The state of cervical cancer in Machakos: a 5-year analysis 2019–2023

Background: Cervical cancer is a leading cause of cancer-related deaths among women in Kenya.Despite human papillomavirus (HPV) vaccination efforts and screening programs, gaps persist in prevention and control, particularly in decentralized settings like Machakos County.This study assessed the cervical cancer burden, demographic patterns, and spatial distribution across Machakos County to inform context-specific prevention and control strategies.Methods: A retrospective descriptive study analyzed cervical cancer cases from 2019-2023 using data from the Machakos County Cancer Registry and HPV vaccination reports.Trends in cervical cancer prevalence, HPV vaccination coverage among girls aged 10-14 years, and diagnosis staging were assessed, alongside geographic distribution of cases across nine subcounties.A policy review provided additional programmatic context.Results: From 2019-2023, 217 cervical cancer cases were reported.Screening peaked in 2020 (18,949 women screened, 0.4% prevalence) but declined to 5,227 in 2022, when prevalence rose to 2.6%.HPV vaccination coverage ranged from 76.2% in Machakos to 51.0% in Kalama, with no sub-county meeting the 90% World Health Organization target.Most cancer diagnoses occurred in women aged 40-69 years, and 58.5% of cases lacked documented staging.Conclusion: While cervical cancer prevalence remains high and positivity rates continue to rise, HPV vaccination coverage in Machakos County remains below target levels.These trends indicate delayed diagnoses and persistent gaps in service accessibility.Strengthening both HPV vaccination and cervical cancer screening programs through a coordinated, dualintervention approach is essential to reduce disease burden and improve health outcomes in Machakos County.