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Grover S, Court L, Amoo-Mitchual S, Longo J, Rodin D, Scott AA, Lievens Y, Yap ML, Abdel-Wahab M, Lee P, Harsdorf E, Khader J, Jia X, Dosanjh M, Elzawawy A, Ige T, Pomper M, Pistenmaa D, Hardenbergh P, Petereit DG, Sargent M, Cina K, Li B, Anacak Y, Mayo C, Prattipati S, Lasebikan N, Rendle K, O'Brien D, Wendling E, Coleman CN. Global Workforce and Access: Demand, Education, Quality. Semin Radiat Oncol 2024; 34:477-493. [PMID: 39271284 DOI: 10.1016/j.semradonc.2024.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
There has long existed a substantial disparity in access to radiotherapy globally. This issue has only been exacerbated as the growing disparity of cancer incidence between high-income countries (HIC) and low and middle-income countries (LMICs) widens, with a pronounced increase in cancer cases in LMICs. Even within HICs, iniquities within local communities may lead to a lack of access to care. Due to these trends, it is imperative to find solutions to narrow global disparities. This requires the engagement of a diverse cohort of stakeholders, including working professionals, non-governmental organizations, nonprofits, professional societies, academic and training institutions, and industry. This review brings together a diverse group of experts to highlight critical areas that could help reduce the current global disparities in radiation oncology. Advancements in technology and treatment, such as artificial intelligence, brachytherapy, hypofractionation, and digital networks, in combination with implementation science and novel funding mechanisms, offer means for increasing access to care and education globally. Common themes across sections reveal how utilizing these new innovations and strengthening collaborative efforts among stakeholders can help improve access to care globally while setting the framework for the next generation of innovations.
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Affiliation(s)
- Surbhi Grover
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Botswana-University of Pennsylvania Partnership, Gaborone, Botswana.
| | - Laurence Court
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center
| | - Sheldon Amoo-Mitchual
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John Longo
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Danielle Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Global Cancer Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital, Belgium; Ghent University, Ghent, Belgium
| | - Mei Ling Yap
- Liverpool and Macarthur Cancer Therapy Centres, Western Sydney University, Campbelltown, New South Wales, Australia; The George Institute for Global Health, UNSW Sydney, Barangaroo, NSW, Australia; Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute, UNSW Sydney, Liverpool, NSW, Australia
| | - May Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Peter Lee
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Ekaterina Harsdorf
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamal Khader
- Radiation Oncology Department, King Hussein Cancer Center, Amman, Jordan
| | - Xun Jia
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD
| | - Manjit Dosanjh
- ICEC, CERN, Geneva, Switzerland; University of Oxford, Oxford, UK
| | - Ahmed Elzawawy
- Department of Clinical Oncology, Suez Canal University, Ismailia, Egypt; Alsoliman Clinical and Radiation Oncology Center, Port Said, Egypt
| | | | - Miles Pomper
- James Martin Center for Nonproliferation Studies, Washington, DC; ICEC, International Cancer Expert Corps, Washington, DC
| | | | | | - Daniel G Petereit
- Monument Health Cancer Care Institute Rapid City, South Dakota; Avera Research Institute, Sioux Falls, SD
| | | | | | - Benjamin Li
- University of Washington, Seattle, WA; Fred Hutch Cancer Center, Seattle, WA
| | - Yavuz Anacak
- Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Chuck Mayo
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | | | - Nwamaka Lasebikan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Katharine Rendle
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Donna O'Brien
- ICEC, International Cancer Expert Corps, Washington, DC
| | | | - C Norman Coleman
- ICEC, International Cancer Expert Corps, Washington, DC; Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Ortiz AP, Hospedales CJ, Méndez-Lázaro PA, Hamilton WM, Rolle LD, Shepherd JM, Espinel Z, Gay HA, Nogueira LM, Shultz JM. Protecting Caribbean patients diagnosed with cancer from compounding disasters. Lancet Oncol 2024; 25:e217-e224. [PMID: 38697167 DOI: 10.1016/s1470-2045(24)00071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 05/04/2024]
Abstract
Caribbean small island developing states are becoming increasingly vulnerable to compounding disasters, prominently featuring climate-related hazards and pandemic diseases, which exacerbate existing barriers to cancer control in the region. We describe the complexities of cancer prevention and control efforts throughout the Caribbean small island developing states, including the unique challenges of people diagnosed with cancer in the region. We highlight potential solutions and strategies that concurrently address disaster adaptation and cancer control. Because Caribbean small island developing states are affected first and worst by the hazards of compounding disasters, the innovative solutions developed in the region are relevant for climate mitigation, disaster adaptation, and cancer control efforts globally. In the age of complex and cascading disaster scenarios, developing strategies to mitigate their effect on the cancer control continuum, and protecting the health and safety of people diagnosed with cancer from extreme events become increasingly urgent. The equitable development of such strategies relies on collaborative efforts among professionals whose diverse expertise from complementary fields infuses the local community perspective while focusing on implementing solutions.
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Affiliation(s)
- Ana Patricia Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico; Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - C James Hospedales
- EarthMedic and EarthNurse Foundation for Planetary Health, Port of Spain, Trinidad and Tobago; Defeat-NCD Partnership Executive Committee Climate and Health, Healthy Caribbean Coalition, Geneva, Switzerland
| | - Pablo A Méndez-Lázaro
- Environmental Health Department, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | | | - LaShae D Rolle
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J Marshall Shepherd
- Institute for Resilient Infrastructure Systems, Department of Geography, University of Georgia, Athens, GA, USA
| | - Zelde Espinel
- Department of Psychiatry and Behavioral Sciences, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hiram A Gay
- Department of Radiation Oncology, School of Medicine, Washington University in St Louis, Saint Louis, MO, USA
| | | | - James M Shultz
- Protect & Promote Population Health in Complex Crises, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
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Buteau AC, Castelo-Loureiro A, Barragan-Carrillo R, Bejarano S, Kihn-Alarcón AJ, Soto-Perez-de-Celis E. Disparities in Cancer Control in Central America and the Caribbean. Hematol Oncol Clin North Am 2024; 38:35-53. [PMID: 37597998 DOI: 10.1016/j.hoc.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
Central America and the Caribbean is a highly heterogeneous region comprising more than 30 countries and territories with more than 200 million inhabitants. Although recent advances in the region have improved access to cancer care, there are still many disparities and barriers for obtaining high-quality cancer treatments, particularly for those from disadvantaged populations, immigrants, and rural areas. In this article, we provide an overview of cancer care in Central America and the Caribbean, with selected examples of issues related to disparities in access to care and suggest solutions and strategies to move forward.
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Affiliation(s)
| | - Alicia Castelo-Loureiro
- Medical Oncology Division, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041, Madrid, Spain
| | - Regina Barragan-Carrillo
- Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Vasco de Quiroga 15, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Suyapa Bejarano
- Excelmedica, Liga Contra el Cancer Honduras, Condominios Médicos del Valle I Apt 318, San Pedro Sula, Honduras
| | - Alba J Kihn-Alarcón
- Research Department, Liga Nacional Contra el Cáncer & Instituto de Cancerología, 6a Avenida 6-58, Cdad. de Guatemala 01011, Guatemala
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, Mexico City, Mexico.
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Reece-Mills M, Bodkyn C, Baxter JAB, Allen U, Alexis C, Browne-Farmer C, Craig J, de Young S, Denburg A, Dindial K, Fleming-Carroll B, Gibson T, Gupta S, Knight-Madden J, Manley-Kucey M, Mclean-Salmon S, Ocho ON, Orrigio K, Read S, Sin Quee C, Smith B, Thame M, Wharfe G, Whitlock JA, Zlotkin S, Blanchette V. Developing a partnership to improve health care delivery to children <18 years with cancer and blood disorders in the English-speaking Caribbean: lessons from the SickKids-Caribbean Initiative (SCI). LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100592. [PMID: 37727865 PMCID: PMC10506063 DOI: 10.1016/j.lana.2023.100592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/29/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
In 2013, the SickKids-Caribbean Initiative (SCI) was formalised among The Hospital for Sick Children in Toronto, Canada, the University of the West Indies, and Ministries of Health in six Caribbean countries (Barbados, The Bahamas, Jamaica, St. Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago). The aim was to improve the outcomes and quality of life of children (<18 years) with cancer and blood disorders in the partner countries. Core activities included filling a human resource gap by training paediatric haematologists/oncologists and specialised registered nurses; improving capacity to diagnose and treat diverse haematology/oncology cases; developing and maintaining paediatric oncology databases; creating ongoing advocacy activities with international agencies, decision makers, and civil society; and establishing an integrated administration, management, and funding structure. We describe core program components, successes, and challenges to inform others seeking to improve health service delivery in a multidisciplinary and complex partnership.
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Affiliation(s)
- Michelle Reece-Mills
- Faculty of Medical Sciences, Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Curt Bodkyn
- Department of Clinical Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Jo-Anna B. Baxter
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Upton Allen
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, Canada
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | - Cheryl Alexis
- Haematology/Oncology Department, Queen Elizabeth Hospital, Bridgetown, Barbados
| | | | - Jenna Craig
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Stephanie de Young
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Avram Denburg
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | - Kevon Dindial
- Department of Paediatrics, Eric Williams Medical Sciences Complex, San Juan, Trinidad and Tobago
| | - Bonnie Fleming-Carroll
- Learning Institute, Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Tracey Gibson
- Department of Pathology, The University of the West Indies, Mona, Jamaica
| | - Sumit Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Jennifer Knight-Madden
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | | | | | - Oscar Noel Ocho
- Faculty of Medical Sciences, School of Nursing, The University of the West Indies, St. Augustine, Trinidad and Tobago
- PAHO/WHO Collaborating Centre for Nursing and Midwifery Development in the Caribbean, School of Nursing, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Kadine Orrigio
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Stanley Read
- Division of Infectious Diseases, Hospital for Sick Children, Toronto, Canada
| | - Corrine Sin Quee
- School of Clinical Medicine and Research, The University of the West Indies, Nassau, The Bahamas
| | - Brian Smith
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Minerva Thame
- Faculty of Medical Sciences, Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Gilian Wharfe
- Department of Haematology/Oncology, The University of the West Indies, Kingston, Jamaica
| | - James A. Whitlock
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Stanley Zlotkin
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Victor Blanchette
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
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Narine D, Yamashita T, Mair CA. An Intersectional Approach to Examining Breast Cancer Screening among Subpopulations of Black Women in the United States. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01781-5. [PMID: 37702971 DOI: 10.1007/s40615-023-01781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
This study examines breast cancer screening behavior among subpopulations of Black women in the United States. Binary logistic regression was used to analyze breast cancer screening among a nationally-representative sample (n = 9,783) of Black women-US-born, non-US-born Caribbean, and non-US-born African-from the 2011-2017 National Health Interview Survey dataset. Non-US-born African Black women were less likely to have breast cancer screening, compared to US-born Black women. Among non-US-born Black women, non-US-born Caribbean Black women were more likely to have had breast cancer screening. Differential healthcare access associated with nativity differences among Black women can be informing their breast cancer screening behaviors. Efforts to improve breast cancer outcomes among Black women can benefit from interventions that account for differential access to healthcare and breast cancer screening behaviors among subgroups of Black women.
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Affiliation(s)
- Donnette Narine
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA.
- Gerontology Doctoral Program, University of Maryland Baltimore County, Baltimore, MD, USA.
| | - Takashi Yamashita
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA
- Gerontology Doctoral Program, University of Maryland Baltimore County, Baltimore, MD, USA
| | - Christine A Mair
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA
- Center for Health, Equity, and Aging, University of Maryland Baltimore County, Baltimore, MD, USA
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Elbanna M, Pynda Y, Kalinchuk O, Rosa A, Abdel-Wahab M. Radiotherapy resources in Latin America and the Caribbean: a review of current and projected needs based on International Atomic Energy Agency data. Lancet Oncol 2023; 24:e376-e384. [PMID: 37657478 DOI: 10.1016/s1470-2045(23)00299-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 09/03/2023]
Abstract
The inequitable access to radiotherapy globally is a complex undertaking that will require sustained work identifying gaps and mobilising efforts to resolve. The purpose of this review is to identify gaps and needs in radiotherapy in Latin America and the Caribbean. Data from 41 countries in Latin America and the Caribbean on teletherapy megavoltage units and brachytherapy resources were extracted from the International Atomic Energy Agency (IAEA) Directory of Radiotherapy Centers. These data were then matched to open-source data from GLOBOCAN and World Bank Data which included data on population size, gross national income per capita, cancer incidence, and mortality. These data were matched to current and projected cancer incidence and mortality (as estimated by the Global Cancer Observatory in 2020) to calculate current and projected gaps in external beam radiotherapy facilities. For brachytherapy, the analysis was focused on cervical cancer and included high dose rate and low dose rate machines. As of Oct 22, 2022, external beam radiotherapy was available in 32 (78%) of 41 countries, representing 742 radiotherapy centres and 1122 megavoltage units. Average coverage was 63%. LINACs accounted for 85% (955 of 1122) of megavoltage units and Cobalt-60 capacity decreased to 12% compared with in 2018. Median megavoltage units per 1000 cancer cases were 0·8 (IQR 0·54-1·03). Most countries clustered in the same range of gross national income per capita for teletherapy units per 1000 cases at a median of US$9380. The current deficit in megavoltage units is estimated at 668 units and is projected to be 2455 units by 2030. 28 (68%) of 41 countries had 279 installed brachytherapy services, both high dose rate and low dose rate, which could treat 108 420 patients with cervical cancer per year and meet the current needs, albeit with inequitable distribution of resources. Overall, this review indicated a 15% improvement in the current external beam radiotherapy capacity in Latin America and the Caribbean compared with 2018. However, there is still a current shortage of at least 668 extra units. By 2030, the need for megavoltage units will be double the current capacity. There is inequitable distribution of brachytherapy resources across the region primarily in the Caribbean. Adoption of hypofractionation can help overcome machine shortage; however, it will present technical challenges that need to be taken into account. Rays of Hope, is a novel IAEA initiative that is designed to mobilise global efforts to address radiotherapy gaps while ensuring the highest return on investment.
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Affiliation(s)
- May Elbanna
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, USA; Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Yaroslav Pynda
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Oleksandr Kalinchuk
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Arthur Rosa
- Department of Radiation Oncology, Oncoclinicas Salvador and Hospital Santa Izabel, Salvador, BA, Brazil
| | - May Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
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Wilson BE, Sullivan R, Peto R, Abubakar B, Booth C, Werutsky G, Adams C, Saint-Raymond A, Fleming TR, Lyerly K, Gralow JR. Global Cancer Drug Development-A Report From the 2022 Accelerating Anticancer Agent Development and Validation Meeting. JCO Glob Oncol 2023; 9:e2300294. [PMID: 37944089 PMCID: PMC10645408 DOI: 10.1200/go.23.00294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/18/2023] [Indexed: 11/12/2023] Open
Abstract
Rapidly expanding systemic treatment options, combined with improved screening, diagnostic, surgical, and radiotherapy techniques, have led to improved survival outcomes for many cancers over time. However, these overall survival gains have disproportionately benefited patients in high-income countries, whereas patients in low- and middle-income countries (LMICs) continue to experience challenges in accessing timely and guideline concordant care. In September 2022, the Accelerating Anticancer Agent Development and Validation workshop was held, focusing on global cancer drug development. Panelists discussed key barriers such as the lack of diagnostic services and human resources, drug accessibility and affordability, lack of research infrastructure, and regulatory and authorization challenges, with a particular focus on Africa and Latin America. Potential opportunities to improve access and affordability were reviewed, such as the importance of prioritizing investments in diagnostics, investing health infrastructure and work force planning, coordinated drug procurement efforts and streamlined regulatory processing, incentivized pricing through regulatory change, and the importance of developing and promoting clinical trials that can answer relevant clinical questions for patients in LMICs. As a cancer community, we must continue to advocate for and work toward equitable access to high-quality interventions for patients, regardless of their geographical location.
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Affiliation(s)
- Brooke E. Wilson
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
- Department of Oncology, Queen's University, Kingston, Canada
| | - Richard Sullivan
- Institute of Cancer Policy, King's College London, London, United Kingdom
- Department of Oncology, Guy's & St Thomas' NHS Trust, London, United Kingdom
| | - Richard Peto
- Department of Medical Statistics and Epidemiology, University of Oxford, Oxford, United Kingdom
| | - Bello Abubakar
- Department of Radiotherapy and Oncology, National Hospital Abuja, Abuja, Nigeria
| | - Christopher Booth
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
- Department of Oncology, Queen's University, Kingston, Canada
| | - Gustavo Werutsky
- Department of Medical Oncology, Hospital São Lucas, Porto Alegre, Brazil
| | - Cary Adams
- Union for International Cancer Control, Geneva, Switzerland
| | - Agnes Saint-Raymond
- International Affairs Division, European Medicines Agency, Amsterdam, the Netherlands
| | | | - Kim Lyerly
- Departments of Surgery, Pathology, and Immunology, Duke University School of Medicine, Durham, NC
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Chidebe RCW, Leibel LL, Orjiakor TC, Shrestha A, Agha AA, Altinok Dindar D, Kisakol B, Ipiankama SC, Okoye IJ, Mason M, Auguste A, Esiaka DK. Promoting cancer prevention through World Cancer Day in Nigeria. Lancet Oncol 2023; 24:319-322. [PMID: 36990607 DOI: 10.1016/s1470-2045(22)00692-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 03/29/2023]
Affiliation(s)
- Runcie C W Chidebe
- Project PINK BLUE, Health & Psychological Trust Centre, Abuja 900108, Nigeria; Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA.
| | - L Leigh Leibel
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Tochukwu C Orjiakor
- Project PINK BLUE, Health & Psychological Trust Centre, Abuja 900108, Nigeria; Department of Psychology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Ashish Shrestha
- Project PINK BLUE, Health & Psychological Trust Centre, Abuja 900108, Nigeria; BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Agha A Agha
- Department of Social Work, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Duygu Altinok Dindar
- Cancer Early Detection Advanced Research Center, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Batuhan Kisakol
- Center for Systems Medicine, Departments of Physiology and Medical Physics, Royal College of Surgeons, Dublin, Ireland
| | - Sampson C Ipiankama
- Project PINK BLUE, Health & Psychological Trust Centre, Abuja 900108, Nigeria
| | - Ifeoma J Okoye
- College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria; University of Nigeria Centre of Excellence for Clinical Trials, Enugu, Nigeria
| | - Malcolm Mason
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Aviane Auguste
- Vaughn Arthur Lewis Institute for Research and Innovation, Sir Arthur Lewis Community College, Castries, Saint Lucia; Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, Villejuif, France
| | - Darlingtina K Esiaka
- Project PINK BLUE, Health & Psychological Trust Centre, Abuja 900108, Nigeria; Department of Family Medicine and Community Health, Rutgers University, new Brunswick, NJ, USA
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A Comparison of the Celiacomesenteric Trunk in the Caribbean with Global Prevalence Calculated by a Systematic Review. Radiol Res Pract 2022; 2022:1715631. [PMID: 36267126 PMCID: PMC9578919 DOI: 10.1155/2022/1715631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Typically, the celiac trunk and superior mesenteric artery branch off separately from the anterior aspect of the abdominal aorta. The celiacomesenteric trunk (CMT) is a rare variant in which those arteries share a common origin. We sought to compare the prevalence of CMT in the Caribbean with the global prevalence as calculated by a systematic review. Methods In this study, we evaluated all consecutive patients who had multiphase contrast-enhanced CT scans at two major referral centres in the Caribbean from August 30, 2017, to September 1, 2019. In patients with a CMT, we recorded demographic and anatomic details. We then conducted a systematic literature search and retrieved raw data to calculate the global prevalence (number of individuals with a CMT divided by the sum total of study samples). We compared CMT prevalence in our sample with the global prevalence using Pearson's chi-square and Fisher's exact tests. Statistical significance was considered to be present when the P value was <0.05. Results From 832 CTs, 665 scans met the inclusion criteria. There were 16 (2.41%) CMTs: 3 (0.45%) classic CMTs, 12 (1.8%) hepato-mesenteric trunks, and 1 (0.15%) hepato-spleno-mesenteric trunk. Forty-two studies reported on CMTs in a total of 74,320 persons. The global CMT prevalence was comparable (3.88%; P = 0.054), but the incidence of hepato-mesenteric variants was significantly lower in our sample (1.8% vs. 3.24%; P = 0.0352). Conclusion There was no difference in the prevalence of a classic CMT in the Caribbean compared to the global prevalence. However, the hepato-mesenteric trunk (incomplete CMT variant) was significantly less prevalent in the Caribbean. Advances in Knowledge: Healthcare professionals performing hepatobiliary interventions must be aware of these differences in order to minimize morbidity during their interventions.
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Gallagher BD, Coughlin EC, Nair-Shalliker V, McCaffery K, Smith DP. Socioeconomic differences in prostate cancer treatment: A systematic review and meta-analysis. Cancer Epidemiol 2022; 79:102164. [DOI: 10.1016/j.canep.2022.102164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/18/2022] [Accepted: 04/16/2022] [Indexed: 11/02/2022]
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Hercules SM, Liu X, Bassey-Archibong BBI, Skeete DHA, Smith Connell S, Daramola A, Banjo AA, Ebughe G, Agan T, Ekanem IO, Udosen J, Obiorah C, Ojule AC, Misauno MA, Dauda AM, Egbujo EC, Hercules JC, Ansari A, Brain I, MacColl C, Xu Y, Jin Y, Chang S, Carpten JD, Bédard A, Pond GR, Blenman KRM, Manojlovic Z, Daniel JM. Analysis of the genomic landscapes of Barbadian and Nigerian women with triple negative breast cancer. Cancer Causes Control 2022; 33:831-841. [PMID: 35384527 PMCID: PMC9085672 DOI: 10.1007/s10552-022-01574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/12/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE Triple negative breast cancer (TNBC) is an aggressive breast cancer subtype that disproportionately affects women of African ancestry (WAA) and is often associated with poor survival. Although there is a high prevalence of TNBC across West Africa and in women of the African diaspora, there has been no comprehensive genomics study to investigate the mutational profile of ancestrally related women across the Caribbean and West Africa. METHODS This multisite cross-sectional study used 31 formalin-fixed paraffin-embedded (FFPE) samples from Barbadian and Nigerian TNBC participants. High-resolution whole exome sequencing (WES) was performed on the Barbadian and Nigerian TNBC samples to identify their mutational profiles and comparisons were made to African American, European American and Asian American sequencing data obtained from The Cancer Genome Atlas (TCGA). Whole exome sequencing was conducted on tumors with an average of 382 × coverage and 4335 × coverage for pooled germline non-tumor samples. RESULTS Variants detected at high frequency in our WAA cohorts were found in the following genes NBPF12, PLIN4, TP53 and BRCA1. In the TCGA TNBC cases, these genes had a lower mutation rate, except for TP53 (32% in our cohort; 63% in TCGA-African American; 67% in TCGA-European American; 63% in TCGA-Asian). For all altered genes, there were no differences in frequency of mutations between WAA TNBC groups including the TCGA-African American cohort. For copy number variants, high frequency alterations were observed in PIK3CA, TP53, FGFR2 and HIF1AN genes. CONCLUSION This study provides novel insights into the underlying genomic alterations in WAA TNBC samples and shines light on the importance of inclusion of under-represented populations in cancer genomics and biomarker studies.
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Affiliation(s)
- Shawn M. Hercules
- grid.25073.330000 0004 1936 8227Department of Biology, McMaster University, Hamilton, ON Canada
- African Caribbean Cancer Consortium, Philadelphia, PA USA
| | - Xiyu Liu
- grid.42505.360000 0001 2156 6853Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | | | - Desiree H. A. Skeete
- African Caribbean Cancer Consortium, Philadelphia, PA USA
- grid.412886.10000 0004 0592 769XFaculty of Medical Sciences, University of the West Indies at Cave Hill, Bridgetown, Barbados
- grid.415521.60000 0004 0570 5165Department of Pathology, Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Suzanne Smith Connell
- grid.412886.10000 0004 0592 769XFaculty of Medical Sciences, University of the West Indies at Cave Hill, Bridgetown, Barbados
- grid.415521.60000 0004 0570 5165Department of Radiation Oncology, Queen Elizabeth Hospital, Bridgetown, Barbados
- Present Address: Cancer Specialists Inc, Bridgetown, Barbados
| | - Adetola Daramola
- grid.411283.d0000 0000 8668 7085Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adekunbiola A. Banjo
- grid.411283.d0000 0000 8668 7085Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Godwin Ebughe
- grid.413097.80000 0001 0291 6387Department of Pathology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Thomas Agan
- grid.413097.80000 0001 0291 6387Department of Obstetrics & Gynaecology, College of Medical Sciences, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Ima-Obong Ekanem
- grid.413097.80000 0001 0291 6387Department of Pathology, College of Medical Sciences, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Joe Udosen
- grid.413097.80000 0001 0291 6387Division of General and Breast Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Christopher Obiorah
- grid.412738.bDepartment of Anatomical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Aaron C. Ojule
- grid.412738.bDepartment of Chemical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Michael A. Misauno
- grid.411946.f0000 0004 1783 4052Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Ayuba M. Dauda
- grid.411946.f0000 0004 1783 4052Department of Pathology, Jos University Teaching Hospital, Jos, Nigeria
| | | | - Jevon C. Hercules
- grid.12916.3d0000 0001 2322 4996Department of Mathematics, University of the West Indies at Mona, Kingston, Jamaica
- grid.12955.3a0000 0001 2264 7233Present Address: Wang Yanan Institute for Studies in Economics, Xiamen University, Xiamen, China
| | - Amna Ansari
- grid.25073.330000 0004 1936 8227Department of Biology, McMaster University, Hamilton, ON Canada
| | - Ian Brain
- grid.25073.330000 0004 1936 8227Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON Canada
| | - Christine MacColl
- grid.25073.330000 0004 1936 8227Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON Canada
| | - Yili Xu
- grid.42505.360000 0001 2156 6853Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Yuxin Jin
- grid.42505.360000 0001 2156 6853Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Sharon Chang
- grid.42505.360000 0001 2156 6853Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - John D. Carpten
- grid.42505.360000 0001 2156 6853Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - André Bédard
- grid.25073.330000 0004 1936 8227Department of Biology, McMaster University, Hamilton, ON Canada
| | - Greg R. Pond
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- grid.25073.330000 0004 1936 8227Department of Oncology, McMaster University, Hamilton, ON Canada
| | - Kim R. M. Blenman
- grid.433818.5Department of Internal Medicine, Section of Medical Oncology, Yale Cancer Center, School of Medicine, New Haven, CT USA
- grid.47100.320000000419368710Department of Computer Science, School of Engineering and Applied Science, Yale University, New Haven, CT USA
| | - Zarko Manojlovic
- grid.42505.360000 0001 2156 6853Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Juliet M. Daniel
- grid.25073.330000 0004 1936 8227Department of Biology, McMaster University, Hamilton, ON Canada
- African Caribbean Cancer Consortium, Philadelphia, PA USA
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12
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Khandwala YS, Ohanian A, Huang FW. Prostate Cancer in the Caribbean: A Baseline Assessment of Current Practices and Potential Needs. Cancer Control 2022. [PMCID: PMC8961354 DOI: 10.1177/10732748221082372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Afro-Caribbean men have a higher risk of prostate cancer than any other population of men
in the world. However, the Caribbean is composed of a heterogenous group of healthcare
systems located on small islands which makes population-based studies difficult to conduct
and interpret. The aim of this review is to compile previously published data on the state
of prostate cancer in Caribbean men and to highlight potential healthcare needs that can
be addressed by public health efforts. We reviewed three databases and identified relevant
papers that were subsequently searched by the authors. Peer-reviewed studies published in
the English language after 2010 with a focus on prostate cancer diagnosis, management, and
outcomes of Caribbean men were prioritized. Afro-Caribbean men were found to have a higher
incidence and mortality rate compared to their counterparts. Misperception about the
disease, lack of regional guidelines, and poor access to care are compounding factors that
result in worse outcomes for these men compared to high-income nations. Urologists and
oncologists in the region, while well-trained, are limited in number and in most cases do
not offer newer treatment modalities. Overall, only a few island nations have cancer
registries, and there remains a significant need for more population-based studies to
assess guideline adherence and outcomes. Until further research and investment in the
region is made, the disparity between the care received by Afro-Caribbean men and their
counterparts will likely remain.
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Affiliation(s)
- Yash S Khandwala
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Alec Ohanian
- Division of Hematology and Oncology, University of California, San Francisco, CA, USA
| | - Franklin W Huang
- Division of Hematology and Oncology, University of California, San Francisco, CA, USA
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13
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Auguste A, Gathere S, Pinheiro PS, Adebamowo C, Akintola A, Alleyne-Mike K, Anderson SG, Ashing K, Awittor FK, Awuah B, Bhakkan B, Deloumeaux J, du Plessis M, Ekanem IOA, Ekanem U, Ezeome E, Felix N, Gachii AK, Gaete S, Gibson T, Hage R, Harrison S, Igbinoba F, Iseh K, Kiptanui E, Korir A, Lawson-Myers HD, Llanos A, Luce D, McNaughton D, Odutola M, Omonisi A, Otu T, Peruvien J, Raheem N, Roach V, Sobers N, Uamburu N, Ragin C. Heterogeneity in head and neck cancer incidence among black populations from Africa, the Caribbean and the USA: Analysis of cancer registry data by the AC3. Cancer Epidemiol 2021; 75:102053. [PMID: 34743058 PMCID: PMC8627451 DOI: 10.1016/j.canep.2021.102053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/12/2021] [Accepted: 10/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Africa and the Caribbean are projected to have greater increases in Head and neck cancer (HNC) burden in comparison to North America and Europe. The knowledge needed to reinforce prevention in these populations is limited. We compared for the first time, incidence rates of HNC in black populations from African, the Caribbean and USA. METHODS Annual age-standardized incidence rates (IR) and 95% confidence intervals (95%CI) per 100,000 were calculated for 2013-2015 using population-based cancer registry data for 14,911 HNC cases from the Caribbean (Barbados, Guadeloupe, Trinidad & Tobago, N = 443), Africa (Kenya, Nigeria, N = 772) and the United States (SEER, Florida, N = 13,696). We compared rates by sub-sites and sex among countries using data from registries with high quality and completeness. RESULTS In 2013-2015, compared to other countries, HNC incidence was highest among SEER states (IR: 18.2, 95%CI = 17.6-18.8) among men, and highest in Kenya (IR: 7.5, 95%CI = 6.3-8.7) among women. Nasopharyngeal cancer IR was higher in Kenya for men (IR: 3.1, 95%CI = 2.5-3.7) and women (IR: 1.5, 95%CI = 1.0-1.9). Female oral cavity cancer was also notably higher in Kenya (IR = 3.9, 95%CI = 3.0-4.9). Blacks from SEER states had higher incidence of laryngeal cancer (IR: 5.5, 95%CI = 5.2-5.8) compared to other countries and even Florida blacks (IR: 4.4, 95%CI = 3.9-5.0). CONCLUSION We found heterogeneity in IRs for HNC among these diverse black populations; notably, Kenya which had distinctively higher incidence of nasopharyngeal and female oral cavity cancer. Targeted etiological investigations are warranted considering the low consumption of tobacco and alcohol among Kenyan women. Overall, our findings suggest that behavioral and environmental factors are more important determinants of HNC than race.
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Affiliation(s)
- Aviane Auguste
- Guadeloupe Cancer Registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France; African Caribbean Cancer Consortium USA.
| | - Samuel Gathere
- The National Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya; African Caribbean Cancer Consortium USA
| | - Paulo S Pinheiro
- University of Miami, Sylvester Comprehensive Cancer Center, FL, USA; African Caribbean Cancer Consortium USA
| | - Clement Adebamowo
- Department of Epidemiology and Public Health and the Institute of Human Virology, The Marlene and Stewart Greenebaum Comprehensive Cancer Centre, University of Maryland School of Medicine, Baltimore, MD, USA; Center for Bioethics and Research, Ibadan, Nigeria; Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria
| | - Adeola Akintola
- Center for Bioethics and Research, Ibadan, Nigeria; Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria
| | - Kellie Alleyne-Mike
- Cancer Centre of Trinidad and Tobago, St. James, Trinidad and Tobago; African Caribbean Cancer Consortium USA
| | - Simon G Anderson
- Barbados National Registry, The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Cave Hill, Barbados; African Caribbean Cancer Consortium USA
| | - Kimlin Ashing
- City of Hope Cancer Center, Duarte, CA, USA; African Caribbean Cancer Consortium USA
| | | | - Baffour Awuah
- Kumasi Cancer Registry, Komfo Anokye Teaching Hospital, Kumasi, Ghana; African Caribbean Cancer Consortium USA
| | - Bernard Bhakkan
- Guadeloupe Cancer Registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France; African Caribbean Cancer Consortium USA
| | - Jacqueline Deloumeaux
- Guadeloupe Cancer Registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France; Biological Resource Center Karubiotec™, BRIF n° KARUBIOTEC-GUA-00971, Pointe-à-Pitre, Guadeloupe; African Caribbean Cancer Consortium USA
| | - Maira du Plessis
- Department of Anatomical Sciences, St Georges University, Grenada, West Indies; African Caribbean Cancer Consortium USA
| | - Ima-Obong A Ekanem
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Calabar Cancer Registry, Department of Pathology, College of Medical Sciences, University of Calabar and Teaching Hospital, Calabar, Nigeria
| | - Uwemedimbuk Ekanem
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Department of Community Health, Faculty of Clinical Sciences, College of Health Sciences, University of Uyo/University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Emmanuel Ezeome
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Enugu Cancer Registry, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Nkese Felix
- Dr. Elizabeth Quamina Cancer Registry, the National Cancer Registry of Trinidad and Tobago, Mount Hope, Trinidad and Tobago
| | - Andrew K Gachii
- Department of Lab Medicine, Kenyatta National Hospital, Nairobi, Kenya; African Caribbean Cancer Consortium USA
| | - Stanie Gaete
- Biological Resource Center Karubiotec™, BRIF n° KARUBIOTEC-GUA-00971, Pointe-à-Pitre, Guadeloupe; African Caribbean Cancer Consortium USA
| | - Tracey Gibson
- Jamaica Cancer Registry, Department of Pathology, University of the West Indies, Kingston, Jamaica; African Caribbean Cancer Consortium USA
| | - Robert Hage
- Department of Anatomical Sciences, St Georges University, Grenada, West Indies; African Caribbean Cancer Consortium USA
| | - Sharon Harrison
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA; African Caribbean Cancer Consortium USA
| | - Festus Igbinoba
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; National Hospital Abuja, Abuja, Nigeria
| | - Kufre Iseh
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Department of Otorhinolaryngology/Head &Neck Surgery, Faculty of Clinical sciences, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; Population Based Cancer Registry, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Evans Kiptanui
- The National Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ann Korir
- The National Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya; African Caribbean Cancer Consortium USA
| | - Heather-Dawn Lawson-Myers
- Liguanea Family Dental Centre, Seymour Park, Kingston, Jamaica; African Caribbean Cancer Consortium USA
| | - Adana Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, USA; African Caribbean Cancer Consortium USA
| | - Daniele Luce
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, Guadeloupe, France; African Caribbean Cancer Consortium USA
| | - Dawn McNaughton
- Jamaica Cancer Registry, Department of Pathology, University of the West Indies, Kingston, Jamaica; African Caribbean Cancer Consortium USA
| | - Michael Odutola
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Center for Big Data Research in Health, University of New South Wales, Sydney, Australia; African Caribbean Cancer Consortium USA
| | - Abidemi Omonisi
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Department of Anatomic Pathology, Ekiti State University and Teaching Hospital, Ado-Ekiti, Nigeria
| | - Theresa Otu
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Abuja Cancer Registry, Department of Haematology and Blood Transfusion, University of Abuja Teaching Hospital, Gawgwalada, Nigeria
| | - Jessica Peruvien
- Guadeloupe Cancer Registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Nasiru Raheem
- Nigerian National System of Cancer Registries, Federal Ministry of Health, Abuja, Nigeria; Department of Pathology, Federal Medical Centre, Yola, Nigeria
| | | | - Natasha Sobers
- Barbados National Registry, The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Cave Hill, Barbados; African Caribbean Cancer Consortium USA
| | - Nguundja Uamburu
- Dental Department, Katutura State Hospital, Windhoek, Namibia; African Caribbean Cancer Consortium USA
| | - Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA; African Caribbean Cancer Consortium USA
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Samaroo K, Hosein A, Olivier LK, Ali J. Breast Cancer in the Caribbean. Cureus 2021; 13:e17042. [PMID: 34522520 PMCID: PMC8428164 DOI: 10.7759/cureus.17042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 11/22/2022] Open
Abstract
Breast cancer (BC) is one of the leading causes of death among women globally. In the Caribbean, there is a higher mortality rate compared with North American and European countries which have higher incidence rates. We conducted a literature review to examine the BC dynamic in the Caribbean and determine the areas where further investigations are needed. The PubMed database was used for identifying relevant studies using a combination of specific keyword searches. All studies focusing on BC within the defined Caribbean population were selected for this review. A total of 117 papers were included. The data were organized and presented under the following headings and reported according to the country where available: BC incidence and mortality, patient demographics, clinicopathology, genetics, behavioral risks, diagnosis and treatment, and BC control. Our review uncovered major variability in the incidence, management, etiology, and mortality of BC among Caribbean countries. Low-resource countries are burdened by more advanced disease with expected poorer BC outcomes (i.e., shorter periods of disease-free survival). Countries with established national cancer registries seem to have a better approach to the management of BC. The introduction of cancer treatment programs in association with international nonprofit groups has shown tremendous improvement in quality, accessible cancer care for patients, particularly in low- and middle-income settings. BC research is relatively limited in the Caribbean, lacking in both scope and consistency. The unique Caribbean BC population of diverse ethnicities, environmental influence, immigrants, socioeconomic status, and sociocultural practices allows an optimal opportunity for epidemiological investigations that can provide deeper insights into the status of BC.
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Affiliation(s)
- Kristy Samaroo
- Biomedical Engineering, The University of Trinidad & Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad & Tobago, Port of Spain, TTO
| | - Lyronne K Olivier
- General Surgeon/Breast Surgical Oncologist, Sangre Grande General Hospital, Port of Spain, TTO
| | - Jameel Ali
- Surgery, University of Toronto, Toronto, CAN
- Breast Unit, St. James Medical Complex, Port of Spain, TTO
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15
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Anglade F, Milner DA, Brock JE. Can pathology diagnostic services for cancer be stratified and serve global health? Cancer 2021; 126 Suppl 10:2431-2438. [PMID: 32348564 DOI: 10.1002/cncr.32872] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/06/2020] [Accepted: 03/11/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Before initiating cancer therapy, a diagnostic tumor tissue sample evaluated within a pathology laboratory by a pathologist is essential to confirm the malignancy type and provide key prognostic factors that direct the treatment offered. METHODS Pathology evaluation includes multiple expensive reagents, complex equipment, and both laboratory and pathologist technical skills. By using breast cancer as an example, at a minimum, key tumor prognostic information required before the initiation of treatment includes subtype, tumor grade, tumor size, lymph node status when possible, and biomarker expression determined by immunohistochemistry for estrogen receptor. The additional determination of biomarker expression of progesterone receptor and human epidermal growth factor receptor (HER2) is the standard of care in high-resource settings, but assays may not be affordable in low-income and middle-income countries. RESULTS With positive tests, patients are eligible for either tamoxifen (for estrogen receptor-positive/progesterone receptor-positive cancers) or monoclonal antibody therapy (for HER2-positive cancers). For settings in which endocrine therapy and/or HER2-targeted therapy is unavailable, biomarker studies have no utility, and high-resource setting standards for pathology evaluation and reporting are unachievable. Resource-stratified pathology evaluation guidelines in cancer diagnosis have not been developed, in contrast to excellent comprehensive, resource-stratified clinical guidelines for use in low-income and middle-income countries, and these are long overdue. CONCLUSIONS The challenges of pathology evaluation in the context of global health are being met by innovative solutions, which may change the face of pathology practice.
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Affiliation(s)
- Fabienne Anglade
- Department of Pathology, Mirebalais Teaching Hospital, Mirebalais, Haiti
| | - Danny A Milner
- American Society for Clinical Pathology, Chicago, Illinois
| | - Jane E Brock
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
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16
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Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094770. [PMID: 33947123 PMCID: PMC8124473 DOI: 10.3390/ijerph18094770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Developing robust systems for cancer care delivery is essential to reduce the high cancer mortality in small island developing states (SIDS). Indigenous data are scarce, but community-based cancer research can inform care in SIDS where formal research capacity is lacking, and we describe the experiences of cancer survivors in Saint Lucia in accessing health services. Purposive and snowball sampling was used to constitute a sample of survivors for interviews. Subjects were interviewed with a questionnaire regarding socio-demographics, clinical characteristics, health services accessed (physicians, tests, treatment), and personal appraisal of experience. We recruited 50 survivors (13 men, 37 women). Only 52% of first presentations were with general practitioners. The mean turnaround for biopsy results in Saint Lucia was three times longer than overseas (p = 0.0013). Approximately half of survivors commenced treatment more than one month following diagnosis (median of 32 days, IQR 19-86 days), and 56% of survivors traveled out-of-country for treatment. Most survivors (60%) paid for care with family/friends support, followed by savings and medical insurance (38% each). In conclusion, cancer survivors in Saint Lucia are faced with complex circumstances, including access-to-care and health consequences. This study can guide future research, and possibly guide practice improvements in the near term.
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17
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Andall-Brereton G, Bromfield B, Smith S, Spence D. Cancer care in the Commonwealth Caribbean in COVID times. Lancet Oncol 2020; 21:1007-1009. [PMID: 32758457 PMCID: PMC7398666 DOI: 10.1016/s1470-2045(20)30395-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 11/21/2022]
Affiliation(s)
| | | | - Steven Smith
- Jamaica Cancer Care and Research Institute, Kingston, Jamaica
| | - Dingle Spence
- Jamaica Cancer Care and Research Institute, Kingston, Jamaica; Hope Institute Hospital, Kingston, Jamaica
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18
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Alleyne-Mike K, Sylvester P, Henderson-Suite V, Mohoyodeen T. Radiotherapy in the Caribbean: a spotlight on the human resource and equipment challenges among CARICOM nations. HUMAN RESOURCES FOR HEALTH 2020; 18:49. [PMID: 32680524 PMCID: PMC7367401 DOI: 10.1186/s12960-020-00489-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 07/07/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND There is limited data on access to radiotherapy services for CARICOM nations. METHODS This was a descriptive mixed-methods observational study which used data collected via survey from staff working in Radiation Oncology in 14 CARICOM countries. Benchmark recommendations from the International Atomic Energy Agency were compared to existing numbers. The Directory of Radiotherapy Centers, World Bank, and Global Cancer Observatory databases were all accessed to provide information on radiotherapy machines in the region, population statistics, and cancer incidence data respectively. Both population and cancer incidence-based analyses were undertaken to facilitate an exhaustive review. RESULTS Radiotherapy machines were present in only 50% of the countries. Brachytherapy services were performed in only six countries (42.9%). There were a total of 15 external beam machines, 22 radiation oncologists, 22 medical physicists, and 60 radiation therapists across all nations. Utilizing patient-based data, the requirement for machines, radiation oncologists, medical physicists, and radiation therapists was 40, 66, 44, and 106, respectively. Only four (28.6%) countries had sufficient radiation oncologists. Five (35.7%) countries had enough medical physicists and radiation therapists. Utilizing population-based data, the necessary number of machines, radiation oncologists, and medical physicists was 105, 186, and 96 respectively. Only one county (7.1%) had an adequate number of radiation oncologists. The number of medical physicists was sufficient in just three countries (21.4%). There were no International Atomic Energy Agency population guidelines for assessing radiation therapists. A lower economic index was associated with a larger patient/population to machine ratio. Consequentially, Haiti had the most significant challenge with staffing and equipment requirements, when compared to all other countries, regardless of the evaluative criteria. Depending on the mode of assessment, Haiti's individual needs accounted for 37.5% (patient-based) to 59.0% (population-based) of required machines, 40.1% (patient-based) to 59.7% (population-based) of needed radiation oncologists, 38.6% (patient-based) to 58.3% (population-based) of medical physicists, and 42.5% (patient-based) of radiation therapists. CONCLUSION There are severe deficiencies in radiotherapy services among CARICOM nations. Regardless of the method of comparative analysis, the current allocation of equipment and staffing scarcely meets 50% of regional requirements.
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Affiliation(s)
- Kellie Alleyne-Mike
- National Radiotherapy Centre, 112 Western Main Road, St. James, Port of Spain, Trinidad and Tobago.
| | - Pearse Sylvester
- National Radiotherapy Centre, 112 Western Main Road, St. James, Port of Spain, Trinidad and Tobago
| | - Vladimir Henderson-Suite
- National Radiotherapy Centre, 112 Western Main Road, St. James, Port of Spain, Trinidad and Tobago
| | - Thana Mohoyodeen
- Port of Spain General Hospital, 61 Charlotte Street, Port of Spain, Trinidad and Tobago
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19
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Reid S, Donaldson-Davis K, Willie-Tyndale D, Thompson C, Wharfe G, Gibson T, Eldemire-Shearer D, James K. Breast Cancer in Jamaica: Trends From 2010 to 2014-Is Mortality Increasing? JCO Glob Oncol 2020; 6:837-843. [PMID: 32552111 PMCID: PMC7328114 DOI: 10.1200/go.20.00022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study sought to provide a detailed analysis of breast cancer–specific mortality in Jamaica on the basis of reported deaths between 2010 and 2014. METHODS A cross-sectional study was done to analyze breast cancer–specific mortality data from the Registrar General’s Department, the statutory body responsible for registering all deaths across Jamaica. RESULTS A total of 1,634 breast cancer–related deaths were documented among Jamaican women between 2010 and 2014, which accounted for 24% of all female cancer deaths. The age-standardized breast cancer mortality rate increased from 21.8 per 100,000 in 2010 to 28 per 100,000 in 2014 for the total female population. The overall difference in breast cancer mortality rates between the 2014 and 2010 rates was not statistically significant (P = .114). Analysis of the year-by-year trend reflected by the annual percentage of change did show, however, a statistically significant increasing trend in breast cancer mortality (P = .028). Mortality rates varied by age, with statistically significant annual increases observed in the 35-44–, 65-74–, and ≥ 75-year age groups (P = .04, .03, and .01, respectively). CONCLUSION Breast cancer remains the leading cause of cancer-related death among Jamaican women. Despite global advances in breast cancer screening and management, breast cancer remains a major public health challenge and represents a public health priority in Jamaica. The increasing breast cancer–specific mortality in Jamaica over the 5-year period contrasts with decreasing mortality rates among US women with breast cancer. This study highlights the critical need to address the implementation of a national organized breast cancer screening program in Jamaica and to focus future research efforts on the biology of breast cancer, especially among young Jamaican women.
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Affiliation(s)
- Sonya Reid
- Vanderbilt University Medical Center, Nashville, TN
| | | | | | - Camelia Thompson
- The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Gilian Wharfe
- The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Tracey Gibson
- The University of the West Indies, Mona Campus, Kingston, Jamaica
| | | | - Kenneth James
- The University of the West Indies, Mona Campus, Kingston, Jamaica
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20
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Singh Y, Cawich SO, Mohammed S, Kuruvilla T, Naraynsingh V. Totally Laparoscopic Whipple's Operation: Initial Report from the Caribbean. Cureus 2020; 12:e7401. [PMID: 32337127 PMCID: PMC7182051 DOI: 10.7759/cureus.7401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Oncologic surgery in the Caribbean has evolved over the past decade, with increasing reports of advanced minimally invasive operations being performed. However, the minimally invasive approach has not been used for peri-ampullary lesions. This is because a laparoscopic Whipple's operation is a technically demanding and time-consuming operation. We report the first case of a totally laparoscopic Whipple's operation to be performed in the Caribbean.
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Affiliation(s)
- Yardesh Singh
- Surgery, University of the West Indies, St. Augustine, TTO
| | | | | | | | - Vijay Naraynsingh
- Surgery, Medical Associates Hospital, St. Joseph, TTO.,Clinical Surgical Sciences, University of the West Indies, St. Augustine, TTO
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21
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Vos RA, Pasmans H, Tymchenko L, Janga-Jansen AVA, Baboe-Kalpoe S, Hulshof K, de Melker HE, van der Klis FRM. High seroprevalence of multiple high-risk human papillomavirus types among the general population of Bonaire, St. Eustatius and Saba, Caribbean Netherlands. Vaccine 2020; 38:2816-2826. [PMID: 32088019 DOI: 10.1016/j.vaccine.2020.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Incidence and mortality of human papillomavirus (HPV)-related cancers differs geographically, with high rates in Caribbean countries. Seroepidemiological data provide information on lifetime cumulative HPV exposure and contributing risk factors, but has not been available yet for Caribbean Netherlands (CN), comprising the islands Bonaire, St. Eustatius and Saba. Therefore, a cross-sectional population-based serosurveillance study was performed in this (recently girls-only HPV-vaccinated) population in 2017. METHODS Blood samples from participants (n = 1,823, 0-90 years) were tested for seven high-risk (hr)-HPV-specific IgG-antibodies using a VLP-based multiplex-immunoassay. Risk factors for HPV-seropositivity were analysed among persons unvaccinated aged ≥ 15 years who ever had sex (n = 1,080). RESULTS Among unvaccinated individuals aged ≥ 15 years, overall seropositivity was high (34%), with over half of them being seropositive for ≥ 2 hr-HPV types, and HPV16 and 52 being most prevalent (13%). Seroprevalence was substantial higher in unvaccinated women (51%) than men (18%), predominantly peaking in women aged 20-59 years, and was highest on St. Eustatius (38%). Besides age and sex, sexual risk factors were associated with HPV-seropositivity. CONCLUSIONS In accordance with the Caribbean region, seroprevalence of multiple hr-HPV types was high in CN. These data corroborate the decision regarding introduction of a sex-neutral HPV-vaccination program and the relevance for considering a population-based cervical cancer screening program.
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Affiliation(s)
- Regnerus A Vos
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - Hella Pasmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Liza Tymchenko
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Alcira V A Janga-Jansen
- Department of Public Health, Public Entity Bonaire, Kaya Neerlandia 41, Kralendijk, Bonaire, Caribbean Netherlands, The Netherlands
| | - Sharda Baboe-Kalpoe
- Department of Public Health, Public Entity St. Eustatius, Cottageroad z/n, Oranjestad, St. Eustatius, Caribbean Netherlands, The Netherlands
| | - Koen Hulshof
- Department of Public Health, Public Entity Saba, The Bottom, Saba, Caribbean Netherlands, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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22
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Joachim C, Almont T, Drame M, Contaret C, Vestris M, Najioullah F, Aline-Fardin A, Escarmant P, Leduc N, Grossat N, Promeyrat X, Bougas S, Papadopoulou E, Vinh-Hung V, Sylvestre E, Veronique-Baudin J. International cooperation in public health in Martinique: geostrategic utility for cancer surveillance in the Caribbean. Global Health 2020; 16:20. [PMID: 32131844 PMCID: PMC7057621 DOI: 10.1186/s12992-020-00551-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/20/2020] [Indexed: 12/14/2022] Open
Abstract
Background Cooperation in public health and in oncology in particular, is currently a major issue for the island of Martinique, given its geopolitical position in the Caribbean region. The region of Martinique shares certain public health problems with other countries of the Caribbean, notably in terms of diagnostic and therapeutic management of patients with cancer. We present here a roadmap of cooperation priorities and activities in cancer surveillance and oncology in Martinique. Main body The fight against cancer is a key public health priority that features high on the regional health policy for Martinique. In the face of these specific epidemiological conditions, Martinique needs to engage in medical cooperation in the field of oncology within the Caribbean, to improve skills and knowledge in this field, and to promote the creation of bilateral relations that will help to improve cancer management in an international healthcare environment. Conclusions These collaborative exchanges will continue throughout 2020 and will lead to the implementation of mutual research projects across a larger population basin, integrating e-health approaches and epidemiological e-cohorts.
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Affiliation(s)
- Clarisse Joachim
- , CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 1441 Registre des cancers, Martinique, F-97200, France.
| | - Thierry Almont
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF3636 INTERREG Surveillance du Cancer Oncofertilité, F-97200, Martinique, France
| | - Moustapha Drame
- CHU de Martinique, Direction de la Recherche, UF 3603, Unité de Soutien Méthodologique à la Recherche, Martinique, F-97200, France
| | - Cédric Contaret
- CHU de Martinique, Direction de la Recherche, UF 3163, Délégation de la Recherche et de l'innovation, Martinique, F-97200, France
| | - Mylène Vestris
- , CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 1441 Registre des cancers, Martinique, F-97200, France
| | - Fatiha Najioullah
- CHU de Martinique, Pôle de Biologie, Laboratoire de Virologie, F-97200, Martinique, France
| | - Aude Aline-Fardin
- CHU de Martinique, Pôle de Biologie, Laboratoire d'anatomopathologie, F-97200, Martinique, France
| | - Patrick Escarmant
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Nicolas Leduc
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Nathalie Grossat
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Xavier Promeyrat
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Stefanos Bougas
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Eva Papadopoulou
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Vincent Vinh-Hung
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, F-97200, Martinique, France
| | - Emmanuelle Sylvestre
- CHU de Martinique, Centre de Données Cliniques, F-97200, Martinique, France.,CHU de Martinique, Pôle de Médecine, Service de Maladies Infectieuses, F-97200, Martinique, France.,INSERM, U1099, F-35000, Rennes, France.,Université de Rennes 1, LTSI, F-35000, Rennes, France
| | - Jacqueline Veronique-Baudin
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF 3596 Recherche en Cancérologie Hématologie, F-97200, Martinique, France
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23
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Sarfati D, Dyer R, Sam FAL, Barton M, Bray F, Buadromo E, Ekeroma A, Foliaki S, Fong J, Herman J, Huggins L, Maoate K, Meredith I, Mola G, Palafox N, Puloka V, Shin HR, Skeen J, Snowdon W, Tafuna'i M, Teng A, Watters D, Vivili P. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncol 2019; 20:e475-e492. [PMID: 31395476 PMCID: PMC7746436 DOI: 10.1016/s1470-2045(19)30400-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 01/03/2023]
Abstract
This Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple burden of infection-related cancers, rapid transition to lifestyle-related diseases, and ageing populations; additionally, PICTs are increasingly having to respond to natural disasters associated with climate change. In the Pacific region, cancer surveillance systems are generally weaker than those in high-income countries, and patients often present at advanced cancer stage. Many PICTs are unable to provide comprehensive cancer services, with some patients receiving cancer care in other countries where resources allow. Many PICTs do not have, or have poorly developed, cancer screening, pathology, oncology, surgical, and palliative care services, although some examples of innovative cancer planning, prevention, and treatment approaches have been developed in the region. To improve cancer outcomes, we recommend prioritising regional collaborative approaches, enhancing cervical cancer prevention, improving cancer surveillance and palliative care services, and developing targeted treatment capacity in the region.
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Affiliation(s)
- Diana Sarfati
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
| | - Rachel Dyer
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Filipina Amosa-Lei Sam
- Pathology Department, Tupua Tamasese Meaole Hospital, Private Bag National Health Services, Apia, Samoa
| | - Michael Barton
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Eka Buadromo
- Pathology Department, Vaiola Hospital, Nuku'alofa, Tonga
| | - Alec Ekeroma
- Department of Obstetrics and Gynaecology, National University of Samoa, Apia, Samoa; Department of Obstetrics and Gynaecology, University of Otago, Wellington, New Zealand
| | - Sunia Foliaki
- Centre for Public Health Research, Massey University-Wellington Campus, Wellington, New Zealand
| | - James Fong
- Obstetrics and Gynaecology Unit, Colonial War Memorial Hospital, Ministry of Health, Suva, Fiji; Department of Obstetrics and Gynaecology, Fiji National University, Suva, Fiji
| | | | - Linda Huggins
- Palliative Care Services, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Kiki Maoate
- Department of Paediatric Surgery, Christchurch Public Hospital, Christchurch, New Zealand
| | - Ineke Meredith
- Department of Surgery, Capital; Coast District Health Board, Wellington Regional Hospital, Wellington, New Zealand
| | - Glen Mola
- Department of Obstetrics, Gynaecology and Reproductive Health, Port Moresby General Hospital, Port Moresby, Papua New Guinea; School of Medicine and Health Sciences, University of Papua New Guinea, Boroko, Papua New Guinea
| | - Neal Palafox
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA; Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Viliami Puloka
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand; Health Promotion Forum of New Zealand, Auckland, New Zealand
| | - Hai-Rim Shin
- Non-communicable Disease and Health Promotion, Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - Jane Skeen
- Starship Blood and Cancer Centre, Starship Children's Health, Auckland, New Zealand
| | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organization, Suva, Fiji
| | - Malama Tafuna'i
- Department of Obstetrics and Gynaecology, National University of Samoa, Apia, Samoa
| | - Andrea Teng
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - David Watters
- Deakin University and Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
| | - Paula Vivili
- Public Health Division, Pacific Community, Noumea, New Caledonia
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24
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Sarfati D, Dyer R, Vivili P, Herman J, Spence D, Sullivan R, Weller D, Bray F, Hill S, Bates C, Foliaki S, Palafox N, Luciani S, Ekeroma A, Hospedales J. Cancer control in small island nations: from local challenges to global action. Lancet Oncol 2019; 20:e535-e548. [PMID: 31395475 PMCID: PMC7746435 DOI: 10.1016/s1470-2045(19)30511-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022]
Abstract
Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer. This final Series paper highlights the challenges and opportunities for small island nations, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities to strengthen cancer-related health systems to improve sharing of technical assistance for research, surveillance, workforce, and service development, and to support small island nations with policy changes to reduce the consumption of commodities (eg, tobacco and unhealthy food products) that increase cancer risk.
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Affiliation(s)
- Diana Sarfati
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand.
| | - Rachel Dyer
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
| | - Paula Vivili
- Public Health Division, Pacific Community, Noumea, New Caledonia
| | | | | | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - David Weller
- James Mackenzie Professor of General Practice, Usher Institute of Population Health, Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Sarah Hill
- Global Health Policy Unit, University of Edinburgh, Edinburgh, UK
| | - Christopher Bates
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Melbourne, VIC, Australia
| | - Sunia Foliaki
- Centre for Public Health Research, Massey University-Wellington Campus, Wellington, New Zealand
| | - Neal Palafox
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA; Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Silvana Luciani
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Alec Ekeroma
- Obstetrics and Gynaecology, University of Otago, Wellington, Wellington, New Zealand; National University of Samoa, Le Papaigalagala Campus, To'omatagi, Samoa
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25
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Spence D, Argentieri MA, Andall-Brereton G, Anderson BO, Duggan C, Bodkyn C, Bray F, Gibson T, Garcia WG, Greaves N, Gupta S, Hobday V, McLean F, Mery L, Nimrod M, Ocho O, Quee-Brown CS, Tortolero-Luna G, Shields AE. Advancing cancer care and prevention in the Caribbean: a survey of strategies for the region. Lancet Oncol 2019; 20:e522-e534. [PMID: 31395471 DOI: 10.1016/s1470-2045(19)30516-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 11/20/2022]
Abstract
Cancer is now the second leading cause of death in the Caribbean. Despite this growing burden, many Caribbean small island nations have health systems that struggle to provide optimal cancer care for their populations. In this Series paper, we identify several promising strategies to improve cancer prevention and treatment that have emerged across small island nations that are part of the Caribbean Community. These strategies include the establishment of a Caribbean cancer registry hub, the development of resource-appropriate clinical guidelines, innovations in delivering specialty oncology services (eg, paediatric oncology and palliative care), improving access to opioids, and developing regional training capacity in palliative medicine. These developments emphasise the crucial role of public-private partnerships in improving health care for the region and show how fostering strategic collaborations with colleagues and centres in more developed countries, who can contribute specialised expertise and improve regional collaboration, can improve care across the cancer control continuum.
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Affiliation(s)
- Dingle Spence
- Hope Institute Hospital, Kingston, Jamaica; Faculty of Medicine, University of the West Indies, Kingston, Jamaica; Jamaica Cancer Care and Research Institute, University of the West Indies, Kingston, Jamaica.
| | - M Austin Argentieri
- Jamaica Cancer Care and Research Institute, University of the West Indies, Kingston, Jamaica; Harvard/ MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK
| | | | - Benjamin O Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Institute, Seattle, WA, USA
| | - Catherine Duggan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Institute, Seattle, WA, USA
| | - Curt Bodkyn
- Faculty of Medical Sciences, The University of the West Indies, Saint Augustine, Trinidad and Tobago
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Tracey Gibson
- Department of Pathology, University of the West Indies, Kingston, Jamaica
| | - Wendy Gomez Garcia
- Oncology Unit, Dr Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
| | - Natalie Greaves
- Faculty of Medical Sciences, University of the West Indies, Wanstead, Barbados
| | - Sumit Gupta
- Division of Haematology/ Oncology, Hospital for Sick Children, Faculty of Medicine and IHPME, University of Toronto, Toronto, ON, Canada
| | | | | | - Les Mery
- Global Initiative for Cancer Registry Development, International Agency for Research on Cancer, Lyon, France
| | - Marisa Nimrod
- The Caribbean Association for Oncology and Hematology, Port of Spain, Trinidad and Tobago
| | - Oscar Ocho
- University of West Indies School of Nursing, Saint Augustine, Trinidad and Tobago
| | | | - Guillermo Tortolero-Luna
- Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Centre, San Juan, Puerto Rico
| | - Alexandra E Shields
- Jamaica Cancer Care and Research Institute, University of the West Indies, Kingston, Jamaica; Harvard/ MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
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