Uganda’s Cancer Crisis: Late Diagnosis Drives Centre Rollout

Uganda faces a severe and escalating cancer crisis, with over 37,000 new cases and approximately 28,000 deaths annually, according to the Uganda Cancer Institute (UCI). The nation’s high mortality rate is largely attributed to patients presenting with advanced disease, driven by delayed health-seeking behaviour, persistent myths, and limited access to specialised care.

Dr. Naghib Bogere, a medical oncologist at UCI, explained that unlike in high-income countries, Ugandan patients often arrive at treatment centres when cancer is terminal. “Many still believe cancer is a curse, wait for pain to begin, or first seek alternative treatments,” he said. This late diagnosis makes treatment more complex, costly, and less effective.

Significant efforts are underway to address the burden through decentralisation. The Gulu and Mbarara Cancer Centres are operational, with construction of facilities in Arua and Mbale scheduled to begin this year. These centres aim to bring diagnostic and treatment services closer to communities, reducing the need for long, costly journeys to the primary UCI facility in Kampala.

Cervical cancer remains the most common and deadly for women, followed by breast cancer. For men, prostate cancer is predominant. Kaposi sarcoma, linked to HIV, affects both sexes, while oesophageal cancer also ranks highly. Infectious agents, including Human Papillomavirus (HPV), HIV, and Hepatitis B, are major drivers. Lifestyle factors, notably Uganda’s high per capita alcohol consumption, further contribute to the rising incidence.

Geographic disparities are stark. The Central Region, particularly Kampala, records the highest incidence at 86.6 cases per 100,000 people, with Northern and southwestern regions also heavily burdened. The strain on families is immense, often involving the sale of assets to cover travel and treatment costs.

The disease also impacts children, who represent about 10% of new cases, with 600-700 paediatric patients admitted to UCI annually. During the 2024/2025 financial year, UCI registered 8,372 new patients, 55% of whom were women. The facility administered 80,438 chemotherapy infusions and 68,125 radiotherapy sessions, averaging over 20,000 and 17,000 per quarter respectively, highlighting the immense and growing demand.

While decentralisation and growing public awareness—that cancer is a treatable disease, not a curse—offer hope, the scale of the burden continues to challenge the health system. The expansion of regional cancer centres is a critical next step in improving early detection and survival rates across Uganda.