In Kenya, studies conducted in Eldoret area of Rift Valley region reveal a nine-fold risk of developing oesophageal cancer among individuals with moderate or severe dental fluorosis. Other risk factors include intake of traditional fermented milk (mursik) which is contaminated with ash. Dr Shaheen Sayed, consultant pathologist at the Aga Khan University Hospital, Nairobi explains that the large tumours sent to laboratories for cancer testing are an indicator that many patients delay visiting a doctor for treatment. She says late diagnosis of new cancers and failure to promptly spot recurrences among survivors contribute to many premature deaths.