Gaps In Diagnostic Follow-up And Referral Pathways For Cervical Cancer.

Background

Cancer screening programs in Kenya have led to increased detection rates though still far below 70% WHO target by 2030; however, many women are lost to follow‑up due to financial barriers and systemic referral challenges. Medical laboratories, as critical links between screening and definitive diagnosis, are often overlooked in strategies to improve continuity of care.
Objective: To explore and identify barriers that hinder women’s ability to access follow‑up diagnostic services after a positive screening result.

Methods

A qualitative descriptive study conducted among women of screening age and healthcare providers in policy or service delivery in Makueni and Mombasa County in 2024. Data was collected through focus group discussion (FGD) among women and Key Informant Interview (KII) among health care workers. Thematic analysis was used to analyze the data from both the women and healthcare providers to identify barriers and facilitators to cervical cancer services. 

Results

From both women and healthcare workers; 3 major themes on gaps in diagnosis were identified. 
1. Financial barriers: High costs of confirmatory diagnostic procedures deterred many women from completing referrals.
2. Referral system failures: Fragmented coordination between screening facilities and diagnostic laboratories left patients confused, leading to high loss-to-follow-up.
3. Access gaps: Study participants expressed strong support for decentralizing diagnostic laboratories closer to community or primary care levels.

Conclusion

Medical laboratories play a pivotal role beyond testing. They are essential in ensuring that screening translates into timely diagnosis. Addressing financial, referral barriers.

Recommendations

1. Decentralize cancer diagnostic laboratory services to county/sub‑county levels to reduce access barriers.
2. Implement affordable pricing strategies/free for follow‑up diagnostic services.
3. Establish robust referral coordination and patient navigation systems linking screening sites and laboratories
4. Integrate laboratory strengthening into national cancer control and public health policies with formal role in referral pathways.