Advancing cancer care and prevention in the Caribbean: a survey of strategies for the region

Spence, Dingle; Argentieri, M Austin; Andall‐Brereton, Glennis; Anderson, Benjamin O.; Duggan, Catherine; Bodkyn, Curt; Bray, Freddie; Gibson, TN; García, Wendy Gómez; Greaves, Natalie; Gupta, Sumit; Hobday, Virginia; McLean, Felicia; Mery, Les; Nimrod, Marisa; Ocho, Oscar Noel; Quee-Brown, Corrine Sin; Tortolero‐Luna, Guillermo; Shields, Alexandra E.

doi:10.1016/s1470-2045(19)30516-9

Cited by 18 publications

(19 citation statements)

References 28 publications

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“…Building robust cancer care systems in SIDS requires substantial investment and prioritization based on careful assessment of the implications for patients. It is apparent that Saint Lucia urgently needs national or several good, local (i.e., regional) clinical databases [ 9 ] to guide research and cancer plans, including a focus on data analytics to discover priority pathways for improvement, and dissemination and implementation science to identify patient- and public-centered solutions (e.g., in patient navigation, multi-disciplinary case conferencing, and so on). Networking with regional SIDS can help strategizing towards greater cancer advocacy, sustainable research, and cancer care more appropriate for SIDS (e.g., regionalization of some services, localization of others).…”

Section: Discussionmentioning

confidence: 99%

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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

Auguste

Jones

Phillip³

et al. 2021

IJERPH

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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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Section: Discussionmentioning

confidence: 99%

“…However, other SIDS have less developed models that also intensify health disparities [ 1 , 3 ]. Developing robust systems for cancer care delivery around out-bound medical tourism may be a solution to improve access to care, given the inherent fiscal and capacity limitations of SIDS [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia

Auguste

Jones

Phillip³

et al. 2021

IJERPH

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“…Cooperative projects have been conducted in the Caribbean through initiatives such as medical cooperation in the Caribbean [25],and networks for cancer surveillance in the region [26,27]. The theme of cooperation in the field of cancer is a major challenge for the Caribbean countries that require investment for the implementation of cancer care strategies [28].…”

Section: Strategy For Cooperation In Oncology In Martiniquementioning

confidence: 99%

International cooperation in public health in Martinique: geostrategic utility for cancer surveillance in the Caribbean

et al. 2020

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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 ecohorts.

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“…Therefore, offering services to additional countries in their current crisis serves only to strain their own resources. This is one of the reasons why Spence et al suggested the establishment of international partnerships with developed countries and support from non-governmental groups and organizations [ 30 ]. In some other LMIC, international training partnerships have been undertaken.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy in the Caribbean: a spotlight on the human resource and equipment challenges among CARICOM nations

Alleyne-Mike¹,

Sylvester²,

Henderson-Suite³

et al. 2020

Hum Resour Health

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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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Advancing cancer care and prevention in the Caribbean: a survey of strategies for the region

Cited by 18 publications

References 28 publications

Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia

Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia

International cooperation in public health in Martinique: geostrategic utility for cancer surveillance in the Caribbean

Radiotherapy in the Caribbean: a spotlight on the human resource and equipment challenges among CARICOM nations

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