collected using standardized forms and managed through the OpenMRS electronic medical record system. Descriptive statistics were used to summarize participant characteristics and screening outcomes.

Results: A total of 31,970 unique participants were screened, including 29,733 women (93.0%) and 2,237 men (7.0%). Most participants were aged 20–49 years (69.2%). Overall, 698 participants (2.18%) were identified with palpable breast abnormalities requiring further evaluation, and 540 (1.69%) underwent biopsy. Histopathological examination confirmed breast cancer in 191 participants, corresponding to an overall breast cancer detection rate of 0.60% among all screened participants. Among participants with abnormal breast findings, 77.4% underwent biopsy and 27.4% had biopsy-confirmed breast cancer. The program successfully linked participants with confirmed cancer to specialist oncology services through an established referral pathway.

Conclusion/Interpretation: This study demonstrates that community-based breast cancer early detection integrated within existing primary healthcare systems is feasible and scalable in resource-constrained settings. The ABCCP successfully combined community engagement, standardized clinical breast examination, diagnostic evaluation, pathology services, and referral for treatment across multiple rural counties in Kenya. These findings support expansion of decentralized breast cancer early detection programs as part of comprehensive national cancer control strategies to improve timely diagnosis and reduce disparities in access to cancer care across underserved populations.