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Scott-Williams J, Hosein A, Akpaka P, Adidam Venkata CR. Epidemiology of Cervical Cancer in the Caribbean. Cureus 2023; 15:e48198. [PMID: 38054120 PMCID: PMC10694396 DOI: 10.7759/cureus.48198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Cervical cancer (CvC) is considered a preventable disease; however, in the Caribbean, it is still one of the fourth most common causes of death in women. Efforts to overcome obstacles to the treatment and control of this preventable disease are being made by several countries within the Caribbean. However, no health issue can be readily managed without first acquiring an understanding of the dynamics relating to its severity of impact reaching the target population, its clinical pathology, and the availability of treatment and/or preventative measures to control or halt its progression. To assess the status of CvC in the Caribbean, a review of the literature was conducted using PubMed. The Caribbean was defined in the review as comprising nations and islands whose coastlines are touched by the Caribbean Sea. This led to an assessment of the available literature on CvC for 33 Caribbean territories. The review showed a lack of published information on CvC and highlights the need for greater research. This also serves as a template for subsequent investigations.
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Affiliation(s)
- Jamie Scott-Williams
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Patrick Akpaka
- Pathology/Microbiology, The University of the West Indies, St. Augustine, TTO
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2
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Gopaul CD, Singh A, Williams A, Ventour D, Thomas D. Cancer morbidity and mortality trends in Trinidad and Tobago (2008-2018). JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:58. [PMID: 37370167 DOI: 10.1186/s41043-023-00395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Cancer is a leading cause of death in the Caribbean, and the Republic of Trinidad and Tobago is no exception. Evidence suggests that cancer incidence and mortality may vary based on demographic factors across the different cancer types. This study aimed to investigate the incidence and mortality trends associated with cancer cases in Trinidad and Tobago for the period 2008-2018, across different age groups, gender, and ethnicity. METHODS Data on 15,029 incident cancer cases were reported to the Dr. Elizabeth Quamina Cancer Registry between 2008 and 2018. The retrospective data were analyzed by sex, ancestry, and age, and were reported using Trinidad and Tobago population statistics for the period 2008-2018. RESULTS The incidence of prostate and breast cancers was high among males and females, respectively. Among males, the highest cancer mortality was associated with prostate, lung, colon, blood, and pancreatic cancers, respectively. Among females, the highest cancer mortality was associated with breast, ovary, colon, blood, and pancreatic cancers. The frequency of occurrence of the top five cancer sites was the highest among Afro-Trinidadians followed by Indo-Trinidadians. Most females diagnosed with breast cancer were at a localized stage, while most males diagnosed with breast cancer were at a distant or regional stage. Most individuals diagnosed with blood cancer were at a distant stage. For lung and colon cancer, the stage of diagnosis for most males and females was either distant or unknown. Majority of males are diagnosed with prostate cancer at an unknown stage. CONCLUSIONS The findings indicate highest cancer incidence and mortality occur among Afro-Trinidadians. The stage at diagnosis varies across cancer types and gender.
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Affiliation(s)
- Chavin D Gopaul
- North Central Regional Health Authority, Ground Floor, Building 7, Eric Williams Medical Science Complex, Uriah Butler Highway, West Indies, Port of Spain, Trinidad and Tobago.
| | - Aruna Singh
- North West Regional Health Authority, Dundonald Street, West Indies, Port of Spain, Trinidad and Tobago
| | - Akil Williams
- Caribbean Centre for Health Systems Research and Development, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Dale Ventour
- University of the West Indies, St. Augustine Campus, West Indies, St. Augustine, Trinidad and Tobago
| | - Davlin Thomas
- North Central Regional Health Authority, Third Floor, Building 39, Eric Williams Medical Science Complex, Uriah Butler Highway, West Indies, Port of Spain, Trinidad and Tobago
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3
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Zeigler-Johnson C, McDonald AC, Pinheiro P, Lynch S, Taioli E, Joshi S, Alpert N, Baudin J, Joachim C, Deloumeaux J, Oliver J, Bhakkan-Mambir B, Beaubrun-Renard M, Ortiz AG, Ragin C. Trends in prostate cancer incidence among Black men in the Caribbean and the United States. Prostate 2023. [PMID: 37244749 DOI: 10.1002/pros.24580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 04/13/2023] [Accepted: 05/07/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Prostate cancer incidence is highest for Black men of the African diaspora in the United States and Caribbean. Recent changes in recommendations for prostate cancer screening have been shown to decrease overall prostate cancer incidence and increase the likelihood of late stage disease. However, it is unclear how trends in prostate cancer characteristics among high risk Black men differ by geographic region during the changes in screening recommendations. METHODS In this study, we used population-based prostate cancer registry data to describe age-adjusted prostate cancer incidence trends from 2008 to 2015 among Black men from six geographic regions. We obtained data on incident Black prostate cancer patients from six cancer registries (in the United States: Florida, Alabama, Pennsylvania, and New York; and in the Caribbean: Guadeloupe and Martinique). After age standardization, we used descriptive analyses to compare the demographics and tumor characteristics by cancer registry site. The Joinpoint regression program was used to compare the trends in incidence by site. RESULTS A total of 59,246 men were analyzed. We found the highest incidence rates (per 100,000) for prostate cancer in the Caribbean countries (181.99 in Martinique and 176.62 in Guadeloupe) and New York state (178.74). Incidence trends decreased significantly over time at all sites except Martinique, which also showed significantly increasing rates of late stage (III/IV) and Gleason score 7+ tumors. CONCLUSIONS We observed significant differences in prostate cancer incidence trends among Black men after major changes prostate screening recommendations. Future studies will examine the factors that differentially influence prostate cancer trends among the African diaspora.
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Affiliation(s)
- Charnita Zeigler-Johnson
- Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alicia C McDonald
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Paulo Pinheiro
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Shannon Lynch
- Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | | | | | | | - Jacqueline Baudin
- Unité Fonctionnelle Recherche en Cancérologie UF3596, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Clarisse Joachim
- Registre Général des cancers de la Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Jacqueline Deloumeaux
- Registre Général des cancers de la Guadeloupe, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-a-Pitre, Guadeloupe
| | - JoAnn Oliver
- Capstone College of Nursing, University of Alabama, Tuscaloosa, Alabama, USA
| | - Bernard Bhakkan-Mambir
- Registre Général des cancers de la Guadeloupe, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-a-Pitre, Guadeloupe
| | - Murielle Beaubrun-Renard
- Registre Général des cancers de la Martinique UF1441, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique
| | - Angel G Ortiz
- Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Camille Ragin
- Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
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4
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Monk BJ, Tan DSP, Hernández Chagüi JD, Takyar J, Paskow MJ, Nunes AT, Pujade-Lauraine E. Proportions and incidence of locally advanced cervical cancer: a global systematic literature review. Int J Gynecol Cancer 2022; 32:1531-1539. [PMID: 36241221 PMCID: PMC9763192 DOI: 10.1136/ijgc-2022-003801] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Optimal treatment of cervical cancer is based on disease stage; therefore, an understanding of the global epidemiology of specific stages of locally advanced disease is needed. OBJECTIVE This systematic literature review was conducted to understand the global and region-specific proportions of patients with cervical cancer with locally advanced disease and to determine the incidence of the locally advanced disease. METHODS Systematic searches identified observational studies published in English between 2010 and June 10, 2020, reporting the proportion of patients with, and/or incidence of, locally advanced stages of cervical cancer (considered International Federation of Gynecology and Obstetrics (FIGO) IB2-IVA). Any staging criteria were considered as long as the proportion with locally advanced disease was distinguishable. For each study, the proportion of locally advanced disease among the cervical cancer population was estimated. RESULTS The 40 included studies represented 28 countries in North or South America, Asia, Europe, and Africa. Thirty-eight studies reported the proportion of locally advanced disease among populations with cervical cancer. The estimated median proportion of locally advanced disease among all cervical cancer was 37.0% (range 5.6-97.5%; IQR 25.8-52.1%); estimates were generally lowest in North America and highest in Asia. Estimated proportions of ≥50% were reported in nine studies from Asia, Europe, Brazil, and Morocco; estimates ≤25% were reported in six studies from Asia, United States, Brazil, and South Africa. Locally advanced disease was reported for 44% and 49% of women aged >70 and ≥60 years, and 5-100% of younger women with cervical cancer. A greater proportion of locally advanced disease was reported for Asian American (19%) versus White women (8%) in one United States study. Two of five studies describing the incidence of locally advanced disease reported rates of 2-4/100 000 women among different time frames. CONCLUSION This review highlights global differences in proportions of locally advanced cervical cancer, including regional variance and disparities according to patient race and age.
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Affiliation(s)
- Bradley J Monk
- Virginia G Piper Cancer Center at HonorHealth, Phoenix, Arizona, USA,Division of Gynecologic Oncology, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, Arizona, USA
| | - David S P Tan
- Department of Haematology-Oncology, National University Cancer Institute, Singapore,Department of Medicine, Yong Loo Lin School of Medicine, Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | | | - Jitender Takyar
- Evidence Evaluation HEOR, Parexel International, Chandigarh, India
| | - Michael J Paskow
- Global Medical Affairs, AstraZeneca, Gaithersburg, Maryland, USA
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Ramdass MJ, Gonzales J, Maharaj D, Simeon D, Barrow S. Breast Carcinoma Receptor Expression in a Caribbean Population. Surg J (N Y) 2022; 8:e262-e265. [PMID: 36131945 PMCID: PMC9484866 DOI: 10.1055/s-0042-1756632] [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: 05/23/2021] [Accepted: 08/02/2022] [Indexed: 12/24/2022] Open
Abstract
Trinidad and Tobago are islands in the Southern Caribbean with a unique mix of races within the population consisting of East Indian (EI) (37.6%), Afro-Caribbean (AC) (36.3%), mixed (24.2%), and Caucasian, Chinese, Lebanese, Syrian, Amerindian, and Spanish groups accounting for 1.9%. It makes it suitable for a comparison of breast carcinoma receptor expression within a fixed environment. This study included 257 women with an age range of 28 to 93 years (mean = 57.2, standard deviation = 15.0), peak age group of 51 to 60 consisting of 105 EI, 119 AC, and 33 mixed descent. Invasive ductal carcinoma accounted for 88%, invasive lobular 9.7%, and ductal carcinoma in situ 2.3%. The triple-negative rates were 24.8, 33.6, and 30.3% for EI, AC, and mixed races, respectively, with the Pearson's chi-square test revealing statistical significance for the AC versus EI (
p
< 0.001); AC versus mixed (
p
< 0.001); and EI versus mixed (
p
= 0.014) groups. The overall estrogen (ER), progesterone (PR), and human epidermal growth receptor (HER) expression negative rates were 52, 64, and 79%, respectively. Chi-square test of the following combinations: ER +/PR +/HER + ; ER +/PR +/HER − ; ER −/PR −/HER + ; ER +/PR −/HER + ; ER +/PR −/HER − ; ER −/PR +/HER + ; ER −/PR +/HER− revealed no statistical differences (
p
= 0.689).
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Affiliation(s)
- Michael J. Ramdass
- Department of Clinical Surgical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies
- Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
| | - Joshua Gonzales
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dale Maharaj
- Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
| | - Donald Simeon
- Caribbean Centre for Health Systems Research and Development, The University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies
| | - Shaheeba Barrow
- Department of Pathology, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
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Glasgow L, Lewis R, Charles S. The cancer epidemic in the Caribbean region: Further opportunities to reverse the disease trend. LANCET REGIONAL HEALTH. AMERICAS 2022; 13:100295. [PMID: 36777319 PMCID: PMC9903961 DOI: 10.1016/j.lana.2022.100295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer incidence has been rising in the Caribbean and is expected to have significant adverse implications for the health of people in the region and health systems in this decade. While developed countries, for the most part, enjoy the benefits of advanced technologies and adaptive systems in cancer control and management, a different experience confronts a large segment of the Caribbean population. The region has experienced some success in enhancing cancer services, however, there is a need to address gaps in several areas through nationally and regionally tailored initiatives. This Review complements previous publications on the challenges, actions, and progress towards cancer prevention and care in Caribbean countries but also further outlines potential positive impacts that can be derived from addressing gaps pertaining to cancer education, data management, screening and risk assessment, navigation services, gender factors, and resource development. The proposed approaches encapsulate concepts of health theories that are applicable across the ecological domains. When implemented in combination, the proposals may effectively contribute to reducing the cancer burden in the region.
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Affiliation(s)
- Lindonne Glasgow
- St. George's University, True Blue, St. George's, Grenada,Corresponding author at: Department of Public Health & Preventive Medicine, St. George's University, P.O. Box 7, True Blue, St. George, Grenada.
| | - Reeba Lewis
- St. George's University, True Blue, St. George's, Grenada
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7
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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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8
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Factors associated with breast cancer recurrence and survival at Sangre Grande Hospital, Trinidad. Cancer Causes Control 2021; 32:763-772. [PMID: 33835281 DOI: 10.1007/s10552-021-01427-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study is to determine the demographic, pathological, and treatment-related factors that predict recurrence and survival in a Trinidadian cohort of breast cancer patients. METHODS The inclusion criteria for this study were female, over 18 years, and with a primary breast cancer diagnosis confirmed by a biopsy report occurring between 2010 and 2015 at Sangre Grande Hospital, Trinidad. Univariate associations with 5-year recurrence-free survival and 5-year overall survival were calculated using the Kaplan-Meier method for categorical variables and Cox Proportional Hazards for continuous variables. A multivariate model for prediction of recurrence and survival was determined using Cox regression. RESULTS For the period 2010-2015, 202 records were abstracted. Five-year overall survival and recurrence-free survival rates were found to be 74.3% and 56.4%, respectively. Median times from first suspicious finding to date of biopsy report, date of surgery, and date of chemotherapy were 63 days, 125 days, and 189 days, respectively. In the univariate analysis, age (p = 0.038), stage (p < 0.001), recurrence (p = 0.035), surgery (p = 0.016), ER (p < 0.001) status, PR status (p < 0.001), and subtype (p < 0.001) were significantly associated with survival. Additionally, stage (p = 0.004), N score (p = 0.002), ER (p = 0.028) status, PR (p = 0.018) status, and subtype (p = 0.025) were significantly associated with recurrence. In the Cox multivariate model, Stage 4 was a significant predictor of survival (HR 6.77, 95% CI [0.09-2.49], p = 0.047) and N3 score was a significant predictor of recurrence (HR 4.47, 95% CI [1.29-15.54], p = 0.018). CONCLUSION This study reports a 5-year breast cancer survival rate of 74.3%, and a recurrence-free survival rate of 56.4% in Trinidad for the period 2010-2015.
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9
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George SHL, Donenberg T, Alexis C, DeGennaro V, Dyer H, Yin S, Ali J, Butler R, Chin SN, Curling D, Lowe D, Lunn J, Turnquest T, Wharfe G, Cerbon D, Barreto-Coelho P, Schlumbrecht MP, Akbari MR, Narod SA, Hurley JE. Gene Sequencing for Pathogenic Variants Among Adults With Breast and Ovarian Cancer in the Caribbean. JAMA Netw Open 2021; 4:e210307. [PMID: 33646313 PMCID: PMC7921902 DOI: 10.1001/jamanetworkopen.2021.0307] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Rates of breast and ovarian cancer are high in the Caribbean; however, to date, few published data quantify the prevalence of inherited cancer in the Caribbean population. OBJECTIVE To determine whether deleterious variants in genes that characterize the hereditary breast and ovarian cancer syndrome are associated with the development of breast and ovarian cancer in the English- and Creole-speaking Caribbean populations. DESIGN, SETTING, AND PARTICIPANTS This multisite genetic association study used data from germline genetic test results between June 2010 and June 2018 in the Bahamas, Cayman Islands, Barbados, Dominica, Jamaica, Haiti, and Trinidad and Tobago. Next-generation sequencing on a panel of 30 genes and multiplex ligation-dependent probe amplification (BRCA1 and BRCA2) were performed. Medical records were reviewed at time of study enrollment. Women and men diagnosed with breast and ovarian cancer with at least 1 grandparent born in the participating study sites were included; 1018 individuals were eligible and consented to participate in this study. Data were analyzed from November 4, 2019, to May 6, 2020. EXPOSURES Breast and/or ovarian cancer diagnosis. MAIN OUTCOMES AND MEASURES Rate of inherited breast and ovarian cancer syndrome and spectrum and types of variants. RESULTS Of 1018 participants, 999 (98.1%) had breast cancer (mean [SD] age, 46.6 [10.8] years) and 21 (2.1%) had ovarian cancer (mean [SD] age, 47.6 [13.5] years). Three individuals declined to have their results reported. A total of 144 of 1015 (14.2%) had a pathogenic or likely pathogenic (P/LP) variant in a hereditary breast and ovarian cancer syndrome gene. A total of 64% of variant carriers had P/LP variant in BRCA1, 23% in BRCA2, 9% in PALB2 and 4% in RAD51C, CHEK2, ATM, STK11 and NBN. The mean (SD) age of variant carriers was 40.7 (9.2) compared with 47.5 (10.7) years in noncarriers. Individuals in the Bahamas had the highest proportion of hereditary breast and ovarian cancer (23%), followed by Barbados (17.9%), Trinidad (12%), Dominica (8.8%), Haiti (6.7%), Cayman Islands (6.3%), and Jamaica (4.9%). In Caribbean-born women and men with breast cancer, having a first- or second-degree family member with breast cancer was associated with having any BRCA1 or BRCA2 germline variant (odds ratio, 1.58; 95% CI, 1.24-2.01; P < .001). A BRCA1 vs BRCA2 variant was more strongly associated with triple negative breast cancer (odds ratio, 6.33; 95% CI, 2.05-19.54; P = .001). CONCLUSIONS AND RELEVANCE In this study, among Caribbean-born individuals with breast and ovarian cancer, 1 in 7 had hereditary breast and ovarian cancer. The proportion of hereditary breast and ovarian cancer varied by island and ranged from 23% in the Bahamas to 4.9% in Jamaica. Each island had a distinctive set of variants.
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Affiliation(s)
- Sophia H. L. George
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, Florida
- Sylvester Comprehensive Cancer Center, Miami, Florida
- Leonard Miller School of Medicine, University of Miami, Miami, Florida
| | - Talia Donenberg
- Sylvester Comprehensive Cancer Center, Miami, Florida
- Leonard Miller School of Medicine, University of Miami, Miami, Florida
- Department of Genetics, University of Miami, Miami, Florida
| | - Cheryl Alexis
- Faculty of Medical Sciences, University of West Indies-Cave Hill, Barbados
| | | | - Hedda Dyer
- Ross University School of Medicine, Commonwealth of Dominica (now in Barbados)
| | - Sook Yin
- Cayman Islands Cancer Society, Grand Cayman, Cayman Islands
| | - Jameel Ali
- St. James Medical Complex, Northwest Regional Health Authority, Port-of-Spain, Trinidad and Tobago
| | - Raleigh Butler
- Princess Margaret Hospital, University of the West Indies, School of Clinical Medicine and Research, Nassau, Bahamas
| | - Sheray N. Chin
- Department of Pathology, University of West Indies-Mona, Kingston, Jamaica
| | - DuVaughn Curling
- Princess Margaret Hospital, University of the West Indies, School of Clinical Medicine and Research, Nassau, Bahamas
| | - Dwight Lowe
- Department of Pathology, University of West Indies-Mona, Kingston, Jamaica
| | - John Lunn
- Princess Margaret Hospital, University of the West Indies, School of Clinical Medicine and Research, Nassau, Bahamas
| | - Theodore Turnquest
- Princess Margaret Hospital, University of the West Indies, School of Clinical Medicine and Research, Nassau, Bahamas
| | - Gilian Wharfe
- Department of Pathology, University of West Indies-Mona, Kingston, Jamaica
| | - Danielle Cerbon
- Sylvester Comprehensive Cancer Center, Miami, Florida
- Division of Medical Oncology, Department of Medicine, University of Miami, Miami, Florida
| | - Priscila Barreto-Coelho
- Sylvester Comprehensive Cancer Center, Miami, Florida
- Division of Medical Oncology, Department of Medicine, University of Miami, Miami, Florida
| | - Matthew P. Schlumbrecht
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, Florida
- Sylvester Comprehensive Cancer Center, Miami, Florida
- Leonard Miller School of Medicine, University of Miami, Miami, Florida
| | - Mohammad R. Akbari
- Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, Canada
| | - Steven A. Narod
- Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, Canada
| | - Judith E. Hurley
- Sylvester Comprehensive Cancer Center, Miami, Florida
- Leonard Miller School of Medicine, University of Miami, Miami, Florida
- Division of Medical Oncology, Department of Medicine, University of Miami, Miami, Florida
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10
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Chattu V, Umakanthan S, Bukelo M, Maharaj R, Khan N, Keane K, Khadoo N, Khan A, Khan A, Kong R, Korkmaz S, Kovoor A. Breast cancer in Trinidad and Tobago: Etiopathogenesis, histopathology and receptor study. J Family Med Prim Care 2021; 10:4438-4445. [PMID: 35280639 PMCID: PMC8884328 DOI: 10.4103/jfmpc.jfmpc_627_21] [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: 04/01/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/09/2022] Open
Abstract
Background: Breast Carcinoma (BCa) is the leading cause of cancer among females in Trinidad and Tobago (TnT). This twin-island has a diversified population of 1.3 million individuals that display and are exposed to a variety of lifestyle choices that have been linked to the development of BCa. Therefore, this study aimed to identify the risk factors that influence the development of BCa, analyze the common histopathological details, and categorize BCa based on receptor study. Methods: Cancer information for 120 BCa cases at Eric Williams Medical Sciences Complex from 2012 to 2019 was retrieved, analyzed, and statistically estimated. The clinical details were categorized based on data tabulations, and histological assessment was performed to identify specific features. The receptor analysis was classified based on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor-2 (HER-2neu) staining intensity. A descriptive data analysis and comparison were statistically evaluated in all these cases. Results: Epidemiological factors influencing the development of BCa were age with a peak of 56–65 years 27.5% (n = 33), ethnicity predominated in Indo-Trinidadians 48.33% (n = 58), and marital status primarily in unmarried/single/widowed patients 55% (n = 66). Infiltrating ductal carcinoma was the principal histopathological type 91.66% (n = 110). Receptor analysis revealed ER/PR + HER-2neu as the most common type 40% (n = 18) for therapeutic surveillance. Conclusion: This study highlights various epidemiological factors that influence the development of BCa among females in TnT. Histopathological analysis and receptor studies would provide a useful link between the tumor behavior and its prognosis.
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11
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Augustus E, Granderson I, Rocke KD. The Impact of a Ketogenic Dietary Intervention on the Quality of Life of Stage II and III Cancer Patients: A Randomized Controlled Trial in the Caribbean. Nutr Cancer 2020; 73:1590-1600. [PMID: 32791011 DOI: 10.1080/01635581.2020.1803930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION This study sought to determine the impact of a ketogenic dietary intervention on the quality of life of stage II and III cancer patients. METHODS A randomized controlled trial was implemented whereby patients in the treatment group followed a modified ketogenic diet (KD) utilizing medium chained triglyceride fats during a four-month period, while the control group followed an institutionalized standard traditional diet. Quality of life and mental health status was assessed using The European Organization for Research and Treatment of Cancer current core questionnaire and The Patient Health Questionnaire. Intervention effects were assessed using repeated measures ANCOVA and multiple linear regression models. RESULTS The quality of life and mental health of the cancer patients in the treatment group were greatly increased and improved due to the utilization of the diet. Most of the persons in the treatment group attained and maintained ketosis after 2 weeks. Age, gender, and state of the disease seemed to affect the keto-adaptation period in terms of the time taken to keto-adapt. CONCLUSION The KD was suitable for stage II and III cancer patients in improving their quality of life, nutritional, functional, and psychosocial statuses.
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Affiliation(s)
- Eden Augustus
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Bridgetown, Barbados, West Indies.,Faculty of Food and Agriculture, Department of Agricultural Economics and Extension, The University of the West Indies, Trinidad, West Indies
| | - Isabella Granderson
- Faculty of Food and Agriculture, Department of Agricultural Economics and Extension, The University of the West Indies, Trinidad, West Indies
| | - Kern D Rocke
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Bridgetown, Barbados, West Indies
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12
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Gosein MA, Narinesingh D, Motilal S, Ramkissoon AP, Goetz CM, Sadho K, Mosodeen MD, Banfield R. Biparametric MRI prior to Radical Radiation Therapy for Prostate Cancer in a Caribbean Population: Implications for Risk Group Stratification and Treatment. Radiol Imaging Cancer 2020; 2:e200007. [PMID: 33778724 PMCID: PMC7983799 DOI: 10.1148/rycan.2020200007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/20/2020] [Accepted: 04/07/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE To assess risk-group migration and subsequent management change following biparametric MRI using a risk-stratified approach in a group of Caribbean men with prostate adenocarcinoma being offered external beam radiation therapy (EBRT). MATERIALS AND METHODS This retrospective study assessed the biparametric MRI findings in men who opted for EBRT from January 2018 to June 2019 (n = 79; mean age, 67.9 years ± 6.2 [standard deviation]). Serum prostate-specific antigen level, digital rectal examination findings, histologic grade group (GG) from transrectal US-guided biopsy, prior androgen deprivation therapy (ADT), and any prior CT results were used to stratify patients into low-, intermediate-, and high-risk groups, according to the National Comprehensive Cancer Network risk categories. Risk-group stratification prior to MRI separated patients into low- (seven of 79 [8.9%]), intermediate- (36 of 79 [45.6%]) and high-risk (36 of 79 [45.6%]) groups. Following MRI, any risk group (low, intermediate, high, nodal involvement, and metastatic disease) or oncologic management changes were recorded. Multivariable binary logistic regression analyses were used to assess predictor of upgrade status, with adjustment for demographic covariates jointly. RESULTS Following MRI, 30 of 79 (38.0%) patients had risk-group upshifts compared with their original assessment. Patients were recategorized into low risk (one of 79, 1.3%), intermediate risk (19 of 79, 24.1%), high risk (51 of 79, 64.6%), nodal involvement (one of 79, 1.3%), and metastatic disease (seven of 79, 8.9%). From the original groupings, there were six of seven (85.7%) from the low group, 18 of 36 (50.0%) from the intermediate group, and six of 36 (16.7%) from the high group that had risk group upward shifts. There was no association with GG: GG2 versus GG1, P = .53; GG3 versus GG1, P = .98; or prior ADT (P = .37) and the adjusted odds of risk-group upshifts. MRI findings resulted in treatment plan modification for 39 of 79 (49.4%) men overall. CONCLUSION Prostate MRI should be considered for patients in high-risk populations prior to EBRT because upstaging from MR image assessment may have implications for modification of treatment.Keywords: MR-Imaging, Prostate, Radiation Therapy© RSNA, 2020See the commentary by Davenport and Shankar in this issue.
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Davenport MS, Shankar PR. Biparametric Prostate MRI Influencing Care Patterns in a Caribbean Population. Radiol Imaging Cancer 2020; 2:e200096. [PMID: 33779668 PMCID: PMC7983729 DOI: 10.1148/rycan.2020200096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Matthew S. Davenport
- From the Departments of Radiology (M.S.D., P.R.S.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, B2-A209A, Ann Arbor, MI 48109
| | - Prasad R. Shankar
- From the Departments of Radiology (M.S.D., P.R.S.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, B2-A209A, Ann Arbor, MI 48109
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14
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Rocke KD. Colorectal Cancer Knowledge and Awareness Among University Students in a Caribbean Territory: a Cross-sectional Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:571-578. [PMID: 30798462 DOI: 10.1007/s13187-019-01499-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The burden of colorectal cancer (CRC) has been on the rise globally over the last decade. Several studies point to the fact that there is a lack of knowledge and awareness for CRC which may be attributed to the increase in the burden over time. Therefore, we aimed to assess the level and predictors for knowledge of CRC and its risk factors. METHODS This study was a cross-sectional study conducted on the student population of the University of the West Indies, St. Augustine Campus, Trinidad. We assessed CRC knowledge using scales examining their level of knowledge for CRC and its risk factors. Lifestyle behaviors (smoking, physical activity, dietary behaviors, and alcohol consumption) and perceived risk for developing CRC were also collected using a standard survey. Predictors for CRC knowledge were assessed using forward stepwise linear and logistic regression models. RESULTS The overall CRC knowledge was 54.740% ± 19.721%. Poor knowledge levels were seen among 36.23% while satisfactory/good knowledge was seen among 63.77%. Predictors of poor CRC knowledge were males (OR = 1.559; p = 0.003), frequent/excessive alcoholic drinkers (OR = 1.924; p = 0.029), and low physical activity (OR = 1.331; p = 0.042). Predictors of satisfactory/good CRC knowledge were those with higher scores for the prudent dietary pattern (OR = 0.893; p = 0.016), and compared with those who reported no risk, participants reporting low risk had an increased likelihood of obtaining good CRC knowledge scores (OR = 0.526; p = < 0.001) and high risk (0.310; p = < 0.001). CONCLUSION The level of awareness/knowledge on CRC and its risk factors is low. Improvement of CRC awareness and healthy lifestyle campaigns among young adults is needed for the Caribbean region.
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Affiliation(s)
- Kern D Rocke
- The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad, Trinidad and Tobago.
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15
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Hercules SM, Hercules JC, Ansari A, Date SAJ, Skeete DHA, Smith Connell SP, Pond GR, Daniel JM. High triple-negative breast cancer prevalence and aggressive prognostic factors in Barbadian women with breast cancer. Cancer 2020; 126:2217-2224. [PMID: 32154924 DOI: 10.1002/cncr.32771] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/17/2020] [Accepted: 01/22/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Women of African ancestry (WAA) are disproportionately affected by triple-negative breast cancer (TNBC), which remains one of the most clinically challenging breast cancer (BCa) subtypes. This study investigated the prevalence of TNBC and epidemiological trends for BCa in Barbados, a Caribbean island with a high percentage of African ancestry. METHODS Pathology reports for all BCa cases between 2007 and 2016 were collected from the sole hospital in Barbados and reviewed. The clinicopathological data collected included age, tumor grade, lymph node status, and hormone receptor status as determined by immunohistochemistry. BCa data for non-Hispanic white (NHW) and non-Hispanic black (NHB) American populations were accessed from the Surveillance, Epidemiology, and End Results database. RESULTS There were 1997 BCa cases in Barbados between 2007 and 2016 for an estimated incidence rate of 135.1 per 100,000 women in Barbados (standardized to the US population, where the standardized incidence rates for NHBs and NHWs were 141.4 and 152.6 per 100,000, respectively). Age-specific incidence rates in Barbados for this period were consistently higher in younger age groups (15-59 years) in comparison with NHWs and NHBs. Between 2010 and 2016 in Barbados, a TNBC prevalence of 25% was observed, whereas TNBC prevalences of 21% and 10% were observed in NHBs and NHWs, respectively. CONCLUSIONS The BCa incidence was higher in younger Barbadian women than NHWs and NHBs, and the TNBC prevalence was ~2.5 times higher than the prevalence in NHWs. This hints at a possible genetic predisposition and other socioeconomic factors that could explain the high TNBC prevalence and aggressive clinical course in WAA globally.
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Affiliation(s)
- Shawn M Hercules
- Department of Biology, McMaster University, Hamilton, Ontario, Canada.,African Caribbean Cancer Consortium, Philadelphia, Pennsylvania
| | - Jevon C Hercules
- Department of Mathematics, University of the West Indies at Mona, Kingston, Jamaica
| | - Amna Ansari
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie A J Date
- African Caribbean Cancer Consortium, Philadelphia, Pennsylvania.,Faculty of Medical Sciences, University of the West Indies at Cave Hill, Bridgetown, Barbados
| | - Desiree H A Skeete
- African Caribbean Cancer Consortium, Philadelphia, Pennsylvania.,Faculty of Medical Sciences, University of the West Indies at Cave Hill, Bridgetown, Barbados.,Department of Pathology, Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Suzanne P Smith Connell
- Faculty of Medical Sciences, University of the West Indies at Cave Hill, Bridgetown, Barbados.,Department of Radiation Oncology, Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Gregory R Pond
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Juliet M Daniel
- Department of Biology, McMaster University, Hamilton, Ontario, Canada.,African Caribbean Cancer Consortium, Philadelphia, Pennsylvania
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Culp MB, Soerjomataram I, Efstathiou JA, Bray F, Jemal A. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates. Eur Urol 2020; 77:38-52. [PMID: 31493960 DOI: 10.1016/j.eururo.2019.08.005] [Citation(s) in RCA: 568] [Impact Index Per Article: 142.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/03/2019] [Indexed: 10/26/2022]
Abstract
CONTEXT Previous studies have reported significant variation in prostate cancer rates and trends mainly due to differences in detection practices, availability of treatment, and underlying genetic susceptibility. OBJECTIVE To assess recent worldwide prostate cancer incidence, mortality rates, and trends using up-to-date incidence and mortality data. EVIDENCE ACQUISITION We present estimated age-standardized prostate cancer incidence and mortality rates by country and world regions for 2018 based on the GLOBOCAN database. We also examined rates and temporal trends for incidence (44 countries) and mortality (76 countries) based on data series from population-based registries. EVIDENCE SYNTHESIS The highest estimated incidence rates were found in Australia/New Zealand, Northern America, Western and Northern Europe, and the Caribbean, and the lowest rates were found in South-Central Asia, Northern Africa, and South-Eastern and Eastern Asia. The highest estimated mortality rates were found in the Caribbean (Barbados, Trinidad and Tobago, and Cuba), sub-Saharan Africa (South Africa), parts of former Soviet Union (Lithuania, Estonia, and Latvia), whereas the lowest rates were found in Asia (Thailand and Turkmenistan). Prostate cancer incidence rates during the most recent 5 yr declined (five countries) or stabilized (35 countries), after increasing for many years; in contrast, rates continued to increase for four countries in Eastern Europe and Asia. During the most recent 5 data years, mortality rates among the 76 countries examined increased (three countries), remained stable (59 countries), or decreased (14 countries). CONCLUSIONS As evident from available data, prostate cancer incidence and mortality rates have been on the decline or have stabilized recently in many countries, with decreases more pronounced in high-income countries. These trends may reflect a decline in prostate-specific antigen testing (incidence) and improvements in treatment (mortality). PATIENT SUMMARY We examined recent trends in prostate cancer incidence and mortality rates in 44 and 76 countries, respectively, and found that rates in most countries stabilized or decreased.
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Affiliation(s)
- MaryBeth B Culp
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, USA.
| | | | - Jason A Efstathiou
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Ahmedin Jemal
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, USA
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Umakanthan S, Chattu VK, Kalloo S. Global epidemiology, risk factors, and histological types of ovarian cancers in Trinidad. J Family Med Prim Care 2019; 8:1058-1064. [PMID: 31041251 PMCID: PMC6482720 DOI: 10.4103/jfmpc.jfmpc_384_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background Ovarian cancer is the seventh most common cancer in women in the world and Trinidad and Tobago is ranked 18th in the world with respect to the rate of occurrence. About 68% cases are diagnosed at a late stage, resulting in low survival rates. Since there is very scanty literature available on the epidemiology of ovarian cancer in the Caribbean region, this study was undertaken to assess the most common risk factors, presenting symptoms and common histological varieties in Trinidad. Methods A hospital-based, cross-sectional study was designed, and all the 23 diagnosed ovarian cancer cases registered during 2015-2017 were considered. Information on sociodemographics, presenting symptoms, and histological type of cancers were collected after getting the ethical approval. Of the total 23 cases, 17 cases were included in this study after ensuring completeness of data as detailed analysis of patient data was done using Microsoft Excel. Results The common risk factors identified were previous pregnancies, previous surgeries, and irregularities in the menstrual cycle. The commonest histological variety was granulosa tumors and the most common associated symptoms were irregular menses and abdominal pain in premenstrual women, and abdominal distention in postmenopausal women. Conclusions It would greatly enhance the detection rate if screening and testing for the CA-125 gene were a mandatory practice, for any patient found with more than three risk factors. The public health authorities should identify the modifiable risk factors and implement cancer reduction and health promotion activities to reduce the mortality related to ovarian cancers.
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Affiliation(s)
- Srikanth Umakanthan
- Department of Paraclinical Sciences, Anatomical Pathology Unit, Faculty of Medical Sciences, San Juan, Trinidad and Tobago
| | - Vijay K Chattu
- Department of Paraclinical Sciences, Public Health and Primary Care Unit, Faculty of Medical Sciences, San Juan, Trinidad and Tobago
| | - Sherene Kalloo
- Department of Obstetrics and Gynaecology, MTS Plaza, San Juan, Trinidad and Tobago
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