Oesophageal cancer: signs, risks and when to get checked in Kenya

Oesophageal cancer starts in the food pipe that carries food from the throat to the stomach. It is unusually common in Kenya and is often found late, so warning signs should never be ignored.

Difficulty swallowing, food sticking in the throat or chest. Pain when swallowing. Heartburn or indigestion that does not go away. Losing weight without trying. A cough or hoarse voice lasting more than 3 weeks. Vomiting, or black stools.

Drinking tea or other drinks very hot: a study in western Kenya linked it to a higher risk. Alcohol, especially strong spirits and traditional distilled brews. Tobacco in any form. Long-term reflux and Barrett's oesophagus. Smoke from cooking over firewood indoors. Having swallowed a corrosive chemical in the past. A diet low in fruit and vegetables.

Difficulty swallowing that keeps happening is never normal and should be checked quickly, even if it comes and goes. So should vomiting blood or black stools.

With endoscopy (OGD), only when a clinician advises. Most adults: there is no routine screening programme in Kenya.

A medical review of your symptoms. An upper endoscopy (OGD) to look at the food pipe. A biopsy if something is seen. A referral to a specialist centre if results need it. A risk result is not a diagnosis.

Do I need an endoscopy, and where can I get one? Could my heartburn be causing damage? Does how I drink tea affect my risk? What can I do now to lower my risk?

Endoscopy is offered at hospitals with an endoscopy unit; prices vary, so ask before you go.

The oesophageal cancer risk assessment asks about 32 questions, including reflux, Barrett's oesophagus, very hot drinks, cooking smoke, alcohol and tobacco, and 14 warning signs from swallowing difficulty to black stools. Any warning sign is flagged for prompt review. It costs KES 300. A care navigator calls you back within 2 hours (Monday to Saturday, 8am to 8pm) to book what you need at a facility that suits your budget and location.