Dear Health Minister, Include colon cancer screening in Ghana’s Free Primary Healthcare promise

Dear Honourable Minister of Health,

Your campaign for Free Primary Healthcare offers Ghana a rare opportunity to move from treating disease late to preventing it early. That promise should not be limited to malaria, hypertension, diabetes and maternal care. It must also include colorectal cancer a silent killer that is becoming too important for Ghana to ignore.

According to GLOBOCAN 2022 estimates, Ghana recorded 986 new colorectal cancer cases and 656 deaths. These figures may appear modest compared with breast, liver, cervical and prostate cancers, but they tell a painful story: too many Ghanaians are reaching care only after bleeding, bowel obstruction, unexplained weight loss or persistent abdominal pain. By then, treatment is costlier, more complicated and less likely to save life.

Honourable Minister, colorectal cancer is exactly the kind of disease that proves the value of primary healthcare. In better-organised systems, stool-based tests detect hidden blood before symptoms appear, colonoscopy confirms suspicious findings, and dangerous polyps can be removed before they become cancer. Globally, colorectal cancer caused about 1.9 million new cases and more than 900,000 deaths in 2022, yet countries with organised screening have shown that early detection can change outcomes.

The comparison is instructive. The United Kingdom offers eligible adults home stool-test kits, with colonoscopy after abnormal results. The United States recommends routine screening for average-risk adults from age 45 to 75 using stool tests, colonoscopy and other approved options. Ghana has had guidance recommending stool-based screening for adults over 50, but implementation remains weak. Policy without delivery does not save lives.

This is why your Free Primary Healthcare programme must deliberately include bowel-health education and colorectal cancer risk assessment at CHPS compounds, health centres, polyclinics, outreach points and health kiosks. If the programme is already designed to bring screening closer to homes, markets, churches, mosques and workplaces, then Ghana should not miss the chance to normalise a simple message: blood in stool is not a private shame; persistent bowel change is not a minor inconvenience; early testing can save life.

I respectfully urge the Ministry to make three commitments. First, include affordable or free stool-based testing for eligible adults as part of primary healthcare screening, beginning with high-risk groups and adults from age 50. Second, guarantee clear referral pathways and subsidised colonoscopy for people with positive stool tests or warning symptoms. Third, strengthen regional pathology, imaging, surgery, oncology and palliative-care pathways so patients are not abandoned after diagnosis.

The economic argument is as strong as the moral one. Late-stage cancer care drains families and the health system. Early screening, timely diagnosis and coordinated treatment are cheaper, kinder and more effective. A Ghanaian in Tamale, Takoradi, Ho, Sunyani, Wa or a rural community should not lose the chance of survival because colonoscopy is unaffordable, pathology is delayed or symptoms are dismissed.

Your Free Primary Healthcare campaign can become a turning point if it treats non-communicable diseases not as future problems, but as present threats. Ghana does not need to copy the United Kingdom or the United States wholesale. It needs a Ghanaian model: community education, stool testing, rapid referral, accessible colonoscopy, reliable pathology and multidisciplinary care.

Honourable Minister, this is a plea to act before colon cancer becomes an even larger national tragedy. Free Primary Healthcare will be judged not only by how many people enter facilities, but by how many lives it prevents from being lost too soon. Let colorectal cancer screening be part of that promise. Let Ghana screen earlier, diagnose faster and treat better.

Yours faithfully,

Razak Azeko

Gh/US/UK-RN. Msc. Gastroenterology.

A concerned public-health advocate

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