Factors Influencing Utilization of Cancer Health Services Among Newly Diagnosed Adult Cancer Patients Attending Garissa County Referral Hospital, Kenya

Cancer remains a major public health challenge globally and is increasingly contributing to morbidity and mortality in low- and middle-income countries. In Kenya, despite ongoing investments in cancer prevention, diagnosis, and treatment services, many patients continue to present with advanced disease and experience poor treatment outcomes. Utilization of cancer health services is essential for timely diagnosis, treatment initiation, and improved survival. However, evidence on factors influencing utilization of cancer health services among newly diagnosed cancer patients in marginalized regions remains limited. This study assessed factors influencing utilization of cancer health services among newly diagnosed adult cancer patients attending Garissa County Referral Hospital, Kenya. A convergent mixed-methods cross-sectional study design was employed. Quantitative data were collected from 161 newly diagnosed adult cancer patients using structured questionnaires, while qualitative data were obtained through Focus Group Discussions and Key Informant Interviews. Quantitative data were analyzed using descriptive statistics and multiple linear regression analysis, whereas qualitative data were analyzed thematically. Statistical significance was determined at p < 0.05. The study achieved a response rate of 97.0%. The multivariable regression model demonstrated a strong positive relationship between the predictor variables and utilization of cancer health services (R = 0.699). The model explained 48.9% of the variation in utilization of cancer health services (R² = 0.489) and was statistically significant (F = 50.115, p < 0.001). Health facility and health system factors were significant predictors of utilization (β = 0.316, p = 0.001), while knowledge level and attitude emerged as the strongest predictor (β = 0.502, p < 0.001). Individual factors were not statistically significant after controlling for the other variables (β = 0.025, p = 0.796). Qualitative findings identified treatment costs, transportation challenges, long travel distances, referral delays, limited awareness, and shortages of specialized services as key barriers to utilization. Utilization of cancer health services among newly diagnosed adult cancer patients is primarily influenced by knowledge level and attitude and by health facility and health system factors. Strengthening cancer awareness, improving patient education, enhancing referral systems, expanding access to specialized oncology services, and reducing financial barriers to treatment may substantially improve utilization of cancer health services and ultimately enhance cancer outcomes in resource-constrained settings.

Cancer health services, healthcare utilization, cancer care, knowledge and attitude, health system factors, oncology services, newly diagnosed cancer patients, Kenya

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